Plavix® (clopidogrel) is a medicine that belongs to the family of platelet aggregation inhibitors. In other words, it is indicated to prevent the formation of a blood clot by preventing the clumping of platelets. Indications, dangers, side effects, price, risk with alcohol…
Plavix® which contains the active substance “clopidogrel” is a medicine belonging to the family of platelet aggregation inhibitors. It is indicated to thin the blood and to reduce the risk of clots forming in the blood vessels, preventing the clumping of platelets. the price of a box of 30 tablets of Plavix (75 mg) is €10.74. This drug is only available on prescription (list I). Why take Plavix®? What are its side effects? Its contraindications? What drug can replace Plavix®? Can you drink alcohol with it?
Is Plavix dangerous?
The drug Plavix® (clopidogrel) can be dangerous if used improperly. Taking Plavix® should be excluded in patients with impaired liver function or active disease such as intracranial hemorrhage or peptic ulcer disease. To limit the danger, several precautions for use must be observed. Due to the increased bleeding time induced by Plavix®, treatment should be discontinued 7 days before planned surgery. Similarly, prior to a surgical procedure, the patient must inform the doctor of his treatment with an antiplatelet agent. As part of a Stroke caused by a blood clot, the drug should not be started earlier than 24 hours for a minor stroke and not before 7 days for severe stroke.
What are the side effects of Plavix?
Plavix® is frequently cause of bleeding which are characterized in particular by prolonged bleeding from the nose, of stomach and intestine. In the event of abnormally long bleeding or signs suggesting hemorrhage, the patient should consult a doctor as soon as possible in order to limit complications. During an injection or a blood test, the bleeding time is always lengthened in a patient on antiplatelet therapy. Similarly, contusions progressing to hematomas can be observed with this treatment. In addition, digestive disorders such as diarrhea, abdominal pain, inflammation of the stomach lining and intestinal discomfort are common. More rarely, decreased white blood cells, intracranial or eye bleeding, nausea and vomiting, and liver disease have been reported.
What monitoring when taking Plavix?
To diagnose platelet disease, platelet aggregation test and measurement of occlusion time are used in particular. However, these tests are not routinely recommended to assess the effectiveness of Plavix®. Contrary to vitamin K antagonists (anticoagulants), no biological test is recommended in the follow-up of the treatment. Recommended monitoring is based on symptom self-monitoring suspecting hemorrhage. Of the hemorrhagic signs such as the presence of blood in the stools or urine, bleeding gums, abnormal fatigue or paleness of the face should lead the patient to consult a doctor as soon as possible. Similarly, in patients allergic to an antiplatelet agent of the same family (ticlopidine, prasugrel), a monitoring of allergic signs (rash, itching) is essential.
With which drugs should Plavix not be combined?
No medication is contraindicated with taking Plavix®. However, due to the increase in hemorrhagic risk, the administration of Plavix® requires vigilance with certain medications: oral anticoagulants, heparins, acetylsalicylic acid. These combinations are not recommended in a patient with a stomach or duodenal ulcer. However, certain medical situations require the administration of an anticoagulant and an antiplatelet agent concomitantly. The onset of hemorrhage should then be monitored. Furthermore, nonsteroidal anti-inflammatory drugs increase the risk of gastrointestinal bleeding. Furthermore, the selective serotonin reuptake inhibitor (SSRI) antidepressants increase this risk by blocking the action of serotonin on platelets, which leads to a reduction in platelet aggregation. The combination of these drugs with Plavix® should be done with caution. Furthermore, other combinations with Plavix® are not recommended. This is the case of rifampicin which increases the risk of bleeding by increasing clopidogrel concentrations in the body and by blocking platelet aggregation. Likewise, proton pump inhibitors (omeprazole, esomeprazole), fluoxetine, fluconazole, carbamazepine decrease the concentrations of clopidogrel and thus lead to the ineffectiveness of the treatment.
Can Plavix and alcohol be mixed?
Taking Plavix® (clopidogrel) does not contraindicate the moderate consumption of alcoholic beverages. No interactions have been reported regarding this association. In contrast, taking alcohol is not recommended with the Duoplavin® specialty containing clopidogrel and acetylsalicylic acid. Indeed, alcohol associated with acetylsalicylic acid increases the risk of gastrointestinal lesions.
Sources:
– Public drug database. ANSM
– French Society of Cardiology