Plavix vs. Eliquis: 7 Things to Know When Comparing These Blood Thinners

Blood clots are your body’s natural way of responding to an injury. They help heal wounds and prevent excessive bleeding. But sometimes, blood clots form when there’s no injury. And they can lead to serious issues, such as heart attacks and strokes.

Fortunately, there are several blood thinners available to help prevent unwanted blood clots. Two options are Plavix (clopidogrel) and Eliquis (apixaban). Below, we’ll discuss how these two medications compare, and why one may be prescribed for you over the other.

1. Plavix and Eliquis are different types of blood thinners

Plavix and Eliquis work differently to prevent and treat unwanted blood clots in the body.

Plavix is an antiplatelet medication. It prevents platelets (a type of blood cell) from sticking together and forming blood clots.

Eliquis is a direct-acting oral anticoagulant (DOAC). It’s also known as a direct factor Xa inhibitor. That’s because it blocks a protein called factor Xa. Factor Xa activates the blood clotting process, so blocking it helps prevent clots from forming.

2. Plavix and Eliquis treat different health conditions

Plavix and Eliquis are both effective at treating and preventing blood clots. But they’re not approved for the same health conditions.

Plavix is approved to:

• Lower the risk of another heart attack or stroke after you’ve had one

• Prevent heart attacks and strokes caused by acute coronary syndrome (ACS)

• Prevent heart attack and stroke caused by peripheral arterial disease (a build-up of plaques in your arteries)

Eliquis is approved to:

• Lower the risk of stroke and blood clots in people with atrial fibrillation (an irregular heartbeat) that’s not caused by a heart valve issue

• Prevent the formation of blood clots in the legs after hip or knee replacement surgery

• Treat blood clots in the legs or lungs and lower the risk of them happening again

Depending on your specific medical condition, your healthcare provider will determine which blood thinner is most appropriate for you.

3. Plavix may not work for some people

Plavix is considered a prodrug. This means it doesn’t have an effect on the body until it’s activated. Once you take Plavix, your liver helps turn it into an active chemical that can prevent blood clots.

But some people have a genetic difference that prevents them from activating Plavix. This means Plavix won’t prevent blood clots for some people who take it. This genetic change can affect anyone, but it’s more common in people of East Asian descent. Your healthcare provider can help decide if this may be an issue for you.

Eliquis, on the other hand, isn’t a prodrug. It’s already in its active form when you take it. So it won’t be affected by the genetic changes the way Plavix is.

4. Plavix and Eliquis have different dosages

Plavix and Eliquis are both tablets that you take by mouth. But Plavix is normally taken once daily, and it’s often combined with low-dose aspirin. Eliquis is taken twice daily, and in most cases you shouldn’t take it with aspirin. You may need a one-time loading dose of Plavix that’s higher than your regular dose when you first start taking it. A loading dose isn’t needed with Eliquis.

There’s also a difference in how long you’ll take Plavix and Eliquis. Most people take Plavix for at least 12 months. And some people need to take it longer than that.

Eliquis treatment length ranges from 12 to 35 days to prevent blood clots after hip or knee surgery. But for other conditions, you’ll likely take Eliquis for at least 6 months. And it may be a lifetime medication for some people.

5. Eliquis can be reversed, Plavix can’t

Increased risk of bleeding is a serious concern while you’re taking blood thinners. And if serious bleeding happens, reversing the effects of your blood thinner medication can help stop bleeding. Eliquis can be reversed in your body, but Plavix can’t.

Andexxa (andexanet alfa) is the medication used to reverse life-threatening or uncontrollable bleeding caused by Eliquis. Andexxa is given as an injection into the vein and can only be administered by a healthcare provider.

Plavix’s effects can’t be reversed. But that doesn’t mean there aren’t treatments for severe bleeding caused by Plavix. Plavix doesn’t last very long in the body. And since it only affects platelets, an infusion of new platelets that haven’t been affected by Plavix can help stop bleeding. A medication called tranexamic acid (Cyklokapron) can also help stop bleeding. Both of these treatments are only given in a hospital setting.

Keep an eye out for any signs and symptoms of severe bleeding while you’re taking Eliquis or Plavix. These include:

• Blood in your urine or stool

• Coughing up or vomiting blood

• Bruising that gets larger or doesn’t heal

• Bleeding that doesn’t stop

Call 911 or seek emergency care if any of these signs or symptoms appear.

6. You may take Plavix and Eliquis together

Since they treat different health conditions, in some cases your healthcare provider may have you take Eliquis and Plavix at the same time. The combination is most often prescribed if you have both atrial fibrillation and ACS. Neither Plavix or Eliquis treats both conditions, but the combination does. And it may be a safer and more effective option for certain people than other blood thinner medications.

Keep in mind that unless your provider OKs it, you shouldn’t combine Plavix or Eliquis with other medications that can thin blood. This includes other anticoagulant and antiplatelet medications. It also includes nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin). Combining these medications can raise your risk of bleeding.

Some antidepressants can also have blood thinning effects. These include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft). It also includes serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor XR). Your provider can help decide if it’s safe to take an antidepressant with Eliquis or Plavix.

7. There are ways to save on both Plavix and Eliquis

Plavix and Eliquis are both available as brand-name medications. But you can also find Plavix as a lower-cost generic. GoodRx can help you find ways to save on your prescription.

• Save with GoodRx. GoodRx can help you save over 95% off the average retail price of the generic version of Plavix. Generic clopidogrel’s price at certain pharmacies is as low as $4.50 with a free GoodRx discount.

• Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Eliquis’ price may be as little as $10 per month using a copay savings card from the manufacturer.

• Save with a free trial card. You may be able to receive a free trial card from your healthcare provider. This card covers a 30-day supply of Eliquis at no cost. And you can use it whether or not you have prescription insurance.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Eliquis’ patient assistance program, which offers the medication free of cost.

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Written by:

ThienLy Neal, PharmD

ThienLy Neal, PharmD, has over 10 years experience in the pharmacy field, including in such settings as retail, hospital, compounding, and managed care. She has led various clinical programs while focusing on medication adherence programs, specialty drug initiatives, and polypharmacy safety initiatives.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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