If you’ve suffered a heart attack, an angina attack, or stroke, or if you have peripheral artery disease with poor blood circulation in the legs, you could be at high risk of another heart or angina attack, or stroke. There are medications to treat heart conditions and prevent stroke, and surgery to treat patients with angina to prevent a heart attack. Amongst the plethora of cardiac medicines, one stands out as the most popular – Plavix, or Clopidogrel bisulfate.

Plavix prevents formation of blood clots that occur due to specific heart or vascular conditions. Once Clopidogrel is metabolized by the CYP450 enzymes it results in the production of its active metabolite that inhibits the binding of adenosine diphosphate [ADP], an ester, which is stored in dense forms inside blood platelets. When ADP interacts with its P2Y12 receptor, it results in further platelet activity. In an irreversible action, Clopidogrel inhibits the binding of ADP to the P2Y12 receptor, successfully preventing coagulation from taking place, eliminating unwanted blood clots from circulating in the body and causing damage.

People who have poor circulation of blood in their legs, because of peripheral artery disease [PAD], are more likely to have had an attack of angina or a myocardial infarction, and face an increased risk of a cardiac attack or stroke. At times, an angioplasty has to be performed for angina patients to open clogged arteries and stents inserted, to help the heart to pump blood and let oxygen move easily, so that the patient can breathe freely. Those who’ve already suffered due to an attack of angina, or stroke, or had a heart attack, find Plavix beneficial as it can help them from having another such attack.

When you visit the cardiologist, let the doctor know if you have any disease of the heart/kidney/liver, a history of stroke, hemophilia [a bleeding or clotting disorder], or ulcerative colitis. Should you be taking treatment for any active bleeding from a brain injury or stomach ulcer, or if you have recently undergone any surgery, let the treating doctor know about that as well. If it is a child in your family who needs treatment, then consult a pediatrician who will be able to advise you best.

To decide upon the dosage to be given to you, and to rule out medicines that will not work with Clopidogrel, you will have to give your treating doctor a list of all the medicines you are taking, including prescription as well as those that are available over-the-counter, herbal products and nutritional supplements. Especially mention whether you are taking any other blood thinning medicines [including injectables to prevent blood clots]; anti-diabetic medicines; anti-seizure drugs; antidepressants; anti-fungals; medicines to treat gastroesophageal reflux disease, gastric ulcers or to prevent GI bleeding; drugs to treat HIV; medications for cancer; NSAIDs; or water pills.

As with other medicines, Plavix may cause some side effects. The most common ones are: dizziness, mild headache, stomachache, constipation, diarrhea, bruising easily, or minor bleeding. If you have an allergic reaction such as a rash, itching, difficulty in breathing, constriction in the chest, or swelling in the face/mouth/lips/tongue, stop the medicine at once and inform your doctor. If any symptom becomes worse, or persists, seek emergency help. Unusual/serious symptoms should be reported to the doctor at once, and could include: coughing up blood, urinating less/more or dark urine, black/tarry stools, bleeding in the eyes or blurred vision, chest pain, perspiration, slurred speech, unsteady gait, jaundice, any unusual bleeding in women or men, sudden numbness/weakness especially if only one side of the body is affected, or a feeling of disorientation.

One very rare but serious condition that this medicine can bring about as a side effect even in the first couple of weeks, is Thrombotic Thrombocytopenic Purpura [TTP], in which blood clots form in the arteries, preventing blood from reaching other parts of the body, especially the brain and kidneys. Purpura [petechiae] are the purplish or reddish spots that may occur in children due to viral infections, but can signify the presence of the life-threatening thrombocytopenia, or even leukemia and meningococcemia. Along with petechiae, TTP manifests itself in fever, headache, bodily weakness, difficulty in speech, confusion, numbness, or transient paralysis. Should any such symptom occur, the doctor must be informed at once, for untreated TTP can lead to kidney failure. Bleeding is rare in this condition, but if it occurs, it’s mostly from the nose or gums.

Prior to having a surgery, you must inform the surgeon or your dentist that you are taking Clopidogrel. If an anti-platelet is not required, then Plavix will have to be discontinued 5 days prior to that in order to prevent excessive bleeding. As the medicine prevents blood from clotting, if you have any bleeding that does not stop soon, even if it is due to a minor injury, contact your doctor at once. You’ll also have to give up your favorite drink, for alcohol with Plavix, can increase the risk of bleeding in the stomach or intestines. To prevent injuries [they carry the risk of easy bleeding!], it would also be worthwhile to stay away from any kind of sports, while you are on this treatment. Be careful while shaving and even when brushing your teeth.

Pregnant women, those who are nursing a baby, or women who are planning to have a child, must consult the doctor before embarking on this therapy.

As Plavix may cause dizziness or drowsiness, people who drive, operate machinery, or perform hazardous tasks, should refrain from doing so, until they are sure that they can handle the effects of the medicine.

Take your doctor’s advice in planning a diet.

Store Plavix at room temperature, protect it from heat and moisture, and keep it out of reach of your children and pets.