How to tell if the drug is working: You should not have a heart attack or stroke. Your doctor will teach you and your family members the symptoms of a heart attack , stroke , or blood clot in your legs or lungs.
If you have symptoms of these problems, you should go to the emergency room or call right away. Before starting treatment with clopidogrel, your doctor may do a genetic test to check your CYP2C19 genotype. This genetic test will help your doctor decide if you should take clopidogrel.
Some genotypes slow how clopidogrel is broken down. If you have this kind of genotype, this drug may not work for you. To make sure your medication is working and is safe for you, your doctor will check the following:. Your doctor can tell you more. Most pharmacies stock the generic form of clopidogrel. However, not every pharmacy stocks Plavix, the brand-name form.
If your doctor prescribes Plavix, when filling your prescription, be sure to call ahead to make sure your pharmacy carries it. There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you. Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date.
However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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Health Conditions Discover Plan Connect. Clopidogrel, Oral Tablet. Highlights for clopidogrel. Other interactions can increase side effects or make them more severe. Below are lists of medications that can interact with Plavix. These lists do not contain all the drugs that may interact with Plavix. Before taking Plavix, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take.
Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Plavix can interact with certain other drugs that are metabolized processed by the same enzymes proteins in your liver. For example, proton pump inhibitors are a class of drugs that are metabolized by the enzymes that break down Plavix.
Taking these drugs with Plavix can make Plavix less effective for you. This may be dangerous to your health. They may recommend a different treatment so you can avoid this interaction. Taking these drugs together further increases your risk of bleeding, especially the risk of bleeding in your stomach. Taking Plavix with warfarin Coumadin or other blood thinners increases your risk of side effects, such as serious bleeding.
This is because Plavix and blood thinner drugs each work to stop your blood from forming clots. This is because opioids can make Plavix less effective if the drugs are taken together. This is because certain antidepressants and Plavix can each increase your risk of bleeding.
Taking these drugs together further increases your risk of bleeding. You should avoid taking Plavix with a certain diabetes drug called repaglinide. This because Plavix increases the level of repaglinide in your body, which may increase your risk of certain side effects from repaglinide.
If you need to take these drugs together, your doctor may adjust your dosage of repaglinide. However, you should still check with your doctor or pharmacist before using any of these products while taking Plavix.
You may wonder if certain foods interact with Plavix. Below, we review some that may or may not interact with the drug. This is because grapefruit interacts with certain enzymes in your liver , which affects how your body metabolizes processes Plavix.
This could be dangerous for your health. This is because coffee can irritate the lining of your stomach, which can sometimes cause stomach upset or bleeding. Plavix also increases your risk of bleeding, which can sometimes occur in your stomach.
For some people, this may increase the risk of bleeding, especially in their stomach. Usually not, because Plavix increases your risk of bleeding. In fact, your doctor will likely recommend that you stop taking Plavix 5 days before you have certain surgeries. They will recommend which drugs are safe for you to take around the time of your procedure.
This drug should work safely and effectively for you regardless of your specific diet. These products can interact with Plavix. Eating a healthy, balanced diet will help to reduce your overall risk of heart disease and cardiovascular events. Probably not. It works by stopping your platelets from sticking together and forming dangerous blood clots. Plavix only works if your body is able to metabolize process the drug.
Every person has a different amount of this enzyme in their body. Some people have very little of it, while other people have a larger amount. Or they may give you a higher dosage usually mg each day of Plavix than is typically given. Plavix starts working inside your body about 30 to 60 minutes after you take it. You can also call the American Association of Poison Control Centers at or use their online tool. But if your symptoms are severe, call or go to the nearest emergency room right away.
Plavix contains the active drug clopidogrel. It belongs to a class of drugs called platelet inhibitors. Your body uses platelets to help it form blood clots. By inhibiting blocking the activity of platelets, drugs like Plavix help to prevent your body from making too many clots. However, in other cases, blood clots can be dangerous. When clots form inside blood vessels, they can block the flow of blood to your heart, lungs, brain, or anywhere else in your body. This can result in serious conditions such as heart attack and stroke.
Plavix works to prevent these conditions by helping prevent blood clots from forming. As with all medications, the cost of Plavix can vary. To find current prices for Plavix in your area, check out GoodRx. The cost you find on GoodRx. If you need financial support to pay for Plavix or if you need help understanding your insurance coverage, help is available.
In reports of women taking clopidogrel during pregnancy, there was no harm seen in fetuses exposed to the drug. In animal studies , there was also no harm seen in fetuses when pregnant females were given the drug.
If you are taking Plavix during pregnancy, your doctor may recommend that you stop taking Plavix for 5 to 7 days before your scheduled or expected delivery date.
This will help reduce the risk of serious, uncontrolled bleeding during and after the birth of your baby. However, animal studies have found that Plavix crosses into breast milk. When a drug passes into animal breast milk, it will likely also pass into human breast milk.
They may recommend that you stop breastfeeding or that you use a drug other than Plavix. This drug has a boxed warning. A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Plavix only works if your body is able to properly metabolize process the drug. Because of this, you may not benefit from taking the drug. Before you start taking this drug, your doctor can order tests to check whether your body is able to metabolize Plavix.
Before taking Plavix, talk with your doctor about your health history. Plavix may not be right for you if you have certain medical conditions or other factors affecting your health. These include:. When you get Plavix from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication. The expiration date helps guarantee the effectiveness of the medication during this time.
If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it. How long a medication remains good can depend on many factors, including how and where you store the medication.
Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.
The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication. Plavix is indicated to reduce rates of cardiovascular death, myocardial infarction, and stroke in people with acute coronary syndrome ACS. Plavix is also indicated to reduce the rate of myocardial infarction or stroke in people with recent myocardial infarction, recent stroke, or established peripheral artery disease PAD.
The metabolite of this prodrug inhibits platelet activation and aggregation by binding to P2Y 12 receptors on platelets. The maximum concentration occurs about 30 to 60 minutes after oral ingestion.
Half-life is 6 hours. Plavix is excreted in the urine and feces over 5 days after oral ingestion. Plavix contains the active drug clopidogrel, which is a prodrug that is processed to active metabolites through the CYP enzymes. Tests are available to determine CYP2C19 genotypes. An appropriate dosing regimen for this population has not yet been established. Plavix is contraindicated in people who have active bleeding or who have hypersensitivity to Plavix or any of its components.
Plavix tablets should be stored at room temperature in a tightly sealed container away from light. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional.
You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Some heart attacks are more severe than others. In this article, learn about the signs and symptoms of each type. We also explore their causes and who…. Many people know the classic signs of a stroke, such as facial drooping, trouble balancing, and difficulty speaking. But what does having a stroke….
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Heart attacks and strokes share many similarities, but they are very different life-threatening medical emergencies. It is crucial to know the signs…. Plavix clopidogrel. What is Plavix? However, if the patient drug intake includes CYP2C19 inhibitors, the latter should be discontinued and a switch to a drug not metabolized by CYP2C19 if available should be considered.
If the patient is well-controlled and shows expected clopidogrel effect as per indication, clopidogrel should be continued as indicated without any change in dose. CYP2C19 genetic test results are provided with a genotype to phenotype interpretation. Clopidogrel remains the thienopyridine drug with the most approved indications for use. To adjust clopidogrel dose and get the desired response in patients with loss of functional CYP2C19 allele, one option is to double the dose: the loading dose can be increased from to mg, and the maintenance dose from 75 to mg.
The benefit has been evident in several studies, 16 — 24 whereas contradictory results have been shown in other studies. Several agents, such as prasugrel, ticagrelor, elinogrel, and cangrelor, have been approved for this purpose. Although the new drugs share a similar molecule or same mechanism of action to that of clopidogrel, and do not require CYP2C19 to biotransform into the active agent, patients have shown to be more prone to bleeding complications.
Considering alternative dosing of clopidogrel, dose adjustment has to be accurately computed as shown in the study results; however, a major limitation is that clopidogrel is only available in 75 mg and mg dosage strengths.
Additionally, clopidogrel tablets are available as pills that cannot be split. Hence, if the patient requires a dose lower than 75 mg, clinician should refer to a clopidogrel substitute. When patients are extremely sensitive or resistant to clopidogrel effects at normal doses, the clinician should verify if the physical product is genuine if possible, exclude drug—drug interactions and then search for genetic variation in CYP2C19 metabolism as the underlying cause.
The availability of such an alternative is integral to the process of integrating the use of the genetic biomarker into clinical decision-making, offering solutions to nonresponders or under-responders to therapy as well as to patients experiencing side effects from the drug. In conclusion, the study integrates clopidogrel—drug interaction and pharmacogenetic studies in a clinical algorithm and provides an accurate dosing recommendation of clopidogrel. The implementation of such pharmacogenetic—drug interaction approach has the potential to maximize the benefit of clopidogrel pharmacological therapy and to refine the choice of pharmacological agent that may be administered along with clopidogrel in patients on polypharmacy.
We would like to acknowledge the Lebanese American University for the financial support. National Center for Biotechnology Information , U. Ther Clin Risk Manag. Published online Sep Author information Copyright and License information Disclaimer.
Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. This article has been cited by other articles in PMC. Method Clopidogrel dose optimization was analyzed based on two main parameters that affect clopidogrel metabolite area under the curve: different CYP2C19 genotypes and concomitant drug intake.
Conclusion The implementation of clopidogrel new algorithm has the potential to maximize the benefit of clopidogrel pharmacological therapy. Keywords: pharmacogenetics, genotype, genetic testing, individualized therapy.
Introduction Clopidogrel is an oral antiplatelet agent and one of the commonly prescribed medications worldwide in the treatment of acute coronary syndrome and in patients undergoing percutaneous coronary intervention to prevent recurrent atherothrombotic events. Methods The authors confirm there is no need for ethics approval as this study does not deal with any ethical issues. Statistical analysis of data The cumulative effect was analyzed based on two main parameters that affect clopidogrel area under the curve AUC : different CYP2C19 genotypes and polypharmacy.
Table 1 Proposed dose adjustment of clopidogrel based on a patient whose CYP2C19 genotype is known and a drug metabolized by CYP2C19 and interacting with clopidogrel is added. Open in a separate window. Clinical-pharmacogenetic algorithm Currently, pharmacogenetic testing is performed in individual cases, and mostly retrospectively, for example, in patients who experience adverse effects or no therapeutic effect. Figure 1. Clinical decision model algorithm for pharmacogenetic testing.
Abbreviation: ADRs, adverse reactions. Clinical situation three — therapeutic clopidogrel active metabolite If the patient is well-controlled and shows expected clopidogrel effect as per indication, clopidogrel should be continued as indicated without any change in dose. Conclusion In conclusion, the study integrates clopidogrel—drug interaction and pharmacogenetic studies in a clinical algorithm and provides an accurate dosing recommendation of clopidogrel.
Acknowledgments We would like to acknowledge the Lebanese American University for the financial support. Footnotes Disclosure The authors report no conflicts of interest in this work. References 1. Efficacy and safety of platelet inhibitors. J Pharm Pharm Sci. Antiplatelet treatment for prevention of cerebrovascular events in patients with vascular diseases: a systematic review and meta-analysis.
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