Plavix with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Plavix (Clopidogrel). Most antibiotics do not interfere meaningfully with Clopidogrel at 75mg, 300mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Cardiovascular Medications agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Clopidogrel at 75mg, 300mg.

Practical guidance

According to the prescribing information for Clopidogrel, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Plavix is co-administered. Adjusted 75mg, 300mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Plavix during an antibiotic course? ▾

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Clopidogrel is metabolised and may need a temporary 75mg, 300mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Plavix regimen.

Will antibiotics make Plavix stop working? ▾

Most antibiotics do not affect Plavix efficacy. Rifampicin and a few others can lower Clopidogrel levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

More on Plavix

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