Two cases of acute arthritis and tendonitis following clopidogrel (Plavix) use have been reported in the British Medical Journal (2000;320:483). Dr Anu Garg and colleagues, from the Royal Bournemouth hospital, say that both patients were aged over 60 and had significant coronary artery disease. Symptoms appeared after two weeks of therapy in one case and three in the second. In both cases, the erythrocyte sedimentation rate (ESR) was raised but both clinical symptoms and ESR returned to normal after the withdrawal of clopidogrel.
The authors say that this may be the first report of such a side effect. A spokeswoman for Sanofi Synthélabo (manufacturer of Plavix) told The Journal that side effects such as pruritus and musculoskeletal inflammation were commonly described by clinicians as "idiosyncratic reactions" and could occur with all drugs. To date, over 17,500 patient-years of data was available for clopidogrel and tolerability had been shown to be at least as good as aspirin 325mg daily.