Clopidogrel (Plavix): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

What is clopidogrel used for?

Clopidogrel is commonly used to prevent complications in the following situations.

You have a condition called acute coronary syndrome (ACS), which includes a variety of conditions related to decreased blood flow to the heart
You have had a heart attack
You have had a stroke
You have a condition called peripheral arterial disease, which happens when fat and other debris build up and cause certain blood vessels (usually in your legs) to narrow

Clopidogrel may also be used for other conditions as determined by your healthcare provider.

How does clopidogrel work (mechanism of action)?

Clopidogrel prevents platelets in your blood from sticking together. This helps prevent the formation of blood clots that can block the flow of blood to your heart and brain and increase your risk of heart attack and stroke.

How is clopidogrel supplied (dosage forms)?

Clopidogrel is available as Plavix and generic clopidogrel in the following dosage forms that are taken by mouth.

75 mg oral tablets
300 mg oral tablets

How should I store clopidogrel?

Clopidogrel should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of clopidogrel?

The most common side effects of clopidogrel are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

Bleeding (see below)
Bruising more easily

There may be other side effects of clopidogrel that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of clopidogrel?

While less common, the most serious side effects of clopidogrel are described below, along with what to do if they happen.

Severe Allergic Reactions. Clopidogrel may cause allergic reactions, which can be serious. Stop taking clopidogrel and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Thrombotic Thrombocytopenic Purpura (TTP). Clopidogrel can lead to a serious problem with blood clotting, called thrombotic thrombocytopenic purpura (TTP). TTP needs to be treated right away in the hospital and can lead to death. Stop taking clopidogrel and get help right away if you have any of the following symptoms without another explanation.

Fever
Shortness of breath
Pale or yellowish skin
Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Changes in your vision
Unusual weakness or tiredness
Dizziness, lightheadedness, or feeling like you are about to pass out
Headache
Fast or abnormal heartbeat
Purplish spots on the skin or in the mouth due to bleeding under the skin

Bleeding. Clopidogrel may cause you to bruise or bleed easier than you normally would. It may take longer to get bleeding to stop while taking it. Clopidogrel can increase your risk of severe bleeding that can lead to death. Some patients with serious bleeding may need a blood transfusion or surgery. Call your healthcare provider right away if you have any of the following signs of severe bleeding while taking clopidogrel.

Pink, red, or brown urine (pee)
Vomit with blood that looks like coffee grounds
Red or black stools (looks like tar)
Coughing up blood or blood clots
Bruising or bleeding without a reason, that lasts a long time, or seems excessive

Warnings & Precautions

Who should not use clopidogrel?

Allergies to Ingredients. People who are allergic to any of the following should not take clopidogrel.

Clopidogrel
Plavix
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific clopidogrel products they stock.

Bleeding Problems. Clopidogrel should not be taken if you have stomach ulcers (can lead to bleeding) or bleeding in your brain (brain hemorrhage).

What should I know about clopidogrel before using it?

Do not take clopidogrel unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share clopidogrel with other people, even if they have the same condition as you. It may harm them.

Do not stop taking clopidogrel without talking to your healthcare provider. Stopping clopidogrel abruptly may increase your risk for a heart attack or dying. If you need to temporarily stop taking clopidogrel, your healthcare provider will give you instructions on how to stop the medicine.

Keep clopidogrel out of the reach of children.

What should I tell my healthcare provider before using clopidogrel?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if clopidogrel is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Ulcers in your stomach or intestines
Bleeding problems
Allergy or side effect to another medicine you have taken in the past for the same condition

Genetic Variation. Clopidogrel may not work well in people with a certain genetic variation, nonfunctional alleles of the CYP2C19 gene (known as CYP2C19 poor metabolizers). Your healthcare provider may do a lab test to check for this variation.

Surgery. Tell your healthcare provider and dentist that you are taking clopidogrel before any planned surgeries (including childbirth) or dental procedures. Your healthcare provider may tell you to stop taking clopidogrel before the procedure to decrease your risk of bleeding. Follow the instructions from your healthcare provider about when to stop clopidogrel and when you can start taking it again.

Other Medicines and Supplements. Clopidogrel may interact with other medicines and supplements. Before taking clopidogrel, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how clopidogrel could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take clopidogrel while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if clopidogrel passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take clopidogrel while breastfeeding.

Interactions

Does clopidogrel interact with foods or drinks?

There are no known interactions between clopidogrel and foods or drinks.

It is unknown if drinking alcohol will affect clopidogrel, but both clopidogrel and alcohol can increase your risk of bleeding. It is best to limit the amount of alcohol you drink.

Does clopidogrel interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking clopidogrel.

Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
Omeprazole (Prilosec) or esomeprazole (Nexium), which is a medicine used to decrease stomach acid
An opioid, such as oxycodone, morphine, codeine, or fentanyl, which is a medicine used for certain types of pain
A non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
Warfarin, which is a blood thinner
A selective serotonin reuptake inhibitor (SSRI) or a serotonin norepinephrine reuptake inhibitor (SNRI), which is a medicine commonly used for anxiety and depression
An antiplatelet medicine, such as ticagrelor (Brilinta), aspirin/dipyridamole, or cilostazol, which is a medicine used to prevent blood clots
Repaglinide (Prandin), which is a medicine for diabetes

Some other medicines may alter the blood levels of clopidogrel, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with clopidogrel. Always check with your healthcare provider.

Does Clopidogrel (Plavix) interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much clopidogrel?

If you or someone else has taken too much clopidogrel, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of clopidogrel?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.