Thanks for your question. Both warfarin (Brand name - Coumadin) and Plavix (generic - clopidogrel bisulfate) are considered blood thinners. But they are very different drugs with different actions.
Warfarin works by counteracting Vitamin K in the plasma of the blood. Vitamin K is key in the coagulation pathways responsible for the clotting of blood, and with less activity of Vitamin K blood takes longer to clot. Too little, as well as too much warfarin can be dangerous. If taking a dose that is ineffective, clot formation is not adequately prevented and the problem you are trying to treat or prevent may very well occur. Taking too much warfarin raises the risk of bleeding, especially in the gastrointestinal tract and, in the elderly, the brain. People taking this drug must have their blood monitored to measure the time it takes to clot, which can result in frequent adjustments of their dose. The use of warfarin is considered "full anticoagulation" and is felt to be more effective (a higher level) than other oral blood thinners.
Plavix is a drug known as an anti-platelet drug. This drug works on the platelets in the blood stream by causing them to be less "sticky". When clots form, platelets stick to each other as part of the clotting process. Other medications in this class of drug are aspirin, persantine and aggrenox. Unlike warfarin, monitoring blood levels or activity is not necessary.
Different situations require different levels (and types) of anticoagulation. Each case has its particular circumstances that influence a physician's choice, and in some cases, medications are combined to provide the optimal therapeutic benefit.
I hope this information has been helpful.
Martin Cane, M.D.
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