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Is generic Plavix as safe and as effective as the name brand?

Robin Wulffson MD's picture
Plavix, clopidogrel, generic, bledding, heart attack stroke, blood clot

On May 17, the US Food and Drug Administration (FDA) approved the blood thinner Plavix (clopidogrel bisulfate). The medication decreases the likelihood that platelets will clump and produce clots in the arteries; thus, risking a heart attack or stroke. It is FDA-approved to treat individuals who have suffered a recent heart attack or stroke or those that have partial or total blockage of an artery.

“For people who must manage chronic health conditions, having effective and affordable treatment options is important,” noted Keith Webber, Ph.D., deputy director of the Office of Pharmaceutical Science in the FDA’s Center for Drug Evaluation and Research. “The generic products approved today will expand those options for patients.”

Generic products become available when the patent of a medication expires. As Dr. Webber noted, the generic version is less expensive. As anyone who has recently filled a prescription and does not have a health insurance plan to cover all or a portion of the cost, filling a prescription can be a budget buster. In the past, many physicians were reluctant to prescribe a generic drug for fear that it might not be equivalent to the name brand. Even today, many physicians prefer not to prescribe generics. The reasoning is that the generic may vary in potency from a name brand. Every medication has a therapeutic range where it is effective. Below that range, it is less effective or non-effective. Above that range, untoward side-effects are more likely to occur. In the case of Plavix, internal bleeding can occur. The therapeutic range of pharmaceuticals varies between individuals. Weight, metabolism, and genetics influence the effectiveness. That is the reason that different dosages of medications are on the market.

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In the past, some generic products were not equivalent to the name brand. For example a 500 mg generic might be comparable to a 400 mg or 600 mg name brand. Even today, some generics may not be equivalent. The good news, however, is that if a generic is FDA-approved it is equivalent to the name brand. The agency notes: “Generic drugs approved by FDA are of the same high quality and strength as brand-name drugs. The generic manufacturing and packaging sites must pass the same quality standards as those for brand-name drugs.”

As noted above, Plavix has a boxed warning to alert healthcare professionals and patients that the drug may not be as effective for individuals with certain genetic factors that affect how the body metabolizes the drug. However, tests for these genetic factors are available to ensure that the medication is the right choice for them. In addition, certain medications, such as proton pump inhibitors (i.e., Prilosec (omeprazole) and Nexium (esomeprazole)), reduce the effect of Plavix, placing a person at greater risk for heart attack and stroke.

Plavix may cause bleeding, which can be serious and sometimes lead to death. While taking the drug, individuals may bruise and bleed more easily, experience nose bleeds, and it may take longer for all bleeding to stop. The drug is dispensed with a patient Medication Guide that provides important instructions on its use and drug safety information.

Dr. Reddy's Laboratories, Gate Pharmaceuticals, Mylan Pharmaceuticals, and Teva Pharmaceuticals have gained FDA approval for 300 mg clopidogrel. Apotex Corporation, Aurobindo Pharma, Mylan Pharmaceuticals, Roxane Laboratories, Sun Pharma, Teva Pharmaceuticals, and Torrent Pharmaceuticals have received approval for 75 mg clopidogrel.

Reference: FDA



This is important information for the public and health care providers. Plavix is expensive. Patients do NOT comply with therapy due to cost, leading to increased health care spending. Some try to stretch out their therapy and miss doses to make their meds last longer. Generic Plavix is long overdue and this is going to help lower rates of re-hospitalization and restenosis after heart attack and stents. As a nurse who does case management - I'm thrilled - and happy to know about the safety question. Thanks!
Thank you for your input.
As a patient who has had multiple bypass surgeries and several stents,, I have been taking Plavix for many years, as well as numerous other drugs. Knowing that generic plavix is safe and effective is great news. It will help to delay my falling into the Medicare Drug Plan 'Donut Hole' each year.
I am really scared to take plavix, even though my dr has ordered it. I have taken coumadin and pradaxa in the past. I have an internal carotid artery on the left side that discected in 1998. It is completely closed. The right carotid is less than 50% stenosis and is flowing nicely. That is the reason for coumadin. I have had only one (1) time of atraial fibrolation and the dr has me on sotalol. I hate to take so many meds, and feel very unsettled about plavix. He also wanted to combine that with asprin and I do not want to do that. I need reassurance. thanks
I have had three TIA's. My Mom died of a stroke, her brother died of an aneurysm in his aortic artery. My neurologist keeps trying to get me to take generic Plavix. He says it is 30% more effective than aspirin. I take two 20mg prilosec every day. I am quite worried about the Plavix, so I do not take it. I take an 81mg Ecotrin instead. I have read that the prilosec keeps the plavix from working as it is supposed to, anyway.
Hi there. Plavix, generic or brand, really is a mainstay therapy for stroke prevention when you are high risk. Do you at least take a cholesterol lowering drug? Also, what condition are you taking the Prilosec for - exactly? Thanks for you input.
Had 90% artery blockage have medical coated stent. Doc put me on plavix 75mg. After 30 days my prescripton refill is mfg by Dr Reddy in India, is this safe to take? Its a generic Clopidogril, i'm kinda afraid to take it from India, any comments?
Hi Patricia, I think the reputation is good, but wondering if your Cardiologist might have an opinion? I would ask him or her for sure.