Can You Take Magnesium with Clopidogrel? The Important Distinctions

October 10, 2025 •

4 min read

Millions of people take clopidogrel (Plavix), an antiplatelet medication, to prevent dangerous blood clots. Many also take magnesium supplements for various health reasons, which raises a critical question: Can you take magnesium with clopidogrel? The answer depends entirely on the specific form of magnesium in question, as some carry a high risk of adverse interaction while others do not.

Quick Summary

Taking magnesium with clopidogrel depends on the specific magnesium form. Magnesium salicylate is contraindicated due to increased bleeding risk, while other oral forms like magnesium hydroxide have no known interaction. A separate risk exists for patients using feeding tubes, where mixing magnesium oxide and clopidogrel suspensions reduces efficacy.

Key Points

Magnesium Salicylate is Dangerous: Avoid this specific form of magnesium with clopidogrel, as it acts like an NSAID and significantly increases the risk of bleeding.
Magnesium Hydroxide is Generally Safe: Oral forms of magnesium commonly found in antacids, like magnesium hydroxide, have no known direct drug-drug interaction with clopidogrel.
Never Mix Suspensions in a Feeding Tube: Mixing magnesium oxide and clopidogrel for administration via a feeding tube causes a physical reaction that reduces the clopidogrel dose and can block the tube.
Check OTC Ingredients: Always read the labels of over-the-counter products carefully to ensure they do not contain magnesium salicylate or other NSAIDs.
Consult Your Doctor: Before starting any new supplement, always discuss it with your healthcare provider to ensure it's safe for your specific medical conditions.
Report Bleeding Symptoms: Be aware of and report any signs of bleeding or unusual bruising to your doctor, particularly when on an antiplatelet regimen.
Spacing Doses: If using magnesium for digestive relief, talk to your doctor about whether spacing doses apart from clopidogrel is advisable, though not a documented necessity for most forms.

The Critical Difference: Magnesium Salicylate vs. Other Forms

When evaluating the safety of combining magnesium and clopidogrel, the most important factor is the type of magnesium. Most people associate magnesium with common supplements, but magnesium can be combined with other compounds that dictate its properties and potential drug interactions. This distinction is crucial for anyone taking the antiplatelet drug clopidogrel.

The Major Interaction with Magnesium Salicylate

Magnesium salicylate is a pain-relieving compound that acts as a Nonsteroidal Anti-inflammatory Drug (NSAID). Because salicylates, like aspirin, are also antiplatelet agents, combining them with clopidogrel can significantly heighten the risk of bleeding. The combination can cause serious complications, including severe gastrointestinal (GI) bleeding. Symptoms of a GI bleed to watch for include black, tarry stools; severe abdominal pain; or vomiting blood. Due to this dangerous additive effect on bleeding risk, this combination is considered a major interaction and should be avoided unless specifically instructed and monitored by a doctor.

Oral Ingestion of Other Magnesium Forms

For most oral magnesium supplements and antacids that do not contain salicylates, there is generally no known adverse drug-drug interaction with clopidogrel. For example, popular antacids containing magnesium hydroxide have been shown to have no interaction with Plavix (clopidogrel) when taken orally. Common supplements such as magnesium citrate, magnesium glycinate, or magnesium oxide for constipation also typically do not pose a direct antiplatelet risk like magnesium salicylate. However, this does not mean there are no considerations to keep in mind, as discussed below.

The Unique Risk of Mixing Suspensions for Feeding Tubes

Another distinct interaction has been identified for patients who require medications to be administered through a feeding tube. A 2021 study investigated the effect of mixing clopidogrel bisulfate tablets with magnesium oxide (MgO) tablets as a suspension. The study found that combining the acidic clopidogrel suspension with the highly alkaline MgO suspension resulted in a chemical neutralization reaction. This reaction caused the clopidogrel to change from a water-soluble form to a water-insoluble, viscous residue.

This physical interaction had two major consequences:

Reduced Dose: A significant portion of the intended clopidogrel dose adhered to the inside of the syringe and feeding tube, meaning the patient received a considerably lower dose than prescribed.
Tube Blockage Risk: The viscous residue also increased the risk of the feeding tube becoming blocked.

The study concluded that for safe and effective treatment, clopidogrel and magnesium oxide suspensions should never be mixed and should be administered separately via the feeding tube. This is a pharmacokinetic interaction based on the physical mixing of two different pH substances, not a systemic drug interaction when taken orally and digested naturally.

Key Considerations Before Combining Medications

Because medication needs are highly individualized, it's essential to follow specific medical advice. Here are general guidelines to discuss with your healthcare provider:

Read Labels Carefully: Always check the ingredients list for over-the-counter products. For pain relief, many common products contain magnesium salicylate. Opt for alternative pain relievers approved by your doctor that do not contain salicylates.
Discuss Timing: For oral supplements and antacids, discuss optimal timing with your doctor or pharmacist. Spacing doses apart can minimize any potential interference with absorption, though it is not a documented problem for most forms.
Report Symptoms: Be vigilant for any signs of bleeding, including easy bruising, unusual bleeding, or black stools, and report them to your doctor immediately.
Inform All Providers: Ensure your entire healthcare team, including pharmacists, dentists, and specialists, is aware you are taking clopidogrel.

Comparison of Magnesium Forms and Clopidogrel Interaction


Magnesium Form	Interaction with Clopidogrel	Primary Risk	Cautionary Note
Magnesium Salicylate	Major Interaction	Increased risk of bleeding, especially GI bleeding.	Avoid this combination entirely; seek alternative pain relief.
Magnesium Hydroxide	No known oral interaction.	Low to none for oral ingestion.	Safe to take orally, but consult your doctor on timing.
Magnesium Oxide (MgO) as an oral tablet	No known oral interaction.	Low to none for oral ingestion.	Safe to take orally, but never mix with clopidogrel tablets for feeding tubes.
Magnesium Citrate/Glycinate	No known oral interaction.	Low to none for oral ingestion.	Always confirm with a healthcare provider before starting any new supplement.

Conclusion

While a blanket statement about combining magnesium and clopidogrel is misleading, understanding the specific types of magnesium is critical for safety. The key takeaway is to strictly avoid magnesium salicylate due to its properties as an NSAID, which dramatically increases bleeding risk. For most other orally ingested forms like magnesium hydroxide or citrate, no direct antiplatelet interaction is documented. However, the special circumstance of mixing medications for feeding tube administration presents a unique and serious issue, where combining magnesium oxide and clopidogrel suspensions can lead to a reduced dose and tube blockage. The best course of action is always to consult with a qualified healthcare provider or pharmacist regarding any drug or supplement regimen to ensure safety and effectiveness.

Your Health Partner

Always speak with your doctor or pharmacist before adding any new supplement, including magnesium, to your regimen, especially while taking an antiplatelet medication like clopidogrel. It's crucial to make sure your treatment plan is safe, effective, and tailored to your specific health needs.

Frequently Asked Questions

Yes, generally. There is no known direct drug-drug interaction between magnesium hydroxide (a common antacid) and clopidogrel when taken orally. However, you should still consult your doctor or pharmacist to confirm it's safe for your specific health situation.

Magnesium salicylate is an NSAID, similar to aspirin. Combining it with clopidogrel, which is also an antiplatelet, increases the risk of bleeding, especially in the gastrointestinal tract. This combination should be avoided.

While there is no known direct interaction for oral ingestion, it is still best to consult with your healthcare provider. They can confirm the safety of your specific supplement and recommend proper timing, if necessary.

A study found that mixing acidic clopidogrel suspension with an alkaline magnesium oxide suspension creates a physical reaction. This results in a thick, water-insoluble residue that can reduce the clopidogrel dose delivered and potentially block the tube.

The amount of magnesium in most multivitamins is usually small and typically not the salicylate form. However, to be certain, always check the ingredients and discuss any new supplements with your doctor before starting.

No. The risk of interaction varies significantly depending on the form of magnesium. The major interaction is with magnesium salicylate. Other common oral forms, like magnesium hydroxide, do not have the same risk.

If you are taking clopidogrel and suspect you may have taken magnesium salicylate, watch for symptoms like black, tarry stools, severe abdominal pain, weakness, or bloody or coffee-ground-like vomit. Seek immediate medical help if these occur.