What is Plavix?

Plavix (clopidogrel) is an antiplatelet drug that prevents blood clots. Plavix is used to prevent heart attack and stroke in people who have had a heart attack or stroke, or who have peripheral vascular disease. Plavix may also be used for purposes not listed in this medication guide.

Plavix

Health Benefits

Plavix is used to prevent heart attack and stroke in people who have had a heart attack or stroke, or who have peripheral vascular disease.

Plavix is also used to prevent blood clots in people with certain medical conditions, such as atrial fibrillation (a heart rhythm disorder).

Side Effects

Common side effects of Plavix include:

bleeding (sometimes severe and sometimes fatal),

bruising,

bloody or tarry stools,

coughing up blood or vomit that looks like coffee grounds,

nosebleeds,

red or pink urine.

Dosage

The recommended dose of Plavix is 75 mg once daily. Plavix may be taken with or without food. Try to take Plavix at the same time each day.

If you miss a dose of Plavix, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Interactions

Plavix can interact with other drugs, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Mechanism of Action

Plavix works by preventing platelets from sticking together and forming clots. Platelets are blood cells that help the blood to clot. When plaque ruptures, platelets stick to the damaged area and form a clot. Plavix prevents platelets from sticking together and prevents them from forming clots.

Pharmacokinetics

Plavix is rapidly absorbed after oral administration and achieves peak concentrations in about 1 hour. The mean steady-state concentration (Css) of clopidogrel active metabolite was approximately 10% higher when Plavix 75 mg was administered with omeprazole 40 mg once daily than when Plavix 75 mg was administered alone. Clopidogrel is a prodrug and is metabolized to its active metabolite, which inhibits ADP-induced aggregation of human platelets. The active metabolite is formed mostly by CYP2C19 with contributions from several other P450 enzymes, including CYP3A4, CYP1A2 and CYP2B6. Inhibition of platelet aggregation by the clopidogrel active metabolite results from its binding to ADP receptors on platelets. This binding inhibits the binding of adenosine diphosphate (ADP) to its receptor and the subsequent ADP-mediated activation of glycoprotein IIb/IIIa complex for fibrinogen binding. In vitro studies have shown that the clopidogrel active metabolite is a strong inhibitor of P2Y12 ADP receptors. The primary mechanism of action of clopidogrel and its active metabolite is based on the prevention of adenosine diphosphate (ADP) binding to its receptor and the subsequent activation of glycoprotein IIb/IIIa complex for fibrinogen binding. Clopidogrel active metabolite also inhibits vasodilator-stimulated phosphorylation, prevents cross-talk between GPIIb/IIIa and integrin αIIbβ3, and abrogates collagen-induced platelet aggregation.

Alternatives

Prasugrel (Effient) is an oral thienopyridine that inhibits the P2Y12 ADP receptor. Ticagrelor (Brilinta) is an oral thienopyridine analogue of clopidogrel that reversibly inhibits the P2Y12 ADP receptor with rapid onset of action and minimal metabolism by CYP3A4.