Key takeaways
- Combining Plavix with alcohol, NSAIDs, anticoagulants, SSRIs, or SNRIs may increase the risk of bleeding. It’s important that you talk with your doctor about safe medication consumption levels and potential dosage adjustments.
- Before starting Plavix, inform your doctor about all drugs and supplements you take, as well as any health conditions you have. This can help prevent interactions.
- Be cautious when taking herbal supplements like garlic, ginger, and ginkgo, as they may raise bleeding risk.
Plavix (clopidogrel) is a prescription drug used to decrease the risk of heart attack and stroke in adults who:
- have acute coronary syndrome (ACS)
- have peripheral artery disease (PAD)
- have had a recent heart attack or stroke
Like other drugs, Plavix may have interactions. Some interactions occur because one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, another drug, or a supplement can affect how a drug acts in your body. Interactions can also occur if you have certain health conditions.
Keep reading to learn about possible interactions with Plavix.
Certain health conditions or other factors could increase your risk of harm if you take Plavix. These are known as contraindications. In such cases, your doctor may not prescribe Plavix for you. The following list includes contraindications of Plavix.
If you have active bleeding: Plavix can increase your risk of bleeding. And if you currently have bleeding, taking Plavix can make your condition worse. This includes internal bleeding, such as that caused by a stomach ulcer. In this case, your doctor will recommend treating your bleeding before you start taking Plavix. Or they may recommend a treatment option other than Plavix for your condition.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Plavix or any of its ingredients, your doctor likely won’t prescribe Plavix for you, since it could cause another allergic reaction. You can ask your doctor about other treatments that may be better options.
Before starting Plavix, talk with your doctor if either of these factors apply to you. They can determine whether Plavix is safe for you to take.
There aren’t any known interactions between Plavix and alcohol. But consuming alcohol during Plavix treatment can increase your risk of certain side effects.
For example, drinking a lot of alcohol can increase your risk of bleeding. Plavix can also cause bleeding. So drinking alcohol while taking Plavix may further increase the risk of this side effect.
If you drink alcohol, talk with your doctor about how much may be safe for you to consume while you’re taking Plavix.
Before starting Plavix, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Plavix interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Plavix?” section.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following chart lists drugs that may interact with Plavix. Keep in mind that this chart does not include all drugs that may interact with Plavix. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug type or drug name | Drug examples | What can happen |
| CYP2C19 blockers | • omeprazole (Prilosec) • esomeprazole (Nexium) | can decrease the effectiveness of Plavix |
| CYP2C19 inducers | • rifampin (Rimactane) • apalutamide (Erleada) | can increase the risk of side effects from Plavix |
| opioids | • hydrocodone (Hysingla ER) • morphine (MS Contin) • oxycodone (Roxicodone) | can decrease the effectiveness of Plavix |
| nonsteroidal anti-inflammatory drugs (NSAIDs) | • meloxicam (Mobic) • ibuprofen (Advil) • celecoxib (Celebrex) | can increase the risk of side effects from Plavix and NSAIDs |
| selective serotonin reuptake inhibitors (SSRIs) | • sertraline (Zoloft) • fluoxetine (Prozac) • escitalopram (Lexapro) | can increase the risk of side effects from Plavix and SSRIs |
| serotonin-norepinephrine reuptake inhibitors (SNRIs) | • venlafaxine (Effexor XR) • desvenlafaxine (Pristiq) • duloxetine (Cymbalta) | can increase the risk of side effects from Plavix and SNRIs |
| repaglinide | — | can increase the risk of side effects from repaglinide |
| anticoagulants | • warfarin (Jantoven) • apixaban (Eliquis) • dabigatran (Pradaxa) | can increase the risk of side effects from Plavix and anticoagulants |
| antiplatelets | • ticagrelor (Brilinta) • acetylsalicylic acid (aspirin) • prasugrel (Effient) | can increase the risk of side effects such as bleeding from Plavix and other antiplatelets |
Note: Anticoagulants and antiplatelets are different types of blood thinners. Plavix is an antiplatelet drug.
Learn more about certain drug interactions that can occur with Plavix.
Interaction with nonsteroidal anti-inflammatory drugs (NSAIDs)
Plavix can interact with NSAIDs, which are used to treat pain, inflammation, or fever.
Examples of NSAIDs include:
What could happen
Taking NSAIDs together with Plavix may increase your risk of bleeding, which can be serious.
What you can do
Before you start Plavix treatment, tell your doctor if you take any NSAIDs. They’ll let you know if it’s safe for you to take an NSAID together with Plavix.
In some cases, your doctor may recommend a different medication for your symptoms that doesn’t interact with Plavix. An example is acetaminophen (Tylenol), which can help treat pain or fever.
Interaction with CYP2C19 blockers
CYP2C19 blockers may interact with Plavix, making it less effective. CYP2C19 blockers decrease the activity of the CYP2C19 enzyme, which breaks down certain drugs in the body.
Certain proton pump inhibitors (PPIs) are CYP2C19 blockers. PPIs are used to treat conditions such as gastroesophageal reflux disease (GERD). Examples include:
- omeprazole (Prilosec)
- esomeprazole (Nexium)
What could happen
To work, Plavix needs to be metabolized (broken down) by the CYP2C19 enzyme. If you’re taking any medications that block the activity of this enzyme, Plavix won’t work as well as it should.
What you can do
Before you start taking Plavix, tell your doctor or pharmacist about any medications that you currently take. They can tell you whether any of them are CYP2C19 blockers.
If you’re taking a PPI such as esomeprazole or omeprazole, your doctor may switch you to a different PPI that doesn’t block CYP2C19. An example is pantoprazole (Protonix).
Interaction with anticoagulants
Plavix may interact with anticoagulants. These are also known as blood thinners, which are often used to treat or help prevent blood clots.
Examples of anticoagulants include:
What could happen
Both anticoagulants and Plavix can increase your risk of bleeding. Taking an anticoagulant with Plavix may increase your risk of bleeding even further.
What you can do
If you’re taking an anticoagulant, tell your doctor before starting Plavix treatment.
Your doctor may suggest that you stop taking the anticoagulant during Plavix treatment. Or they may recommend taking Plavix together with the anticoagulant while monitoring you more often for bleeding.
Your doctor will discuss with you the best treatment plan for your condition.
Plavix may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. Note that the following information does not include all other possible interactions with Plavix.
Does Plavix interact with supplements?
Before starting Plavix, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Plavix and herbs
Some herbal supplements can interact with Plavix. Examples include:
- garlic
- ginger
- ginkgo
Taking these supplements with Plavix could increase the risk of bleeding. Talk with your doctor or pharmacist before taking any herbal supplements during Plavix treatment.
Plavix and vitamins
There are currently no reports of Plavix interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future. For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during Plavix treatment.
Does Plavix interact with food?
Although garlic and ginger supplements may interact with Plavix, there are currently no reports of Plavix interacting with food. The amount of garlic or ginger in food is much smaller than what’s in garlic or ginger supplements. So it’s less likely that foods containing these ingredients may interact with Plavix.
If you have questions about eating certain foods during your treatment with Plavix, talk with your doctor.
Does Plavix interact with vaccines?
There aren’t any known interactions between Plavix and vaccines. If you have questions about getting certain vaccines while taking Plavix, talk with your doctor.
Does Plavix interact with lab tests?
There are no known interactions between Plavix and lab tests. If you have questions about getting specific lab tests while taking Plavix, talk with your doctor.
Does Plavix interact with cannabis or CBD?There are currently no reports of Plavix interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Plavix.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Plavix. Before taking this medication, talk with your doctor about your health history. They’ll determine whether Plavix is right for you.
Health conditions or other factors that might interact with Plavix include:
Upcoming surgery: If you have a surgery scheduled during Plavix treatment, tell your doctor. In some cases, they may recommend stopping Plavix since it can increase your risk of bleeding. Your doctor can recommend the best treatment plan for you if you have an upcoming surgery.
Bleeding: Plavix can increase your risk of bleeding. And if you currently have bleeding, taking Plavix can make your condition worse. This includes internal bleeding, such as that caused by a stomach ulcer. In this case, your doctor will recommend treating your bleeding before you start Plavix. Or they may recommend a treatment option other than Plavix for your condition.
Kidney problems: Before you start taking Plavix, tell your doctor about any kidney problems you have. It’s possible that Plavix may not work as well as it should in people with kidney problems. Depending on your condition, your doctor will determine whether Plavix may be a good treatment option.
Certain drug metabolism problems: To work, Plavix needs to be metabolized (broken down) by an enzyme called CYP2C19. In the body of a person who has problems with this enzyme, Plavix may not break down. This can reduce the effectiveness of the drug. Plavix has a boxed warning about this side effect. (See the beginning of this article for more information.)
Before you start taking Plavix, tell your doctor if you have any drug metabolism problems. If your body can’t break down Plavix well, they may recommend taking a different drug to treat your condition.
Pregnancy: It’s not known whether it’s safe to take Plavix during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor before taking this drug.
Breastfeeding: It’s not known whether Plavix passes into breastmilk or what effects it may have on a child who’s breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor about whether it’s safe for you to take Plavix during this time.
Allergic reaction: If you’ve had an allergic reaction to Plavix or any of its ingredients, your doctor will likely not prescribe Plavix in order to avoid another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Find answers to some frequently asked questions about Plavix and possible interactions.
Does Plavix interact with prednisone?
No, there aren’t any known interactions between Plavix and prednisone. Prednisone is a corticosteroid that’s used to treat many conditions. Examples include rheumatoid arthritis and breathing problems.
It’s likely safe for you to take Plavix with prednisone. If you have questions about taking these medications together, talk with your doctor or pharmacist.
Are there any interactions between Plavix and Cialis?
No, there aren’t any known interactions between Plavix and tadalafil (Cialis), which is used to treat benign prostatic hyperplasia and erectile dysfunction (ED).
But Plavix can be prescribed for people with certain heart or blood vessel problems. Your doctor may not prescribe Cialis for ED if your heart isn’t healthy enough for sex.
If you have questions about taking Plavix and Cialis together, ask your doctor or pharmacist.
Can I drink coffee while I’m taking Plavix?
Yes, you can drink coffee while you’re taking Plavix. There aren’t any known interactions between coffee and Plavix.
If you have additional questions about foods or drinks that are safe to take with this medication, talk with your doctor or pharmacist.
Taking certain steps can help you avoid interactions with Plavix. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Plavix treatment.
It’s also important to read Plavix’s
You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. If you did not get paperwork with Plavix, ask your pharmacist to print a copy for you. If you have difficulty understanding this information, your doctor or pharmacist can help.
Taking Plavix exactly as prescribed can also help prevent interactions.
Disclaimer: MyistyClan 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.