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What is this medication?

Clopidogrel, Plavix
Antiplatelet, Thienopyridine P2Y12 antagonist

Clopidogrel/Plavix is officially indicated for acute coronary syndrome, stroke/transient ischemic attack, or peripheral atherosclerotic disease.  It is also commonly prescribed off-label for use in percutaneous coronary intervention for stable ischemic heart disease, carotid artery atherosclerosis, or post coronary artery bypass graft surgery. (may be used for conditions not listed)

“ALERT: US Boxed Warning

Diminished antiplatelet effect in patients with two loss-of-function alleles of the CYP2C19 gene:
The effectiveness of clopidogrel results from its antiplatelet activity, which is dependent on its conversion to an active metabolite by the cytochrome P450 (CYP-450) system, principally CYP2C19. Clopidogrel at recommended doses forms less of the active metabolite and has a reduced effect on platelet activity in patients who are homozygous for nonfunctional alleles of the CYP2C19 genes (termed “CYP2C19 poor metabolizers”). Tests are available to identify patients who are CYP2C19 poor metabolizers. Consider use of another platelet P2Y12 inhibitor in patients identified as CYP2C19 poor metabolizers.”

How does this medication work? 

After activation by the liver to its active form, the thiol metabolite of Clopidogrel/Plavix blocks the P2Y12 site on the ADP receptor on the surface of platelets which prevents the series of events resulting in platelet aggregation from occurring 

How should I take this medication?

Generally a loading dose of 300-600mg if required followed by 75 mg once daily

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day unless otherwise directed, store at room temperature.

You Need to Avoid: Grapefruit juice may diminish the effects of this medication

What should I watch for while using this medication? 

Before starting Clopidogrel/Plavix make sure your physician is aware of any allergies or medications you currently take, if you have kidney disease, if you have a bleeding disorder or active pathological bleed (such as an ulcer), or if you are pregnant or breastfeeding 

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light.  Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

The main side effects are bruising and hemorrhage (bleeding) both minor and major.  Patient should monitor for black tarlike stool, what appears to be coffee grounds in vomit, major unexplained bruising, minor cuts that do not stop bleeding, blood when brushing teeth etc.  These are signs of over anticoagulation or an internal bleed in which case immediate medical attention is required.

Note this is not a complete list of side effects, only common ones