Plavix 75 mg film-coated tablets (clopidogrel) – prevention of atherothrombotic events

Plavix 75 mg is a medicine containing the active substance clopidogrel (as clopidogrel hydrogen sulphate). It belongs to the group of platelet aggregation inhibitors (ATC B01AC04) and is used to reduce the chance of blood clots forming in the arteries of adult patients at increased risk of atherothrombotic events.

Clopidogrel reduces the clumping together of platelets (blood cells involved in clotting). In this way it helps prevent the formation of a thrombus that could lead to a heart attack, ischaemic stroke or other complications of atherosclerosis. Plavix is not a medicine for treating an acute heart attack or stroke at home – sudden chest pain, shortness of breath, weakness of one side of the body, a drooping corner of the mouth or speech disturbance require emergency medical help.

What is Plavix used for and how is it taken correctly?

Key facts about the medicine

What is Plavix used for?

Plavix is prescribed for the secondary prevention of atherothrombotic events in adult patients who:

• have previously had a heart attack (myocardial infarction);
• have had an ischaemic stroke;
• have confirmed peripheral arterial disease;
• have acute coronary syndrome, including unstable angina or myocardial infarction – including patients undergoing percutaneous coronary intervention with stent placement (usually together with acetylsalicylic acid);
• have had certain forms of transient ischaemic attack or minor ischaemic stroke (with acetylsalicylic acid, as decided by the doctor);
• have atrial fibrillation, cannot use oral anticoagulants (vitamin K antagonists), have no high risk of major bleeding, and the doctor considers the combination of clopidogrel and acetylsalicylic acid appropriate.

The leaflet explains that oral anticoagulants are more effective than acetylsalicylic acid or the combination with clopidogrel in atrial fibrillation; Plavix is used there only when anticoagulants cannot be taken.

How is it used and dosed?

• Swallow the tablet whole with enough water.
• Do not increase the dose or take an extra tablet because of chest pain.
• Do not stop treatment because you feel well.

This is the general dosage from the official documentation and is not an individual recommendation.

Special patient groups

• Children and adolescents: Plavix is not intended for use in children and adolescents.
• Kidney or liver disease: tell your doctor before starting; severe liver disease is a contraindication.
• Older patients: the higher risk of bleeding should be taken into account; the doctor assesses the overall therapy.

Contraindications – when the medicine must not be used

Plavix must not be taken:

• in case of allergy to clopidogrel or any of the excipients;
• if you currently have a condition that may cause bleeding, such as a stomach ulcer or bleeding in the brain;
• in severe liver disease.

Precautions and warnings

Before starting treatment, tell your doctor if you have:

• a stomach ulcer or previous bleeding from the stomach or intestine;
• a blood disorder or an increased tendency to bleed (internal bleeding into tissues, organs or joints);
• a recent serious injury or surgery (including dental);
• surgery (including dental) planned within the next seven days;
• an ischaemic stroke within the previous seven days;
• kidney or liver disease;
• a previous allergic reaction to clopidogrel or a similar antiplatelet medicine, or to any medicine used for your illness;
• had non-traumatic bleeding in the brain in the past.

• During treatment, cuts and minor injuries may bleed longer than usual. Slightly prolonged bleeding may be expected, but any heavy, spontaneous, unusual or hard-to-stop bleeding requires assessment.
• Contact your doctor immediately if fever and bruising appear (small red spots), with or without unexplained extreme tiredness, confusion or yellowing of the skin or eyes – possible signs of thrombotic thrombocytopenic purpura (TTP).
• The tablet contains lactose and hydrogenated castor oil, which may cause stomach upset and diarrhoea.

Interactions with other medicines, alcohol and food

It is particularly important to tell your doctor if you use:

• warfarin, dabigatran, rivaroxaban, apixaban or other oral anticoagulants;
• heparin and other injectable medicines against blood clotting;
• acetylsalicylic acid, ticlopidine and other antiplatelet medicines;
• ibuprofen, diclofenac, naproxen and other non-steroidal anti-inflammatory drugs;
• selective serotonin reuptake inhibitors such as fluoxetine or fluvoxamine;
• rifampicin;
• omeprazole or esomeprazole;
• fluconazole or voriconazole;
• efavirenz or other antiretroviral medicines (HIV);
• carbamazepine;
• moclobemide;
• repaglinide;
• paclitaxel;
• opioid medicines for severe pain;
• rosuvastatin.

Omeprazole and esomeprazole may reduce the conversion of clopidogrel into its active form. A stomach-protecting medicine should not be started or changed on your own – the right medicine is chosen by the doctor. Acetylsalicylic acid is deliberately prescribed together with clopidogrel in some indications; this combination should not be started, changed or stopped without the doctor's instruction. Occasional use of acetylsalicylic acid (never more than 1000 mg in 24 hours) usually does not cause problems, but long-term use should be discussed with the doctor.

Alcohol may further increase the risk of bleeding from the stomach and intestine, especially together with other medicines that affect the mucosa or blood clotting.

Pregnancy and breastfeeding

Use of clopidogrel during pregnancy is not recommended. If you are pregnant or become pregnant during treatment, tell your doctor immediately. Breastfeeding should be stopped during treatment with Plavix; if you are breastfeeding or plan to, ask your doctor before starting.

Driving and using machines

Plavix has no or negligible influence on the ability to drive and use machines.

Possible side effects

The most important and most common side effect is bleeding. It may appear as:

• bruises and haematomas under the skin;
• nosebleeds;
• prolonged bleeding from a cut;
• blood in the urine;
• bleeding from the stomach or intestine;
• less often, bleeding in the eye, lungs, joints or brain.

Other common side effects may include diarrhoea, abdominal pain, indigestion and heartburn. Uncommonly, headache, dizziness, nausea, vomiting, constipation, flatulence, rash, itching, stomach or duodenal ulcer, tingling or numbness may occur. Report suspected side effects to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose: may significantly increase the risk of bleeding and prolong the time needed to stop it. Contact your doctor or the nearest emergency service immediately and take the pack with you.
• Missed dose: if less than 12 hours have passed since the usual time, take the tablet when you remember; if more than 12 hours have passed, skip the missed dose and take the next one at the usual time. Do not take a double dose.
• Stopping treatment: only on the doctor's instruction – stopping early may increase the risk of a clot, heart attack or stroke.

Composition, packaging and manufacturer

• Each film-coated tablet contains 75 mg clopidogrel (as clopidogrel hydrogen sulphate).
• The tablet contains lactose and hydrogenated castor oil, which may cause stomach upset and diarrhoea.
• Pack: 28 film-coated tablets.
• Marketing authorisation holder: AMICUS SRB d.o.o., Belgrade.
• Manufacturers: Sanofi Winthrop Industrie, Ambarès-et-Lagrave, France, and Sanofi S.r.l., Scoppito, Italy (the printed leaflet names the manufacturer of the specific batch).

Storage

• Storage conditions depend on the type of blister stated on the pack.
• PVC/PVDC/aluminium blister: store below 30 °C.
• Al-Al blister: no special storage conditions.
• Keep out of the sight and reach of children; do not use after the expiry date.
• Return unused medicine to a pharmacy that collects pharmaceutical waste.

Frequently asked questions

Can Plavix be stopped before a tooth extraction or surgery?

Not on your own. The leaflet requires you to tell your doctor or dentist about the treatment; any temporary interruption is decided by the doctor, because stopping early (especially after a stent) increases the risk of heart attack or stroke.

What should I do if I miss a dose of Plavix?

If less than 12 hours have passed since the usual time, take the tablet immediately. If more than 12 hours have passed, skip the missed dose and take the next one at the usual time. Never take a double dose.

Which painkiller can I take with Plavix?

Non-steroidal anti-inflammatory drugs (ibuprofen, diclofenac, naproxen) and acetylsalicylic acid increase the risk of bleeding. The leaflet states that occasional acetylsalicylic acid up to 1000 mg in 24 hours usually does not cause problems, but always check the choice of painkiller with a doctor or pharmacist.

Why is omeprazole not recommended with Plavix?

Omeprazole and esomeprazole may reduce the conversion of clopidogrel into its active form and thus its protective effect. If you need stomach protection, the right medicine is chosen by your doctor.

Related information

For additional care and support with high blood pressure and heart conditions (regular blood pressure checks), see also the Blood pressure monitors category – products in this category do not replace the medicine you have been prescribed.

Sources

• ALIMS – Patient Information Leaflet Plavix® 75 mg, film-coated tablets (Serbian)
• ALIMS – Summary of Product Characteristics Plavix® 75 mg, film-coated tablets (Serbian)

Sources checked on: 23 October 2026.