Plavix, Aspirin and Stents (July-December 2006)
| ||
| Postings on This Page (150): • I had been on plavix for 6 years due to clotting
caused by a lupus antigen in my blood. I am also taking 5 mg. coumadin
6 days a week. Dr. recently discontinued plavix due to a second episode
of bleeding inside my eye. Should I be concerned about platelets beginning
to stick together and causing clotting? • On 20040410 I had
a 100% blockage in the mid LAD coronary artery. After 3 hours, a drug-eluting
stent was placed. For 6 months I have taken aspirin and Plavix. In
sept 2004 I felt more and more out breathing. On 17 nov the cardiologist
found a 90% blockage at the edge of the stent(caused by connective
tissue). He placed a second stent in front of the old one to open it.
The cardiologist prescribed again ascal(aspirin) and Plavix for 6 month.
But I had a thought of "Deja Vu" and decided to take no "medicine" at
all. At 5 dec 2005 the cardiologist found both stent 100 % open but
I had another blockage 70% in an other branch. He won't give me a new
stent because I had no damage of it (He said) and because of the trouble
I had had with the first stent. I had not agreed I think that the use
of aspirin after stent placing prevents the natural healing of the
arterial wall when it has a little damage by placing a stent. I think
that there is no scientific research about the influence of aspirin
on damaged tissue in the coronary artery. It is even possible that
in some cases the "wonder medicine" Plavix repairs the damage of the
use of aspirin. My cardiologist ( a professor) called me a fantasist.
Am I? (ps. I am a biologist) • I had the drug eluting stent (Taxus) inserted
in an artery in March 2006. I was initially told I would need to take
Plavix and 81mg aspirin for 6 months. After my six months checkup which
included another thallium test, my cardiologist said I would need to
stay on this medication for another six more months. I recently had
a nose bleed and cough up some blood daily. I have many other health
problems such as TMJD, degenerative Scoliosis,asthma, vertigo, Tinnitus,GERD,arthritis,possibly
fibromyalgia. I am 54 years and I have noticed that when I take Plavix
either with aspirin or without aspirin I get severe Tinnitus(ringing
in the ears) which affects my equilibrium and concentration. I am currently
still working, hoping I will be able to work till I am eligible to
retire at 55 in 2007. I did not know about the side-effects with drug-eluting
stents until recently. I don't think I can take the Plavix for another
5 months because it is making my Tinnitus worse and difficult for me
do my work on the job. My ENT specialist told me several years ago
that aspirin, and too much salt aggravates Tinnitus. If I stay on Plavix
for 5 more months I will probably have to retire sooner. Could you
please give me some advice what to do here. Is there another substitute
for Plavix which may not aggravate Tinnitus? SJY • My husband had 5 Cypher stents inserted into
1 artery in July 2005 (2 procedures). In Sept 2005, he had an emergency
quad bypass after doctors realized that the 5 stents had clotted and
that his other lesser blocked arteries had progressed significantly
(despite all of the meds he was on). He was on Plavix right up until
the surgery but he hasn't taken it since. He is on Toprol and Lipitor
and baby aspirin only. Even though he had the bypass, should he still
be on Plavix because of the stents? He is just 49 yrs old and was very
active prior to all of this. Although he is back to working full-time,
his stamina has been greatly reduced since his first heart attack and
the insertion of those stents. The bypass has helped a little but he
is still is not the same. • Dear educated -- you're right in many respects.
And Ticlid and Plavix are similar, but they are different drugs and
some patients who are allergic to Plavix, are not allergic to Ticlid,
and vice-versa. Ticlid was the first antiplatelet drug used. Then Plavix,
which touted less side effects, came on the scene and Ticlid was relegated
to second place. But some doctors find it works as well if not better.
Also in Japan, Ticlid is the antiplatelet drug of choice. As for aspirin
dose, the current AHA/ACC guidelines state: "Patients who have
undergone percutaneous coronary intervention with stent placement should
initially receive higher-dose aspirin at 325 mg/d for 1 month for bare
metal stent, 3 months for sirolimus-eluting stent, and 6 months for
paclitaxel-eluting stent." • This is so frustrating reading so many of
these comments. For one, Ticlid is Plavix. Plavix is derived from the
Ticlid molecule. So if you have an allergic reaction to Ticlid it will
most likely be the same for Plavix. You will not have the same success
with Ticlid as you will have with Plavix because it's not the same
isomer. What so many of you are missing with the frustrations with
having a DES and needing to be on Plavix for the rest of your life,
is the fact that if you had a blockage in the kitchen, you probably
have blockages in the basement and top floor too. Plavix will prevent
you from having a heart attack from other areas where you don't currently
have stents. There have been so many cases that stented patients were
taken off Plavix after one year and they show in the ED [Emergency
Room] with a heart attack and 100% blockage in the artery that was
clean 10 days before. The time frame of how long to be on Plavix is
a big issue just like a previous writer stated. Many cardiologists
feel like I stated in the previous paragraph that you will have more
problems. Why would take a risk with your life if you know that Plavix
can help prevent that? Also, the bleeding factor-it is Aspirin dose
driven. You should NEVER be on 325mg of asa and Plavix together! You
should be on no more than 162mg of asa. Many trials have shown that
the bleed rate is dependant on the asa dose. • Salim -- you and your twin brother are a clinical
trial of two! Just curious. I assume your bother did not get a drug-eluting
stent (they were not yet on the market in 2001) which may be a testimonial
to the benefit of these devices. • I had a Taxus Stent put in my LAD in 2003.
My Cardiologist told me to go on Plavix/Aspirin for the rest of my
life. My twin brother had a Stent implanted in 2001, unfortunately
his Cardiologist told him to stop Plavix after few months . Well he
had a severe Heart Attack due to a Blood Clot. Both of us are very
active and jog everyday . I went for another angiogram on 2006 and
fortunately My Stent is only 30% blocked due to tissue build up . I
am now planning to cut Plavix to 1/2 a tablet and continue taking ASA
(81mg) until further data is released on the safety . We had blocked
arteries because of genetics. Thanks to my Cardiologist to keep me
on ASA for life . • To all who report an allergic reaction --
Plavix definitely can result in an allergic reaction, often a rash.
But it is difficult to discren exactly the cause of the allergic reaction
without systematically withdrawing each drug, step-by-step to determine
which one, if any, is the cause. This is NOT something patients should
attempt on their own. There could be significant and adverse consequences.
But an ongoing study of the possibility of stent allergies is now being
conducted and a protocol for determining what is causing the reaction
has been developed. If you think you may have a stent allergy, email
us at stentstudy@angioplasty.org to
get more information. • My wife had stents
in july 2006. has been on plavix since. Has had multiple problems mostly
pain in legs and insomnia, also upset stomach constantly. She got so
bad she went off and has started to live again .Well while she was
so sick she must of had a another blockage form and will know more
tomorrow. She tires more now than before stents. keep her in your prayers
guys and girls, she's a wonderful person much too young for this trouble.
We also want to thank the producers of this forum, we would be in the
dark about all this going on without you. • 10 years ago, I underwent by pass surgery
and have been doing well since. About 2 months ago, I went thru a battery
of tests where a blocked artery was discovered, I then had a stent
put in and the Doctor prescribed Plavix, 75 mg 1 X day. I have been
taking the Plavix for 42 days. 3 days ago, I suffered intense pain
in my right wrist. I went to emergency and the Doctor upon seeing a
red streak going up my inner wrist, put me on an immediate IV of Cipro
and prescribed Cipro for another 10 days. The next day, the red streak
was gone but the pain was still there. By the evening, the pain was
completely gone. In the early morning hours of the third day after
the original wrist pain, I woke up with extreme pain in my right knee
right at the knee cap. As I lay in bed, I thought something must be
causing the pain and wondered if it was the Plavix because that was
the only thing I have started taking in the previous 7 months. I then
did a search on "Plavix Reaction" and low and behold, I found this
forum. I hobbled to the Doctors office this morning, and he was completely
stumped and ordered X Rays of my knee and an ultra sound of my right
leg. Nothing was discovered. Today, I stopped taking Plavix and tonight,
the pain in my knee is going away fast and I can now walk again without
pain. I am now convinced that the Plavix was the problem. Needless
to say, when I told the Doctor in today's visit about this web forum,
he doubted me and told me to continue with the plavix. Fat Chance!
Can anyone here tell me if I am on the right track about Plavix Reaction? • In November or December, 2003, I had 2 stents (1 drug inducing) placed in my heart at --------------------------------. The Doctor prescribed Plavix, Metropoal, Crestor aspirin, (I have always been able to aspirin on a daily basis without any side effects). When I went home, I was feeling good. After having the prescriptions filled and initial use, I believed I had a stroke. I had very severe headaches, Severe acid reflux, my eyesight became very bad and I had to start wearing glasses, rectal bleeding, ringing in my ears, numbness on my right side and back. I became cloudy and noticed that I could not spell and think as I did before the operation. I also started having severe pain in my thighs from nerve damage (I have had this type of pain before taking plavix or other medicines which later was diagnosed as nerve damage from unknown causes) which seemed to be exacerbated. I felt it was one of the medicines I was taking so I took my self off Crestor but the symptoms remained, I then tried taking myself off Metropoal and the symptoms remained. Then I took myself off plavix and the headache, and acid reflux disappeared and I became more active. I called Dr. ------------office and let them now of the results. I was told by the Doctor to immediately get back on the Plavix or I could have a blocked artery. I went back on the Plavix and the symptoms returned. Later in the month, I visited Dr. -------- and told him that I was allergic to plavix and believed I had a stroke. He told me that it was nonsense and that plavix was necessary for my well being. I told him that I couldn't t take it any more and that I will not take the plavix. He was very upset and because of my refusal and prescribed ticlopidine. I started feeling better and the acid reflux disappeared. I cannot recall the date and think it was just before my Doctors visit that I checked myself into the -----------. This time it was for what I believed was a stroke and severe acid reflux. They performed a cat scan and mri which came back negative; They did not do anything for the acid reflux. I went to my personal Doctor in __________ who prescribed Nexium and some other medicines. I started feeling better and was even jogging. In December of 2004, I had 2 more stents placed in my heart (drug inducing). My cardiologist again put on plavix (I told ------------- of the side effects of my taking plavix but she insisted that I take it. After starting plavix again (I still take it) my symptoms returned and I have to live with them I guess. Because of the side effects I have not been able
to work and my whole life has been turned around. On Nov. 20th 2006
(approx.) I fell in a store and suffered a concussion and stroke. Currently,
I do fall down and my right side is partially paralyzed, I do not think
as clearly. Last week I visited a new cardiologist who prescribed sucralfate
and protonix (helps with my acid reflux) and I will be visiting him
in a couple of weeks and go over my symptoms and the side effects caused
by plavix. I will be seeing my neurologist. regarding my stroke. Previously
he had prescribed Cymbalta and Gabapentin for my nerve pain (works
well) and recently prescribed butalbital for my headaches. • Feb. 2005 my husband had triple bypass. Nov.
16, 2006 he had balloon angioplasty and received a nickel drug eluting
stent. He was put on Plavix and Isosorb mono. Nov. 18, 2006, he started
Ranexa. Two days later he began having hives and unbearable itching.
Because of the different dates of the medications we don't know what
to suspect as the source of the hives and itching. Could an allergy
to nickel cause these symptoms too? Thanks. • Tom Higgins and Brian M. -- generic is Clopidogrel
Bisulfate -- the FDA says it is equivalent to Plavix -- we've gotten
some differing opinions from patients. Your doctor is right. The area
could not be grayer! • I am a 40 y/o male with 3 cypher stents in
my coronary arteries. My cardiologist recently refilled my rx for plavix
and was very specific that I use branded plavix. Could you aid me in
a third party justification for the specification. We are a military
family and the rx is free if I use generic as opposed to $150.00 a
month for branded. It really isn't about the money but more about why
a federal pharmacy would carry a generic form of a drug that may not
live up to it's branded brother. Thank you • I am 62 years old. I had a Cypher stent put
in, in May 06. I have been on plavix since then. This month I started
taking the generic (clopidogrel) it does not say bisulfate. Two questions
1. are they the same? 2. How long must I stay on this. My doctor says
its a gray area. Its just that the drug makes me feel lousy. • Tom -- we have actually gotten reports both
ways. Some who were allergic to Plavix seem to not be allergic to the
generic. • I seem to recall that one or more patients
have complained that the Plavix generic drug caused them allergic reactions
while the Plavix brand did not. Can this really be true? If a generic
is supposedly chemically identical to the original brand, I would think
that any reaction would be the same for the brand product or the generic.
I have been on Plavix for 10 months now, and am giving thought to switching
to the generic to save money. • Maureen -- bruising can be a side effect of
Plavix (capillaries in the skin not clotting) and while it may not
be serious, it should definitely be reported to your husband's cardiologist,
as you have done. Let us know what happens. • My husband is a 60 year old healthy man.
On November 06 he recently had 3 stents put in with a 99.9% blockage.
He never had any heart attack. His cardiologist put him on Plavix.
Just this past week we noticed 2 large bruises, one on his leg and
one on his arm. We called his doctor today and have yet to hear from
him. Is this normal? In the little pamphlet that came with the Plavix
it said to contact the doctor immediately. • I'm a 67 year old male, never smoked who
had heart attack Oct. 1, 2006, two Cordis/Cypher coated stents placed
in right side of heart. Taking Plavix (75mg) aspirin (81mg) and Zocor
(20 mg) & Lopressor (25mg 2x da). I had no indications of heart problem
and blood work was good. hmmmm, it's in the genes with father and younger
brother. So far, I'm having no side affects from meds or stents. Interesting
reading, I, with Google's help found this forum. • At the FDA Stent Meeting this week, someone
from Accumetrics presented information about a simple FDA-cleared blood
test called VerifyNow that can be used to tell whether or not your
aspirin is working and potentially adjust the dose. • I am 43/Male..Had a heart attack Sat 12/2/06
after a workout. RCA was 100% blocked and had non-coated stent put
in within 2 hours of attack. All other arteries appear to be fine.
Since being released Wed 12/6/06, I am on Lisinopril 5mg, Atenolol
25mg, Clopidogrel 75mg, aspirin 325mg, Lipitor 40mg (up from 10mg preattack),
Zetia 10mg, Prevacid 30mg(5 years now). I soon developed a rash on
my feet and buttocks which seems to get worse each day. On 12/8/06
my GP and cardiologists suggested dropping the Zetia and Lisinopril
which I did today, however the rash still covers my feet and has spread
to most of my torso. It doesn't itch a lot but is warm. I suspect it
is the Clopidogrel causing it though. Should I try brand name Plavix
instead if that turns out to be the case? or should I switch to ticlid?
Is ticlid as effective? • to Anonymous, USA, May 4, 2006. Just reading
this now and wonder if you are seeing the same young, cocky, opinionated,
self centered, holier than thou, cardiologist that I have been seeing.
Is he at the med center in Houston? Do you have the bare metal stents?
If so, "I" do not believe you need to be on blood thinners for BMS
as long as you do for Drug Coated Stents. Good Luck To You. • Prior to my four DES and 2 years on Plavix
I always had normal blood work, i.e. Electrolytes, CBC, Liver and Kidney
function. I have not felt well since these DES and Plavix and do not
know which is the culprit. For the past 14 months, my albumin is high
and serum globulin is low. My Ferritin is also low. On the advise of
my hubby, I saw an Endocrinologist as TSH was also a little high. This
doctor ran a battery of tests and called me the other day and told
me my Parathyroid Levels are thru the roof and and my Vitamin D levels
are in the cellar. I have secondary Hyperparathyroidism and with symptoms.
I have been placed on a strong RX of Cacitrol with repeat testing.
This doctor asked me what meds I have been taking over the past year
or so consistently. HELLO! • Hi, I'm a newbie to this site, found as the
result of googling after widespread publicity about possible dangers
of DES stents. I am a 64-year-old white male, had 2 stents implanted
at VA Hospital in Madison, Wis., September 2004 after nuke stress test
found 75% of two arteries blocked. Cardiograms previously proved normal,
but doctor said stress test much more determinative. Pictures don't
lie, do they? In the wake of the FDA's announcement about DES stents
possibly raising risk of clots, I'm naturally concerned. I was put
on Plavix after procedure for a couple of months, then taken off. No
episodes in past two years, but I did have gastric bypass surgery in
January 2005 and lost 150+ pounds since then. Down from 351 to 199
currently. Also had knee replacement in November 2005. The trauma of
two major surgeries, the weight loss plus the stenting has me worried
that this ol' bod might be a bit traumatized. I don't want to worry
about these coil springs in my heart but can't help feeling that there
may be a ticking time bomb ready to go off any day. Contacted VA for
follow-up consultation to see if I should take Plavix again or get
retested. Awaiting appointment, which could take weeks at the VA, which
isn't known for adopting a sense of urgency in even the most severe
cases. Would appreciate any info, anecdotal or otherwise, from DES
patients. I wonder whether Plavix or equivalent is worth the risk.
Sometimes the cure is worse than the disease. All comments help appreciated.
Post here or email me. Thank you! • I am new to this forum. I have 8 DES Cypher
stents and I am on nine medications (testim, tricor, crestor, clonazepam,
generic plavix, 85mg aspirin, lexapro, prescription vitamin D, and
norvasc). I am only 39 years old, but I have none of the issues or
drug reactions noted above, other than a widely dispersed itching and
rash. My cardiologist recommended zyrtec, and allergy medication, which
cleared up the rash issue and I was able to stop taking that after
about one month with no return of symptoms. I exercise now every day
and my total cholesterol is below 100 (my triglycerides were at 1200
at one point). Soon I will be off the Norvasc. I can't stress enough
the role that multiple major clinical depressive episodes had on my
health. Controlling stress is one of the most important aspects of
any recovery so I urge the readers of this forum to not shy away from
visiting a Psychiatrist if you feel it is necessary. It has really
made a difference for me. I am able to work and live a normal life,
and have no anxiety whatsoever about the 8 stents residing is my chest.
If anyone is interested, I have a picture of the LAD blockage (100%
blocked - needed 5 stents) on my site http://www.lumponablog.com/?p=163.
I wish all of you well and hope that knowing of a 39 year old with
8 stents is doing well and living a wonderful life will encourage you. • Thanks for the compliment Linda!! • My husband went to the ER three times and
was hospitalized due to a reaction from Plavix. He had many of the
symptoms that others on the forum had mentioned- hives, swelling in
hands and feet, severe joint pain, worse at night. Each time, despite
telling the doctors about this forum and the fact that many people
had reported the exact symptoms as my husband, they refused to accept
that it was the Plavix. The reason being, "he should have had a reaction
right away" despite what I had told them about other patients mentioning
their symptoms did not start until two to three weeks after starting
Plavix. Finally, after copying many of the comments from this forum
and showing it to the 5th doctor they accepted it was the Plavix and
determined it was actually not an allergic reaction but "serum sickness" which
can develop 7 to 21 days after exposure and can be induced by blood
products. Finally, they took him off the Plavix and he is now recovering.
If it were not for this forum, the clueless doctors would probably
still be grasping at straws and insisting it's not the Plavix. Thank
goodness for the Internet and sites like this. BTW~the doctors felt
it was a rare reaction, however judging by the number of patients on
this forum with similar symptoms, I doubt it. H • Rick -- boy, your question could not be more timely! I am in Washington (DC, not Seattle...) attending the special FDA panel meeting on stent safety and your question was actually discussed at some length just yesterday afternoon. Now remember, in this room of 500 people were some of the most prominent cardiologists in the world (yes, well-known physicians from The Netherlands, Italy, Japan, etc. as well as the U.S.) And the question of whether to restart a patient on Plavix after they had successfully completed the usual 6 month course went back and forth. There is also significant debate on whether there is any benefit to be derived from more than 6 months anyway. The resolution was that it should be left up to the individual cardiologist and his/her patient. This wasn't exactly a "cop-out" because it is a very complex issue. Long-term Plavix therapy might not be a problem for some; for others, there might be a risk of bleeding or other adverse reaction -- one that might outweigh risks of the late stent thrombosis. And, to some extent, that risk of thrombosis after 6 months can be impacted by specific information about your particular medical situation, where the stents are placed, the characteristics of the artery, all things your cardiologist may be looking at. The panel couldn't agree on a consensus statement
(of course, the meeting continues today -- maybe one will emerge).
A perfect example of this situation can be seen in an exchange that
took place between Dr. Christopher White of The Ochsner Clinic (New
Orleans) and the panel chairperson, Dr. William Maisel of Beth Israel
Deaconess (Boston). When debating if the FDA label for antiplatelet
therapy with Plavix or Ticlid after drug-eluting stents (DES) should
be changed from 3 months (Cypher) and 6 months (Taxus) to a year or
more, Dr. White quite forcefully said, "No" -- these are
minimum recommendations. The actual duration should be up to the individual
physician. Dr. Maisel then asked, "Dr. White, if you had a DES
and no bleeding risk, how long would you take Plavix?" Without
hesitation, Dr. White responded, "Indefinitely!" and the
room rippled with laughter. Not that this is funny, Rick, but it had
been a very long day! Of course, having been allergic to Plavix, you're
taking the older drug Ticlid (ticlopidine) which has other adverse
events (by the way, yesterday we heard that in Japan, Ticlid, not Plavix,
is the antiplatelet drug of choice). So you can talk more to your Cardio
Guy -- or you could talk to the room full of Cardio Guys here in Washington
-- they don't have a one-size-fits-all answer either. Hopefully your
doctor can explain his reasoning to you and his analysis of your risk/benefit
assessment so you are comfortable with the decision. • I'm a 66 year old white 230 lbs male. 2 Cypher
stents placed 5/19/2006. Began a banquet of new meds in recovery area
to include Plavix, 325 mg aspirin, Toprol, Uroxotral & Crestor. Within
2 days a skin reaction occurred, (severely itching red blotches) Cardio
Guy suspended Crestor and switched me from Plavix to Ticlid. I say
he could not have known if I was allergic to Plavix under those conditions.
Now after 6 months and 14 blood tests I am off both Plavix and Ticlid.
Under the new JNJ Cypher news I'd like to begin a regimen of Plavix
until definitive news, the Cardio Guy says'"No". I say "I don't like
the odds of 1 in 200 of post stent thrombosis" Should I find another
Cardiologist?? • On Nov. 28, 2006, Paul from New Hampshire
was concerned about his 6 DES stents, and asked whether a voluntary
bypass would protect him against stent thrombosis occurring after the
bypass (suspenders and a belt, so to speak). I was wondering the same
thing, but I have seen no opinions posted regarding his question. An
additional question: If such surgery would protect one against stent
thrombosis, would that likely be considered "urgent" and therefore
covered by many health insurance plans, or be considered "elective",
and therefore probably not covered? • In March 2006, I was enrolled in a clinical
trial (which was recommended as I lay in the bed from the cardiac cath
in the recovery room) The DES was implanted and I also take the Plavix
and Aspirin. Now the fear has started to kick in....and no one has
the answers....I am planning to attend the FDA meeting to learn what
all of this really means.....I feel duped. • why don't the doctors ask the patient before
the angio procedure which stent we want. I was never given a choice
and now look what I have to live with: drugs the rest of my life and
I had no choice. I think we are all being used as test dummies and
its not right. Oh well, I hope I live a long healthy life because I'm
suing the bastard and he better have a good insurance company -- my
turn to ruin his life. • Erna, it's not Angioplasty.Org that suggests
Plavix or Ticlid -- the package inserts, required by the FDA for both
Taxus and Cypher stents, specifically state that the recommended antiplatelet
therapy is either Plavix or Ticlid with aspirin. Perhaps there is some
reason why your cardiologist doesn't think ticlopidine (Ticlid) will
work for you. Have you asked him/her? • I have severe reactions from Plavix severe
tiredness, bruises, bleeding from my nose stomach ages and nausea and
on and on. I asked the doctor to put me on Ticlopidine (Ticlid), like
angioplasty.org suggested and the cardiologist asked me if I wanted
to die?? And I was going to die if I did not take Clopidogrel. I explained
that I had stopped Plavix several times for one to two days and I was
feeling completely healthy. I had energy to work and more. The first
time I was on Plavix 3 years ago, I had my platelet count dropped so
low that they wanted to do a transfusion. The cardiologist also said
he most all people tolerate Clopidogrel. So, what do I do now? • Follow up to December 1 posting: The Rash
seems to be subsiding at day 3 off of Plavix. I had taken Plavix for
7 days prior to the procedure. I'm new at this and still caught up
in some fear but the rash does seem to be retreating. At day three
on Ticlid I am experiencing what I am guessing is simply thinner blood.
Kinda warm maybe flushed now and then. Reminds me of niacin and the
tingle and warmth when capillaries open up. I am sympathetic to anyone
trying to manage new and fearful sensations surrounding these procedures.
Thank you for your comments and I will keep you posted as to my progress. • Just wanted to call everyone's attention to
Thursday's blog entry from "Voice in the Ear", written by
Burt Cohen, Editor-in-Chief of Angioplasty.Org. It's called "The
Catch-22 of Plavix and the FDA: Not My Job" and talks about
the unbelievable and little-known fact that the use of Plavix for stent
patients in a non-emergency situation, is technically speaking "not
an approved indication" from the FDA. • Posters are describing some of the problems
with long-term antiplatelet therapy: bleeding, complexity of scheduling
surgery, etc. And one can't stop taking these drug because of the higher
risk of stent thrombosis. No easy answers here -- possibly the FDA
meeting later this week will lay out some clearer procedures. • James -- Sorry for your problems. Your reaction
showed very quickly after the stenting, but is possibly Plavix-related.
Sometimes drug reactions take a while to show up and it may be coincidental
that it showed up right after the angioplasty. We'd be very interested
if the rash goes away after the switch to ticlopidine (Ticlid). Ticlid
is the drug that was used as an anti-clotting medication before Plavix
came on the market. Most cardiologists moved toward the newer drug
because it had less side-effects. However, cardiologists today often
put patients who show a sensitivity to Plavix back on Ticlid -- one
recently told us he was surprised at how effective Ticlid was and the
allergic reactions of his patient went away. Please let us know if
this occurs in your case. By the way, your cardiologist's quick action
(and his taking your symptoms seriously) are a sign that you have a
very good cardiologist! • Angiogram 8 days ago two blockages 90% and
70 %. I had 2 Cordis Cypher stents implanted 11/29. I was on Plavix
for 7 days prior to procedure and felt no reaction to the drug. Early
next morning following the procedure I awoke with an aggressive rash
spreading over my body. It was open and oozing in two locations nurses
put it off to possible allergic reaction to laundry detergent. I called
my cardiologist and told him about the RASH and he wanted to see me
immediately and subsequently concluded I was having an allergic reaction
to PLAVIX and changed my prescription to (TICLID) with the warning
that it to may cause an allergic reaction. It's late at nite and I
have been researching on the Internet for several hours as I have grown
a little frightened about this whole issue as it pertains to me. Am
I allergic to the Stent itself ? (I asked that question and was given
a pat answer) "NO" that just doesn't happen. Will the alternate
thinner TICLID do the job and are the possible bone marrow issues,
mentioned by my doctor life threatening. Just like most lay people
I really don't know what to think. I expected the whole thing to be
under whelming namely because of the almost "routine" air
around all aspects of this procedure. I'm scared that my quality of
life is going to plummet if I am allergic to the Stent itself or the
medications or both. I am not done living quite yet. • I'm a 45 yo male that
never smoked, was always in the gym, had normal chol. numbers. In Sept
of 2004 I received 6
DES and 1 BMS. I hit the jackpot. I've been on Plavix, toprol, lipitor,
cozaar and full a dose aspirin since the stent placements. I am heading
for a stress test tomorrow. It will be the second one in the past two
years. My big question is, Is it possible to check to see if all the
stents have properly endothelialized. Also, I'm wondering if a voluntary
bypass might be a good idea considering the DES danger? Would a bypass
make a difference if the stents thrombosed later on? • In April this year I had three DES (Taxus)
emplaced after a series of stress tests and a couple MRI procedures.
I m 60 yrs old. Besides being a tad
husky (6 ft and 220 lbs) and consistently sedentary, I'm in pretty good
health. Upon walking out of the hospital after the procedure I felt
noticeably better.
I was prescribed a modest drug regime (Plavix, aspirin and some little
ones to lower cholesterol) but felt I was good for another 10,000
miles! Because of Plavix
I noted excessive bleeding when I nicked myself shaving, but discounted
any
further problems. Well, sometime in August '06 I had a couple
bleeders in my head (probably
the result of banging my head while moving a 20 ft boat) which resulted
in a hemorrhagic stroke and a follow-on hard surgery. Immediately
prior to this surgery
I had to have platelet replacement--four units-to allow the craniotomy
to go
forward. Then, per my neurosurgeon and against the better advice from
my cardio surgeon I was taken off the Plavix for better than a month!!
Well, I've recovered
from most of the effects but am back on Plavix as the medicos assess
I
am in more jeopardy for a heart attack--thanks DES-- than a follow-on
stroke although
I was told I am a likely candidate for a stroke given my history and
current drug regime. As I assess all this I guess I've landed on a
question of
timing. I do wish my cardio had taken more time and laid out the
risks as known then
and given me more of a choice. I would have elected to go on the drug
regime without the stenting for a while as I suspect the stents were
premature.
But like many in the arrogant physician community, they know best
and I'm just
a layman. What to do?? I guess make my peace with those around
me, tell my family
I love
them and don t sweat the small stuff and most of it is small stuff. • I had a Cordis DES with angioplasty on Oct.
17, for a 95% blockage in the LAD. Was put on plavix 75 mg, toprol
25 mg, aspirin 325 mg. After 4 weeks by continuing cardiologist (not
the one who had performed the procedure) stopped the toprol. On plavix
and aspirin, I had severe nosebleeds on Nov. 14 and 15. The second
one couldn't be stopped and after 5 hours I went to the ER and they
ended up packing one nostril. Saw my GP's assistant the next day
and she recommended stopping the aspirin, which I did. Saw an ENT on
Nov.
20 and he recommended saline washes. Resumed aspirin on Nov. 23 and
had another severe nosebleed that sent me to the ER at 5 in the morning
of Thanksgiving day and ruined my family's holiday. I stopped the
aspirin again. Talked to my continuing cardiologist on Nov. 27 and
asked if
there is any alternative to the plavix-aspirin combination, but he
was completely adamant that I go back on that same regimen. He didn't
mention any other possible drugs and before reading this forum I
didn't know to ask about any. He views the nosebleeds as somebody else's
problem
to get under control. I live in dread of when the next one will start
and send me to the ER for a further several days of lost work and
abject misery. I have an appointment with the ENT guy in 13 days and
just
hope my nose holds out that long so that he may be able to cauterize
the site of the bleeds. This is no way to live. • Tom L., aspirin and Plavix (or Ticlid) work
differently, inhibiting platelets grouping together in different ways.
That's why both are prescribed. There has been evidence of "aspirin
resistance" and there is a test for it, although many feel it is not
that accurate. • Follow up appointment today with Cardiologist. Put me on Ticlid. Hope I don't get the same rash that I had with the Plavix. Went three weeks with only 325mg aspirin and no Plavix. I am still here. Read that aspirin doesn't work to thin blood in some people. Is it possible that the aspirin/Plavix combo or the aspirin/Ticlid combo works better than aspirin alone because of the percentage of people who don't get the blood thinning with aspirin or is there something else going on? Should people be tested to see if they respond to aspirin? Apparently this is an easy test. Articles I have read say it doesn't matter how much aspirin you take - it all works about the same, that is, 325mg works as well as 81mg. If that is true why take the 325mg and risk more stomach irritation? Does ones level of physical activity and other metrics (blood pressure,
cholesterol levels, openness of other vessels in the heart, etc.) make
any difference in the outcome of the aspirin/Plavix or aspirin/Ticlid
regimen? That is, if one is on an exercise routine after the stent
surgery is one less likely to get a clot? It seems to me that if one
is physically active and there is more blood being pumped through the
heart there would be less chance of a clot forming at the stent site.
Are there any studies about this? • S.M., you might want to check out the topic
on stent allergies (to the right) as well. There is a new study being
done and there is information in that topic about it. • My wife had taxus stents in August. She is
on plavix and aspirin. Had to come off zocor because of muscle deterioration
She has had numerous shingle attacks since. Also she suffers from
diabetes she didn't have before treatment.(burning muscle cramp)s.We
have a
friend who also had stents two years ago (non drug eluting) and he
also has numerous shingle attacks and diabetes trouble. Would like
feedback
on this. • I HAD TWO STENTS PUT IN LEFT ARTERY PUT ON
PLAVIX , LIPITOR AND ASPIRIN THE STENTING TOOK PLACE IN OCT 2005
DOCTOR TOOK ME OFF PLAVIX OCT.2006 WILL TAKE 1/2 325 MG ASPIRIN AND
80 MG
LIPITOR FOR LIFE I AM MALE 40 YRS. SMOKED PRIOR OCT. 2005 . ONE
GOOD THING CAME FROM MY HEART ATTACK, THAT IS NO SMOKING NOW, I QUIT
WITH
NO PROBLEMS. • We've been on a short hiatus, so some quick
multiple replies: Remy -- we have discussed patients attempting to desensitize themselves to Plavix at home directly with Dr. Walker and others and it is definitely a no-no! First off, headaches can be caused by a number of things -- Plavix allergies usually take the form of rashes. Nevertheless, any desensitization should only be done under the supervision of an M.D. -- there exists a possibility of an anaphylactic allergic reaction which could be fatal if not done in a controlled setting. Finally, Soames -- you must have a prescription for
Plavix. However, a large number of cardiologists
have been prescribing Plavix for life, until more data are in (see
our Patient
Advisory -- especially the quotes in the sidebars). There
are side effects from Plavix, not to mention the increased risk for
bleeding, so it needs to be taken in conjunction with your physician
-- ideally your interventional cardiologist should be involved in the
decision. • I have been off of Plavix for over a year. when I took plavix for the
1 year following my angioplasty I had no side effects. I was considering taking
plavix along with my 325mg of aspirin in order to make sure I do not have another
blockage. Have you heard of anyone voluntarily taking plavix for life? and if
so, what do you think? I am 42 years old and want to make sure that stents are
not part of my future? • I just wanted to know how I can test the
desensitization conducted by Dr. Nicholas Walker of the University
of Iowa Healthcare. shall i cut the Plavix in 8 and take each with
15 min intervals. I have 4 DES since last week and I have a severe
headache, this might be a Plavix reaction. • Oct. 27th went to ER because of irregular
heart beat after my usual 10k run on treadmill. Hospital kept me overnight
and next day did angiogram. Found
1 narrowed artery - all others wide open. I am 60 yr. old runner - excellent
physical condition and diet. Cardiologist put in 1 Cordis DES and put me on
Plavix and Aspirin. Several days later I developed a head to foot major
rash. My doctor
(not cardiologist) took me off the Plavix but said to continue the 325mg aspirin
only. He said that aspirin was statistically about as effective as the Plavix
as a blood thinner and because of my general physical condition I shouldn't
be concerned. I have low blood pressure, good cholesterol readings
(slightly high
LDL). I have an appointment with my cardiologist next week. After reading posts
here I am concerned that I am ONLY on the aspirin. Should I be concerned? • I've had 3 stents placed in the last 2 years
in my LAD. I'm on Crestor, Plavix, Aspirin, Niaspan (2000 mg), Toprol.
My cholesterol is normal, my blood pressure 120/80, but my Lipoprotein
A is 225. The Dr said it should be 75 and he can't seem to bring it
down. I'm told it may be hereditary and it can't be verified because
my Dad died at 29 of cancer. I'm not very clear on what the Lipoprotein
A issue means? I'm 53 yrs old and in relatively good physical shape,
never smoked
and I always have run 2 miles every other day. Thanks. • I am on plavix, have a small rash on my checks
(not bad). Was wondering if tingling of the fingers, feet (not
every day) is a side effect of Plavix? • Thank you so much for the update.
After taking Plavix every other day I am happy to report I have NOT
had any major nose bleeds. Small ones here and
there but nothing like I was experiencing. I was apprehensive as I was thinking
the nose bleeds stopped but am I now MORE at risk of a heart attack? I have
been having shortness of breath the past two days and will probably
go to the ER tonite
if it does not go away. I was away in New York City last weekend and definitely "overdid" it
with walking and staying up late. I'm hoping this is the reason for the shortness
of breath and recent "little" nose bleed tonite. Overall, I like taking the
Plavix every other day! • I had a drug eluting stent inserted on Tuesday
Nov 7. Was released from the hospital after 2 days and was treated
with plavix 75mg, toprol xl 25mg, vytorin 10/20mg and aspirin When
I came home for the hospital I purchased the generic form of plavix
- clopidogrel bisulfate 75 mg. After taking my first round of meds
this AM I am having a sensation of mild choking or inability to swallow,
but am actually having no trouble swallowing at all ... only the
sensation. Am I having an allergic reaction to the stent or one of
the meds or
is this part of
the healing process after just 4 days. • Terry, you've surfaced another big problem
-- the cardiologist prescribes Plavix for a year, but the general practioner
(or surgeon) says it's okay to stop. We have interviewed many of the
top interventional cardiologists in the U.S. and have attended the
major international meetings and they all agree on one thing: Always
ask your interventional cardiologist what you should do and for how
long. It's a complex and confusing topic (see the posts below) and
non-cardiac physicians are just not current with what is happening
in this field. The AHA/ACC/SCAI recomendations are listed here, but
bifurcation stents are a specific case and your interventionalist should
be your best guide. • Following BiFurcation stent in February this
year (BMS) I was told (in writing) by the Cardiologist that fitted
the stent to take Plavix and Aspirin
for 12 months. It comes on prescription in the UK. Have just requested the prescription
for November, and have been told by my Doctor that I should only have it for
9 months and that the prescription will not be issued. (In the UK that means
you can`t get it at all) Have yet to consult with my Cardiologist, but what a
shambles???????? Don`t they read each others notes?? In any event I'm scheduled
for another stent in December, when regardless of what stent is fitted I will
be placed back on Plavix for sure. What is the general recommendation for Plavix/Aspirin
for BMS? • boy oh boy. i am on my last month of plavix
before the prescription runs out. My cardiologists says thats it
i should stop. as i have a des stent it sure seem like a scarey issue.
i think i will call him up and ask for another year since so far
i
have been tolerating it. just seems to be no downside to continue.
i am 50 years old. • Anneand R. from Ohio -- your questions hit
the nail on the head. It is confusing for physicians as well as patients.
The
FDA
has
called a major two-day meeting on December 7-8 to discuss drug-eluting
stents and the recommendations for Plavix and aspirin will hopefully
be discussed. Who is responsible for educating patients and physicians
about the implications of long-term antiplatelet therapy is a subject
that Angioplasty.Org will be posting a feature about shortly. Keep
tuned! • Hi, I had 3 stents implanted four weeks ago
and am now on the usual medication regime. I am taking Vitamin C since
years, however, have heard that when on Blood thinning medication one
should not take Vitamin C. Your comments will be appreciated.
Thanks. • My question is what if any clinical data studies
have been done that provide guidelines for recommendations regarding
plavix and ASA 81 mg or 325 mg? It seems
to me that guidelines based on clinical studies should be given to Cardiologists
rather then just base it on the patient??? I too had the Taxus II stent inserted
for 99% LAD blockage and told Plavix 75 and ASA 325 daily . I too have had
bruising and now 2 episodes of Epistaxis . My problem is that I get
advised to stop Plavix
and continue ASA, to stop ASA and keep taking Plavix and or just take baby
ASA instead of regular. Now please help me I just want to do the right
thing and
stop the bruising and bleeding. • I am 57 and now have 5 stents - 2 metal and
3 coated. I received the 3 coated stents in January 2005 and continue
on Plavix and a 325 mg aspirin. It appears I may be on this regimen
the "rest of my life". Plavix is not cheap - and now they blocked the
distribution of a generic plavix! I am on a drug insurance plan through
my employer, so the extra $50 per month is tolerable now. I feel for
those who have to pay out-of-pocket! Those who cannot afford the drugs
are the ones referred to in the articles that stop taking the medication
- and become statistics. Has any work been done to have Boston-Scientific
and J&J provide Plavix and aspirin to those now required to take the
meds so long due
to their lack of product testing? • Walter -- we always recommend that patients
consult their interventional cardiologist about ANY adjustments to
medications prescribed after stenting. Going off Plavix won't negatively
affect the way you "feel" (except to reduce any adverse effects of
the drug) but the reason Plavix is prescribed is to prevent blood
clotting inside or around the stent. You're almost two years out which
is good,
although you did have five stents implanted. We strongly recommend
that you consult with your interventional cardiologist (not just
any doctor) about your Plavix regimen. That being said, congratulations
on your turn-around and recovery from a heart attack, something that
was very uncommon only a couple decades ago, before angioplasty and
stents. • I am a 55 year old male that had an MI in
Dec. 04, I received 5 cordis eluting stents in one artery. I was
given Toprol XL 100 MG, Plavix 75 mg, 325 Mg Aspirin, Lisinopril 10mg,
crestor
20 mg, I reduced my own crestor to 10 mg after about 6 months due
to the sharp drop in all my numbers, got tested 4 months after reduction
and bad LDL was 82, I have now taken my self off Plavix, I have been
off of Plavix since July 06 with no visible effect. Still feel fine
except
do not bruise as easily. • Lacy -- well, instead of the Wall Street Journal,
start by reading our Patient
Advisory (link on the right sidebar). It's free and no subscription
is needed! (We posted our advisory over a month ago -- we just returned
from the Washington meeting, along with all the other reporters, and
can say that our advisory remains a good summation of what many cardiologists
were saying.) Have you tried to contact Dr. Kandzari? We posted
the story of his
appointment to Cordis a couple of weeks ago, but he doesn't start there until
December. As for Dr. Califf, his opinion on this issue was quoted by
us in a previous
post. He said, "In my practice,
if you get a drug-eluting stent, you're going to be on clopidogrel
for life until more data come in." Last week's Washington meeting
of the TCT didn't add much to this particular debate. In fact, an Italian
study, presented by Dr. Alaide Chieffo, showed that there was no benefit
to dual antiplatelet therapy after 6 months. Interestingly, when asked
what her institution's current protocol is, Dr. Chieffo said dual antiplatelet
therapy for one year, almost as if she didn't believe her own study.
Dr. Sigmund Silber of Germany called all the conflicting studies "totally
confusing". So for you, facing surgery, we can say that most cardiologists
probably would feel okay about your stopping briefly for the surgery
(but staying on aspirin, if possible) and then resuming. Mainly because
you are two years out. But this is NOT medical advice for you. You
should definitely be in touch
with
an interventional cardiologist about this. Your clinical condition,
etc. can only be judged by a physician (which we are not) who has your
complete medical records and history. Some
cardiologists talk to their surgeons about this problem as well and
surprisingly, when
surgeons hear that there may be a chance of a stent thrombosis or heart
attack, they are persuaded to do the surgery without taking the patient
off Plavix. These are only reports which we have read or heard. Please
talk to your interventional cardiologist about this. And let us know
what he/she says! • I am a first time reader. Had 3 stents (2
Cordis, 1 Taxus) done at Duke U. August of 2004. Plavix 75mg, 81mg
aspirin, 5mg Altace were follow-up meds. I'm doing well but am not
assured as to new danger with DES as my cardiologist is leaving to
head J & J Cordis division! It seems the only information (I noticed
Rob Califf can't be reached by mere patients) is such as in this forum.
My last admonition was to remain on Plavix for life, but I face surgery
which will require my stopping it for a week. To Plavix or not to Plavix?
Can't we do better? my god! i just went to read Wall St. Journal's
report only to find i must subscribe
to do so!!! • Rosanne (from
earlier in October) -- your situation is one of the reasons that there
has been a rethinking about
drug-eluting
stents
and long-term
antiplatelet therapy. We have heard all week about these problems from
cardiologists at the TCT. I spoke with one who has recommended to a
patient the same course, take one Plavix every other day (the drug
stays in the system) -- but nothing on this board should be substituted
for medical advice, and it sounds like your cardiologist is aware of
these controversies. The problems you are having are a trade-off against
the benefits of drug-eluting stents -- the big question is how much
of a trade-off and are there alternatives for some patients. We're "on" this
topic, so keep tuned to our site. • My mother takes Actos Plus
for her diabetes. She started taking Plavix because we were traveling and all
of a sudden
her blood sugar was way out of line. It shot up to over 170. She
didn't change her eating habit while we were away. While at home before taking
Plavix, her blood sugar was generally below
100 every morning. • How quickly the questions build up. We have been attending the TCT meeting in Washington this week and we can assure all posters that the topic of dual antiplatelet therapy (aspirin + Plavix) was one of the most discussed -- and that there is anything but a consensus of opinion about how long patients should stay on it after stenting. We'll be writing more about this soon, but we'll try to give some quick answers to some of the questions.... Melissa in Indiana -- depression and heart disease are very closely associated: the causes range from reactions to medications to psychological adjustments that people need to get used to. It's a complex issue and a patient support group might be helpful -- many others feel this way and depression has the unfortunate characteristic of closing one off from others. Your doctor, hospital or local heart association may be able to help you find one. Good luck and let us know what you find out. As for allergic reactions to Plavix, they are well-documented (just read the postings on this board) and physicians may switch patients with such reactions to ticlopidine (Ticlid). If the allergic symptoms remain, it could be an allergy to any number of other drugs, or to the stent -- a phenomenon which has NOT been well-documented but does exist. We urge any readers who have good reason to suspect the stent to read the Forum Topic on that subject and to post your story there. M. in Georgia, you discuss starting and stopping
Plavix, but you don't mention having a stent? Did you get one or was
Plavix prescribed for other reasons? If you got a stent, especially
a drug-eluting stent, you definitely do not want to stop antiplatelet
therapy -- call your
interventional
cardiologist,
the
one placed your stent, about this. • Plavix....Ugh!~! Since I have been on Plavix
for a little over 2 years now for my 4 DES Cypher stents, I have
had a very low Ferritin reading. WBC is OK for now. The diarrhea is
a hit
and a miss but leaving me very weak on the days it hits. I normally
pop a potassium pill on those days. I have developed cataracts. A
rare side effect to Plavix but none the less it was the Plavix (determined
by the MD Ophthalmologist as drug induced) I have now developed an
uncontrollable itch. I have scratched myself to death and have scabs
where I have dug into my arms and legs. Aw...to be rid of Plavix.
Doctor
said I need to take it for life...I don't think I can take much more
of that drug. • Has anyone had an allergic reaction where
there nose stopped up and they had a hard time breathing through their
mouth after their stent? I had a Taxus
II, drug eluting stent on June 13, '06. The next day I had the reaction listed
above. The Drs. do not know if it was the Plavix; the polymer coating the stent;
or the Paclitaxel on the stent. The problem began to diminish at about 2-1/2
mon., but has not gone away completely yet. The Drs. prescribed several medications
during this time, but none worked very well. I am still on Ticlid and a Baby
Aspirin a day and after going to a health food store, I'm taking ALJ which
is for respiratory problems. That has helped a lot. • I started Plavix about a month ago, had noted
for about 2 weeks my feet feeling hot. This week I started getting
a red rash on the top of my feet and mid-way up the legs. Not really
itching but burning and uncomfortable, tight. I have been taking
25 mg Benadryl plus I take Zyrtec for allergies. Today it became more
severe, looks like a heat rash or diaper rash and tonight some of
the
places looked red-red and bright orange. I called the dr 2 days ago
and they said to try stopping the Plavix, I was also started on Crestor.
This scares me as I had an anaphylactic reaction to aspirin about
20 years ago. The dr was to call back today about further plans but
received
no call so I assume I need to stay off of it until I hear from them,
I am thinking about stopping the Crestor too until I talk to them.
My heart problem is attributed to coronary spasms and I also have
an abnormal EKG which reads out always like I am having a severe ischemic
attack. I have not had hives/welts but this severe rash. As in the
last few days, tonight it went away after about 3 hrs on the Benadryl.
I just hate
the Benadryl because it makes me feel so bad. • I am 38 yrs old. I had a heart attack in july,
went into cardiac arrest twice. I had an angiogram, angioplasty, and
2 stents put in. My dr. has me on
Plavix 75mg, aspirin 325mg, and metoprolol 50mg. I have been feeling very depressed.
It is not everyday but it is about 2-3 days a week. My husband and I have only
been married 6 months and this is been very difficult for us. Is that normal
or could that be a side effect of the plavix or one of the other medications
I am taking? Should I contact my dr.? • Have been on 75mg Plavix o/d since first
angioplasty in Oct 2005 - original planned regimen was 9 months -
however had a second one in June 2006 and will be on Plavix till at
least June
2007. Only significant side-effect is frequent nose bleeds (pretty
much every day). These can take some time to stem. Compared to the
risks of not taking Plavix after two DES angioplasties, this is something
I'm happy to LIVE with. PS. This forum is a great resource and reassurance
-
keep it up. Thanks. • Also a quick addendum to Ted in New Zealand
who experimented with desensitizing himself to Plavix, as a study in
Iowa is currently doing. I've mentioned his experience to the
doctor
heading the Iowa team -- he was impressed that someone would do this
successfully in this manner, but also sounded a strong note of caution,
seconded by Dr. William O'Neill of University of Miami yesterday in
a conversation -- doing this at home and not under medical supervision
could be dangerous. If you have an allergic reaction and go into anaphylactic
shock as a result, you could stop breathing and with no medical personnel
around, you'd be in trouble. So it's a great story, but we'll strongly
caution our readers: "Don't Try This At Home!" • Roseanne -- glad the Forum has been of some
comfort. Bruising and bleeding problems can be side effects of blood-thinners
or antiplatelet drugs -- it's why many surgeons ask their patients
to stop Plavix and aspirin several days before a procedure -- something
which no stent patient should do without consulting their interventional
cardiologist. We can't give specific medical advice to anyone and only
your cardiologist can adjust dosage, as it seems he has. Given that
your stent is now past the one-year mark may be one reason. The problem
is that the data about when one can stop antiplatelet therapy is not
strong. Current recommendations in the package insert for the Taxus
say six months; most cardiologist give it for a year or more (see our
Patient
Advisory). Both Plavix and aspirin can cause bleeding, or the combination
of the two. But both act as antiplatelet therapy in different ways,
which is why they are used together. Unfortunately people like yourself
who have bleeding or allergic proplems get caught in this Catch-22. • I received a Taxus stent in September of
05 in my LAD artery because of an angina attack. Blockage showed 99%
also 60%. They did not stent 60%. I am 55 now and have never smoked.
I've had ITP (platelet dysfunction) the past 30 years making Plavix
really difficult for me. My continuous bloody noses having
to be "packed" this past June have caused me to ask if taking Plavix every other
day "appropriate" and safe for me. Cardiologist said to try it and I have. Blood
noses have stopped for the most part with one this morning as I'm writing to
you for your advice. I love your website. It has been of great comfort to me
hearing stories that sound like me when I've had no one to talk to about my feelings
of uncertainty in knowing what will happen next. I am full of bruises but can
deal knowing the Plavix is helping along with aspirin. Is the aspirin or the
plavix causing these bloody noses? thank you for this Forum..It's my comfort
zone for sure.. • Michael -- the only other antiplatelet med
discussed is ticlopidine (Ticlid). Don't know if that has the white
cell problem as well, but it is what was used before Plavix became
available and while it tends to have more adverse reaction than the
newer drug, some cardiologists we have talked to find that some patients
tolerate Ticlid just as well. Let us know what else you find out
from the doctors. Meanwhile, anyone out there have some comments?? • My friend Jeff had 3 Cypher stents inserted at the end of August. He was put on Plavix. Prior to the angioplasty his blood work was normal. After the procedure his white blood cell count was decreased. He has had his blood tested again since then and his white blood count is still low. His primary care doctor was concerned and told him to schedule an appointment with a hematologist. My friend's sister told us to ask the doctor about the Plavix because one of the rare side effects is that it can cause decreased white blood cell counts. We asked our pharmacist about that and she confirmed that Plavix can cause that effect. My friend saw the hematologist today and asked whether the Plavix could be responsible for the low white blood count. The doctor confirmed that it could be the reason and recommended that my friend speak to his cardiologist. The hematologist also wants to schedule a bone marrow test. Does anyone in the forum have any experience
of Plavix causing a decreased white blood cell count. Also, if the
Plavix
is responsible is there an alternative to Plavix that my friend
could take? Obviously he is going to follow the advice of the cardiologist,
however, we just want to educate ourselves on alternative medicines.
We have been told that if the drug coated Cypher stents are implanted
it is important to stay on the Plavix for at least a year. Any
feedback
or advice would be greatly appreciated.
Thanks. • My 86 yr old mom was given the generic Plavix.
She broke out in a rash around her neck, had severe stomach problems,
and no appetite. Stopped the generic and got back to normal. GENERICS
ARE NOT THE SAME! But a lot more money for the money hungry. • Ted in New Zealand -- that's great that
it worked for you. We've posted a link to the full
story about desensitizing patients to clopidogrel in the
right-hand sidebar. Sounds like we should do an interview with the
doctors who did the study. And Martha, glad you've been able to lessen
the adverse symptoms as well. We would caution patients that benadryl is
a vasoconstrictor -- it can narrow blood vessels, so you want to be
careful self-medicating with it, especially if you have high blood
pressure. You might want to check with your doctor, but it's great
that its working for you. We'd like very much to thank patients like
Ted and Martha who are writing in with solutions to some of these problems! • Looks like I am not alone with allergic reaction
to Plavix. But, I think I've found relief. I started taking a 25
mg. Benadryl tablet one hour before I took the Plavix. I did this for
about
a week. The itching and hives was substantially reduced. I started
today to take Plavix without the Benadryl and I seem to have overcome
the allergy. Also, I found out that you need to take the Plavix with
a full glass of water; no more stomach pain or diarrhea. Anyway,I
am much better. • Yes it
was from our Forum that I heard of this procedure. It was an
article
you posted dated May 12 2006 about "a study just presented at the annual meeting
of the Society for Cardiovascular Angiography and included the results of an
experiment in desensitization conducted by Dr. Nicholas Walker of the University
of Iowa Healthcare." • I have given this quite a bit of thought.
It certainly appeared to me that the difference was due to the
change from Plavix to generic Clopidogrel. However, I started taking
the
generic in the 4th month after having received an endeavor IV stent
as part
of the clinical trial. Perhaps I was experiencing a reaction
to the DES and the 4 month time frame is about the time the stent became
covered with my own cells. I have had a lot of problems and I am
still
much
worse overall from a feel good perspective than I ever was prior
to the MI and stent placement. I am slowly starting to feel better
though,
five months after the incident. At least now I have hope, even
if I never know for sure why I have felt so bad. The doctors are
very
little
help when your tests are normal,
but you feel terribly. • S.M. from Georgia -- most interesting, since
we've gotten a few postings with just the opposite reaction: patients
who were having allergic reactions to the generic clopidogrel, but
were OK with brand-name Plavix. Supposedly the two are equivalent.
Anyone out there care to give an opinion or relate a story? • Yes, I was having a fairly severe reaction to Plavix. I received 3 months
worth of the generic from my mail order prescription service last month. The
itching, sores in the mouth, bad taste, are all much better or gone altogether. • My father has has a history of AMI 23 years
ago subsequently treated with angioplasty, CABGx3 with mitral valve
repair 11 years ago, an additional coronary stent and a stent in
his subclavian about 3 years ago. His following Cardiologist has prescribed
Coumadin and Plavix but the Cardiologist who rounded on him at the
hospital told him this combination was not recommended. Is there
ever
a situation where both of these meds are recommended in conjunction
with one another and if so, is there
more frequent testing needed? • Ted -- great to hear this self-desensitization
worked for you. Where did you hear about this? Was it on this
Forum? • Was having serious side effects on Plavix
75mg plus Aspirin 300mg daily. Welted rashes all over, severe joint
and muscle pain, etc. Tried self-desentisation by cutting up one
75mg tablet of Plavix, taking very small dose first, then increasing
every
15 minutes over two hours until whole tablet was consumed. Within
24 hours all joint and muscle pain and rashes had disappeared! Will
inform
my cardiologist
next time I see him. • Stephanie -- your report of a difference between
generic clopidogrel and brand-name Plavix is most interesting --
first report we've had of this. Anyone else out there seeing a difference?? • My husband went back to his cardiologist after having a reaction to the
generic Plavix and he wrote a script for Plavix only no generic. He started the
Plavix a couple days ago and hasn't had any problems with hives and itching since
so we know it was the generic. The insurance company charged us for the difference
in the Plavix and the generic and we are trying to get that resolved. Looks like
the generic is a little different than the real Plavix or at least it affects
my husband differently. • My husband had angioplasty and 2 Taxus stent
placements in mid August. He developed a rash immediately which became
hives within the first week post procedure. After medications review
with the cardiologist and primary care physicians and eliminations
or changes of possible causes; he was left with topicals and antihistamines
for any relief. These were of minimal help until he tried Noxema. THIS
WORKS!! For anyone suffering from the severe itching, apply Noxema
after showering or in between. Available not only in a cream, Noxema
wipes can be used when the cream is not an option, and relieves the
itch as an 8-9 on a a scale
of 1-10. • hi i had to have a stent put in a couple
of weeks ago, got was was tried but fine I'm on plavix and a aspirin.
have started breaking out in hives. called heart dr. nurse said
to stop taking the plavix for the weekend my question is how long after
stop taking the plavix will the itching and hives stop per say
that
is the cause ? anyone have any thoughts on it? you can email me
at joanbaity@aol.com
thank you • Can someone give me some advice on this:
I am a 55 year old non smoking, non drinking woman who has a drug eluting
stent (Taxus) procedure last year. I had 99% and 60% blockage. I also
suffer from a "bleeding disorder called ITP.it is a platelet dysfunction
disorder. I've been on Plavix for one year now, with baby aspirin.
I've had to have my nose packed from 24 hours of bleeding. At times,
the black and blues on my body make me look like a "battered women".
I am so tired at times although my hematocrit is in normal range. Last
blood test showed low platelet count. Had cardiologist visit last week.
He will not take me off Plavix for all the reasons stated..He did suggest
I could maybe take Plavix every other day.. What do you think? I am
on high blood pressure medicine, Lipitor, Plavix and two Protonix's
a day...Would the change to every other day be a good one for me? It
may stop the gushing of bloody noses once a week. Will it be safe for
my heart and the chance of a blood clot? I have not been without boxes
of tissues besides me since this procedure..Thank you for any advice
and
help! • L.C.D. -- Isn't this the problem with drug-eluting
stents? And it's one which just seems to be getting addressed. First
of all, remember not to take anything you read on this or any website
as "medical
advice" or
as a substitute
for
seeing
a doctor.
That being said, we have spoken with
some interventional cardiologists
who say
that they make a practice of talking with their surgical colleagues
to explain the need for blood-thinners. Some surgeons, once they understand
the
implications of stopping antiplatelet medications prematurely, will
go ahead with some minimally invasive surgical procedures where the
risk
of
bleeding
may be lower (we
don't
know if
a biopsy
would
be in
this category). Since your mother's situation seems time-sensitive,
perhaps your cardiologist and surgeon could discuss this option. Some
cardiologists stop Plavix briefly, but stay on aspirin, then resume
Plavix immediately after surgery. As for a different drug, any
antiplatelet drug has the downside of allowing bleeding to occur --
in fact that's the point. Good luck and please write back to the Forum
to let us know how you fare. • My mother just had two stents put in her
right coronary artery which was 100% blocked three weeks ago. She
just had her second stent procedure, putting stents in the left anterior
coronary artery and one other which were 70% blocked. Her mitral
valve
is damaged but seemed to repair itself between the two stent procedures.
They did not do open heart due to a growing spot on her lung and
several enlarged lymph nodes in her mid chest area. The lung spot was
first
detected in late July and now shows to have grown along with now
the enlarged nodes. A bronchoscopy was done but yielded no results
due
to the difficulty in reaching the spot with a brush or with a flush.
The next procedure to attain tissue to biopsy would be surgical and
the thoracic surgeon and her cardiologist won't do it for a minimum
of four weeks due to her being on plavix and the new stents. Isn't
there an alternate blood thinning drug to use in the interim while
the biopsy is performed? There seems to be significant change in
the lung and now the nodes to indicate immediate action is necessary.
Please
advise.....thanks. • Jing -- the decision to revascularize (unblock)
an artery is something that is a judgement call by the interventional
cardiologist. It is not recommended to angioplasty a blockage less
than 50% blockage. Over that, it really depends on many factors:
which artery, clinical status of the patient, etc. Diet and exercise
is important
for all people. It may not prevent heart disease (or reverse it)
but it certainly helps. There is less and less importance being put
on
stress as well. Everyone has stress, but not everyone has coronary
artery disease. Smoking -- definitely the worst thing you can do.
As for aspirin, it has a number of benefits and most cardiologists
recommend
a baby (low-dose) aspirin a
day for life for all male patients, assuming there are no bleeding
problems. • My wife had stents following angiogram.The
doctor told her before the procedure she would need plavix for a short
time till they healed. Afterwards they told her a year and she better
take it or she would have a heart attack. Same doc afterwards told
her to work on stress control. Where do they get people like that,
from Hell? I guess. Better go to church and be poor give all your wealth
away and follow Christ. Must be something about never hearing about
stents, angioplasty or drugs in the bible. I myself have lost all faith
in medicine today. Especially since our youngest son died last year
from the propofol infusion syndrome. The Christian Scientists have
a point. • I had an angioplasty in '03 after showing
abnormally in a stress test when I was only 34 :( I had
placed two bare metal stents for two arteries that were 70% and 50%
blocked.
I
have always wondered about the necessity of the surgery. I had high
cholesterol (HDL+LDL = 300) at that time and the doctor has never given
me an option to have diet and/or Lipitor first. In fact taking Lipitor
a while after right before the surgery has lowered my cholesterol quickly
to normal. My heart problem is mostly due to stress. No family history
of heart problems. Was the doctor too quick to make the decision? I
had Plavix for a couple months, and been having 81mg Aspirin and 10mg
Lipitor ever since. Now 3 years after the surgery, I am wondering if
it's necessary to continue to take aspirin for life? The earlier discussion
seems to indicate that it may not need to take antiplatelet drug for
too long if it's bare metal stent. I am always more interested in trying
natural method like exercise, Chinese herb and acupuncture to recover
the heart
problem. • What is the new news on the Generic drug Plavix.
I have read where the FDA and the US drug makers were screaming about
the sale of drugs coming from
Canada and Mexico, well what about the generic drug Plavix. The reason i am
concerned is the last script i had filled were filled with the generic
Plavix and i questioned
the druggist about the drug and they hum-haw around and did not give me a straight
answer, only saying my insurance would pay for the generic and it was only
$20.00 less than the brand. What is your, or all people taking this
drug think about
this. Thanks • Stephanie -- we haven't heard reports of allergic
reactions to the generic version of clopidogrel from patients who have
been fine with brand-name Plavix, but this experience is just starting
up. I would definitely
report this reaction to your interventional cardiologist. Possibly
try going on brand-name Plavix for a while and see if the hives subside.
If they do and they return when switching back to generic clopidogrel,
you will have made a discovery (and please let us know). Another
possibility
is
a reaction
to
the polymer coating of the drug-eluting
stent. While allergic reactions to these devices are rare, they definitely
do exist. See that topic in the right-hand column. • My husband received 3 stents in August 2001
and was put on plavix and lipitor. He again had a heart attack in
November 2003 and received 2 more stents, the newer and improved version.
He
started taking the generic plavix 2 1/2 weeks ago and now has the
hives. Called the pharmacy and was told it couldn't be the generic
but that
is the only change in his diet, soap, etc. Any one else having problems
similar. He is allergic to aspirin. • My doctor prescribed 325MG of aspirin for
life and Plavix 75 MG per day for six months. I had a bare stent inserted
8-18-06 after an acute MI. Everything
I have researched states aspirin in women deters strokes but not heart attacks
but the opposite results for men. I will take the aspirin for stroke protection
even though it is not going to head off another MI. • KJ -- a year is a pretty good distance, but
of course every patient is different. You've done the right thing by
consulting your interventional cardiologist before scheduling surgery.
We can't say do or don't go off Plavix -- that's your cardiologist's
call -- but if there are any questions, he/she may take you off briefly,
and then put you on again post-surgery. Have your cardiologist discuss
the situation with the surgeon as well. Let us know how things go and
good luck with the knee replacement. • I had a Cypher stent placed on 10/05 and
have been compliant on meds since -- toprol 25XL, plavix 75 mg, asa
325 mg for 6 weeks, and 81 mg since, and lipitor. I need knee replacement
surgery -- cardiologist wants to wait until stent is in place for
1 year -- In light of World Cardiology Congress concerns in Sept. 06,
is this a
safe waiting time? Normal chemical stress test in July 06. • Don from Texas -- generic Plavix (clopidogrel)
is the subject of our recent news article, "Court
Grants Injunction Against Generic Plavix", so get it while
you can. The current supplies on the shelves will continue to be
sold until
they
run out.
As far as we know, there is no difference in the generic and the
branded version (otherwise the FDA would not have approved the generic). • I had a drug-eluting stent put in on Sep 7.
I'm on 81 mg aspirin, 75 mg. Plavix, 240 mg diltiazem ext. release,
90 mg. generic Imdur (isosorbide MN ext. release), 10 mg. Lipitor.
I don't know brand of stent - I will find out from cardiologists' office
Tues. after Labor day. My question - I can get generic Plavix at my
pharmacy for next several prescriptions, which will save me some money,
not a huge amount. I want to know if generic is equally effective and
safe. • RJ, had your aunt been implanted with a drug-eluting
stent?? Is that why she was on Plavix? • My aunt was on plavix, she had a dentist
appointment, and her doctor told her to go off plavix. That was a
friday by next thursday she had a massive stroke. Was it just bad timing
or
was it because she was off plavix for those days. • Some quick replies -- Christina in New Jersey -- as we always say, you should discuss any medication with your physician (including over-the-counter meds and "nutraceuticals" from the health food store) -- just because a pill isn't a prescription med doesn't mean it can't have a significant effect. Sounds like your doctor is responsive. If you had written before you saw your doctor, we also would have suggested that perhaps the statin is causing you the muscle pain (a known side-effect) but we still would have recommended consulting your doctor. Congratulations also on your increasing stamina (many people much younger than you couldn't do 10 laps in a pool). By all means let us know how you fare and if the cramps subside or if you continue to have problems. As for others who have been having reactions to Plavix, there are a few other antiplatelet agents: aspirin, ticlopidine -- we have also heard of physicians using persantine and dipyridamole, but none of these (except aspirin which you should be taking anyway unless it's contraindicated) seem to work as well as Plavix. The question as to why physicians implant drug-eluting stents in patients who have a known allergy to Plavix is an excellent one. Perhaps the physician is not aware of the allergy, which is why it is vitally important for patients to bring any allergy to their attention. And strongly. Drug-eluting stents have been shown to work very well, but bare metal stents, which do not require Plavix beyond 1 or 2 months, can work very well in many cases and they avoid the long-term antiplatelet therapy. Don in L.A. -- if your doctor told you to start aspirin before the procedure, and you had questions if that was wise, did you ask this of your doctor? The reason he/she prescribed aspirin was to keep your blood thin -- something which will aid in reducing possible complications during the angioplasty. If a stent is placed, you'll most likely be prescribed Plavix as well. If you have an allergy to Plavix, tell the doctor BEFORE the procedure. Finally, there have been some small studies at the
University of Iowa in desensitizing patients to Plavix -- a very small
dosage is given, then it is increased slowly every 15 minutes. After
2 or so hours, the full 75mg dose has been reached without the allergic
(hypersensitive) reaction taking place. Almost all the patients that
have been in this study no longer had allergic reactions to Plavix. • In May, 06, I had a Cordis Cypher Sirolimus Eluting Coronary Stent placed
in LAD artery, which was 70% blocked. I was given a handful of plavix pills to
take before the procedure, and was then placed on 81 mg aspirin, 75 mg plavix
and 40 mg lovastatin daily. Afterward I had severe headaches at home which gradually
stopped. I have been puzzled at the variety of complaints I have had and felt
the need for a support group, wish I had found this site earlier. I have had
episodes of chest pain, weakness, breathing difficulty, extreme fatigue after
exertion and interspersed with these, episodes of increased strength and ability
to do things. I have been an active person, swimming and walking for many years,
now in my 70's. Have been able to return to both although I could barely swim
4 laps in July, now doing 10 in August. A follow up stress test in July showed
no dec. blood flow to heart. During the past month or so I have developed pains
in different places in my body which weren't there before, and really bad cramps
in my legs at night. The last episode of leg cramps was really horrible. Saw
my internist for routine visit a week ago and he advised that I should go off
the lovastatin, which I did the next day, but had blood testing first for lipids
and muscle enzymes. Now I am stuck in the Labor Day holiday, unable to call my
dr., (I believe he is on vacation anyway) and I want to keep the good gains in
my lipid profile since my cholesterol usually runs high. I would like to start
taking non-flushing niacin and lecithin granules for the latter problem. I wonder
if this would be ok with the plavix. Any info appreciated. • I suffered a heart attack in 2001 and had
Angioplasty and two drug eluting Cypher stents were implanted in
June 2004. I have been taking 75 mg every day clopidogrel 75mg and
81 mg
Aspirin ever since. • Sherry's Response to Editor: yes, I am taking
a muscle relaxer. Let me report this to my physicians to see if there
is any
possibility this may be one of the root
causes. I am afraid to come off of any of my medications as we still do not know
what caused the closure of the subclavian. Thank you for the tip. • I am set to have a angioplasty in 6 days.
Catheter with possible stent/angioplasty. The Dr. told me to start
aspirin NOW. I thought that a procedure like this one would stop aspirin
before. Also does anyone know the failure rate of stents? • Hi, I had three Cypher plants implanted 3
month ago, I also have three stents from three years earlier when
I had a heart attack. Now I am a 53 yr old female. With no high cholesterol
and my blood pressure is usually below normal. I had a severe allergy
the first time to Plavix and almost needed a blood transfusion.
Since I do not believe in blood transfusion, the doctors at the time
let
wait two days and my white or red blood cells came back right away
after discontinuing the plavix. This time I have been on plavix
again the doctor ignored the fact of my last experience with plavix
and
told
me I would die if I would not take this medication. This time I
have been severely tired my legs are shaking when I lay down after
just
4 hours of work. I am almost depressed because of not being able
to work. And having so many bruises that people believe I have a
husband that beats me. I live by myself so this is not true and I am
not
a
self abuser (laughing). My pharmacist hardly will give me the plavix
and says I should for sure not take the aspirin. Right now the
pharmacy can also only give me the generic form of plavix (Clopidogrel)
75mg.
Now my tiredness seems even more extreme. I have no clue what to
do since my doctor says I will die if I do not take these pills and
have
to take them for the rest of my life. I cannot go on like this,
not exercising is not going to be helpful for my heart either. Thank
you. • I have been on plavix since April, 2004. I
had 2 drug eluting stents put in -- both taxus. I have gained 45lbs
and am tired, achy and depressed all the
time. My Dr. said I would take the plavix all my life. • I read pages and pages of your comments.
Same here. Husband only 62 had stent three weeks ago. Just found
it was the plavix with the shakes and fever and pain. His allergists
suspected
it. It started with his second resting heart test with nuclear agents.
His blood pressure plummeted. But 10 minutes at home and chill and
fever. He also had just reduced his steroid pills to back down to
normal (only small dose). High dose of Prednisone was probably stopping
any
symptoms. He stopped plavix almost whole day and he was back to his
exercising body. Took it last night and within 5 hours chills started
up and fever went to 103. He is in bed now, drained, and pain in
ankles and some parts of body. He would have been better off with an
artery
transplant. I am also worried about statins which he is not on now
because some of you are also having effects from
those. • To Kathy. Hi from Portugal. Yes I too have
AF 24/7 and have been on Warfarin (Coumadin) for 7 years, When artery
problem came to light end of last year, I had a bare metal stent (bifurcation)
fitted in UK, Put on Plavix (75) + Aspirin 75mg and still take Warfarin
5/6 mg. Have been like this for 6 months now, need further angiogram
next week cause now getting chest pains and AF seems to me to be worse,
so needs checking out what might have happened. As far as all meds
are concerned, haven`t really noticed any difference, but for sure
you need to be extra careful at least with any cuts; internal is, of
course, something
a bit out of our control. • S. in India and Michael in UK -- only your
physician (cardiologist) should advise you to change a prescription
medication,
especially something
like Plavix (clopidogrel). For drug-eluting stents, many cardiologists
now recommend clopidogrel for at least one year post DES and many,
depending
ont
he patient's clinical situation, recommend it for life. S. -- Did you
have an angioplasty or stents (bare metal or drug-eluting) after
your
heart
attack? • Diabetic MI June '05, 3 DES and 2 BM stents.
Clopidogrel 75 mg, Aspirin 75mg, Bisoprolol 5mg, Atorvastatin 80 mg,
Metformin 2 gm bd + Insulin. MI July 06 1 week after stopping Clopidogrel.
Angio no change with good LVF. Should I
continue Clopidogrel for life? • Sherry -- we haven't heard from other readers
of any differences between Plavix and the generic version. Are you
taking any statins (this class of drugs are known to cause muscle aches
and pain in some patients). If anyone out there is taking generic clopidogrel
and has experienced any differences, please chime in. • I received a stent implant in 11/05 of the
subclavian artery and four days later underwent a thrombectomy of
the left wrist. Recently my medication was changed from Plavix to Clopidogrel
(75mg) and I have had tingling in both legs, feet, and left arm prior
to the change, but now have joint pain in both shoulders, wrists,
elbows,
and knees. I am trying to understand if there are any significant
differences between the generic and name brand of this blood thinner.
As I am a
type 2 diabetic taking oral medication, I cannot distinguish what
may be related to clotting problems or diabetic problems. I would appreciate
your input on this. (I have seen various doctors, but all are unable
to give a fixed response to the root of this condition). • I had MI in FEB 2004. I am on Aspirin 75
and Clopidogrel 75. My EF even after MI is 65. Can I discontinue
Clopidogrel and continue Aspirin 75. • Sheila, we assume your mother is also on aspirin,
which has antiplatelet properties of its own. How long ago were
the stents implanted and what type were they (Taxus or Cypher). Minimum
recommended times for Plavix (clopidogrel) are 3 months for the
Cypher
and 6 for the Taxus. In many articles throughout Angioplasty.Org,
we note why antiplatelet therapy is so critical for those with
drug-eluting stents -- which is why your mother's cardiologist is insisting.
Sometimes ticlopidine (Ticlid) can be used instead of clopidogrel
(Plavix).
It
is what was used before Plavix became available. It has its own
set
of side effects and may or may not be better. We have heard of
physicians using other antiplatelet medications as well. Plus, there
has been
some research in desensitizing patients who are allergic to Plavix
by giving them a very small dose and increasing it slowly over
two-three hours, every 15 minutes, until the full dose is achieved. • My 72 year old mother had two stents and
was prescribed Plavix. She had a severe allergic reaction, a complete
red body rash with severe itching. There was no question of her not
taking the medications. She also experienced a persistent cough,
runny nose, joint pain and severe cracking of the skin on her feet.
She was
constantly tired and depressed - she had become like a stranger to
us. She stopped taking Plavix and her symptoms disappeared. Three
weeks ago she had an appointment with her cardiologist who insisted
she go
back on the medication and she has developed all of the same symptoms
again. Her life is a misery on this medication and when she asks
her doctor about adverse effects she is made
to feel that she is crazy. • Ralph, these types of reactions are difficult
to connect to causes. While stent allergies are rare, they are known
to exist. If you can determine that your reaction is not drug-related,
this may be the case. We urge you, however, not to stop any of your
prescriptions to test this. Talk to your physician and definitely check
out our Forum Topic on Stent
Allegies. • On May 5th I had 6 stents installed and
am on plavix, aspirin full strength and other meds. About a month
ago I got very tired, no get up and go, my hands joints hurt all the
time,
can't even wear my wedding ring. any one have any suggestions what
may be wrong? any suggestions are welcome. Thanks • I am Male 53, who thought was in good health until I experienced MI in May 2006, although I did smoke, until the day I had heart attack. I was treated with drug eluting stent to one artery 90% blocked, I am unsure of which stent was used, although I do know I am included in a special trial of a new stent. I have been back to my cardiologist 3 times complaining of fatigue, some chest pain, lack of energy, etc. I feel much worse than I did prior to the MI and subsequent treatment. Subsequent tests indicate echocardiogram is normal, nuclear X-rays of blood flow in heart is normal, and EKG appears almost normal, with one small spike in the signal. My cardiologist says I had a very mild heart attack, with miniscule damage to the heart muscle. I did walk into the emergency room on my own. Drug therapy includes, 75 mg plavix, 81mg aspirin, 50 mg Toprol XL, 40 mg Lipitor, and 10mg Lisinopril. Doctor changed Toprol to Coreg 6 mg twice a day on my last visit, but it made me feel worse and I went back to the Toprol. Chest pain has since subsided, but I have otherwise continued to feel much worse. In the past few weeks I began experiencing itching, starting with inside of nose and mouth, some sores in the mouth with the itching being the roof of my mouth. The itching has since spread to back, arms, hands, feet, face, especially forehead, and genital area. My hands are ultra sensitive to the touch of leather, paper, and other smooth surfaces. I had a similar reaction several years ago to niacin, prescribed for high cholesterol. I went out of town last weekend and accidentally went without my medication, so I missed Friday night, Saturday morning, night, and Sunday morning regimen. I had up until this time thought I was depressed, causing the fatigue, lack of energy symptoms. However, after having missed medication doses, I felt much better by late Sunday afternoon. I resumed medication on Sunday night when I got home, Monday morning and by late Monday all of the symptoms were back, with itching seeming to be much worse. I made an appointment to see my cardiologist this Thursday afternoon
(tomorrow)as soon as I could get the appointment. My question is: how
much risk would I be taking to stop my medication for the next two
days, or could I skip one or more of the medications short term without
risking restenosis? I think my reaction is due to the plavix, but of
course I am not certain of that. I do know that one of the drugs is
causing the itching, even if the other symptoms are due to another
problem. Thank You. • My husband just had a stent put in on Friday. He has atrial fibrillation
and has been on Coumadin for 2 years. Now he has to take the Coumadin along with
plavix and a baby aspirin every day. Has anyone else heard of such high doses
of blood thinners? • MY 80 YEAR OLD FATHER HAD STENTS PLACED IN
MAY 06. HE IS SEVERELY ALLERGIC TO PLAVIX. DOES ANYONE KNOW OF ANOTHER
MEDICATION HE MAY TRY? HE ALREADY TRIED PREZANTINE (THIS WAS MAKING
HIM ILL AS WELL). THANKS • To all users of Plavix, this
breaking news should be of interest: Apotex has launched a generic
version of
Plavix.
Cost is estimated to be 30% lower. Read all about it in our news
feature: "Generic
Version of Plavix® (Clopidogrel) is Launched by Apotex". • Thanks for the clarification on the dosing.
I suspected I might have found a few isolated sites that recommended
100mg, and that seems to now be the case. My cardiologist has expressed
her desire to keep me on Plavix perhaps as long as 1 year after the
procedure. Cost isn't an issue since the insurance pays 80% ($149/30
tablets list, ~$30 my cost after insurance). It certainly seems like
a good investment to me, and I am not at any risk for bleeding problems. • Six days without the Plavix and now the joint
inflammation is traveling between varied fingers, usually getting worse
in the evening. I'm glad to say I think the worst is over and I should
be back to normal in a few days. I did see a general physician who
did a full blood workup on me.....all was normal. She believes that
this was an adverse reaction to the Plavix also. I'm very curious to
know how it turned out for John N. from Wisconsin, who posted on July
18 with almost the exact symptoms as myself. This will be my final
post, barring any unusual developments. I wish everyone in the "Stent
Club" good health. • Kevin, the American College of Cardiology, American Heart Association and Society | ||