Plavix Drug Information: Uses, Side Effects, Drug Interactions and Other Warnings

Plavix, or commonly known as clopidogel, has been proven to help protect against future heart attacks or strokes in PAD patients, but in March 2010, FDA has added a boxed warning to the label for anti-blood clotting drug Plavix. Learn about the drug uses, side effects, drug interactions and other warnings to help avoid any unexpected health risk that may be caused by using Plavix as the blood thinner.

Plavix, also known as clopidogrel bisulfate is one of the world’s top-selling drugs marketed by Sanofi-Aventis, a French drug manufacturer, and Bristol-Myers Squibb of New York found in over 80 countries. Distributed under the trade name of Plavix in 75mg oral tablets, it was clinically proven to inhibit blood clots in peripheral vascular disease, cerebrovascular disease, and in coronary artery disease as well.

Since Plavix was launched in 1998, it has been used to help protect against future stroke or heart attack. It is documented to help keep platelets in the blood from sticking together and forming clots (direct cause of most strokes and heart attacks), and its effectiveness has been proven in 4 large clinical studies with 81,000 patients. 

Chemically, it is methyl (+)-(S)-α-(2-chlorophenyl)-6,7-dihydrothieno[3,2-c]pyridine-5(4H)-acetate sulfate (1:1), along with its empirical formula: C16H16ClNO2S•H2SO4, is a widely used drug with proton pump inhibitors (PPIs) such as Prilosec and AstraZeneca's Nexium to help cut the risk of gastric problems.

Uses of Plavix

Plavix is particularly recommended for individuals who have experienced a recent clot-related event- heart-related chest pain (unstable angina), heart attack, or stroke, or for those who have been diagnosed with Peripheral Artery Disease, or P.A.D. (also known as poor circulation in the legs). Plavix is also prescribed to be taken along with aspirin for those who have been diagnosed with 2 types of heart attack (heart-related chest pain and heart attack) or Acute Coronary Syndrome (ACS), in which each of this condition can give rise to a future risk of stroke or heart attack. It is also used together with aspirin for the prevention of thrombosis (a blood clot inside a blood vessel which obstructs the flow of blood via circulatory system) after placement of intracoronary stent (a man-made tube that is put into a natural passage/conduit in the human body to help prevent/counteract a disease-induced, localized flow constriction) to aid in reopening the blocked arteries.

Plavix is also used to treat a medical condition, including Non-Q wave Heart attack, Acute ST Elevation Myocardial Infarction, Unpredictable Severe Constricting Chest Pain, or Acute Syndrome of the heart, while helping to prevent blood clots in the brain, Myocardial Reinfarction, blood clots following Percutaneous Coronary Intervention and as a treatment to prevent a blood clot in a Vascular Stent.

Boxed Warning by FDA in March 2010

Over 11 years, doctors have prescribed this anti-platelet medication to help over 100 million people worldwide to protect against another stroke or heart attack, and thus Plavix plays a crucial role in reducing the future risk of stroke or even heart attack. Despite of its remarkable benefits, U.S. Food and Drug Administration (FDA) has placed a boxed warning to the label for anti-blood clotting drug Plavix by March 2010, as a measure to alert the consumer that this drug can be less effective for the individuals who cannot effectively metabolize it to its active form. In this case, patients who have been identified of “poor metabolizers” (who carry a variant CYP2C19 gene that affects the enzyme to convert Plavix into its active form) may need an alternate treatment. Besides adding the new “black box” warning on its normal doses which have a potentially deadly lack of effect in 2% to 14% of patients, FDA also wants doctors to discuss Plavix options with patients.

Plavix Side Effects

Muscle aches, dizziness, headache and stomach pain are common side effects of Plavix. Individuals who suffer from stomach ulcers may have a higher risk of progressing to intestinal bleeding, and this medical condition can sometimes be life-threatening. If you’re experiencing this situation, seek medical assistance right away!

Even though Plavix is shown to be effective in preventing blood clots, certain individuals may experience uncomfortable moments while or after using it. Since unexpected reactions may have occurred among Plavix’s users, please consult your doctor immediately if you’ve any of these severe side effects occur while using Plavix.

Severe side effects of Plavix include dark or bloody urine, fever or severe sore throat, chest pain, low white blood cell counts or thrombotic thrombocytopenic purpura (low platelet counts with spontaneous bleeding and clotting), difficulty in breathing, bleeding in the eyes, black or tarry feces, severe and persistent headache, change in the amount of urine produced, severe allergic reactions (itching; hives; swelling of the face, lips or tongue; tightness in the chest), pale skin, excessive bleeding from cuts, yellowing of the skin or eyes, loss of appetite, speech problems, unexplainable vaginal bleeding, unusual weakness or tiredness, change in vision, increased menstrual bleeding, unexplainable weight loss, seizures, unusual bleeding or bruising.

Plavix Drug Interactions and Other Warnings

Currently, more than 50 drugs have been known to have a major interaction with Plavix. They include abciximab, Aciphex (rabeprazole), Aggrastat (tirofiban), amoxicillin/clarithromycin/lansoprazole, anisindione, Aptivus (tipranavir), ardeparin, Arixtra (fondaparinux), Arixtra 10mg/dose (fondaparinux), Arixtra 5mg/dose (fondaparinux), Arixtra 7.5mg/dose (fondaparinux), armodafinil, Atripla (efavirenz/emtricitabine/tenofovir), Bexxar (tositumomab/ iodine i 131 tositumomab), Bexxar Dosimetric (tositumomab), Bexxar Therapeutic (tositumomab), Chloracol (chloramphenicol), Chloramphenicol, Chloromycetin (chloramphenicol), Chloromycetin Sodium Succinate (chloramphenicol), Coumadin (warfarin), Clexane Forte (enoxaparin), Cimetidine, Clexane (enoxaparin), Desirudin, Delavirdine, Danaparoid, Dasatinib, Dalteparin, Drotrecogin alfa, Diflucan (fluconazole), Dicumarol, Dexlansoprazole, Dexilant (dexlansoprazole), Enoxaparin, Eptifibatide, Effient (prasugrel), efavirenz/emtricitabine/tenofovir, efavirenz, Esomeprazole, Etravirine, Felbatol (felbamate), Felbamate, Femara (letrozole), Fluoxetine, Fluconazole, Fragmin (dalteparin), Fondaparinux, Fluvoxamine, fluoxetine/olanzapine, In-111 Zevalin (ibritumomab), Innohep (tinzaparin), Integrolin (eptifibatide), ibritumomab, IsonaRif (isoniazid/rifampin), Iprivask (desirudin), Intelence (etravirine), isoniazid, isoniazid/rifampin, isoniazid/pyrazinamide/rifampin, Jantoven (warfarin), Kapidex (dexlansoprazole), Ketoconazole, Lovenox (enoxaparin), Lansoprazole/naproxen, Lansoprazole, Luvox CR (fluvoxamine), Luvox (fluvoxamine), Lovenox HP (enoxaparin), Modafinil, Miradon (anisindione), Nuvigil (armodafinil), Normiflo (ardeparin), Nizoral (ketoconazole), Nexum IV (esomeprazole), Nexium (esomeprazole), Nydrazid (isoniazid), Oxcarbazepine, Orgaran (danaparoid), Omeprazole/ sodium bicarbonate), Omeprazole, Prevacid IV (lansoprazole), Prevacid 24HR (lansoprazole), Pantoprazole, Prasugrel, Prilosec (omeprazole), Prevpac (amoxicillin/ clarithromysin/lansoprazole), Prevacid NapraPAC (lansoprazole/naproxen), Prevacid NapraPAC 375 (lansoprazole/naproxen), Prevacid NapraPAC 500 (lansoprazole/naproxen), Prevacid SoluTab (lansoprazole), Protonix (pantoprazole), Prilosec OTC (omeprazole), Protonix IV (pantoprazole), Provigil (modafinil), Prozac (fluoxetine), Prozac Weekly (fluoxetine), Rapiflux (fluoxetine), rabeprazole, Rifater (isoniazid/pryrazinamide/rifampin), Rifamate (isoniazid/rifampin), ReoPro (abciximab), Rescriptor (delavirdine), Sprycel (dasatinib), Selfemra (fluoxetine), Sarafem (fluoxetine), Symbyax (fluoxetine/ olanzapine), Sustiva (efavirenz), Ticlid (ticlopidine), Tagamet HB (cimetidine), Tagamet (cimetidine), Tipranavir, Tinzaparin, Ticlopidine, Tositumomab/ iodine 1 131 tositumomab, tositumomab, Tirofiban, Trileptal (oxcarbazepine), Voriconazole, Vfend (voriconazole), warfarin, Xigris (drotrecogin alfa), Y-90 Zevalin (inritumomab), Zegerid (omeprazole/ sodium bicarbonate), Zevalin (ibritumomab), Zegerid OTC (omeprazole/ sodium bicarbonate) and Zegerid (Original Formulation) (omeprazole).

The combination of Plavix and aspirin as recommended by doctors to help prevent heart attacks, has unexpectedly doubled the risk of death related to heart attacks or strokes. Caution should be taken so as not to take Plavix together with aspirin as it has brought adverse effects instead of its suggested benefits in preventing heart attacks or strokes, and this condition is particularly obvious among those with medical conditions like high cholesterol or/and high blood pressure although they may have no clogged arteries.

Plavix is also found to interact with herbs and natural supplements, and thus caution is advised when supplements and medications are combined since unexpected reactions may have occurred. Bear in mind that several supplements as well as Plavix may decrease coagulation of blood, and it’s always your responsibility to discuss in details with the doctor who prescribes your anti-platelet medication or Plavix to avoid any unexpected side effects of the drug. The doses of Plavix should be kept lower if you consume more flavonoids or certain traditionally prepared herbs.

The recent study shows that patients with stents who were prescribed heartburn drugs (such as PLC’s Nexium, AstraZeneca) taken together along with Plavix were more prone to be hospitalized for chest pains, stroke, heart attack or a coronary artery bypass operation in comparison to those who only took Plavix alone.

Final Remark:

Prior to taking Plavix prescribed by your doctor, you should alert your doctor about your existing health conditions and dietary supplements. You should also address your personal medical questions clearly and briefly to seek special attention of your doctor who prescribed the anti-blood clotting medication of Plavix to help reduce stroke or heart attack.

A good doctor, in general, should carefully evaluate the patient’s overall health and medical condition prior to making decisions upon the matter of prescribing medications and the amount that should be taken, which medication is best to be taken by the individual, combinations and use with supplements to help ensure the effectiveness of the prescriptions being given.

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