Plavix (clopidogrel)

Plavix is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) to help prevent heart attack and stroke in certain adults.

Doctors prescribe Plavix for adults with the following conditions.

• Acute coronary syndrome (ACS). ACS refers to a group of conditions that suddenly stop or reduce blood flow to the heart. These conditions include unstable angina and certain types of heart attack. Plavix helps prevent heart attack and stroke in people who have any type of ACS. It may be used in people who need a certain heart procedure to help improve blood flow to the heart. For these purposes, Plavix should be used with aspirin.
• Recent heart attack or stroke. People who’ve recently had a heart attack or ischemic stroke are at high risk of having another one. (An ischemic stroke happens when the brain does not receive enough oxygen.) Plavix helps lower this risk.
• Peripheral arterial disease (PAD), which is also known as peripheral vascular disease. PAD is a condition that can reduce blood flow to the heart and brain, which can result in a heart attack or stroke. Plavix helps prevent heart attack and stroke in people with PAD.

For details about these conditions and how the drug treats them, see the “Plavix: Uses” section below.

The following table provides key facts about Plavix.

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Plavix is a brand-name medication. It contains the active drug clopidogrel, which also comes in a generic form. A generic is an identical copy of the active drug found in a brand-name medication.

The Food and Drug Administration (FDA) ensures that generic drugs are as safe and effective as their original drug. Generics tend to be less expensive than brand-name drugs.

If you’d like to know about the generic version of Plavix, ask your doctor or pharmacist. They can tell you if the generic medication comes in forms and strengths recommended for your condition.

As with most drugs, it’s possible to have side effects with Plavix. These can include some mild side effects but also some serious ones.

To learn more about Plavix’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

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

Mild and serious side effects of Plavix are listed below. This article does not include all of Plavix’s possible side effects.

Mild side effects* of Plavix may include:

• bruising more easily than usual
• minor bleeding, such as nosebleeds
• itchy skin
• mild allergic reaction†

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

* This is not a complete list of Plavix’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† To learn more about allergic reaction, see below. An allergic reaction is possible after taking Plavix. This side effect wasn’t reported in clinical studies. However, allergic reaction has been reported since the drug was approved for use.

Serious side effects of Plavix may include:

• thrombotic thrombocytopenic purpura, which is a rare but life threatening condition that causes blood clots to form in small blood vessels
• severe bleeding that may be life threatening, such as bleeding in the eyes, brain, or digestive tract
• severe allergic reaction*

Serious side effects from Plavix aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

* To learn more about allergic reaction, see below. An allergic reaction is possible after taking Plavix. This side effect wasn’t reported in clinical studies. However, allergic reaction has been reported since the drug was approved for use.

Prescription drugs, such as Plavix, are approved by the Food and Drug Administration (FDA) to treat certain conditions. Doctors sometimes prescribe drugs off-label for other conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

The Food and Drug Administration (FDA) has approved Plavix to help prevent heart attack and stroke in adults with acute coronary syndrome (ACS).

ACS refers to a group of conditions that suddenly stop or reduce blood flow to the heart. These conditions include:

• Unstable angina. This type of chest pain can occur without a known trigger, such as while sleeping or resting.
• Certain types of heart attack. Heart attack happens when the heart does not receive enough oxygen. Symptoms include squeezing or tightening of the chest. They also include pain that travels to the jaw, neck, back, or arm. Plavix is used for the following types of heart attack:
  • Non-ST-elevation myocardial infarction (NSTEMI). This type of heart attack does not show certain changes in the heart’s activity on an ECG. (An ECG is a test that records electrical activity of the heart.)
  • ST-elevation myocardial infarction (STEMI). This type of heart attack does show certain changes in the heart’s activity on an ECG.

ACS is typically caused by coronary artery disease (CAD). In CAD, plaque (a type of fatty substance) builds up inside the arteries. This buildup blocks the flow of blood and oxygen to the heart and brain. The blockage can lead to chest pain, heart attack, or stroke.

Doctors prescribe Plavix for people with any type of ACS to help prevent heart attack and stroke. Doctors also prescribe Plavix for people with unstable angina or NSTEMI who need a certain heart procedure to improve blood flow to their heart. For these purposes, Plavix should be used with aspirin.

The Food and Drug Administration (FDA) has approved Plavix to help prevent heart attack and stroke in certain adults.

Heart attack happens when the heart does not receive enough oxygen. Symptoms of heart attack include squeezing or tightening of the chest. They also include pain that travels to the jaw, neck, back, or arm.

An ischemic stroke happens when the brain does not receive enough oxygen. Symptoms of ischemic stroke include:

• sudden numbness or weakness in one side of the face or in an arm or leg on one side of the body
• trouble speaking
• loss of balance and coordination
• severe headache

Both heart attack and ischemic stroke can be caused by a buildup of plaque (a type of fatty substance) inside the arteries. This buildup blocks the flow of blood and oxygen to the heart and brain. The blockage can result in a heart attack or ischemic stroke.

People who’ve recently had a heart attack or ischemic stroke are at high risk of having another one. Doctors prescribe Plavix to help lower this risk.

The Food and Drug Administration (FDA) has approved Plavix to help prevent heart attack and stroke in adults with peripheral arterial disease (PAD). PAD is also known as peripheral vascular disease.

PAD is a condition that happens when blood vessels outside of the heart narrow. A buildup of plaque (a type of fatty substance) inside the arteries can cause blood vessels to narrow. Narrow blood vessels may not supply enough blood or oxygen to the heart and brain. This can result in a heart attack or stroke.

Some people may not have any symptoms of PAD. However, possible symptoms of this condition include:

• numbness, burning, or pain in the buttocks, legs, or feet
• muscle weakness
• shiny skin on the legs

Doctors prescribe Plavix to help prevent heart attack and stroke in people with PAD.

When used for acute coronary syndrome (ACS), Plavix should be used with aspirin. Your doctor will tell you the dosage of aspirin that’s right for you. For details, see “Taking Plavix and aspirin” below.

For conditions other than ACS, your doctor will recommend whether to take Plavix alone or with other treatments.

Plavix is used to help prevent heart attack and stroke in adults with ACS. For this purpose, Plavix should be used with aspirin.

ACS can happen when plaque builds up inside the arteries. This buildup blocks the flow of blood and oxygen to the heart and brain. The blockage can lead to chest pain, heart attack, or stroke.

When a plaque breaks away from an artery, the artery may be damaged. If so, the body will send platelets to help repair the area by forming a blood clot. However, having a blood clot in an artery can increase the risk of heart attack and stroke even further. 

Plavix and aspirin used together help prevent platelets from sticking together to form a blood clot. By lowering the risk of blood clots, Plavix and aspirin can help prevent heart attack and stroke. Clinical studies have shown the drugs to be effective for this use when taken in combination.

Your doctor will tell you the dosage of aspirin that’s right for you. If you have questions about taking Plavix with aspirin, talk with your doctor or pharmacist.

Doctors typically won’t prescribe Plavix for children. The drug is approved only for use in adults.

If you’re interested in taking Plavix, you can find a doctor or healthcare professional who might prescribe it by searching here. You can prepare for your appointment by viewing these Healthgrades materials:

• coronary artery disease appointment guide, which may help you prepare for a discussion about acute coronary syndrome
• heart attack recovery appointment guide

Doctors may prescribe drugs other than Plavix for your condition. Certain drugs may work better for you than others.

Plavix is used to lower the risk of heart attack and stroke in certain people. Here’s a summary of other drugs that doctors sometimes prescribe for this purpose.

To learn more about some alternatives to Plavix, view the following articles:

• Plavix vs. Brilinta
• Plavix vs. Effient

Your doctor can tell you about other similar drugs, such as rivaroxaban (Xarelto) and apixaban (Eliquis).

For additional information about alternatives to Plavix, ask your doctor. They can tell you about other medications that could be prescribed for your condition.

Below you’ll find dosages that are commonly recommended for Plavix. However, you should take the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

The dosage of Plavix that your doctor prescribes will depend on the condition you’re using Plavix to treat. It also will depend on the severity of the condition.

Plavix is available as follows.

• Form: oral tablet
• Strengths: 75 milligrams (mg) and 300 mg

Plavix is used to help prevent heart attack and stroke in adults with the following conditions:

• acute coronary syndrome (ACS) 
• recent heart attack or stroke
• peripheral arterial disease (PAD), which is also known as peripheral vascular disease

Recommended dosages for Plavix are described below.

* A loading dose is a higher starting dose that allows a drug to start working quickly.
† A maintenance dose is the typical ongoing dosage that’s taken for the condition being treated.

Below are some things to consider about Plavix’s dosage.

• Missing a dose. If you miss a dose of Plavix, take it as soon as you remember and then continue your usual dosage schedule. However, if it’s almost time for your next dose, skip the missed dose and take your next dose at the usual time. Do not take two doses to make up for a missed dose. Doing so can increase your risk of side effects with Plavix. Try these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Length of treatment. Doctors typically prescribe Plavix as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for you.

Here are some common questions about Plavix and brief answers to them. If you’d like to know more about these topics, ask your doctor.

The manufacturer of Plavix hasn’t reported an interaction between Plavix and coffee.

Coffee may affect warfarin (Jantoven), which is a drug used to treat and help prevent blood clots. Like Plavix, warfarin can be used to help prevent heart attack and stroke in certain situations. However, coffee is not known to have an effect on Plavix.

Yes, it is. Plavix belongs to a class of drugs called platelet inhibitors, which are also known as antiplatelet drugs.

Platelet inhibitors work by preventing platelets in the blood from sticking together to form a blood clot. To learn more, see the “Plavix: How it works” section below.

Plavix is not approved to treat atrial fibrillation (AFib). However, doctors may prescribe the drug off-label for this condition. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

AFib is a type of abnormal heart rhythm. This condition increases the risk of a blood clot forming in the heart. If the clot breaks free from the heart and travels to the brain, it can cause a stroke.

Doctors may prescribe Plavix for people who have both AFib and acute coronary syndrome (ACS). (For details about ACS, see the “Plavix: Uses” section above.)

If you have AFib and would like to learn more about using Plavix for this condition, talk with your doctor.

Alcohol and Plavix don’t have any known interactions.

However, both Plavix and alcohol prevent blood from clotting, which increases your risk of bleeding. So, drinking alcohol while taking the drug could increase your risk of bleeding even more.

If you drink alcohol, talk with your doctor. They can recommend an amount that’s safe to consume during Plavix treatment.

Plavix may interact with other medications and certain herbs and supplements. It is not known to interact with foods.

Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

Before you start Plavix, be sure to tell your doctor about any medications, herbs, vitamins, or supplements you take. They can check for any possible interactions between these products and Plavix.

If any of the interactions listed below might pertain to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.

• Plavix and certain other medications. Because Plavix may interact with the following drugs, your doctor may recommend you do not take it with these drugs:
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve)
  • opioid drugs, such as morphine (Mitigo, MS Contin, others) and tramadol (ConZip, Qdolo, Ultram)
  • selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa) and sertraline (Zoloft)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs), such as desvenlafaxine (Pristiq) and duloxetine (Cymbalta)
  • certain proton pump inhibitors (PPIs), such as omeprazole (Prilosec) and esomeprazole (Nexium)
  • the antibiotic drug rifampin (Rimactane, Rifadin)
  • the blood thinner drug warfarin (Jantoven)
  • the diabetes drug repaglinide
• Plavix and herbs and supplements. Certain herbs and dietary supplements may increase the risk of bleeding if taken with Plavix. One example Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source is the herb St. John’s wort. If you have questions about taking specific herbs or supplements with Plavix, talk with your doctor or pharmacist.
• Plavix and foods. There aren’t any interactions known between Plavix and foods. If you have questions about eating certain foods with Plavix, talk with your doctor or pharmacist.

For information about drug-condition interactions, see the “Plavix: Precautions” section below.

Plavix is used to help prevent heart attack and stroke in adults with the following conditions:

• acute coronary syndrome (ACS) 
• recent heart attack or stroke
• peripheral arterial disease (PAD), which is also known as peripheral vascular disease

To learn more about these conditions, see the “Plavix: Uses” section above.

These conditions can happen when plaque (a type of fatty substance) builds up inside the arteries. This buildup blocks the flow of blood and oxygen to the heart and brain. The blockage can lead to chest pain, heart attack, or stroke.

When a plaque breaks away from an artery, the artery may be damaged. If so, the body will send platelets to help repair the area by forming a blood clot. However, having a blood clot in an artery can increase the risk of heart attack and stroke even further. 

Plavix belongs to a class of drugs called platelet inhibitors. Its mechanism of action (how it works) is preventing platelets from sticking together to form a blood clot. By lowering the risk of blood clots, Plavix can help prevent heart attack and stroke.

Plavix starts working within 30 to 60 minutes after taking your first dose. However, it takes longer than this to receive the full effects of the drug.

Doctors typically prescribe a loading dose of Plavix to start treatment in certain people. A loading dose is a higher starting dose that allows a drug to start working quickly. After a loading dose, Plavix should block platelets from sticking together within a few hours. Without a loading dose, Plavix may take several days to block platelets from sticking together.

Be sure to take the dosage your doctor prescribes for you.

As with other medications, prices for Plavix may vary. The drug’s price will depend on factors such as:

• the pharmacy you use
• your insurance coverage

Here’s a list of things to consider when looking into the cost of Plavix.

• Option for a 90-day supply. For some drugs, it’s possible to get a 90-day supply. If this option is approved by your insurance company, it can help lower the cost of the drug. It can also help you avoid frequent trips to your pharmacy. If you’d like to learn more about this option, ask your doctor, pharmacist, or insurance company.
• Need for prior authorization. Before insurance coverage for Plavix is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Plavix. Then, the insurance company will decide if the drug will be covered. To find out if you need prior authorization for Plavix, contact your insurance company.
• Possible cost assistance options. Financial assistance to help lower the cost of Plavix may be available. To learn more and see if you’re eligible for support, visit the Medicine Assistance Tool website. Also, check out this article to learn about ways to save on prescription drugs.
• Use of a mail-order pharmacy. Plavix may be dispensed through mail-order pharmacies. Getting your prescription through a mail-order pharmacy could lower its cost. It can also allow you to get the drug without leaving home. To find out more about this option, check with your doctor, pharmacist, or insurance company.
• Availability of a generic form. Plavix comes in a generic form called clopidogrel. A generic drug is an exact copy of the active drug in a brand-name medication. Generics are typically less expensive than brand-name drugs. If your doctor prescribes Plavix but you want to know about taking clopidogrel, talk with them about which option might be better for you. Also, check your insurance plan because it might cover just one form.

Your doctor will recommend how you should take Plavix. It’s important to take the drug exactly as your doctor instructs.

Plavix comes as an oral tablet. You’ll take the drug by swallowing it.

Here’s a list of common questions related to taking Plavix.

• When should I take Plavix? You’ll likely take Plavix once a day. View these medication reminder options to help avoid missing doses of Plavix. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Do I need to take Plavix with food? You can take Plavix with or without food.
• Can Plavix be chewed, split, or crushed? The manufacturer of Plavix doesn’t state whether the tablets can be chewed, split, or crushed. If you have trouble swallowing Plavix tablets, talk with your doctor or pharmacist.
• Is there a best time of day to take Plavix? No, there isn’t a best time of day to take it. You can take Plavix any time of day.

It’s not known whether Plavix is safe to take during pregnancy.  

If you’re pregnant or planning to become pregnant during Plavix treatment, talk with your doctor. They can recommend whether it’s safe for you to take the drug.

Doctors aren’t sure whether it’s safe to take Plavix during pregnancy. Talk with your doctor about your birth control needs with Plavix if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend if you should use birth control with this medication.

It’s not known whether Plavix passes into breast milk or causes side effects in a breastfed child.

If you’re breastfeeding or planning to do so, talk with your doctor before taking Plavix. They can suggest healthy ways to feed your child during treatment.

This drug comes with several precautions.

This drug has a boxed warning Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , 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.

A liver enzyme (type of protein) called CYP2C19 is found in the body. It is responsible for converting Plavix to its active form so it can work in your body.

Some people have differences in their genes that affect the CYP2C19 enzyme. This is sometimes called “CYP2C19 poor metabolism.” It keeps Plavix from converting to its active form, which prevents Plavix from being effective. For this reason, doctors typically will not prescribe Plavix to people who have CYP2C19 poor metabolism.

In addition, doctors may not prescribe Plavix in combination with other medications that affect how well CYP2C19 works. Examples of these drugs include omeprazole (Prilosec) and esomeprazole (Nexium).

Before starting treatment with Plavix, your doctor may order a test to check for gene differences affecting your CYP2C19 enzyme. Your doctor will discuss the test results with you. If the results show that you have CYP2C19 poor metabolism, your doctor likely will prescribe a treatment other than Plavix for you.

Be sure to tell your doctor about all medications you take before starting Plavix treatment. They’ll advise whether these drugs are safe to take with Plavix.

Tell your doctor about your health history before starting treatment with Plavix. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions. These situations are considered drug-condition interactions.

These factors and conditions include those listed below.

Active bleeding. Doctors typically will not prescribe Plavix to people who have active bleeding (ongoing bleeding). This is because Plavix may cause serious bleeding, which could worsen bleeding you already have.

If you have active bleeding, your doctor will likely prescribe a drug other than Plavix for your condition.

Planned dental procedure or surgery. Certain dental procedures or surgeries can increase your risk of serious bleeding. Bleeding is a common side effect of Plavix. So, your risk of bleeding with dental procedures or surgery may be even higher while taking the drug.

For this reason, it’s important to tell your dentist or surgeon that you’re taking Plavix. They may recommend that you stop taking Plavix at least 5 days before the procedures. This may help lower your risk of bleeding. They’ll also tell you when it is safe for you to restart Plavix.

Allergic reaction. Your doctor will likely not prescribe Plavix if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.

Pregnancy. It’s not known whether Plavix is safe to take during pregnancy. If you’d like additional information about taking Plavix while pregnant, view the “Plavix: Taking while pregnant” section above.

Breastfeeding. It’s not known whether Plavix is safe to take while breastfeeding. If you’d like additional information about taking Plavix while breastfeeding, view the “Plavix: Taking while breastfeeding” section above.

To learn more about effects of Plavix that could be harmful, see the “Plavix: Side effects” section above.

Serious effects can occur if you use more than the recommended dosage of Plavix. Do not use more Plavix than your doctor recommends.  

An overdose of Plavix may cause:

• vomiting
• trouble breathing
• bleeding problems, such as bleeding in the digestive tract
• tiredness or weakness

Call your doctor if you think you’ve taken too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or a local emergency number. Or go to the nearest emergency room right away.

Here’s some information about Plavix’s expiration date, as well as how to store and dispose of the drug.

Expiration. Your pharmacist will add an expiration date to the label on Plavix’s bottle. This date is usually 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time.

The Food and Drug Administration (FDA) advises Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source that you avoid taking expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know whether you might still be able to use the medication.

Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug. Store Plavix tablets at a temperature of about 77°F (25°C). You can temporarily store them at temperatures between 59°F and 86°F (15°C and 30°C), such as when traveling. Avoid storing Plavix in areas where it could get damp or wet, such as bathrooms. Keep the medication in a tightly sealed container.

Disposal. It’s important to safely dispose of Plavix if you no longer need to take it and have unused medication. Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps avoid causing harm to the environment.

Ask your pharmacist for information about disposing of Plavix. Also, check out this page for several tips on safe medication disposal.

If you have questions about Plavix, talk with your doctor. They can help advise you on whether Plavix could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor:

• Will I take any other medications with Plavix to treat my condition?
• Can I switch from another platelet inhibitor drug to Plavix?
• Do I have a higher risk of any side effects from Plavix?

Your doctor may also tell you about other treatment options for your condition. You may find this article helpful in learning about alternative drugs for heart attack prevention. And view our selection of videos on heart health and cardiovascular conditions.

Disclaimer: Healthgrades 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 another 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.