Clopidogrel (Plavix): What Is It Used For?
Quick summary Clopidogrel is an antiplatelet medicine used to help prevent atherothrombotic and thromboembolic events, including heart attack and stroke in certain patients. In the United States, the brand name is Plavix. Medical disclaimer:...
This content is for educational purposes only and does not replace medical advice, diagnosis or treatment from a qualified healthcare professional.
Quick summary
Clopidogrel is an antiplatelet medicine used to help prevent atherothrombotic and thromboembolic events, including heart attack and stroke in certain patients. In the United States, the brand name is Plavix.
Medical disclaimer: This article is for general information only. It does not replace the advice of a doctor, pharmacist, or the official medication guide. Do not use it to diagnose a condition or to change any treatment plan.
What is clopidogrel?
Clopidogrel is an active ingredient used for the prevention of atherothrombotic and thromboembolic events, such as acute myocardial infarction and cerebral infarction.
The product ingredients listed in the source include clopidogrel besilate, clopidogrel bisulfate, and clopidogrel hydrochloride (HCl).
In the United States, the best-known brand name is Plavix.
How clopidogrel works
Clopidogrel helps inhibit platelet aggregation. It does this by blocking the binding of ADP to its platelet receptor and reducing activation of the ADP-mediated GPIIb-IIIa complex.
In simple terms, it helps platelets stick together less easily.
Therapeutic uses and indications
Clopidogrel is taken orally and is used in adults for prevention of atherothrombotic events in the following situations:
- Recent myocardial infarction.
- Recent cerebral infarction.
- Established peripheral arterial disease.
- Acute coronary syndrome, including certain patients undergoing stenting after percutaneous coronary intervention.
- Acute myocardial infarction with ST segment elevation in patients who are candidates for thrombolytic therapy.
- Prevention of atherothrombotic and thromboembolic events, including stroke, in some adults with atrial fibrillation who are not eligible for vitamin K antagonists and who have a low bleeding rate, in combination with AAS.
Dosage information from the source
The source lists the following adult oral doses. Always confirm the exact dose and duration with the official leaflet or a healthcare professional.
| Situation | Dose listed in source |
|---|---|
| Prevention after recent myocardial infarction, cerebral infarction, or in established peripheral arterial disease | 75 mg once daily |
| Non-ST segment elevation acute coronary syndrome, including some patients after stenting, with AAS | Loading dose 300 mg, then 75 mg once daily with AAS; maximum 12 months |
| ST segment elevation acute myocardial infarction with thrombolytic therapy, with AAS | Loading dose 300 mg, then 75 mg once daily; minimum 4 weeks |
| Adults older than 75 years in this setting | Start without a loading dose |
| Atrial fibrillation in selected adults, with AAS | 75 mg once daily with AAS |
How it is administered
Clopidogrel is used by oral administration as a single daily dose, with or without food.
The source lists tablet strengths of 75 mg and 300 mg.
Contraindications listed in the source
- Hypersensitivity.
- Severe liver failure.
- Active pathologic bleeding, such as peptic ulcer or intracranial hemorrhage.
Warnings and precautions
The source highlights several situations where extra caution is needed:
- Risk of bleeding, especially with trauma, surgery, gastrointestinal lesions, or intraocular lesions.
- Increased bleeding risk when used with AAS, heparin, glycoprotein IIb/IIIa inhibitors, NSAIDs, SSRIs, oral anticoagulants, thrombolytics, and some other medicines.
- Need to suspend treatment 7 days before surgery, according to the source.
- Risk of thrombotic thrombocytopenic purpura.
- Possible acquired hemophilia after clopidogrel administration.
- Possible allergic cross-reactivity in people with a history of hypersensitivity to thienopyridines.
- Caution in kidney failure and moderate hepatic insufficiency.
- Not for use in children or adolescents.
- Not recommended during the 7 days after an acute ischemic cerebral infarction.
- Caution with concomitant treatment involving CYP2C8 substrates such as repaglinide and paclitaxel.
Liver and kidney considerations
Liver failure
Clopidogrel is contraindicated in severe liver failure. The source also advises caution in moderate hepatic insufficiency because of hemorrhagic risk.
Renal insufficiency
The source advises caution in renal insufficiency due to limited experience.
Drug interactions
The source says clopidogrel is not recommended with potent or moderate CYP2C19 inhibitors because they may reduce the active metabolite of clopidogrel.
- Omeprazole
- Esomeprazole
- Fluvoxamine
- Fluoxetine
- Moclobemide
- Voriconazole
- Fluconazole
- Ticlopidine
- Carbamazepine
- Efavirenz
- Ritonavir
- Cobicistat
The source also discourages concomitant use with pharmacokinetic enhancers of antiretroviral therapy.
Pregnancy and breastfeeding
According to the source, there is not enough data to recommend clopidogrel during pregnancy.
For breastfeeding, the source states that it is not known whether clopidogrel is excreted in human milk, although animal studies show excretion in breast milk. As a precaution, breastfeeding should be stopped during treatment.
Possible adverse reactions
The source lists the following adverse reactions and side effects:
- Hematoma
- Epistaxis
- Gastrointestinal bleeding
- Diarrhea
- Abdominal pain
- Dyspepsia
- Bleeding at the injection site
What to verify in the official leaflet
If you are checking clopidogrel for a specific medicine or prescription, it is useful to confirm the following in the official FDA medication guide or package leaflet:
- The exact indication for use.
- The correct dose and duration.
- Whether it is meant to be used with AAS or another medicine.
- Interaction warnings with other prescription or over-the-counter medicines.
- Instructions before surgery or procedures.
Safety reminder
Because clopidogrel can increase bleeding risk, any unusual bleeding, black stools, blood in vomit, severe headache, or sudden weakness should be discussed with a healthcare professional promptly. Always follow the official leaflet and the advice of your prescriber.
Frequently asked questions
▸ What is clopidogrel used for?
The source describes clopidogrel as being used to help prevent atherothrombotic and thromboembolic events, including heart attack and stroke in selected adults.
▸ Is clopidogrel the same as Plavix?
Plavix is the brand name listed in the source for clopidogrel in the United States.
▸ How is clopidogrel taken?
The source says it is taken orally as a single daily dose, with or without food.
▸ What are the main safety concerns?
The main concern highlighted in the source is bleeding, especially when clopidogrel is used with other medicines that also affect clotting.
▸ Can clopidogrel be used with other medicines?
Some medicines may interact with clopidogrel, including certain CYP2C19 inhibitors and drugs that increase bleeding risk. A pharmacist or prescriber should review the full medicine list.
▸ Where can I check the official information?
The FDA medication guide and the product leaflet are the best places to confirm the approved use, dose, warnings, and interactions.
Sources and references
- FDA Medication Guides
- UNII: A74586SNO7
- ChemIDplus
- DrugPortal
- PubChem CID: 60606
- NCI Thesaurus: C61686
Medical disclaimer
This content is for educational purposes only. It should not be used as a substitute for professional medical advice, diagnosis or treatment. Always ask a doctor, pharmacist or qualified healthcare professional before starting, stopping or changing any medicine.
Sources and verification
The following sources or official references are listed to support verification of the medicine information discussed in this article.
Medicine information can change and may vary depending on country, product formulation, patient history and professional guidance. Always check official medicine information and ask a healthcare professional for personal medical questions.