Clopidogrel, Aspirin, or Both?

January 24, 2021


Plavix (clopidogrel) and aspirin (acetylsalicylic acid) both keep platelets, blood cells that form blood clots, from clumping. They are given to patients to prevent clots from forming in blood vessels. This prevents blood clots from blocking blood flow to the heart muscle (heart attack) or brain tissue (stroke). Various studies have been performed to determine which medication or medications should be prescribed in which cases.

Harvard Medical School recommends clopidogrel with or without aspirin for the following conditions:

  • A stent is a wire mesh device placed into arteries to hold them open. They frequently produce clots. For a month to a year after the stent is installed, Plavix is given to prevent platelet clumping.
  • Serious chest pain can be caused by blockage in the coronary arteries, the ones that feed oxygen-laden blood to the heart muscle. Plavix and aspirin are given during heart attacks or what is known as unstable angina, or uncontrolled chest pain due to blockage of the coronary arteries. Plavix is continued 9 to 12 months after a heart attack for prevention.
  • Stroke, or cerebrovascular accident, can be caused by blockages in arteries feeding blood to the brain. After a stroke either aspirin or Plavix lowers the risk of another stroke, but both drugs do not work better than either one alone, and can increase the risk of internal bleeding.
  • Transient ischemic attack (TIA), or small stroke, can occur before a major stroke. When a tia is diagnosed, Plavix or aspirin can be given for 3 months, followed by either medication.
  • Peripheral artery disease (PAD) is narrowing of arteries in the legs, causing pain when patients walk. Patients with PAD are at increased risk for strokes and heart attacks. Either Plavix or Plavix with aspirin lowers the risk of either.
  • Aspirin intolerance can occur due to allergy or stomach sensitivity. Some patients’ platelets do not react to aspirin. Those patients are often prescribed Plavix.


Did you know? QuickMD can refill Plavix online—from the convenience of your home.

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