Plavix Side Effects
Generic name: clopidogrel
Medically reviewed by Drugs.com. Last updated on Dec 21, 2021.
Note: This document contains side effect information about clopidogrel. Some of the dosage forms listed on this page may not apply to the brand name Plavix.
For the Consumer
Applies to clopidogrel: oral tablets
Diminished Antiplatelet Effect in Patients with 2 Loss-of-Function CYP2C19 Alleles
- Clopidogrel is a prodrug; requires conversion to its active metabolite by the CYP enzyme system (primarily by CYP2C19).1 2 6 8 11 121
- Genetic variations of CYP2C19 can result in impaired metabolism and reduced effectiveness of clopidogrel.1 121 (See Reduced Efficacy in Poor CYP2C19 Metabolizers under Cautions.) Patients who are homozygous for nonfunctional alleles of CYP2C19 have reduced levels of the active clopidogrel metabolite and reduced antiplatelet effects.1 121
- Genetic tests are available to identify patients who are poor CYP2C19 metabolizers.1 20 121 122
- Consider use of another P2Y12 receptor antagonist (e.g., prasugrel, ticagrelor) in patients identified as poor CYP2C19 metabolizers.1 121
Side effects include:
For Healthcare Professionals
Applies to clopidogrel: oral tablet
The most commonly reported adverse effect was bleeding, including life threatening and fatal bleeding.[Ref]
Rare (0.01% to 0.1%): Neutropenia
Very rare (less than 0.01%): Decreased platelet count
Postmarketing reports: Serious cases of bleeding (mainly skin), hemarthrosis, hematoma, hemorrhage of operative wound, fatal hemorrhage (intracranial, gastrointestinal, and retroperitoneal), thrombotic thrombocytopenic purpura (TTP), acquired hemophilia A, aplastic anemia, pancytopenia, agranulocytosis, granulocytopenia, anemia[Ref]
In the COMMIT study (n=45,852), the incidence of major non-cerebral or cerebral bleeding was 0.6% in clopidogrel plus aspirin treated patients, with 0.4% classified as major non-cerebral (0.2% fatal) and 0.2% as hemorrhagic stroke (0.2% fatal). Non-major noncerebral bleeding or any noncerebral bleeding occurred in 3.6% and 3.9% of patients receiving this drug plus aspirin, respectively. Major bleeds were defined as cerebral bleeds or non-cerebral bleeds thought to have caused death or that required transfusion.
Rare (0.01% to 0.1%): Retroperitoneal hemorrhage
In the CAPRIE study (n=19,185), gastrointestinal hemorrhage occurred in 2% of patients taking clopidogrel compared to 2.7% taking aspirin. Bleeding requiring hospitalization occurred in 0.7% clopidogrel-treated and 1.1% aspirin-treated patients.[Ref]
Common (1% to 10%): Chest pain, hypertension, angina pectoris, coronary artery disorder, peripheral ischemia
Very rare (less than 0.01%): Hematoma
Uncommon (0.1% to 1%): Paresthesia
Rare (0.01% to 0.1%): Vertigo, intracranial hemorrhage
Postmarketing reports: Taste disturbances, ageusia[Ref]
Common (1% to 10%): Arthralgia, back pain
Postmarketing reports: Arthritis, myalgia, musculoskeletal bleeding[Ref]
Common (1% to 10%): Depression
Postmarketing reports: Hallucinations, confusion[Ref]
Common (1% to 10%): Rash, purpura, pruritus, bruising
Postmarketing reports: Maculopapular, erythematous, or exfoliative rash, urticaria, bullous dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, drug-induced hypersensitivity syndrome, drug rash with eosinophilia and systemic symptoms (DRESS), eczema, lichen planus[Ref]
In CAPRIE (n=19,185), 4.2% of patients receiving clopidogrel developed a rash compared to 3.5% in the aspirin group. In CURE (n=12,562), 1.3% treated with clopidogrel and aspirin compared to 1.1% placebo, as well as 0.7% of patients in CLARITY (n=3491) reported a rash. Drug discontinuation due to skin disorders in CAPRIE was 0.8% and in CURE 0.4% of patients.[Ref]
Common (1% to 10%): Hypercholesterolemia[Ref]
Common (1% to 10%): Urinary tract infection
Postmarketing reports: Eye bleeds (conjunctival, ocular, retinal)[Ref]
Common (1% to 10%): Accidental/inflicted injury, influenza-like symptoms, pain, fatigue, infection
Postmarketing reports: Fever[Ref]
Uncommon (0.1% to 1%): Hematuria
Postmarketing reports: Glomerulopathy, serum creatinine increase[Ref]
Postmarketing reports: Gynecomastia[Ref]
Common (1% to 10%): Puncture site bleeding[Ref]
Frequently asked questions
- How long does Plavix stay in the body once I stop taking it. How much Plavix is too much?
- Brilinta vs Plavix: what's the difference?
- Is ticagrelor better than clopidogrel?
More about Plavix (clopidogrel)
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- Drug class: platelet aggregation inhibitors
Related treatment guides
1. "Product Information. Plavix (clopidogrel)." Bristol-Myers Squibb (2001):
2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
3. Cerner Multum, Inc. "Australian Product Information." O 0
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.