Has your doctor prescribed you a medicine called Clopidogrel? You may know it by the brand name Plavix. This is a very important medicine that is used to prevent heart attacks, strokes, and blood clots in the blood vessels. Simply put, it stops the platelets in our blood from sticking together, clumping together, and forming a blood clot. Just like cars stuck together in a traffic jam on the road, a blood clot inside a blood vessel is very dangerous. So this medicine reduces that risk.
What should I tell the doctor before starting this medication?
Before starting Clopidogrel, it is very important to give your doctor a complete picture of your health. It is especially important to tell them if you have any of the conditions listed below.
| Situation you need to report | Why is that important? |
|---|---|
| Bleeding disorders. | This medicine increases the risk of bleeding, so it can be dangerous if you already have such a condition. |
| If there is bleeding inside the brain. | Doctors should think twice about giving this medicine to people with this kind of history. |
| If you have to undergo surgery or have teeth extracted in the future. | Your doctor may advise you to stop taking this medication a few days before surgery, otherwise it will be difficult to control bleeding during surgery. |
| If you have had a previous stomach injury that caused bleeding (history of stomach bleeding). | Clopidogrel may increase the risk of rebleeding from stomach ulcers. |
| If you are pregnant, trying to get pregnant, or breastfeeding. | In these cases, you should talk to your doctor about the effects of the medication and make a decision. |
| If you have allergies to other medicines, foods, or things. | It is important to know if you are allergic to Clopidogrel or any of its ingredients. |
How to use the medicine correctly?
The method of using this medicine is very simple, but it is very important to follow the instructions exactly.
- Swallow the tablet with a glass of water. Do not crush or chew the tablet. Swallow it whole.
- You can take this with or without food. However, if you experience stomach upset, it is best to take it with food.
- Make it a habit to take your medicine at about the same time every day. Do not take more than the doctor tells you to.
- Most importantly: Do not stop taking this medicine suddenly for any reason without consulting your doctor. Remember, some people stop taking the medicine without consulting their doctor after they feel better. This is very dangerous, because a blood clot can suddenly form and make it difficult again. This is especially dangerous if you have a stent.
What if I take too much medicine?
If you have any suspicion that you have taken too much of this medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
What if I miss a dose?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at once to make up for a forgotten dose.
Medicines that should not be used with Clopidogrel
Clopidogrel is a drug that can interact with other medications. This means that when taken with another drug, the effects of Clopidogrel may be reduced or increased, or the side effects may increase.
Important: This list is not exhaustive. Tell your doctor about all the medications you are taking, not just prescription medications, but also vitamins, herbs, and supplements.
| Drug category | Examples |
|---|---|
| Other medications that prevent blood clotting | Warfarin, Aspirin (without a doctor's prescription) |
| Some medications for pain and inflammation (NSAIDs) | Ibuprofen, Naproxen, Diclofenac |
| Some medications for gastritis (Proton Pump Inhibitors) | Omeprazole, Esomeprazole (these may reduce the effectiveness of Clopidogrel) |
| Some medications for depression (SSRIs/SNRIs) | Fluoxetine, Sertraline, Venlafaxine |
What are the possible side effects?
Like any medicine, Clopidogrel can cause side effects. Most people don't get them. But some people do. It's important to be aware of these.
Serious side effects that require immediate medical attention
- Allergic reactions: skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing.
- Abnormal bleeding:
- Black, tarry stools.
- Red or dark brown urine.
- Vomiting that looks like coffee grounds or vomiting blood.
- The appearance of hard spots (bruises) on the skin.
- Frequent bleeding from the nose and gums.
- It takes a long time for even a small wound to stop bleeding.
- TTP (Thrombotic Thrombocytopenic Purpura) is a rare but serious condition: purple spots on the skin or inside the mouth, yellowing of the skin, yellowing of the whites of the eyes, extreme fatigue, fever, rapid heartbeat, confusion, and difficulty speaking or walking.
Side effects that are usually nothing to worry about, but should be reported to your doctor if they persist
- Diarrhea
- Headache
- Stomach ache
Be aware of possible signs of a stroke!
If you experience sudden numbness or weakness in your face, arm or leg, difficulty speaking, slurring your words, difficulty walking, changes in vision, or severe headache while taking this medicine, this may be a sign that your condition is getting worse. Go to a hospital's Emergency Department (ETU) immediately.
Frequently Asked Questions
Does Clopidogrel (Plavix) make you feel tired?
Yes, some people may feel more tired and fatigued than usual due to this medication. If this is a big problem for you, talk to your doctor. But do not stop taking the medication without your doctor's advice.
How long does this medicine stay in the body?
The concentration of the drug decreases by half after about 6 hours. The drug is almost completely eliminated from the body after about a day. However, the effect of the drug, that is, the effect on blood platelets, can last for about 5 days. That is why the risk of bleeding increases even after a few days of stopping the drug.
Is Clopidogrel (Plavix) an anticoagulant?
Not exactly. This is an antiplatelet drug. Anticoagulants (e.g. Warfarin) work on other factors in the blood clotting process. Clopidogrel works by preventing platelets from sticking together and forming a clot. Although the mechanisms of action are different, the end result of both is to prevent blood clots from forming.
Take-Home Message
- Never stop taking Clopidogrel without your doctor's advice. This is especially important if you have had a stent inserted.
- Tell your doctor about all other medications, vitamins, and herbal products you are taking.
- Before having any surgery or dental treatment, tell your doctor or dentist that you are taking Clopidogrel.
- If you notice any signs of unusual bleeding (black stools, vomit that looks like coffee grounds, unusual bruising), seek medical advice immediately.
- Due to the risk of bleeding, be extra careful when using sharp objects such as razors and to protect yourself from falls.
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