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Clopidogrel (Plavix): Uses, Dosage, Side Effects & Interactions
Summary of Key Points
Clopidogrel is a prescription medication used to prevent blood clots, which helps lower the risk of heart attacks, strokes, and other cardiovascular events. It works by stopping platelets from clumping together. Clopidogrel is often prescribed for individuals with heart disease, peripheral artery disease, or those who have recently experienced a stroke or heart attack. Always consult your healthcare provider before starting or adjusting your dose.
Names of Medication
US Brand Name: Plavix (Clopidogrel)
The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. In this case, Clopidogrel is the generic name, and Plavix is the brand name.
Pharmacologic Category
Antiplatelet Agent
Thienopyridine
Clopidogrel Dosage
Clopidogrel is used to treat various cardiovascular conditions, with the dosage tailored to the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.
Myocardial Infarction (Heart Attack)
Initial Dose: 300 mg once, followed by 75 mg daily.
Maintenance Dose: 75 mg once daily, typically for at least 12 months or as directed by your doctor.
Stroke
Maintenance Dose: 75 mg once daily. Treatment is usually long-term to prevent future strokes.
Peripheral Artery Disease (PAD)
Maintenance Dose: 75 mg once daily. Treatment is generally long-term to reduce the risk of blood clots.
Acute Coronary Syndrome (ACS)
Initial Dose: 300 mg once, followed by 75 mg daily.
Maintenance Dose: 75 mg once daily, often combined with aspirin for up to 12 months or longer, depending on your doctor’s recommendation.
Atrial Fibrillation
Maintenance Dose: 75 mg once daily. This is often prescribed for patients who cannot take other blood thinners like warfarin.
Coronary Artery Disease (CAD)
Maintenance Dose: 75 mg once daily. Treatment is typically long-term to prevent future heart attacks or strokes.
Transient Ischemic Attack (TIA)
Maintenance Dose: 75 mg once daily. Long-term treatment is recommended to prevent future strokes.
Angina (Chest Pain)
Maintenance Dose: 75 mg once daily. Treatment duration depends on your doctor’s advice.
Thrombosis (Blood Clots)
Maintenance Dose: 75 mg once daily. Treatment duration varies based on individual risk factors and your doctor’s recommendation.
Ischemic Heart Disease
Maintenance Dose: 75 mg once daily. Long-term treatment is often required to prevent further cardiovascular events.
Dosage Forms and Strengths
Tablets: 75 mg
Tablets: 300 mg
Administration Instructions for Clopidogrel
Clopidogrel is typically taken once daily, with or without food. Swallow the tablet whole with a glass of water. It’s important to take Clopidogrel at the same time each day to maintain consistent levels in your bloodstream. If you miss a dose, take it as soon as you remember, but skip it if it’s almost time for your next dose. Do not take two doses at once. Always follow your healthcare provider’s instructions, and if you have any questions, you can consult one of our telemedicine providers for guidance.
Contraindications for Clopidogrel
A contraindication is a medical reason or condition that makes it unsafe to use a particular medication. If you have any of the following conditions, taking Clopidogrel may not be safe for you. Always talk to your healthcare provider before starting or stopping any medication.
- Active bleeding: Clopidogrel is a blood thinner, so taking it while you have active bleeding (such as a stomach ulcer or brain hemorrhage) can worsen the bleeding.
- Allergy to Clopidogrel: If you have had an allergic reaction to Clopidogrel or any of its ingredients, you should not take this medication, as it could cause serious allergic reactions like hives, swelling, or difficulty breathing.
- Severe liver disease: Clopidogrel is processed by the liver. If your liver is not functioning properly, the medication may not be broken down correctly, leading to an increased risk of bleeding or other complications.
Clopidogrel Drug Interactions
Clopidogrel can interact with other medications, which may increase the risk of side effects or reduce the effectiveness of the treatment. Be sure to tell your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with Clopidogrel:
- Omeprazole (Prilosec): This medication reduces stomach acid and can decrease the effectiveness of Clopidogrel, making it less effective at preventing blood clots.
- Esomeprazole (Nexium): Like Omeprazole, Esomeprazole can interfere with how Clopidogrel works in your body.
- Warfarin (Coumadin): Both Warfarin and Clopidogrel thin the blood. Taking them together can increase the risk of serious bleeding.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like Ibuprofen (Advil, Motrin) or Naproxen (Aleve) can increase the risk of bleeding when taken with Clopidogrel.
- Selective serotonin reuptake inhibitors (SSRIs): Medications like Sertraline (Zoloft) or Fluoxetine (Prozac) can increase the risk of bleeding when taken with Clopidogrel.
Clopidogrel in Pregnancy
Is it safe to take Clopidogrel during pregnancy? The safety of Clopidogrel, also known as Plavix, during pregnancy has not been fully established. It is generally recommended to avoid using this antiplatelet medication unless it is absolutely necessary. If you are pregnant or planning to become pregnant, it’s important to consult your healthcare provider. Together, you can carefully weigh the potential risks and benefits of using Clopidogrel. Your provider may suggest alternative treatments or closely monitor your condition if Clopidogrel is deemed essential.
Clopidogrel While Breastfeeding
Is it safe to take Clopidogrel while breastfeeding? There is limited information on whether Clopidogrel passes into breast milk. Due to the potential risk of bleeding in a nursing infant, it is generally advised to avoid Clopidogrel while breastfeeding. If you are breastfeeding, speak with your healthcare provider to determine the safest course of action for both you and your baby.
Estimated Cost of Clopidogrel
The cost of Clopidogrel can vary depending on the pharmacy and your insurance coverage. Without insurance, the estimated cost for a 30-day supply of Clopidogrel (75 mg) using a GoodRx coupon typically ranges from $9 to $15. Prices may differ, so it’s a good idea to check with your pharmacy or use a coupon service like GoodRx to find the most affordable option for this blood thinner medication.
Possible Alternatives to Clopidogrel
If you have any of the following conditions and are considering alternatives to Clopidogrel, it’s important to discuss these options with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to review your options.
Myocardial infarction (heart attack): Alternatives may include Aspirin, Ticagrelor (Brilinta), or lifestyle changes such as quitting smoking, adopting a heart-healthy diet, and engaging in regular exercise.
Stroke: Aspirin or Dipyridamole (Aggrenox) may be considered as alternatives. Lifestyle changes like managing high blood pressure and controlling diabetes can also help reduce your risk.
Peripheral artery disease: Cilostazol (Pletal) or lifestyle changes such as increasing physical activity and quitting smoking may be recommended.
Acute coronary syndrome: Ticagrelor (Brilinta) or Prasugrel (Effient) may be used as alternatives. Your provider may also suggest lifestyle changes like adopting a low-sodium diet and incorporating regular exercise.
Atrial fibrillation: Anticoagulants such as Warfarin (Coumadin) or newer agents like Apixaban (Eliquis) or Rivaroxaban (Xarelto) may be considered.
Coronary artery disease: Aspirin or lifestyle changes such as following a heart-healthy diet, exercising regularly, and managing cholesterol levels can be helpful.
Transient ischemic attack (TIA): Aspirin or Dipyridamole (Aggrenox) may be used. Managing risk factors like high blood pressure and diabetes is also crucial.
Angina: Beta-blockers or calcium channel blockers may be considered as alternatives. Lifestyle changes like stress management and regular physical activity can also be beneficial.
Thrombosis: Anticoagulants such as Heparin or Warfarin (Coumadin) may be used. Your provider may also recommend lifestyle changes to reduce your risk of blood clots.
Ischemic heart disease: Aspirin, beta-blockers, or statins may be considered. Lifestyle changes such as following a low-fat diet, exercising regularly, and quitting smoking can also help manage the condition.
Recent Updates on Clopidogrel Research
Recent studies have focused on genetic factors that influence how well Clopidogrel works in different individuals. Some people have a genetic variation that makes them “poor metabolizers” of Clopidogrel, meaning the drug may not be as effective in preventing blood clots. Ongoing research is exploring the use of genetic testing to identify these individuals and adjust their treatment accordingly. Additionally, new studies are comparing Clopidogrel with newer antiplatelet drugs like Ticagrelor (Brilinta) and Prasugrel (Effient) to determine which is more effective in specific patient populations.
If you have questions about how Clopidogrel might work for you, or if you are concerned about potential genetic factors, schedule a telemedicine appointment with one of our providers to discuss your options.
