Q: I had a small stroke and am taking Plavix now, but it's giving me stomach problems. Is there a better medication for me?
A: Plavix (Odrel) is an antiplatelet medication that keeps the blood from clotting, to prevent heart attack or stroke. Plavix may be harsh on the stomach, as stomach pain is one of the more common side effects seen with this medication. There are alternatives to Plavix, but your doctor must be the one to determine if any of them are acceptable treatments for your health. Speak with your doctor to about the side effects you're experiencing. Some other treatments may include aspirin, Aggrenox (aspirin/dipyridamole), Ticlid (ticlopidine), Pletal (cilostazol), and Effient (prasugrel). For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Megan Uehara, PharmD
General Risk Of Bleeding
Thienopyridines, including Plavix, increase the risk of bleeding.
Thienopyridines inhibit platelet aggregation for the lifetime of the platelet (7-10 days). Because the half-life of Odrel’s active metabolite is short, it may be possible to restore hemostasis by administering exogenous platelets; however, platelet transfusions within 4 hours of the loading dose or 2 hours of the maintenance dose may be less effective.
Q: After having heart stents I have been taking Plavix for one year since the last stent was placed. Now I am getting two different opinions about length of taking the drug. One doctor says stop now and one doctor says stay on for life. What should I do?
A: Unfortunately, the medical community is still split on this decision. Plavix is so good at stopping blood clots from forming that many doctors advise patients to continue it for a year or more, as long as patients are not having bleeding problems or any other side effects. It also depends on whether your stent was coated with a medication or if it is a bare stent. People who receive stents that are coated with medication need longer courses of Plavix (Odrel), because it takes much longer for cells to cover their stents. The best thing to do is to have a discussion with your cardiologist in order to decide what your options are.
What should I avoid while taking Odrel?
Avoid alcohol. It can increase your risk of stomach bleeding.
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
If you also take aspirin: Ask a doctor or pharmacist before using medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to aspirin (such as salicylates, ibuprofen, ketoprofen, or naproxen). Taking these products together can increase your risk of bleeding.
Q: Can Plavix cause blood vessels to break in the eye?
A: Plavix (Odrel) is a medication that is used to prevent blood clots. It keeps the platelets in your blood from clotting to prevent unwanted blood clots in patients with heart or blood vessel conditions. The prescribing information for Plavix does list eye disorders such as conjunctival (white part of the eye), ocular, and retinal bleeding as side effects of this medication. If you experience any type of bleeding in the eye, you should consult with your physician to be sure damage is not being done to your eyesight. Lori Poulin, PharmD
FDA Warning: Liver function warning
- This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.
- Odrel is broken down by your liver. Some people have genetic differences in how one of the liver enzymes, cytochrome p-450 2C19 (CYP2C19), works. This could slow how this drug is broken down in your body and make it not work as well. Your doctor may test you to see if you have this genetic difference. If you have it, your doctor will prescribe other treatments or drugs instead of Odrel.
Q: I am taking Plavix. Can I safely eat grapefruit, or will it have an effect on the Plavix?
A: Plavix (Odrel) does not interact with grapefruit. It is generally considered safe to eat grapefruit or drink grapefruit juice while taking Plavix. You may also find helpful information at //www.everydayhealth.com/drugs/plavix. Sarah Lewis, PharmD
Q: Does Plavix cause dizziness?
A: According to the prescribing information, dizziness was not a reported side effects associated with Plavix (Odrel) treatment. Plavix (Odrel) inhibits the platelets in the blood from clotting and is used to prevent blood clots that can occur after a heart attack, stroke and in patients with certain heart and blood vessel disorders. According to the prescribing information, the most commonly reported side effect associated with Plavix treatment was bleeding. If you experience any signs and symptoms of bleeding, including nosebleeds or other bleeding that will not stop, coughing up blood or vomit that looks like coffee grounds or black, bloody or tarry stools, it is important to contact your healthcare provider immediately. Plavix should be taken with a full glass of water and can be taken without regard to food. If you need dental work or surgery, it is extremely important to inform your doctor that you take Plavix. You may need to stop taking Plavix for at least 5 days prior to surgery or a procedure to avoid bleeding excessively. This should only be done under the supervision of your doctor. You should begin taking Plavix as soon as possible and exactly as directed by your doctor. Beth Isaac, PharmD
What are some other side effects of Odrel?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if you have any side effects that bother you or do not go away.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
How the interaction occurs:
Grapefruit juice may decrease the amount of activated Odrel in your blood.
When to avoid Odrel
Odrel should not be taken if you have:
- an active (bleeding) peptic ulcer
- recently had a brain haemorrhage
- haemophilia or any other bleeding disorder
Odrel must not be given to anyone under 16 years old, unless under specialist advice.
Although serious reactions are rare, Odrel can cause side effects including indigestion and nausea.
Odrel can also interact with other medicines. Always read the patient information leaflet that comes with your medicine to check it is safe to take with Odrel. If you are unsure, ask your pharmacist or GP.
Odrel (brand name Plavix) is an antiplatelet medicine. This means it reduces the risk of blood clots forming.
Normally, when there is a cut or break in a small blood vessel, a blood clot forms to plug the hole until the blood vessel heals.
Small cells in the blood called platelets cause the blood to clot. When a platelet detects a damaged area of a blood vessel, it produces a chemical that attracts other platelets and makes them stick together to form a blood clot.
Odrel reduces the ability of the platelets to stick together and reduces the risk of clots forming. This protects you from having a stroke or heart attack.