Plavix (Clopidogrel) Oral Tablets
Plavix is a prescription oral antiplatelet medication containing clopidogrel. It is used in adults after acute coronary syndrome, percutaneous coronary intervention, ischaemic stroke or peripheral arterial disease to reduce atherothrombotic events.
- Active ingredients
- Clopidogrel
- Manufacturer
- Sanofi
- Dosage forms
- tablet
- Available dosages
- 75mg, 300mg
- Category
- Cardiovascular Medications
What is it?
Plavix is the original brand name for clopidogrel, marketed by Sanofi (originally jointly with Bristol-Myers Squibb). It was approved by the United States Food and Drug Administration in 1997 and is supplied as oral tablets at 75mg and 300mg (loading dose). Plavix is dispensed only on prescription. The molecule appears on the World Health Organization List of Essential Medicines and remains a key option in dual antiplatelet therapy after coronary stent placement.
Active ingredients
Each tablet contains clopidogrel (as bisulphate) as the sole active ingredient at 75mg or 300mg. Clopidogrel is a thienopyridine antiplatelet prodrug that requires hepatic activation, mainly by CYP2C19, to its active metabolite, which irreversibly binds the P2Y12 ADP receptor on platelets.
Forms and dosages
Plavix is administered orally once daily with or without food. According to the prescribing information, the usual maintenance dose is 75mg once daily. A loading dose of 300mg or 600mg may be given at the start of treatment for acute coronary syndrome or before percutaneous coronary intervention. Tablets are swallowed whole with water at the same time each day.
Indications
Plavix is approved in adults for the prevention of atherothrombotic events after recent acute coronary syndrome (with or without ST-segment elevation), recent ischaemic stroke or established peripheral arterial disease, and in atrial fibrillation when oral anticoagulants are not suitable. According to international guidelines, it is part of dual antiplatelet therapy with acetylsalicylic acid for a defined period after percutaneous coronary intervention, with the regimen tailored to bleeding and thrombotic risk.
How it works
After absorption, clopidogrel is converted in the liver to an active metabolite that irreversibly binds the P2Y12 ADP receptor on platelets. This blocks ADP-induced amplification of platelet activation and aggregation throughout the platelet's seven to ten-day lifespan. Because the inhibition is irreversible at the receptor level, the antiplatelet effect persists until new platelets are produced, which is relevant for surgery and bleeding management.
Frequently asked questions
How long after acute coronary syndrome is Plavix needed? ▾
International guidelines typically recommend dual antiplatelet therapy with Plavix and acetylsalicylic acid for around twelve months after acute coronary syndrome managed with stenting, with shorter or longer durations in selected cases based on bleeding and thrombotic risk. After this period, single antiplatelet therapy is usually continued long-term. According to the prescribing information, treatment duration is determined individually by the prescriber.
Does the omeprazole interaction matter with Plavix? ▾
Omeprazole and esomeprazole are strong inhibitors of CYP2C19, the enzyme that activates clopidogrel. Pharmacokinetic studies show reduced active metabolite concentrations and antiplatelet effect when these proton pump inhibitors are co-administered with Plavix. According to the prescribing information and several regulatory communications, this combination should be avoided when possible; alternative proton pump inhibitors such as pantoprazole are preferred.
Should Plavix be stopped before surgery? ▾
Yes, in many cases. Because Plavix irreversibly blocks platelets, the antiplatelet effect persists for several days after the last dose. According to the prescribing information, Plavix is usually stopped five days before elective major surgery, with the timing reviewed by the prescribing cardiologist or surgeon. Urgent surgery may require platelet transfusion or specific bleeding-management strategies.
What about CYP2C19 genetic testing? ▾
Some patients carry CYP2C19 loss-of-function variants that reduce the activation of clopidogrel and increase the risk of stent thrombosis. Genotype-guided antiplatelet therapy is offered in selected centres, particularly after percutaneous coronary intervention. According to international guidelines, alternatives such as ticagrelor or prasugrel may be preferred in known poor metabolisers; the choice is made by the prescriber on the basis of bleeding risk.
What are the main contraindications for Plavix? ▾
Plavix is contraindicated in known hypersensitivity to clopidogrel and in active pathological bleeding such as peptic ulcer or intracranial haemorrhage. Caution is required in severe hepatic impairment, recent surgery, concomitant anticoagulants and patients at high risk of bleeding. According to the prescribing information, the medical history must be reviewed by a clinician before any prescription, including all concomitant antithrombotic and CYP2C19-active drugs.
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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.