title: A randomized crossover study comparing the antiplatelet effect of plavix versus generic clopidogrel.
abstract: BACKGROUND
  Clopidogrel exists in different salt formulations. All published data that have demonstrated its beneficial effect are based entirely on the hydrogen sulphate salt contained in the branded product Plavix, which had US sales of $6.1 billion in 2010 alone. A number of cheaper generic versions of clopidogrel are increasingly being used in Europe as an alternative to Plavix, mainly for cost reasons. However, there is insufficient evidence to show that their pharmacodynamic effect is equivalent to Plavix.
  
  
  METHODS
  This prospective study investigated whether there is any significant difference in the antiplatelet effect of Plavix versus generic clopidogrel hydrochloride in healthy male volunteers. All participants received loading and maintenance doses of both drugs, in a crossover manner, separated by a 2-week washout period. Adenosine diphosphate (ADP)-induced platelet reactivity was measured using short thrombelastography at multiple timepoints.
  
  
  RESULTS
  The results showed interindividual heterogeneity in responses to clopidogrel but no significant difference in ADP-induced platelet reactivity between Plavix versus generic clopidogrel hydrochloride.
  
  
  CONCLUSIONS
  Our findings suggest comparable inhibition of ADP-induced platelet reactivity with Plavix and generic clopidogrel hydrochloride. This observation is particularly pertinent at a time when the patent for Plavix is expected to expire in the near future leading to the large-scale switch to cheaper generic preparations.
authors.affiliation: Wessex Cardiothoracic Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom. sambunh@hotmail.com
authors.forename: Nalyaka
authors.initials: N
authors.lastname: Sambu
authors.forename: Ashwin
authors.initials: A
authors.lastname: Radhakrishnan
authors.forename: Nick
authors.initials: N
authors.lastname: Curzen
mesh_terms: D000244:Adenosine Diphosphate; D000328:Adult; D000077144:Clopidogrel; D018592:Cross-Over Studies; D016568:Drugs, Generic / Q000627:therapeutic use*; D004739:England; D006801:Humans; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D013810:Therapeutic Equivalency; D013916:Thrombelastography; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D016568:Drugs, Generic; D010975:Platelet Aggregation Inhibitors; D000244:Adenosine Diphosphate; D000077144:Clopidogrel; D013988:Ticlopidine