{"id":54396,"date":"2022-10-17T14:35:52","date_gmt":"2022-10-17T18:35:52","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=54396"},"modified":"2024-11-20T10:40:58","modified_gmt":"2024-11-20T15:40:58","slug":"clopidogrel-alternatives","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/clopidogrel-alternatives\/","title":{"rendered":"Clopidogrel alternatives: What can I take instead of clopidogrel?"},"content":{"rendered":"

Compare clopidogrel alternatives<\/a> | Brilinta<\/a> | Effient<\/a> | Aspirin\/dipyridamole<\/a> | Cilostazol<\/a> | Xarelto<\/a> | Natural alternatives<\/a> | How to switch meds<\/a><\/span><\/p>\n

In the tenuous situation of a sudden <\/span>heart attack<\/span>, known as an acute <\/span>myocardial infarction<\/span>, any of us would take whatever medicine the cardiologist suggested. There is a good chance that one of the drugs would be a platelet <\/span>inhibitor<\/span> like <\/span>Plavix<\/span><\/a>, the brand name of <\/span>clopidogrel<\/span>. <\/span>Antiplatelet agents<\/span> like <\/span>clopidogrel<\/span> are vitally important to reverse blood clotting in the field of <\/span>cardiology<\/span>, and in treatment of a <\/span>heart attack<\/span>, a cardiologist will be the one who decides what agent to use in the critical first hours.\u00a0<\/span><\/p>\n

Beyond that timeframe, <\/span>clopidogrel<\/span> can also be used to prevent recurrent blood clotting within the coronary arteries of the heart or to prevent recurrences of blocked arteries elsewhere in the body. These longer timeframes of use enable you to gauge its beneficial and <\/span>adverse effects<\/span><\/a>. If you are unsatisfied with either, if the expense of the drug is unrealistic, or if you encounter interactions with your other medications, you need to know that you have other options. We will walk you through the alternatives to <\/span>clopidogrel<\/span> that are available, detailing how they compare. In the end, you will be well prepared to talk to your <\/span>healthcare<\/span> provider about a change.<\/span><\/p>\n

What can I take in place of <\/span>clopidogrel<\/span>?<\/span><\/h2>\n

Plavix inhibits platelets, the blood cells which form clots. As a member of the <\/span>thienopyridine<\/span> class, it does so by irreversibly binding to <\/span>adenosine diphosphate<\/span> (<\/span>ADP<\/span>) at the <\/span>P2Y12 receptor<\/span>. Brilinta and Effient are fellow class members and <\/span>P2Y12 receptor antagonists<\/span> as well. In the setting of both major types of <\/span>heart attack<\/span>, ST-elevation and <\/span>non-ST-elevation myocardial infarctions<\/span> (differentiated by presence or lack of <\/span>ST-segment elevation<\/span> on electrocardiogram), this drug category can be given as a <\/span>loading dose<\/span> to kick start the antiplatelet effect. Each <\/span>P2Y12 inhibitor<\/span> has nuances that may be appealing to you.<\/span><\/p>\n

Platelet inhibition can be achieved by other mechanisms. Aspirin does so by inhibiting cyclooxygenase, dipyridamole by blocking adenosine uptake, and cilostazol by inhibiting phosphodiesterase 3. The end result of all of these is to reduce platelets from sticking together to form a clot. Alternatively, the <\/span>anticoagulant<\/span><\/a> Xarelto can be used at a low dose as a blood thinner for some of the same medical conditions. Whatever the category or mechanism of action, the important differences for you to consider involve factors like convenience, cost, effectiveness, drug interactions, and <\/span>side effects<\/span>.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
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Compare clopidogrel alternatives<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

Drug name<\/b><\/td>\nUses<\/b><\/td>\nDosage<\/b><\/td>\nSavings options<\/b><\/td>\n<\/tr>\n
Plavix (<\/span>clopidogrel<\/span>)<\/span><\/td>\nAcute coronary syndrome<\/span> (<\/span>ACS<\/span>), <\/span>thrombotic<\/span> event prevention<\/span><\/td>\n75 mg once daily<\/span><\/td>\nPlavix coupons<\/span><\/a><\/td>\n<\/tr>\n
Brilinta (<\/span>ticagrelor<\/span>)<\/span><\/td>\nACS<\/span>, <\/span>cardiovascular<\/span> event prevention, <\/span>coronary artery disease<\/span> (CAD), acute <\/span>ischemic stroke<\/span>, transient ischemic attack (TIA)<\/span><\/td>\n60 or 90 mg twice daily<\/span><\/td>\nBrilinta coupons<\/span><\/a><\/td>\n<\/tr>\n
Effient (<\/span>prasugrel<\/span>)<\/span><\/td>\nACS<\/span><\/td>\n10 mg once daily<\/span><\/td>\nPrasugrel<\/span> coupons<\/span><\/a><\/td>\n<\/tr>\n
Aspirin<\/span><\/td>\nACS<\/span>, <\/span>myocardial infarction<\/span> (MI) prevention, TIA and thromboembolic stroke prevention\u00a0<\/span><\/td>\n75-325 mg once daily<\/span><\/td>\nAspirin coupons<\/span><\/a><\/td>\n<\/tr>\n
Aspirin-dipyridamole ER<\/span><\/td>\nThrombotic<\/span> stroke prevention<\/span><\/td>\n25 mg\/100 mg twice daily<\/span><\/td>\nAspirin-dipyridamole ER coupons<\/span><\/a><\/td>\n<\/tr>\n
Cilostazol<\/span><\/td>\nIntermittent claudication, secondary prevention of noncardioembolic stroke or TIA (<\/span>off-label<\/span><\/a>), <\/span>percutaneous coronary intervention<\/span> such as stent placement (off-label)<\/span><\/td>\n100 mg twice daily<\/span><\/td>\nCilostazol coupons<\/span><\/a><\/td>\n<\/tr>\n
Low-dose Xarelto (rivaroxaban)<\/span><\/td>\nCardiovascular<\/span> event reduction, <\/span>thrombotic<\/span> event reduction<\/span><\/td>\n2.5 mg twice daily<\/span><\/td>\nXarelto coupons<\/span><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Top 5 <\/span>clopidogrel<\/span> alternatives<\/span><\/h2>\n

The following are some of the most common alternatives to <\/span>clopidogrel<\/span>.<\/span><\/p>\n

1. Brilinta<\/span><\/h3>\n

Plavix and Brilinta<\/span><\/a> have the same mechanism of action, but <\/span>Brilinta<\/span><\/a> (<\/span>ticagrelor<\/span>) has a longer list of approved indications from the Food and <\/span>Drug Administration<\/span> (FDA). In particular, <\/span>use of ticagrelor<\/span> is approved for the treatment of acute stroke. <\/span>Ticagrelor<\/span> has a faster onset and higher potency than <\/span>clopidogrel<\/span><\/a>, often making Brilinta preferable for treatment of acute conditions like MI and stroke. The potency advantage of Brilinta could be particularly helpful for the percentage of people with genetic resistance to <\/span>P2Y12 inhibitors<\/span>. A shorter duration of action also makes Brilinta easier to stop in advance of surgery. Yet another advantage of Brilinta is that it avoids a major drug interaction with certain members of the antacid class <\/span>proton pump <\/span>inhibitors<\/span><\/a> (PPIs), like Prilosec (omeprazole), which is a potential concern with Plavix.<\/span><\/p>\n

Before you jump on the Brilinta train, you should recognize some disadvantages. The lower potency of Plavix is not all bad. It may explain why <\/span>Plavix has less <\/span>risk of bleeding<\/span> side effects<\/span><\/a>, which is noteworthy for anyone at <\/span>higher risk of bleeding<\/span>, including seniors. A unique <\/span>side effect<\/span> of Brilinta<\/span><\/a> is the tendency to cause shortness of breath. If <\/span>adverse effects<\/span> are not enough to cause you to avoid Brilinta, the cost might. Brilinta does not have a generic drug available on the market, so it is <\/span>typically more expensive<\/span><\/a> than Plavix.<\/span><\/p>\n

2. Effient<\/span><\/h3>\n

Effient is another fast-acting and highly potent <\/span>P2Y12 receptor antagonist<\/span>, reminiscent of Brilinta in that it may be favored over Plavix in an <\/span>acute coronary syndrome<\/span><\/a> (<\/span>ACS<\/span>), a term for when blood supply to the heart is suddenly reduced. Effient was found to be more effective than Brilinta in a <\/span>randomized <\/span>clinical trial<\/span><\/a> and in a <\/span>post hoc analysis<\/span><\/a> involving patients with <\/span>ACS<\/span>. These findings need to be confirmed with further studies, but they speak to the efficacy of Effient.\u00a0<\/span><\/p>\n

The effectiveness of Plavix can be undermined by one\u2019s genetics. <\/span>Your genetics could lessen the drug\u2019s activity<\/span><\/a> by reducing absorption in the intestinal tract or limiting conversion of <\/span>clopidogrel<\/span> to its active form by <\/span>CYP2C19<\/span> enzyme<\/span>. Other medications, such as PPIs, could even impair <\/span>clopidogrel<\/span>\u2019s activity. While platelet inhibition may be limited in these scenarios, there may not be a correlation between the reduced <\/span>platelet inhibition and patient outcomes<\/span>. Meaning, we do not know how important these drug interactions are. Like Brilinta, Effient avoids some of the drug interactions that can negatively impact Plavix users, and the higher potency of both Brilinta and Effient could reduce the chances of you being a non-responder to P2Y12 inhibition.<\/span><\/p>\n

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