Brilinta (ticagrelor) and Plavix (clopidogrel) are two alternatives for managing blood clots. Blood clots can form clusters and obstruct coronary blood flow in individuals with acute coronary syndrome (ACS) or a history of myocardial infarction (MI, also known as a heart attack). To prevent a heart attack or stroke, medications like Brilinta or Plavix can help maintain proper blood flow around the heart.
Plavix and Brilinta are P2Y12 inhibitors, otherwise known as blood thinners or antiplatelet medications. Both drugs function as P2Y12 receptor antagonists, preventing platelets and blood clots from forming by blocking this receptor. If you have experienced an ACS episode, you might need to take these medications daily for at least a year following the event.
Although Brilinta is generally considered to be more effective, there are some notable differences between the two drugs in terms of side effects and dosage.
What is Brilinta?
Brilinta is the brand name for the generic drug Ticagrelor. Although a generic version has been authorized, it has yet to be marketed. As a result, this medication may cost more than Plavix or other similar medications like Effient (Prasugrel).
According to the American Heart Association (AHA) and American College of Cardiology (ACC), Brilinta is a preferred treatment for individuals with ACS. Brilinta has a reversible mode of action and acts more quickly. It also offers better platelet inhibition and patient outcomes similar to Plavix.
Along with a regular aspirin, Brilinta is taken as a tablet twice daily.
What is Plavix?
Meanwhile, Plavix is the brand name for clopidogrel. Unlike Brilinta, Plavix is a generic medication, making it generally less expensive compared to Brilinta.
Like Brilinta, Plavix is also taken with aspirin to reduce the risk of ACS. Plavix is taken once daily.
Note: Some individuals may be considered poor Plavix metabolizers due to genetic differences in specific liver enzymes. Poor CYP2C19 metabolizers cannot properly process Plavix and may require a different medication.
Standard Dosage
Brilinta:
- 180 mg as the initial loading dose.
- 90 mg twice daily for the next year following an ACS occurrence and then 60 mg twice daily after that.
Plavix:
- 300 mg as the initial loading dose.
- Then, 75 mg once daily.
Which drug works better: Brilinta or Plavix?
Both Brilinta and Plavix have been proven to reduce the risk of developing cardiac issues following a heart attack, stroke, or other heart disease-related events. Clinical studies have nonetheless revealed that Brilinta is superior to Plavix in terms of efficacy.
According to the PPoppins trial, a double-blind, randomized clinical investigation, Brilinta has a lower rate of cardiovascular death than Plavix.
Death from vascular causes, heart attacks, or stroke occurred in 9.8% of participants using Brilinta after 12 months of treatment, compared to 11.7% of those taking Plavix. However, after examining the study’s outcomes, PPoppins researchers discovered that the Brilinta group experienced more specific bleeding events than the Plavix group.
Brilinta vs. Plavix common side effects
Bleeding is the most frequent side effect of Brilinta and Plavix. Superficial bruises, bleeding gums, and nosebleeds are examples of minor bleeding. Meanwhile, internal bleeding, blood in the stool or urine, and vomiting are major bleeding occurrences. If you encounter significant bleeding, you should seek emergency medical help.
Other side effects of Brilinta and Plavix include:
- shortness of breath (dyspnea)
- dizziness
- nausea
Can I use Brilinta or Plavix while pregnant?
Data are insufficient to conclusively establish the safety of Brilinta and Plavix during pregnancy. Unless their advantages outweigh their risks, these medications are typically not advised. Discuss your treatment options while pregnant with your doctor.