Clopidogrel (Plavix)

What is this medication?

CLOPIDOGREL (kloh PID oh grel) lowers the risk of heart attack, stroke, or blood clots. It prevents blood cells (platelets) from clumping together to form a clot. It belongs to a group of medications called antiplatelets.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Plavix

What should I tell my care team before I take this medication?

They need to know if you have any of the following conditions:

• Bleeding disorders
• Bleeding in the brain
• Having surgery
• History of stomach bleeding
• An unusual or allergic reaction to clopidogrel, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth with a glass of water. Follow the directions on the prescription label. You may take this medication with or without food. If it upsets your stomach, take it with food. Take your medication at regular intervals. Do not take it more often than directed. Do not stop taking except on your care team's advice.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with the following:

• Dasabuvir; ombitasvir; paritaprevir; ritonavir
• Defibrotide
• Selexipag

This medication may also interact with the following:

• Certain medications that treat or prevent blood clots like warfarin
• Narcotic medications for pain
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Repaglinide
• SNRIs, medications for depression, like desvenlafaxine, duloxetine, levomilnacipran, venlafaxine
• SSRIs, medications for depression, like citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline
• Stomach acid blockers like cimetidine, esomeprazole, omeprazole

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular check-ups. Do not stop taking your medication unless your care team tells you to.

Notify your care team and seek emergency services if you develop sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, or change in vision. These can be signs that your condition has gotten worse.

If you are going to have surgery or dental work, tell your care team that you are taking this medication.

Certain genetic factors may reduce the effect of this medication. Your care team may use genetic tests to determine treatment.

Only take aspirin if you are instructed to. Low doses of aspirin are used with this medication to treat some conditions. Taking aspirin with this medication can increase your risk of bleeding, so you must be careful. Talk to your care team if you have questions.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Bleeding—bloody or black, tar-like stools, red or dark brown urine, vomiting blood or brown material that looks like coffee grounds, small, red or purple spots on the skin, unusual bleeding or bruising
• TTP—purple spots on the skin or inside the mouth, pale skin, yellowing skin or eyes, unusual weakness or fatigue, fever, fast or irregular heartbeat, confusion, change in vision, trouble speaking, trouble walking

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Diarrhea
• Headache

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature of 59 to 86 degrees F (15 to 30 degrees C). Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Does Plavix make you tired?

Yes, clopidogrel (Plavix®) can make you feel very tired. Contact your healthcare provider if this side effect is severe. Don’t stop taking clopidogrel unless your provider tells you to stop.

How long does Plavix stay in your system?

After six hours, 50% of a typical clopidogrel (Plavix) dose is still in your system. After a little over a day, it’s out of your body. But the effect of clopidogrel on your platelets may last for up to five days, making the risk of bleeding higher for a few days after you stop taking the medication.

Can Plavix be crushed?

No. You should take clopidogrel (Plavix) whole without changing it. A study found that when people took crushed clopidogrel, they had a high concentration of it in their bodies 40 minutes after taking it. You may be at a higher risk of bleeding at this time. To avoid this spike, don’t crush clopidogrel.

Is Plavix an anticoagulant?

No. It works differently than anticoagulants. Plavix (clopidogrel) is an antiplatelet medicine. It keeps platelets in your blood from attaching to each other and making blood clots.

What happens if I miss a dose of Plavix?

If you had a recent stent placement in one of your arteries (especially your coronary arteries, which supply blood to your heart), your provider might want you to take Plavix for a prolonged period of time. This is because stopping Plavix beforehand might put you at risk of forming a blood clot in your stent.

If you’ve had recent stents placed, you should take Plavix daily until your provider tells you it’s OK to stop it. If you miss a dose of Plavix by a few hours, take the daily dose as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. You shouldn’t take a double dose of Plavix if you missed the dose the day prior.

A note from Cleveland Clinic

Today, there are lots of medication options for people at risk of forming blood clots. But it’s good to remember that the medicines that protect you also make you bleed more easily. You may want to switch to an electric razor and find safer food prep methods to prevent cuts. Avoid direct blows to the head, as you might be at increased risk for intracranial bleeding with head trauma. Be sure to follow your healthcare provider’s instructions for taking clopidogrel and ask questions if you need to clarify anything.