Side Effects of Plavix: What You Need to Know

Plavix (clopidogrel) is a prescription drug used to manage certain heart-related conditions. It can cause side effects that range from mild to serious. Examples include bruising, bleeding, and rash.

Plavix is used to lower the risk of stroke and heart attack in adults who:

• have certain kinds of acute coronary syndrome
• have peripheral artery disease
• have had a stroke or heart attack in the past

The active ingredient in Plavix is clopidogrel. (An active ingredient is what makes a drug work.) Plavix comes as a tablet you swallow.

Keep reading to learn about the more common, mild, and serious side effects that Plavix can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild to serious side effects during their Plavix treatment. Examples of the drug’s commonly reported side effects include:

Mild side effects have been reported with Plavix. These include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Plavix unless your doctor recommends it.

Plavix may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Serious side effects have been reported with Plavix. These include:

• blood in urine
• severe bleeding*
• thrombotic thrombocytopenic purpura*
• severe allergic reaction*

* To learn more about this side effect, see the “Side effects explained” section below.

If you develop serious side effects while taking Plavix, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Plavix, visit MedWatch.

Get answers to some frequently asked questions about side effects of Plavix.

Can Plavix cause different side effects in older adults?

It’s possible. How your body reacts to treatment with Plavix depends on your individual circumstances. Certain factors such as your overall health, your age, and other medications you take can increase your risk of side effects from this drug.

There are no dosage adjustments recommended by the maker of Plavix when the drug is used in older adults (people ages 65 years and over).

Your doctor will decide the best Plavix dosage for you based on your overall health and the condition you’re taking the drug to treat. They’ll talk with you about possible side effects, including the risk of severe bleeding. Ask them for more information if you’re concerned about certain side effects based on your age.

If I stop taking Plavix 75 mg, will I experience certain side effects?

Yes, it’s possible. Stopping Plavix can increase your risk of heart-related problems. It’s important to take this drug exactly as your doctor recommends. Do not stop taking Plavix without asking them first.

If you’re scheduled for certain kinds of surgery, your doctor may have you temporarily stop Plavix. They may also have you stop taking it if you have active bleeding. They’ll have you restart the drug as soon as it’s safe to do so.

If you experience severe bleeding or other serious side effects, tell your doctor. They’ll decide whether you should stop Plavix. If needed, they’ll switch you to a different drug.

If you think you’re experiencing a life threatening medical emergency, such as severe bleeding that won’t stop, call 911 or a local emergency number right away.

Does Plavix cause fatigue?

Fatigue (low energy) wasn’t reported in studies of Plavix. But it’s a symptom of some heart conditions, such as stroke and heart attack. Plavix can be used to help prevent these conditions from reoccurring in people who’ve already experienced them. Plavix is also prescribed to lower the risk of certain other heart conditions, such as acute coronary syndrome, which can also cause fatigue.

Certain side effects of Plavix, such as bleeding and thrombotic thrombocytopenic purpura, can also cause fatigue. If you have fatigue that’s bothersome, call your doctor. They’ll try to determine the cause and suggest ways to help manage it. If you have severe fatigue, they may recommend switching you to a medication that’s safer for you.

Learn more about some of the side effects Plavix may cause.

Boxed warning: Drug metabolism problem

Plavix has a boxed warning for a drug metabolism problem. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Plavix is broken down in the liver by an enzyme (protein) called CYP2C19. In some people, this enzyme doesn’t work well or is missing. This affects how well their liver breaks down certain drugs, including Plavix. If your liver can’t break it down, the drug will be less effective in treating your condition.

What might help

Before you start Plavix, your doctor will check to see whether you have the CYP2C19 gene. If you don’t, they’ll suggest other treatments that will work better for your condition.

Severe bleeding

Plavix works by preventing your blood from clotting as it would normally. This can increase your risk of bruising or bleeding, which may be serious. In rare cases, Plavix can cause severe, life threatening bleeding that requires immediate medical attention. This drug is not recommended for people with active bleeding, such as from a peptic ulcer or bleeding in the brain.

Symptoms of severe bleeding can include:

• red or black stools
• blood in urine
• unexplained bruising
• coughing up blood, such as coffee ground vomitus
• unexplained severe bleeding that lasts a long time

What might help

If you experience bruising or bleeding with Plavix, call your doctor. They’ll determine the cause and whether to treat it. They’ll discuss the risks and benefits of continuing Plavix versus switching to a different treatment for your condition.

Do not stop Plavix without talking with your doctor first. Stopping this drug can increase your risk of a heart attack or stroke.

Thrombotic thrombocytopenic purpura (TTP)

Taking Plavix can cause a serious side effect called TTP. This was a rare side effect reported in studies of the drug. This condition causes small clots to form throughout your body, including in your blood vessels. This can cause severe or life threatening medical complications.

With TTP, you have bruising or purple or red spots that look like a skin rash. Symptoms of TTP include:

• confusion
• kidney problems
• fever
• headache
• anemia (low level of red blood cells)
• fatigue (low energy)
• blood in urine
• jaundice (yellowing of your skin and the whites of your eyes)
• thrombocytopenia (low level of platelets)

What might help

If you have symptoms of TTP, such as skin rash, call your doctor right away. They’ll order tests to determine whether you have TTP and treat it if you do. For a severe reaction, they’ll likely have you stop Plavix permanently and switch you to a medication that’s safer for you.

Nosebleeds

People taking Plavix may experience nosebleeds. This was reported in studies of the drug. Plavix prevents your blood from clotting, so you could have bleeding that doesn’t stop easily.

What might help

If you experience a mild nosebleed with Plavix, consider these tips:

• lean forward and sit upright
• pinch the bridge of your nose (under the boney area) for about 10 minutes
• put an ice pack or cold cloth against your nose and face to lessen the bleeding

If bleeding is severe or doesn’t stop after 15 minutes, call your doctor or seek medical help.

Allergic reaction

Like most drugs, Plavix can cause an allergic reaction in some people. This side effect was reported in studies of the drug. Symptoms can be mild to serious and can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

• an antihistamine you swallow, such as Benadryl (diphenhydramine)
• a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Plavix, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Plavix, they may have you switch to a different treatment.

• what dose of the drug you were taking when you had the side effect
• how soon you had the side effect after starting that dose
• what your symptoms were
• how your symptoms affected your daily activities
• what other medications you were taking
• any other information you feel is important

Plavix may not be right for you if you have certain medical conditions. This is known as a drug-condition interaction. Other factors may also affect whether this drug is a good treatment option for you.

Talk with your doctor about your health history before starting Plavix. Factors to consider include those described below.

Boxed warning: Drug metabolism problem

Plavix has a boxed warning for a drug metabolism problem. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Plavix is broken down in the liver by an enzyme (protein) called CYP2C19. In some people, this enzyme doesn’t work well or is missing. This affects how well their liver breaks down certain drugs, including Plavix. If your liver can’t break it down, the drug will be less effective in treating your condition.

Before you start Plavix, your doctor will check to see whether you have the CYP2C19 gene. If you don’t, they’ll suggest other treatments that will work better for your condition.

Other warnings

Bleeding disorder. If you have a bleeding disorder such as hemophilia, Plavix may not be safe for you. This is because Plavix prevents your blood from clotting as it normally would, which can increase your risk of severe bleeding. Tell your doctor if you have a bleeding disorder. They’ll discuss the benefits and risks of Plavix with you and may recommend a different treatment for your condition.

Active bleeding. Do not take Plavix if you have active bleeding, such as from a peptic ulcer or bleeding in the head. Because it prevents your blood from clotting as it normally would, Plavix could increase your risk of severe, uncontrolled bleeding.

Allergic reaction. If you’ve had an allergic reaction to Plavix or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Surgery. If you’re scheduled to have surgery (including dental surgery) while taking Plavix, tell your doctor. They may recommend that you stop taking the drug a few days before your surgery. This is to lower the risk of severe bleeding from Plavix. They’ll discuss your risks and when to stop taking the drug as well as when it’s safe to start it again after surgery.

Tell all of your doctors about all of the drugs you’re taking. This includes over-the-counter products, as some of these may increase your risk of serious side effects with Plavix.

Kidney disease. If you have moderate to severe kidney disease, it’s not known whether Plavix would work well for you. Tell your doctor about any kidney problems you may have. They’ll be able to tell you more about the risks and benefits of Plavix for you.

Alcohol and Plavix

There are no known interactions between Plavix and alcohol. But drinking too much alcohol with Plavix could increase your risk of bleeding. If you plan to consume alcohol while taking this drug, ask your doctor how much is safe.

Pregnancy and breastfeeding while taking Plavix

There have been no reports of harm to a fetus in studies of clopidogrel* use during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor about the benefits and risks of taking Plavix during pregnancy. They can provide more information based on your individual situation.

If you’re taking Plavix during your pregnancy, your doctor may suggest stopping it 5 to 7 days before your delivery date. This will lower your risk of serious bleeding during and after delivery.

It’s not known whether Plavix passes into breast milk. If you’re taking Plavix, talk with your doctor about the safety of breastfeeding. They may recommend other ways to feed your child while you’re taking this drug or suggest a different medication for you.

* Clopidogrel is the active ingredient in Plavix. The active ingredient is what makes a drug work.

Plavix is used to manage certain heart conditions. Some people may experience mild to serious side effects while taking this drug. Serious side effects happen less often than mild ones. If you have questions about side effects that Plavix can cause, talk with your doctor.

Examples of questions to help get you started include:

• Does my risk of side effects depend on my dosage of Plavix?
• How do the side effects of Plavix compare with those of Brilinta?
• Do I have a higher risk of side effects when I first start taking Plavix?

To learn more about Plavix, see these articles:

• Plavix (clopidogrel)
• Dosage Details for Plavix
• Plavix Interactions: Alcohol, Medications, and Others
• Plavix and Cost: What You Need to Know

To get information on different conditions and tips for improving your health, subscribe to any of Austra Health’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Austra Health has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Last medically reviewed on March 17, 2023