Plavix, also known generically as clopidogrel, is prescribed to prevent blood clots. People who have stents placed in their coronary arteries are often at high risk for clots that would obstruct blood flow through to the heart. That’s why doctors usually prescribe Plavix for up to a year after the drug-eluting stent is put in place.
A new analysis of Plavix research in the Journal of the American Medical Association reveals that non-smokers get little, if any benefit, from Plavix. The authors of this review found that in several studies the patients who did well on Plavix were smokers. Cigarette smoking revs up the enzyme that metabolizes clopidogrel to its active form. Non-smokers actually got as much benefit from aspirin as they did from clopidogrel. Cardiologists will need to assess this controversial analysis to determine whether the benefits of Plavix outweigh the risks for non-smokers.

[JAMA, June 20, 2012]

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  1. JulieB

    My doctor recently suggested that I no longer need to take Plavix (clopidogrel) because of the study that claimed that Plavix is no more effective than aspirin. I had a TIA 16 years ago and have been taking Plavix ever since. I used to have severe headaches before the TIA and used heavy doses of aspirin prior to the time I experienced the TIA. In my case aspirin did not prevent the TIA. Needless to say, I plan to stay on Plavix.

  2. A.M

    Is it a fact that the latest research/tests has proved that patients who have had DES cardiac stents placed, can now stop taking plavix/clopidogrel after 6 months (after being on dual anti platelet therapy (Plavix/clopidogrel and aspirin) since having had a mild heart attack and drug eluting stent (Xience V stent) placed for 70% blockage – female aged 61???
    I was prescribed 12 months therapy, have been on it for eight and a half months, and cardiologist says I can stop the clopidogrel/[plavix now, as recent results proved it is safe to stop after 6 months.
    I am reluctant to stop the clopidogrel, as I still have 3 and half months to take it, of the 12 months prescribed????
    What should I do????
    PEOPLE’S PHARMACY RESPONSE: Discuss this further with your cardiologist and ask about the evidence. When you are satisfied that there is good evidence behind the recommendation, you will feel more comfortable about following it.

  3. Annie

    I agree. Scenario; smoker has heart attack, has stent placed, prescribed plavix/aspirin for a year – stops smoking – then basically finds out that for the (expensive) medication to work, patient has to be a smoker??????
    So now? what would be the steps, going forward with plavix being prescribed to ex smokers/non smokers?

  4. RJZ

    I find this so frustrating. After spending 15 months looking like I was being beaten, research shows that this non-smoker didn’t reap any benefits from the Plavix? I’d like to smack Big Pharma for more than just this.

  5. fbl

    Nattokinase works for me. The maximum dose of regular blood thinners didn’t do anything. No more problems!

  6. DWD

    Was it the nicotine doing the activation? If so perhaps the nicotine patch would help non-smokers on plavix?

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