From the Guidelines
Plavix (clopidogrel) can cause several side effects, including common ones like bruising, bleeding, headaches, and gastrointestinal issues, as well as more serious side effects that require immediate medical attention, such as unusual bleeding, blood in urine or stool, and signs of allergic reaction. The most common side effects of Plavix include:
- Bruising
- Bleeding that takes longer to stop
- Nosebleeds
- Bleeding gums Some patients may also experience:
- Headaches
- Dizziness
- Gastrointestinal issues like nausea, vomiting, diarrhea, and stomach pain More serious side effects that require immediate medical attention include:
- Unusual bleeding or bruising
- Blood in urine or stool
- Coughing up blood
- Vomit that looks like coffee grounds
- Severe headache
- Confusion
- Fever
- Weakness
- Extreme skin paleness
- Yellowing of skin or eyes
- Signs of allergic reaction such as rash, itching, swelling, or difficulty breathing According to the study 1, Plavix works by preventing platelets from clumping together to form blood clots, which explains why bleeding-related side effects are common. Patients should inform healthcare providers about all medications they take, as certain drugs like omeprazole, fluconazole, and some antidepressants can interact with Plavix and reduce its effectiveness, as noted in the study 1. Additionally, patients should not stop taking Plavix without consulting their doctor, as this could increase the risk of heart attack, stroke, or other serious problems, as stated in the study 1. It is also important to consider the potential interaction between Plavix and proton pump inhibitors (PPIs), as some studies have suggested that concomitant use of clopidogrel and a PPI may increase the risk of adverse cardiovascular outcomes, as reported in the study 1. However, other studies have found that the use of PPIs with clopidogrel does not significantly increase the risk of bleeding or other adverse events, as noted in the study 1. Overall, patients taking Plavix should be closely monitored for signs of bleeding or other adverse effects, and healthcare providers should carefully consider the potential risks and benefits of concomitant therapy with PPIs or other medications, as recommended in the study 1.
From the FDA Drug Label
Bleeding, including life-threatening and fatal bleeding, is the most commonly reported adverse reaction. A blood clotting problem called Thrombotic Thrombocytopenic Purpura (TTP). TTP can happen with clopidogrel tablets, sometimes after a short time (less than 2 weeks). Get medical help right away if you have any of these symptoms and they cannot be explained by another medical condition: purplish spots (called purpura) on the skin or in the mouth (mucous membranes) due to bleeding under the skin your skin or the whites of your eyes are yellow (jaundice) you feel tired or weak your skin looks very pale fever fast heart rate or feeling short of breath headache speech changes confusion coma stroke seizure low amount of urine, or urine that is pink or has blood in it stomach area (abdominal) pain nausea, vomiting, or diarrhea vision changes persistent low blood sugar symptoms
The side effects of Plavix (clopidogrel) include:
- Bleeding: life-threatening and fatal bleeding
- Thrombotic Thrombocytopenic Purpura (TTP): a blood clotting problem
- Symptoms that require medical help: purplish spots, jaundice, tiredness, weakness, pale skin, fever, fast heart rate, headache, speech changes, confusion, coma, stroke, seizure, low urine output, abdominal pain, nausea, vomiting, diarrhea, vision changes, and persistent low blood sugar symptoms 2 2
From the Research
Plavix Side Effects
The side effects of Plavix (clopidogrel) include:
- Thrombotic thrombocytopenic purpura (TTP) 3, 4, 5, 6
- Isolated profound thrombocytopenia 4
- Skin reactions, such as purpura and ecchymoses 5
- Neurological changes, including hallucinations, bizarre behavior, and altered mental status 5
- Renal dysfunction 5, 6
- Hemolytic anemia with fragmented red cells 6
- Severe deficiency of ADAMTS13 activity with the presence of the inhibitor 6
- Bleeding from the nose and gum 5
- Fever 5, 6
- Headache 5
- Sepsis due to perforated small intestinal diverticulitis (in rare cases) 6
Timing of Side Effects
These side effects can occur:
- Within the first two weeks of initiation of clopidogrel therapy 3, 5
- Within 12 weeks after initiation of the therapy 6
- After 6-8 weeks of clopidogrel treatment 5, 6
Diagnosis and Treatment
Physicians should be aware of the possibility of these side effects when initiating clopidogrel treatment and monitor patients closely, especially during the first 12 weeks of therapy 3, 4, 5, 6. Plasma exchange may be an effective treatment for TTP associated with clopidogrel use 3, 6.