Plavix is a brand-name prescription drug. It’s approved to help prevent cardiovascular events such as heart attack and stroke. Specifically, Plavix can be given to people who:

  • have acute coronary syndrome (ACS). With ACS, you have a lack of blood flow to your heart due to a blockage. Unstable angina (a type of chest pain) and heart attack are two types of ACS.
  • have had a heart attack or stroke in the past.
  • have peripheral artery disease (PAD). With PAD, blood vessels outside of your heart and brain are narrowed.

For these uses, Plavix is given in combination with daily aspirin.

Plavix comes as 75-mg and 300-mg tablets. It contains the drug clopidogrel, which belongs to a class of drugs called platelet inhibitors. These drugs help to prevent blood clots from forming in your body.

Effectiveness

Plavix was found effective in preventing cardiovascular events during clinical studies. For more information on the effectiveness of Plavix, see the section “Plavix uses” below.

Plavix contains the active drug clopidogrel, which is available as a generic medication. A generic drug is an exact copy of a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics also tend to cost less than brand-name drugs.

Plavix can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Plavix. These lists do not include all possible side effects.

For more information on the possible side effects of Plavix, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Plavix, you can do so through MedWatch.

More common side effects

The more common side effects of Plavix can include:

  • bleeding, such as from:
    • cuts that take longer than usual to stop bleeding
    • nosebleeds
  • bruising more often than usual
  • fever
  • muscle pain
  • confusion
  • skin rash or itching

If you have any bleeding that seems to last too long, or if you have any blood in your stool or urine, call your doctor right away.

Besides bleeding or bruising, most of these common side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Plavix aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Severe, life threatening bleeding. Symptoms can include:
    • unexplained bleeding that lasts a long time
    • blood in your urine
    • blood in your stool (you may have red stool, or black stool that looks like tar or coffee grounds)
    • bruises that you can’t explain
    • vomiting blood (your vomit may be pink or red in color, or look like coffee grounds)
  • Thrombotic thrombocytopenic purpura (TTP). With this condition, blood clots are formed throughout your body, including in your small blood vessels. Symptoms can include:
    • purple spots on your skin or inside your mouth
    • red dots on your skin that may look like a rash
    • pale skin color
    • jaundice (yellow color to your skin or the whites of your eyes)
    • tiredness
    • weakness
    • fever
    • headache
    • confusion
    • passing small amounts of urine or having blood or protein in your urine, which can indicate kidney failure

If you have symptoms of either of these severe, life threatening conditions, call your doctor right away. You may need emergency medical treatment to prevent complications.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Plavix. However, it’s not known how many people have had an allergic reaction to Plavix. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Plavix. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Bruising

You may have bruising while you’re taking Plavix. Bruising is common with medications, such as Plavix, that prevent your body from forming blood clots. Bruising occurs when small blood vessels underneath your skin break open and release a small pool of blood.

Typically, bruising isn’t something you need to worry about. However, bruising can sometimes be serious. You should call your doctor right away if you have bruises that:

  • you can’t explain (you don’t know what caused them)
  • are very large in size
  • don’t seem to be healing or getting better

If you have questions about bruising while you’re using Plavix, talk with your doctor.

Skin rash

It’s possible to have skin rashes while you’re using Plavix. In one clinical study, 0.26% of people who took Plavix reported having a severe rash during treatment. This is compared to 0.10% of people who took aspirin.

A skin rash may be a symptom of an allergic reaction to the drug. (See the section above called “Allergic reaction” for more details.) However, skin rashes can also be a symptom of a dangerous condition called thrombotic thrombocytopenic purpura (TTP).

TTP is a serious condition that results when your body responds to Plavix in the opposite way than it should. Normally, your body stops making blood clots during Plavix treatment. But if you develop TTP while you’re taking Plavix, your body makes blood clots everywhere, including inside your small blood vessels. With TTP, you can have small red or purple spots underneath your skin. These spots may look like a rash.

If you have a skin rash while you’re using Plavix, call your doctor right away. They can check to see if you’ve developed TTP and recommend whether you need any medical treatment.

Nosebleeds

You may have nosebleeds while you’re taking Plavix. Minor bleeding, including having occasional nosebleeds, has been reported in people using this drug.

Plavix doesn’t cause nosebleeds, but it does prevent your body from forming blood clots like it usually does. This means that when you have bleeding, including nosebleeds, your body isn’t able to stop the bleeding as quickly as it normally does.

If you have a nosebleed, you should:

  • sit in a chair, with your head facing forward and your mouth kept open
  • apply pressure on your nose by squeezing the bridge (area just below the boney area) of your nose for about 15 minutes
  • place a cold cloth or ice pack against your nose and face to reduce bleeding
  • release pressure on your nose after 15 minutes

You shouldn’t put anything inside your nose to plug or block your nostrils. If your nose continues to bleed for more than 15 minutes, or if the bleeding gets worse before 15 minutes have passed, call your doctor right away. You may need medical treatment.

Headaches

It’s possible to have mild headaches while you’re using Plavix. In fact, many drugs are known to cause headaches as a side effect.

If you have a headache while you’re using Plavix, it’s important to understand which pain medications are safe for you to take. Usually, your doctor or pharmacist will recommend that you take acetaminophen (Tylenol) if you’re using Plavix. This is because acetaminophen is an over-the-counter (OTC) pain medication that’s least likely to cause bleeding.

Talk with your doctor or pharmacist before you start any new medications (including OTC drugs) while you’re using Plavix.

If you have a sudden or severe headache, call your doctor right away. This type of headache may be a sign of serious bleeding in your body.

Blood in your urine

It’s possible to have blood in your urine during Plavix treatment. But having blood in your urine may sometimes indicate serious bleeding or kidney problems.

If you notice that your urine looks pink or red in color while you’re taking Plavix, call your doctor right away. They can check to see whether you’re having serious bleeding and recommend if you need medical treatment.

Itching

You may have itching while you’re taking Plavix. In some cases, itching can be a symptom of a mild allergic reaction to the drug. For more information on this side effect, see the “Allergic reaction” section above.

Diarrhea

You may have either diarrhea or an upset stomach when you’re taking most drugs, including Plavix. In one clinical study, 0.23% of people who took Plavix reported having severe diarrhea during treatment. This is compared to 0.11% of people who took aspirin.

If you have diarrhea while you’re taking this drug, make sure to drink plenty of fluids to keep your body hydrated.

Call your doctor right away if you have diarrhea that’s red or pink in color, or if you have diarrhea that’s black and looks like tar or coffee grounds. These color changes could indicate that you have serious bleeding inside of your body.

Blood pressure changes

You likely won’t have blood pressure changes while you’re taking Plavix. However, sudden drops in blood pressure may be a symptom of serious internal bleeding, which is a possible side effect of Plavix.

If you have symptoms of low blood pressure, such as dizziness or lightheadedness when you’re standing up, call your doctor right away. They can check your blood pressure and let you know if you need any medical treatment. But if you have symptoms of low blood pressure that feel life threatening, call 911.

Muscle pain

You may have muscle pain while you’re taking Plavix. It’s not known for sure why this occurs in people taking the drug. If you have severe muscle pain while you’re taking Plavix, call your doctor right away. They can check to see what’s causing your discomfort, and they’ll recommend whether you need medical treatment.

Shortness of breath

Shortness of breath is not a common side effect of Plavix, but it may be symptom of a serious side effect of the drug.

Plavix is used to help prevent blood clots from forming in your body. If you’re taking Plavix, you were probably started on the drug because you had an increased risk of having blood clots. Shortness of breath can be a sign of a dangerous side effect called thrombotic thrombocytopenic purpura (TTP). With TTP, blood clots are formed throughout your body.

Some blood clots can form in your arms or legs and then travel to your lungs. Once inside your lungs, the clot can block the flow of blood to your lung tissue. This condition is known as pulmonary embolism (PE). Symptoms of PE can include shortness of breath and chest pain. This condition is very dangerous and can be life threatening.

Call your doctor right away if you have any unexplained shortness of breath while you’re taking Plavix. You may need medical treatment.

Stomach pain

Stomach pain is not a common side effect of Plavix. However, if you have stomach pain or cramping while taking this drug, there’s a small chance you could have bleeding in your stomach. (Serious bleeding is a possible side effect of Plavix. See “Serious side effects” above.)

Stomach pain can also be a sign of a dangerous side effect called thrombotic thrombocytopenic purpura (TTP). With TTP, blood clots are formed throughout your body, including in your small blood vessels.

Call your doctor right away if you have stomach pain while you’re taking Plavix. Your doctor can check to see what’s causing your stomach pain and recommend if you need any medical treatment.

The Food and Drug Administration (FDA) approves prescription drugs such as Plavix to treat certain conditions. Plavix is FDA-approved to reduce the risk of heart attack and stroke in people with certain cardiovascular conditions. These conditions are described below.

Plavix for acute coronary syndrome

Plavix is approved to reduce the risk of heart attack and stroke in people with acute coronary syndrome (ACS), which includes these three conditions:

  • Unstable angina. This is a type of angina (chest pain) that may lead to a heart attack. The pain can occur when you’re resting, or when you’re physically active or stressed.
  • Non-ST segment elevation myocardial infarction (NSTEMI). NSTEMI is a type of heart attack that doesn’t show ST-segment elevation (a certain measurement) on an electrocardiogram (EKG).
  • ST-segment elevation myocardial infarction (STEMI). This is a type of heart attack that does show ST-segment elevation on an EKG.

These conditions are typically caused by coronary artery disease (CAD). With CAD, there’s a buildup of plaque in your arteries. (Sometimes plaques are made of cholesterol.) Plaque formation causes your arteries to be partly or fully blocked, not allowing enough blood to flow through them. The lack of blood flow results in a lack of oxygen to your heart.

Symptoms of either unstable angina or heart attack can include:

  • chest pain
  • pain in your shoulder, arm, jaw, back, or neck
  • tightening or squeezing in your chest
  • shortness of breath

Effectiveness in people with ACS

In clinical studies of people admitted to the hospital with ACS, people were given aspirin and either Plavix or a placebo (treatment with no active drug). After up to 1 year of treatment, people using Plavix had fewer severe ACS complications than people who took the placebo. For details, see the Plavix package insert.

Plavix for recent heart attack

Plavix is approved to reduce the risk of heart attack and stroke in people who’ve had a recent heart attack. Heart attacks occur when your heart doesn’t get enough blood flow because of blocked blood vessels or other heart problems. This results in a lack of oxygen in your heart muscle and causes damage in your heart.

People who’ve had a heart attack in the past have a higher risk of having another one. Plavix has been shown to reduce this risk in people using the drug.

Effectiveness in people who’ve had a recent heart attack

A clinical study compared the use of Plavix versus aspirin in preventing heart attack, stroke, or cardiovascular-related death. The study looked at people who’d had heart attack or stroke in the recent past, or people who had peripheral artery disease (PAD). After up to 3 years of treatment, fewer people taking Plavix had these serious effects. For details, see the Plavix package insert.

Plavix for recent ischemic stroke

Plavix is approved to reduce the risk of heart attack and stroke in people who’ve had a recent ischemic stroke. With ischemic stroke, your brain doesn’t get enough blood flow because of blocked blood vessels. The blocked blood flow results in a lack of oxygen to your brain. This can lead to brain damage if it’s not treated right away.

People who’ve had a stroke in the past have a higher risk of having another one. Plavix has been shown to reduce this risk in people using the drug.

Effectiveness in people who’ve had a recent ischemic stroke

A clinical study compared the use of Plavix versus aspirin in preventing heart attack, stroke, or cardiovascular-related death. The study looked at people who’d had heart attack or stroke in the recent past, or people who had peripheral artery disease (PAD). After up to 3 years of treatment, fewer people taking Plavix had these serious effects. For details, see the Plavix package insert.

Plavix for established peripheral artery disease

Plavix is approved to prevent heart attack and stroke in people with peripheral artery disease (PAD). With PAD, your arteries are narrowed. This results in less blood flow to certain areas of your body, such as your arms and legs. PAD can cause pain in your legs, especially when you’re walking.

With PAD, your arteries typically become narrowed by a buildup of plaque inside of them. (Sometimes plaque is made from cholesterol.) The buildup causes your vessels to be either partly or fully blocked.

People with PAD have a higher risk of cardiovascular events, such as heart attack and stroke. Plavix has been shown to reduce the risk of heart attack, stroke or cardiovascular-related death in people who have PAD.

Effectiveness in people who have peripheral artery disease

A clinical study looked at the use of Plavix in people who had established PAD or who’d had a heart attack or stroke in the recent past. People were given either Plavix or aspirin for up to 3 years.

Compared with those taking aspirin, fewer people taking Plavix had a stroke or heart attack. But there was no difference between the two treatment groups for the percentage of people who died from cardiovascular events. For details, see the Plavix package insert.

Plavix for other conditions

In addition to the uses listed above, Plavix may be used off-label. Off-label drug use is when a drug that’s approved for one use is used for a different use that’s not approved. And you may wonder if Plavix is used for certain other conditions.

Plavix for use after coronary artery bypass graft surgery (off-label use)

Plavix isn’t approved to prevent heart attack or stroke in people who’ve had a coronary artery bypass graft (CABG). But sometimes it’s used off-label for this purpose.

CABG is a type of open-heart surgery that helps improve blood flow to your heart. During CABG surgery, an artery or vein is taken from one part of your body (such as your leg). The blood vessel is then moved up to your heart and is used as a “bypass graft.” The grafted vessel allows blood to flow around a blocked artery in your heart. This way, blood can flow into an area of heart muscle that would otherwise be blocked from blood flow.

Although it’s not approved for this use, Plavix is often prescribed in combination with aspirin for people who’ve had CABG surgery. It’s thought that this combination of drugs helps to prevent blood clots from forming in the bypass graft. The combination of drugs may also help to keep the newly grafted vessel flexible.

If you’d like to know more about using Plavix after having CABG surgery, talk with your doctor.

Plavix for use after stent placement (off-label use)

Plavix isn’t approved to prevent heart attack or stroke in people who’ve had a stent placed. But sometimes it’s used off-label for this purpose.

Stents are mesh tubes that are sometimes placed into your arteries to keep the arteries open. Stents are usually placed when someone has a blockage in their artery that is stopping blood from flowing through the artery.

Aspirin is almost always prescribed for people after they’ve had a stent placed. This drug helps to reduce the risk of a blood clot forming inside the stent. However, Plavix is also sometimes prescribed for a while after a stent is placed. The length of Plavix treatment depends on if the stent placed is a drug-eluting stent (a stent that gives off a drug) or a bare metal stent.

If you’d like to know more about using Plavix after having a stent placed, talk with your doctor.

Plavix for atrial fibrillation (off-label use)

Plavix isn’t approved to prevent heart attack or stroke in people who have atrial fibrillation. But sometimes it’s used off-label for this purpose.

Atrial fibrillation is a type of heart arrythmia (abnormal rate or rhythm of your heart beat). People with atrial fibrillation have a higher risk of blood clots forming inside their heart. This is because their heart is not pumping their blood properly.

Blood clots are dangerous because they can travel inside your body and may get trapped in smaller vessels. If this happens, the clots can cut off blood flow to your heart, lungs, or brain.

Sometimes, Plavix is prescribed to help prevent blood clots from forming in people who have both atrial fibrillation and acute coronary syndrome.

If you have atrial fibrillation and you’d like to know more about using Plavix, talk with your doctor.

Plavix for prevention or treatment of deep vein thrombosis (not an appropriate use)

Plavix is not approved to treat or prevent deep vein thrombosis (DVT). And it shouldn’t be used for this purpose.

Plavix for cholesterol treatment (not an appropriate use)

Plavix is not approved to treat elevated cholesterol. And it shouldn’t be used for this purpose.

Plavix is often prescribed in combination with other drugs. The drugs that Plavix is prescribed with depend on the condition that it’s being used to treat.

Note: Some of the drugs listed below are used off-label. Off-label drug use is when a drug that’s approved for one condition is used for a different one that’s not approved.

Plavix with aspirin

Plavix is often prescribed in combination with aspirin to treat various conditions. The combination of Plavix and aspirin is called dual antiplatelet therapy. This is because both drugs work to stop your platelets from sticking together and forming dangerous clots.

Several studies have shown a benefit to using these drugs together rather than taking either of the drugs alone.

Plavix is FDA-approved for use in combination with aspirin to prevent heart attack and stroke in people with acute coronary syndrome (ACS).

Plavix with anticoagulants

Plavix may be used in combination with an anticoagulant (blood thinner) in some people who have conditions such as atrial fibrillation, or in people who have very high risk of a cardiovascular events. (Cardiovascular events include heart attack and stroke.)

Examples of certain blood thinners that may be used with Plavix include:

  • warfarin (Coumadin)
  • rivaroxaban (Xarelto)
  • apixaban (Eliquis)
  • edoxaban (Savaysa)
  • fondaparinux (Arixtra)
  • betrixaban (Bevyxxa)
  • dabigatran (Pradaxa)
  • enoxaparin (Lovenox)

The Plavix dosage your doctor prescribes will depend on the type and severity of the condition you’re using Plavix to treat. The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Plavix comes as oral tablets. It’s available in two strengths: 75 mg and 300 mg.

Dosage for acute coronary syndrome

The typical dosage of Plavix for acute coronary syndrome (ACS) depends on whether you have:

  • unstable angina (a type of chest pain)
  • non-ST-segment elevation myocardial infarction (NSTEMI), a type of heart attack
  • ST-segment elevation myocardial infarction (STEMI), a type of heart attack

The typical dosage of Plavix is one 75-mg tablet taken by mouth once daily. It can be taken with or without food.

Your doctor may recommend that you start Plavix therapy by taking a loading dose. With a loading dose, the drug is given to you at a dosage higher than the typical dosage. A loading dose is used to increase the level of the drug in your body right away. The typical loading dosage of Plavix is 300 mg (four 75-mg tablets or one 300-mg tablet) taken by mouth one time.

After taking your loading dose of Plavix, your doctor will recommend the dosage of Plavix that you should continue to take each day.

Dosage for peripheral artery disease, recent stroke, or recent myocardial infarction

The typical dosage of Plavix for people with peripheral artery disease (PAD), recent stroke, or recent heart attack is one 75-mg tablet taken by mouth once daily. It can be taken with or without food.

What if I miss a dose?

If you miss a dose of Plavix, try to take it as soon as you remember. However, if it’s almost time for your next dose, just skip the missed dose and take your next dose at the usual time. Don’t take two doses of Plavix at the same to make up for a missed dose. Doing this may increase your risk of serious side effects.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

You might. Plavix is meant to be used as a long-term treatment. If you and your doctor determine that Plavix is safe and effective for you, you’ll likely take it long term.

Other drugs are available that can reduce your risk of cardiovascular events, such as heart attack and stroke. Some may be better suited for you than others. If you’re interested in finding an alternative to Plavix, talk with your doctor. They can tell you about other medications that may work well for you.

The drugs listed below all help to prevent your body from making too many blood clots. However, these drugs each work in slightly different ways. Because of this, some drugs may work better for you than other drugs.

Examples of other drugs that can help reduce your risk of cardiovascular events include:

  • certain antiplatelet drugs, such as:
    • prasugrel (Effient)
    • aspirin/dipyridamole (Aggrenox)
  • certain anticoagulant drugs, such as:
    • warfarin (Coumadin, Jantoven)
    • rivaroxaban (Xarelto)
    • apixaban (Eliquis)
    • edoxaban (Savaysa)
    • fondaparinux (Arixtra)
    • betrixaban (Bevyxxa)
    • dabigatran (Pradaxa)
    • enoxaparin (Lovenox)

Note: Some of the drugs listed above are used off-label. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

You may wonder how Plavix compares to other medications that are prescribed for similar uses. Here we look at how Plavix and Brilinta are alike and different.

About

Plavix contains the drug clopidogrel, while Brilinta contains the drug ticagrelor. These drugs belong to the same class of medications called platelet inhibitors.

Uses

Plavix and Brilinta are both approved to prevent cardiovascular complications, such as heart attack and stroke, in people who have acute coronary syndrome (ACS). This syndrome is caused by a lack of blood flow to your heart due to a blockage. Unstable angina (a type of chest pain) and heart attack are two types of ACS.

For this use, Plavix can be prescribed for people with peripheral artery disease (PAD), or people who’ve had a heart attack or stroke in the past.

Brilinta can be prescribed for people who’ve had a heart attack in the past. It’s also approved to prevent blood clots in people with ACS who’ve had a stent (mesh tube) placed in one or more of their blood vessels.

Both Plavix and Brilinta are often prescribed for use in combination with aspirin.

Drug forms and administration

Plavix comes as tablets that are taken by mouth once each day. It also comes in higher-strength tablets that are used at the start of therapy as a “loading dose.” (A loading dose is used to increase the level of the drug in your body right away.)

Brilinta comes as tablets that are taken by mouth twice each day. There is also a loading dose for Brilinta. But it’s given by having you take more than one tablet of Brilinta one time at the start of treatment.

Both Plavix and Brilinta can be taken with or without food.

Side effects and risks

Plavix and Brilinta belong to a class of drugs called platelet inhibitors. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Plavix, with Brilinta, or with both drugs (when taken individually).

  • Can occur with Plavix:
    • fever
    • muscle pain
    • confusion
    • skin rash or itching
  • Can occur with Brilinta:
  • Can occur with both Plavix and Brilinta:
    • bleeding more than usual (such as having nosebleeds or cuts that take longer than usual to stop bleeding)
    • bruising more often than usual

Serious side effects

These lists contain examples of serious side effects that can occur with Plavix, with Brilinta, or with both drugs (when taken individually).

Effectiveness

Plavix and Brilinta have different approved uses, but they’re both used to prevent cardiovascular events, such as heart attack or stroke, in people with acute coronary syndrome (ACS).

The use of Plavix and Brilinta in people with ACS has been compared in studies. In one clinical study, people who had experienced an ACS event within the past 24 hours took aspirin and either Plavix or Brilinta.

Researchers followed the people for up to 1 year to see if they would have a cardiovascular event such as heart attack, stroke, or cardiovascular-related death. By the end of the study, compared with people taking Plavix and aspirin, fewer people taking Brilinta and aspirin had experienced a cardiovascular event. For details on this study, see the Plavix package insert.

Costs

Plavix and Brilinta are both brand-name drugs. A generic form of Plavix, called clopidogrel, is available for use. However, a generic form of Brilinta is not yet available. A generic drug is an exact copy of a brand-name medication. The generic is considered to be just as safe and effective as the original drug. Generics also tend to cost less than brand-name drugs.

According to estimates on GoodRx.com, Brilinta generally costs more than Plavix. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

You may wonder how Plavix compares to other medications that are prescribed for similar uses. Here we look at how Plavix and Effient are alike and different.

About

Plavix contains the drug clopidogrel, while Effient contains the drug prasugrel. Both drugs belong to the same class of medications called platelet inhibitors.

Uses

Plavix and Effient are both approved to prevent cardiovascular events, such as heart attack and stroke, in people who have acute coronary syndrome (ACS). With ACS, there is a lack of blood flow to your heart due to blockage. Unstable angina (a type of chest pain) and heart attack are two types of ACS.

For this use, Plavix and Effient can both be prescribed for people who’ve had a heart attack in the past. But while Plavix can be used in people who’ve had a stroke in the past, Effient should not be used in people who’ve had a stroke in the past.

And for each of these uses, Effient should only be given to people who will be having or have had percutaneous coronary intervention (PCI) treatment. (With PCI, a thin, flexible tube is used to open up blood vessels that are narrowed because of plaque buildup.) But Plavix can be used in people who’ve either had or will have PCI, or in people who don’t need PCI.

Effient is also approved to prevent blood clots from forming on or inside stents (mesh tubes) in people with ACS. It’s used for this purpose in people who’ve had a stent placed in one or more of their blood vessels.

Plavix is also approved to prevent heart attack and stroke in people with peripheral artery disease (PAD).

Both Plavix and Effient are often prescribed for use in combination with aspirin.

Drug forms and administration

Plavix comes as tablets that are taken by mouth once each day. It also comes in higher-strength tablets that are used at the start of therapy as a “loading dose.” (A loading dose is used to increase the level of the drug in your body right away.)

Effient comes as tablets that are taken by mouth twice each day. There is also a loading dose for Brilinta. But it’s given by having you take more than one tablet of Effient one time at the start of treatment.

Both Plavix and Effient can be taken with or without food.

Side effects and risks

Plavix and Effient both belong to a class of drugs called platelet inhibitors. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Plavix, with Effient, or with both drugs (when taken individually).

  • Can occur with Plavix:
    • fever
    • muscle pain
    • confusion
    • skin rash or itching
  • Can occur with Effient:
    • no unique common side effects
  • Can occur with both Plavix and Effient:
    • bleeding more than usual (such as having nosebleeds or cuts that take longer than usual to stop bleeding)
    • bruising more often than usual

Serious side effects

Examples of serious side effects that can occur with both drugs (when taken individually) include the following:

Effectiveness

The use of Plavix and Effient has been directly compared in studies. In one clinical study, certain people were given aspirin and either Plavix or Effient for up to 15 months. Researchers found that compared with those taking Plavix and aspirin, fewer people taking Effient and aspirin had experienced a heart attack, stroke, or cardiovascular-related death.

In another clinical study, compared to Plavix, Effient didn’t reduce the rate of cardiovascular events in people who’d had a previous stroke or transient ischemic attack (mini stroke). Because of this, Effient isn’t recommended for use in these people.

Costs

Plavix and Effient are both brand-name drugs, but there are generic forms available for each drug. The generic form of Plavix is called clopidogrel, while the generic form of Effient is called prasugrel. A generic drug is an exact copy of a brand-name medication. The generic is considered to be just as safe and effective as the original drug. Generics also tend to cost less than brand-name drugs.

According to estimates on GoodRx.com, Effient generally costs more than Plavix. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

There aren’t any known interactions between Plavix and alcohol. However, drinking too much alcohol while you’re taking Plavix can irritate your stomach. For some people, this may increase the risk of bleeding, especially in their stomach.

Talk with your doctor about how much alcohol is safe for you to drink while you’re taking Plavix.

Plavix can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Plavix and other medications

Below are lists of medications that can interact with Plavix. These lists do not contain all the drugs that may interact with Plavix.

Before taking Plavix, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Plavix and certain proton pump inhibitors

Plavix can interact with certain other drugs that are metabolized (processed) by the same enzymes (proteins) in your liver. For example, proton pump inhibitors are a class of drugs that are metabolized by the enzymes that break down Plavix. Taking these drugs with Plavix can make Plavix less effective for you. This may be dangerous to your health.

Examples of proton pump inhibitors that can decrease the effectiveness of Plavix include:

If you’re taking one of the drugs listed above, talk with your doctor about whether it’s safe for you to use Plavix. They may recommend a different treatment so you can avoid this interaction.

Plavix and ibuprofen or other NSAIDs

Taking Plavix with ibuprofen (Motrin) or other NSAIDs (nonsteroidal anti-inflammatory drugs) can increase your risk of serious bleeding. This is because Plavix and NSAIDs can each increase your risk of bleeding on their own. Taking these drugs together further increases your risk of bleeding, especially the risk of bleeding in your stomach.

Examples of NSAIDs that can increase your risk of bleeding include:

  • naproxen (Aleve)
  • celecoxib (Celebrex)
  • etodolac
  • ketorolac (Acuvail)
  • indomethacin (Indocin, Tivorbex)
  • aspirin

If you need to take something for pain relief while you’re using Plavix, your doctor may recommend that you take acetaminophen (Tylenol) instead of ibuprofen or other NSAIDs. This is because acetaminophen has a lower risk of causing bleeding when it’s taken with Plavix.

While you’re using Plavix, talk with your doctor before you start taking any new medications, including pain relievers.

Plavix and warfarin or other blood thinners

Taking Plavix with warfarin (Coumadin) or other blood thinners increases your risk of side effects, such as serious bleeding. This is because Plavix and blood thinner drugs each work to stop your blood from forming clots.

Examples of other drugs that can increase your risk of bleeding if taken with Plavix include:

  • rivaroxaban (Xarelto)
  • apixaban (Eliquis)
  • edoxaban (Savaysa)
  • fondaparinux (Arixtra)
  • betrixaban (Bevyxxa)
  • dabigatran (Pradaxa)
  • enoxaparin (Lovenox)

If you’re taking one of the drugs listed above, talk with your doctor about whether it’s safe for you to use Plavix.

Plavix and opioids

Taking Plavix with opioids (strong pain relievers) isn’t recommended. This is because opioids can make Plavix less effective if the drugs are taken together.

Examples of opioids that may make Plavix less effective for you include:

  • morphine (Kadian, MS Contin)
  • oxycodone (Oxycontin, Xtampza ER)
  • hydrocodone (Zohydro ER)
  • fentanyl (Fentora, Subsys)
  • methadone (Dolophine, Methadose)
  • buprenorphine (Belbuca, Butrans, Buprenex)
  • hydromorphone (Dilaudid)
  • tramadol (ConZip, Ultram)
  • codeine

If you’re taking an opioid, talk with your doctor about whether it’s safe for you to use Plavix. They may recommend a different treatment so you can avoid this interaction.

Plavix and certain antidepressants

Taking Plavix with certain antidepressant medications isn’t recommended. This is because certain antidepressants and Plavix can each increase your risk of bleeding. Taking these drugs together further increases your risk of bleeding.

Examples of antidepressants that may increase your risk of bleeding include:

  • selective serotonin reuptake inhibitors (SSRIs), such as:
    • sertraline (Zoloft)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs), such as:

If you’re taking any medications to treat depression, talk with your doctor about whether it’s safe for you to take Plavix with your antidepressant.

Plavix and repaglinide

You should avoid taking Plavix with a certain diabetes drug called repaglinide. This because Plavix increases the level of repaglinide in your body, which may increase your risk of certain side effects from repaglinide.

If you need to take these drugs together, your doctor may adjust your dosage of repaglinide. They’ll also monitor you closely for side effects of the drug.

Plavix and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Plavix. However, you should still check with your doctor or pharmacist before using any of these products while taking Plavix.

Plavix and vitamin K (not an interaction)

There aren’t any known interactions between Plavix and vitamin K. Talk to your doctor if you’re concerned about taking this vitamin while you’re using Plavix.

Plavix and foods

You may wonder if certain foods interact with Plavix. Below, we review some that may or may not interact with the drug.

Plavix and grapefruit

It may not be safe for you to eat grapefruit or drink grapefruit juice if you’re taking Plavix. This is because grapefruit interacts with certain enzymes in your liver, which affects how your body metabolizes (processes) Plavix. With this interaction, your body’s Plavix levels will be lower than what’s needed for the drug to work properly. This could be dangerous for your health.

If you have questions about consuming grapefruit while you’re taking Plavix, talk with your doctor or pharmacist.

Plavix and coffee (not an interaction)

Plavix doesn’t interact with coffee. However, you shouldn’t drink too much coffee when you’re taking Plavix. This is because coffee can irritate the lining of your stomach, which can sometimes cause stomach upset or bleeding. Plavix also increases your risk of bleeding, which can sometimes occur in your stomach.

Talk with your doctor about how much coffee is safe for you to drink while you’re using Plavix.

Here are answers to some frequently asked questions about Plavix.

Can I take Plavix if I’m going to have surgery?

Usually not, because Plavix increases your risk of bleeding. In fact, your doctor will likely recommend that you stop taking Plavix 5 days before you have certain surgeries. This recommendation can vary depending on what type of surgery you’re going to have and any other health conditions you may have.

If you’re planning to have surgery, talk with your doctor about all the medications you’re taking. They will recommend which drugs are safe for you to take around the time of your procedure.

Do I need to follow a special diet while I’m taking Plavix?

No, you don’t need to follow a special diet while you’re taking Plavix. This drug should work safely and effectively for you regardless of your specific diet.

One exception to this is that your doctor may recommend that you avoid consuming grapefruit and grapefruit juice while you’re taking Plavix. These products can interact with Plavix. For more information, see the “Plavix interactions” section above.

However, keep in mind that if you’re taking Plavix, you’ve probably had a cardiovascular event, such as heart attack or stroke, or you’re at a risk of having one. Eating a healthy, balanced diet will help to reduce your overall risk of heart disease and cardiovascular events.

Talk to your doctor about healthy foods you can eat to support your heart and blood vessels.

Will I need to get blood tests while I’m using Plavix?

Probably not. If you’re taking certain blood thinners, you’ll need to have frequent testing to check how quickly your blood forms clots. But Plavix isn’t a blood thinner. Instead, it’s a platelet inhibitor. It works by stopping your platelets from sticking together and forming dangerous blood clots.

If you have a blood clotting disorder or other risks of bleeding, your doctor may monitor you more closely by performing blood tests while you’re taking Plavix. Otherwise, you likely won’t need to have routine blood tests to check your clotting ability.

My doctor said I’m a “poor metabolizer” of Plavix. What does that mean?

Plavix only works if your body is able to metabolize (process) the drug. In order to metabolize Plavix, your body uses an enzyme (type of protein) called CYP2C19 that’s found in your liver.

Every person has a different amount of this enzyme in their body. Some people have very little of it, while other people have a larger amount. The amount can vary because of a person’s genetic makeup, or if they’ve had liver problems in the past.

People with small amounts of CYP2C19 are considered “poor metabolizers” of Plavix, since their body can’t break down the drug very well.

Your doctor may order a blood test to see if you’re a poor metabolizer of Plavix before you start taking the drug. If you’re a poor metabolizer, your doctor may recommend that you take a drug other than Plavix. Or they may give you a higher dosage (usually 150 mg each day) of Plavix than is typically given.

How long will I need to take Plavix?

Plavix is meant to be used as a long-term treatment. If you and your doctor determine that Plavix is safe and effective for you, you’ll likely take it long term.

How long does Plavix keep working inside my body?

Plavix starts working inside your body about 30 to 60 minutes after you take it. It will continue to help prevent blood clots from forming for 7 to 10 days after you’ve taken a dose.

Using more than the recommended dosage of Plavix can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • vomiting blood (your vomit may be pink or red in color, or look like coffee grounds)
  • coughing up blood
  • blood in your stool (you may have red stool, or black stool that looks like tar or coffee grounds)
  • passing small amounts of urine or having blood or protein in your urine, which can indicate kidney failure
  • trouble breathing

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

You should take Plavix according to your doctor’s or healthcare provider’s instructions.

When to take

You’ll take Plavix tablets by mouth once each day. It doesn’t matter what time of day you take the drug, but you should try to be consistent each day.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Plavix with food

Plavix can be taken with or without food.

Can Plavix be crushed, split, or chewed?

No, Plavix tablets shouldn’t be crushed, split, or chewed. They should be swallowed whole.

Plavix contains the active drug clopidogrel. It belongs to a class of drugs called platelet inhibitors. Your body uses platelets to help it form blood clots. By inhibiting (blocking) the activity of platelets, drugs like Plavix help to prevent your body from making too many clots.

Having your body form blood clots can sometimes be helpful, especially if you’re injured or bleeding. However, in other cases, blood clots can be dangerous.

When clots form inside blood vessels, they can block the flow of blood to your heart, lungs, brain, or anywhere else in your body. This can result in serious conditions such as heart attack and stroke. Plavix works to prevent these conditions by helping prevent blood clots from forming.

How long does it take to work?

Plavix starts to work inside of your body about 30 to 60 minutes after you’ve taken it.

As with all medications, the cost of Plavix can vary. To find current prices for Plavix in your area, check out GoodRx.com:


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

In addition to cost information for Plavix, you’ll also find pictures of the drug on GoodRx.com.

Financial and insurance assistance

If you need financial support to pay for Plavix or if you need help understanding your insurance coverage, help is available.

Bristol-Myers Squibb, the manufacturer of Plavix, offers the BMS Access Support program, which may help to lower your cost of Plavix. To learn more information and to find out if you’re eligible for support, call 800-861-0048 or visit the program website.

There haven’t been any controlled studies in humans to know for sure whether it’s safe to use Plavix during pregnancy. In reports of women taking clopidogrel during pregnancy, there was no harm seen in fetuses exposed to the drug.

In animal studies, there was also no harm seen in fetuses when pregnant females were given the drug. However, animal studies don’t always predict what will happen in humans.

If you’re pregnant or may become pregnant, talk with your doctor about the benefits and potential risks of using Plavix during pregnancy.

If you are taking Plavix during pregnancy, your doctor may recommend that you stop taking Plavix for 5 to 7 days before your scheduled or expected delivery date. This will help reduce the risk of serious, uncontrolled bleeding during and after the birth of your baby.

It’s not known if Plavix is safe to take during pregnancy. If you or your sexual partner can become pregnant, talk with your doctor about your birth control needs while you’re using Plavix.

It’s not known if Plavix is passed into human breast milk. However, animal studies have found that Plavix crosses into breast milk. When a drug passes into animal breast milk, it will likely also pass into human breast milk.

If you’re breastfeeding, talk with your doctor about whether it’s safe for you to take Plavix. They may recommend that you stop breastfeeding or that you use a drug other than Plavix.

This drug comes with several precautions.

FDA warning: Drug metabolism

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Plavix only works if your body is able to properly metabolize (process) the drug. In order to metabolize Plavix, your body uses an enzyme (type of protein) called CYP2C19 that’s found in your liver. If you’re missing this enzyme, you may not be able to metabolize Plavix. Because of this, you may not benefit from taking the drug.

Before you start taking this drug, your doctor can order tests to check whether your body is able to metabolize Plavix.

Other warnings

Before taking Plavix, talk with your doctor about your health history. Plavix may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Bleeding disorder. If you have a bleeding disorder (such as hemophilia), talk with your doctor before you start taking Plavix. Taking this drug may increase your risk of bleeding.
  • Active bleeding in your body. Plavix should not be taken by someone who has a serious, active bleed in their body.
  • Kidney problems. If you have kidney problems, you may not benefit from taking Plavix. Talk with your doctor about any kidney problems you’ve had in the past.
  • Planned surgery. If you’re planning on having surgery, your doctor may recommend that you stop taking Plavix for several days before your surgery. Doing this will help to reduce your risk of having a serious bleed during or after surgery.
  • Pregnancy. It’s not known for sure if the drug is safe for use during pregnancy. For more information, please see the “Plavix and pregnancy” section above.
  • Breastfeeding. It’s not known if Plavix is safe to take while you’re breastfeeding. For more information, please see the “Plavix and breastfeeding” section above.
  • Severe allergic reaction. You shouldn’t take Plavix if you’ve had a severe allergic reaction to Plavix or any of the drug’s ingredients in the past. If you’re not sure if you’ve had a severe allergic reaction in the past, talk with your doctor.

Note: For more information about the potential negative effects of Plavix, see the “Plavix side effects” section above.

When you get Plavix from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Plavix tablets should be stored at room temperature (about 77°F/25°C) in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Plavix and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Plavix is indicated to reduce rates of cardiovascular death, myocardial infarction, and stroke in people with acute coronary syndrome (ACS). ACS includes the following conditions: unstable angina, non-ST segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).

Plavix is also indicated to reduce the rate of myocardial infarction or stroke in people with recent myocardial infarction, recent stroke, or established peripheral artery disease (PAD).

Mechanism of action

Plavix contains the active drug clopidogrel. The metabolite of this prodrug inhibits platelet activation and aggregation by binding to P2Y12 receptors on platelets.

Pharmacokinetics and metabolism

After oral intake, Plavix absorption is approximately 50% with or without the presence of food. Plavix is metabolized by two main pathways: esterases and CYP450 enzymes (including CYP2C19).

The maximum concentration occurs about 30 to 60 minutes after oral ingestion. Half-life is 6 hours. Plavix is excreted in the urine and feces over 5 days after oral ingestion.

Pharmacogenomics

Plavix contains the active drug clopidogrel, which is a prodrug that is processed to active metabolites through the CYP450 enzymes. Genetic variants of CYP450 enzymes differ according to the CYP2C19 genotype. This affects the formation of Plavix’s active metabolite, and ultimately the drug’s efficacy.

People who are classified as “poor metabolizers” display decreased active metabolite exposure compared to other groups. The majority of poor metabolizers express CYP2C19*2 and CYP2C19*3 alleles. Tests are available to determine CYP2C19 genotypes. An appropriate dosing regimen for this population has not yet been established.

Contraindications

Plavix is contraindicated in people who have active bleeding or who have hypersensitivity to Plavix or any of its components.

Storage

Plavix tablets should be stored at room temperature in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.