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Plavix, Effient, Aspirin and Stents (2007 archive)
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Archived Postings from 2007 on This Page (195): • Dear Angioplasty.org, One year ago tomorrow
I underwent my second angioplasty and DES stenting in 10 days-no MI,
just accelerating anginal symptoms. NO co-morbidity prior to or after
(was a fat kid so I am thinking Juvenile Metabolic syndrome as the culprit).
OK, here are the 2 questions: (1) today is the 365th day since my second
stent. Do I stop Plavix after today? I want to start ice skating, possibly
return to playing hockey, and other activities with possibility of blows
to the head. As an emergency physician who takes care of the rare Plavix
disasters, my one fear is a closed head injury or intracranial vascular
accident while on Plavix. I also am tired of the bruise with minor (or
major!)bumps to soft tissues. So I want to stop the Plavix in the worst
way. But I am a good patient so I have continued for the full year. I
have the OK from my cardiologist> What does everyone else think? 2) What
is the antiplatelet effectiveness of the Plavix? In other words, how
long should I be off the Plavix before there are no antiplatelet effects?
I know I should be able to get this from websites/pharmacists but I trust
the input here more and have kept my stents quiet for fear of employment
discrimination. Thank you all for being my distant reassurance and support
through this. Sincerely, PA doc • For some of people that don't have drug coverage,
you should go to your family DR, and your cardiologist and ask them for
samples the drug reps leave at their offices for people when they start
on plavix. A lot of time they would rather write a scrip than give samples
to people who are not covered by insurance. I have seen out of date samples
trashed when they could have give them to their patients. You just have
to ask and ask again. • Hi all..It's been awhile since I've written
and sad news about my mom suddenly passing away Oct. 7th. A lot of stress
going on here..To recap I had a DES in place Oct. 18, 2005. Although
my doctor suggested I can now go off my Plavix (75mg) and continue my
81 mg of baby aspirin, I've decided to take my plavix every other day...Overall
I've been feeling much better..Today, here's my concern: I have been
extremely fatigued the past 3 days. Last nite for the first time in along
time, I had to take a nitro as I was having arm and jaw pain like I did
the night I had my angina attack...We had snow up here in Boston and
although I didn't "shovel" any snow, I did clean off my car using my
arms for a while...I'm wondering if I am so tire because of this exertion???
I was anemic 3 months ago and required 5 infusions of IRON...I'm not
sure if it's my blood counts going down or is it my heart? Does anyone
experience this fatigue on exertion? Thank You...Rosanne • T.M. -- did your husband get a drug-eluting
stent (DES)? All the major cardiology associations (ACC, AHA, SCAI) have
recommended that DES patients stay on Plavix and aspirin for at least
one year, assuming there are no complications. The US FDA has now seconded
that and will soon be issuing a formal recommendation. You might want
to check out and post to the Forum Topic on "Financial
Assistance". • Is there anymore information about the VA refusing
to continue issuing Plavix? They informed my husband that they will no
longer dispense Plavix, even though his cardiologist says that he needs
to remain on it. • Why on plavix and aspirin does one feel cold? • Roger -- we love
it when patients and readers scoop our news! We actually just conducted
an interview with Dr. von Tiehl and Angioplasty.Org will be posting an
article soon about this subject. For those interested, here's the link
to the abstract (free) for Dr. von Tiehl's journal article in the Journal
of the American College of Cardiology (JACC). The article is titled "Clopidogrel
Desensitization After Drug-Eluting Stent Placement". And, as
we've said, and Dr. von Thiel strongly agrees, "don't try this at
home!" • Last August I placed a post noting my experience
with a simple desensitization procedure, performed at the Scripps Clinic,
to overcome allergic reactions to Plavix. As a follow up for those who
may be interested, I note that the Scripps Clinic staff, Dr. K von Tiehl
et al, has recently published a paper on this topic in the Journal of
the American College of Cardiology. The article is available on line
at the journal's website. • After receiving two DES stents in early 2007
in the US I was placed on one 75M Plavix and a 325M Aspirin daily. After
moving to Germany I continued to have chest pain. I consulted German
doctors and after various tests to include treadmills and nuclear medicine
it was decided that my heart was OK. Following some blood tests my German
doctors changed my daily dose to a 100M Aspirin and two (2) 75M plavix
pills daily. Is anyone aware of a someone being prescribed to take two
75m plavix daily along with Aspirin? • Re: Bruce's post below -- please see our disclaimer
at the bottom of the page and our
note from November 16. • Shelly, I buy my plavix & lipitor in Tijuana,
There are hundreds of farmacias at the border competing for the trade
of many americans in our predicament. The plvx. & lip. are brand name
in sealed 30 pill packs. Prices are haggled according to volume so shop
prices. These are "over the counter" and do not require a Rx, I do take
my empty american bottles though. Customs only once checked my bag and
the drugs must be for your personal use. Prices are a little more than
you can get from Canada via internet where they advertise 90 Lipitor
generics 80mg. which can be split for about $3ea. I take the San Diego
trolly to the border and meet people that fly in and out the same day.
Maybe a trip to Texas is in your future. Customs rule I think is 60 days
supply, but I've heard that six months worth is not a problem as they
tend to look the other way and not enforce this. • In your response of 11/18 to Salman, you mention
that CT can show a lot, but with stents the only good way to check on
them is with angiography. Recently my cardiologist did a CT 64 Slice
Scan and showed me the results, in which he said (and it looked to my
untrained eye that he was right) that their was no-restenosis in my three
stents. Is there a difference of opinion on the results shown from the
CT? • To the Forum Editor: Thank you for the detailed
reply. I do not believe I was given DES but the plain metal ones. I wonder
if the Surgeon decides which ones to use or maybe because the government
pays for health care in Canada, they use the cheaper ones. Not quite
sure. Are periodic routine exercise stress tests a good enough indicator
of how a patient is doing? I was also told that as a South Asian my risks
were greater of CAD. Is that borne out by statistics? Because the sub-continent
has people of all races, starting with the Aryan invasion 3 millennium
ago. I don't have a family history either. Mom's fine at 89 and Dad got
a stroke in his 70's at a time when medical science was not as advanced
as now. Besides I was told that the text book definition of "family history" was
one of the parents having heart disease under the age of 55. Is it the
same in the U.S.? • Salman -- you're right -- there is a debate
going on. We just attended the TCT meeting in October where studies were
presented, showing that stent thrombosis is not decreased by clopidorgel
(Plavix) after 1 year, and others that were less clear. The debate will
no doubt continue, but in the U.S. right now, the guidelines recommend
a minimum of one year of dual antiplatelet therapy (clopidogrel or ticlid
and aspirin) post-DES. As for a continuing benefit, that's something
between you and your cardiologist. Plavix has benefit beyond helping
to prevent stent thrombosis, but it also raises the risk for bleeding
complications. Like the ads says, "Ask Your Doctor...". Stents
are permanent implants, but they can close up, or restenose. Drug-eluting
stents restenose less than bare metal stents, which have a restenosis
rate of 15-20%. Remember, that means 4 out of 5 stents never restenose.
With DES, it's more like 9 out of 10 never do. CT Angiography can show
a lot, but when there are stents implanted, the only good way, right
now, to image the arteries is through invasive angiography in the cath
lab. • I had angioplasty in Mar 2004 at age 60. Two
stents (a 90% blockage and a 75% blockage) and a ballooning without stent
in the 3rd, cause I was told it was too narrow. I took Plavix (75mg once
a day) for a year. I believe there's a debate going on, on whether to
take it for a lifetime or up to a year. If it is a blood thinner, it
could only be good for someone with CAD; so I wonder why do they stop
it? Does anyone know, how long do the stents last? Is there any imaging
technology available to see the arteries with the stents and the flow
of blood? • Thanks Betty & Pete, I will check out both the
sites you mentioned. I am not giving up! When I find one that works ya'll
will hear from me!! I'll yell it from the rooftops!! lol And, no worries,
my meds will be legal... I have enough problems without adding any new
ones. ;) Thank all of you again, this is a great bunch of people!! • By "stent
site", the doctors are talking about the site of the actual
stent - the midportion of the distal vessel (I think) in the right
coronary artery. Still unsure of exact origin of bleed. • Shelly, I don't know if this will help or not
but I found this site. It seems to offer some help in finding a program
that can assist you in getting your prescriptions. I have not signed
up but it looked interesting. This is the website: http://www.rxassist.org --
Good luck and let us know if that helped at all and anything else we
can do for you. And hang in there, you'll get this figured out. • Just a note to all --
we welcome opinions and information from our readers, but any opinion
expressed by posters are their own and do not necessarily reflect those
of Angioplasty.Org or its editors. We also do not endorse obtaining prescription
medicines or pharmaceuticals from any source that may conflict with the
laws or regulations of any country. • i keep reading about the cost of drugs like
plavix in US and Europe and difficulty in people not financially sound
to continue on treatment. I am from india where lot of angioplasty procedures
are performed daily and though i do not have data to support but am sure
restenosis and or Late thrombosis rates would be similar to the world.
The patients are given same prescriptions like Clopidogrel, aspirin,statins,ace
inhibitors. These are dirt cheap here and i must add they are generic
versions but i am sure equally effective. let me tell people are taking
these even if they are rich enough to import and afford 200-300 dollars
a month but still doctors (let me again say Indian doctors are as good
as anyone in the world and they know that quite a few of the patients
can easily AFFORD imported medications but they say indian medicines
are equally good. Now lot of indian company medications are marketed
in US and EU. So my suggestions to people who cannot afford drugs in
US like plavix etc is to consider getting it from india just for reference
- clopidogrel 75+ aspirin 150 combo tablet for 30 days dose costs only
3(three)dollars in india.please dont think they are not effective ,they
are as good. indian medicine compares to the best in the world today.
even procedures like stenting ,bypass etc on the same machines. are much
cheaper . a angiaoplassty with one cypher des costs 3000 -3500 dollars
at the best hospital which let me say are comparable to world standards.
bypass costs 1ian medicine 10000-12000 usd. i myself went thru angioplasty
im mar 06.so people rather than not taking plavixe for one year as recommended
should explore indian medicine options. it is false propoganda of big
cos that generics is not effective. my emailid is tarunsud@hotmail.com • Shelly--Have you checked out www.scbn.org?
I'm sure there is paperwork, but it might be worth a shot if you haven't
already tried it. It stands for Select Care Benefits Network, a patient
advocacy organization. Good luck to you. YOU GO GIRL!!!! • I still do not have my Plavix but it is nice
to see the support here. I am not giving up, I feel there has to be a
way for me to get this much needed med I need. It gets very frustrating,
but I am very persistent and I vow to follow every lead I can find. Again,
I urge any of you if you know of other companies, web sites, etc. that
assist people in obtaining Rx medications they need to please post here.
I see I am not the only one in this position, and I am sure there are
lots more that aren't aware of this site. I did get in touch with my
Cardiologist (his nurse) and they do not have any samples of Plavix,
but I was told if they did get any I would be called. I'm keeping my
fingers crossed & praying.. it scares me every night I go to sleep...
I need a miracle as I'm sure others do. It's ridiculous knowing drug
companies make the huge amounts of money they do and people as myself
and others have to live in fear of death not being able to afford their
meds. The amount of red tape these companies put you thru only to be
turned down is frustrating. I have filled out no less than 30 pages to
qualify for free/reduced meds only to be turned down since they have
a quota they can't go over. Hard to think a quota has move value than
a human life... (sigh) I haven't offered much information to anyone here,
but it helps me to vent. Who knows, maybe someone reading this will know
of another place I can try for assistance. At my local drug store I checked
the price of Plavix today, $136.00 for a 30 day supply. The U.S. needs
better health policies for those like us. I doubt I will ever see that
day in view of my current dilemma, but I can fight for future generations.
I do plan to fight this; it may take a while, but if it means possibly
saving one life it is MORE than worth it! Please, if you have any information
on this subject please take a minute and post it for all of us out here
in this situation. Thank you & God Bless. • Susan -- when you say "stent site",
do you mean the access site (probably in the groin or femoral artery)?
We assume you don't mean the actual place in the coronary artery where
there stent is. Bleeding complications at the femoral access site are
approximately 3-4% (we think higher) but we haven't heard of such a complication
occurring 5-6 months out. Possibly it was, as you said, a slow bleed
from the beginning. These complications are one reason we have initiated
a section on "Radial
Access". • My husband had
surgery to close a PFO in 1999, bare metal stent in 2000, bypass surgery
in 2006, drug-eluting stent in 5/07. Ascending aortic aneurysm diagnosed
in 5/06 at 4.2 cm. On 75 mg plavix and 325 mg aspirin daily. 10/31 he
experienced severe bleeding in the chest cavity. Prior to diagnosis of
bleeding, cath showed all previous repairs were open. Chest tube evacuated
about 3000 ml of blood and fluid. Transferred to TX Heart Inst. because
of two previous surgeries and possibility of aneurysm bleed. Latest diagnosis
is that he had a slow bleed from the 5/07 stent site, which pooled and
caused extensive chest pain. Lovomax [Lovenox??] given in ER and aspirin/Plavix
therapy exacerbated bleeding. Do you know incidence of bleeding from
stent site after 5-6 months? • Shelly -- you have sure been persistent. We've
found out a bit more about Boston Scientific's program. It's called "StentPLUS" and
the person in charge of it told me the same thing they told you -- they
are looking to launch it right after the first of the year. Even so,
it's not going to give direct financial relief to patients -- only to
help them find ways to lower their costs through various government,
etc. programs. Bristol-Myers and Sanofi-Aventis are the companies that
are making Plavix which IS the largest selling drug in the world ($6
billion worldwide sales last year) so keep after them. • Well, unfortunately the [Boston Scientific]
program I wrote about in the prior
post (Oct 16) will not go into effect until 2008. In the meantime
they referred me to PPA which I did apply for online. I got my response.
Due to the number of people requiring medications I am presently taking
there is no assistance available at this time. They did tell me to re-apply
January 2008. That means at least 4 months with NO Plavix, Lipitor, or
any other expensive medicine my Dr has Rx for me. I do have a call into
my Cardiologist hoping for some miracle... All I can do at this point
in time is pray. If anyone else has this issue, if you are able to speak
with your Dr. prior to surgery that may require you to take these meds
please talk with him/her about it so you don't end up in the same position
I am. Good Luck to everyone.. • Very interesting website! Glad to have found
it. In Jan. '06, I had a blockage in the left leg. Went into hospital
and 3 stents were placed in the inner thigh area. I was already on a
Plavix/aspirin regimen and this was continued at discharge. Absolutely
no beneficial results from the stents. Doing a little research of my
own, I learned of the Silverhawk Plaque Removal procedure. My cardiologist
had never heard of it, contacted a representative of the company. That
person came to meet with me, explained all about it, risks, etc. I had
the procedure in June '06. The results were amazing to me. I could walk
with no pain whatsoever for the first time in a long time. But the surgeon
who performed the procedure didn't seem too happy with me for wanting
that method. When he discharged me from the hospital, his comment was, "Well,
stents are better". In Sept. '06, I had a routine visit with my cardiologist.
He had a Physician's Assistant I had never met. This person took me off
daily Plavix and told me to take it every three days. Within 3 weeks,
I had a blood clot in the left leg. The same doctor who did the Silverhawk
procedure also removed this clot. At the same time, he also implanted
3 Cordis stents. I had no idea he intended doing that. From the time
I left the hospital my leg hurt terribly in the calf, back of knee and
back of thigh areas. I kept being told it was just soreness and would
work itself out. In Jan. '07, my cardiologist performed an atherectomy
on the leg to try and determine the cause of the pain. Could find no
reason for it. In Sept. '07, I had another blood clot in the same leg,
even on Plavix/aspirin. I have never missed a day taking the meds. Well,
lo and behold, the same surgeon who implanted the stents also removed
this clot. Afterwards, he demanded to know who had put those stents in.
He said they are the wrong size and are too big and the clot had formed
at the stent. I told him he did, but he denies doing it! He told me that
when my cardiologist did the atherectomy, he must have done it! Well,
I have the card showing when, where, what and who signed it. He did.
I am very upset that he is now saying that not only did he NOT do it,
but that they are the wrong ones. • I have been on plavix and few more other expensive
medications for more than 4 years. I had 3 stents put in over 4 years
ago and i ended up with an open heart less than 6 months ago (quad).
I am not insured and every thing i get i have to pay for. As i said earlier
i am taking few other expensive medications beside plavix, such as lipitor
80 mg,zetia 10 mg , hi blood pressure medication, nitro glycerin patched
.04 mg and because they are so expensive i am afraid that i might not
be able to continue taking them. My question is ,is there any way of
getting some help ? If yes , where and how? By the way i am american
citizen. Thank you. • Glenn -- it's always a comfort to get a second
opinion (some insurance plans cover patients for this) but it's reasonable
for your doctor to be concerned if you are at high risk for bleeding.
Only your doctors can make this assessment, but it is one of the big
problems with drug-eluting stents and the need for antiplatelet therapy.
However, we've recently seen several studies that show no increased benefit
of Plavix after a year, that is in regards to prevention of stent thrombosis. • April 2005 I had a heart attack. I had a cath,
angioplasty, and drug emitting stent. My cardiologist put me on Plavix
for one year then took me off. When I questioned being taken off, he
said the concern is for bleeding problems. Should I consider an additional
opinion? I am not taking plavix now and do take 325 mg aspirin, though
he suggested going to low dose • Otis -- thanks for the info. We've mentioned
Ticlid often -- but bee stings!!?? That's a new one on us. Which stent
did you get and where did you find out that the med in the stent is the
same as a bee sting?? • I have a medicated stent placed in 2005. I was
put on PLAVIX and aspirin. I had bad reactions to the PLAVIX and the
MEDICATED stent! My cardiologist put me on TICLID. No more problems.
Hope this helps others. The problem with the medicated stent is that
I am allergic to BEE STINGS. The meds in the stent are the same as getting
a bee sting, that is why I got HIVES from the med stent. • Shelly, I have a friend who ran out of insurance
and plavix is the one he's having trouble finding an alternative for.
There is no longer a generic. Try needymeds.com and you can get an application
to Bristol-Myers among many other companies for drug assistance. He does
complain of itching, but thought it was from dry skin. I'll share your
story with him. You are not alone. Your local retail/pharmacy, big chain
stores also may offer assistance with their prescription drug plans for
as little as $4 per month if you can get a generic. Good luck! • Clifford -- if your husband is coughing up blood,
it's a possible sign of a bleeding complication. You should not hesitate
to see your interventional cardiologist -- right away!! Don't make medication
decisions without consulting him/her -- and don't go off Plavix without
discussing this with the cardiologist who prescribed it. • my husband has been on plavix for 2 months,
he has been coughing up blood . since he has been on it . he had one
stent put in.what do you suggest about it. we are getting concerned. • What is the current medical wisdom or findings
concerning medicated stents and stopping plavix. I have two taxus 2 stints
(for 1 year)in my LAD And i am seeking 2nd and 3rd. opinions before I
stop taking Plavix. • In January 2007 I had two Taxus DES stents placed
in my heart by an American Dr. The Dr. prescribed a Plavix (75) one each
day and a 325M aspirin. I have since moved to Germany and, due to persistent
pain in my chest, made an appoint with a German Cardio Dr. He changed
my medication to a 100m aspirin and two 75M plavix pills each day. I
was wondering if anyone else has ever been prescribed to take two 75M
plavix daily. I would think I would be getting less medicine since it
has been over six month since the placement of the DES stents, however,
the prescription is for more Plavix. • D.C. -- see other posts about allergic reactions.
The rash is something that's definitely been seen with Plavix, but it's
hard to sat with all the various meds. There is an alternative called
Ticlid -- it used to be prescribed before Plavix was available. Many
docs switched to Plavix because Ticlid seemed to cause more reactions,
but some docs actually find Ticlid has less allergic reactions in some
patients. It's the only drug they use in Japan. Maybe your doc could
try that. But you should discuss this with your interventional cardiologist
-- and do not go off Plavix without his/her knowledge. • My husband just had three stents placed in three
arteries Oct 19,07. They sent him home taking these meds: Plavix 75mg,
Lipitor 20mg, Atenolol 25mg, Nexium 40mg, Aspirin 325mg & Zoloft 100mg.
Now my question is which one of these med's is causing him to have an
allergic reaction with hives all over his body? I noticed third day home
he had broke out under is arm's and down his side, called the doctor
no response, woke up today all over. Called general doctor they said
to start taking benadryl. He has taken six tablets in eight hours no
relief. What do we do now? • Steve - thanks for writing in. We do not know
of any studies about Cipla -- and any Google ads on this site are automatically
placed there -- we do not in any way endorse any of them (we're just
trying to raise some funds to help keep the Forum online). Again we would
urge you to discuss this with your physician. But it is interesting that
you're not having reactions to it. We hope it is actually doing what
it's supposed to. • First let me say that I have adequate insurance and can otherwise pay for brand name Plavix as needed. However, I have experienced unpleasant side affects from the brand name drug. For over a year I bought generic plavix from medco, my provider, and had no problems with the generic equivalent. After the Federal judge ruling, medco could no longer manufacture generic plavix and I am back to taking the brand name drug. I am now experiencing the unpleasant side affects, such as sores in mouth and nose, anxiety, muscle spasms, irritability, among others likely precipitated by some of the previous ones. This situation resulted in my purchasing generic Clopidogrel from discount drugs from Canada online. I received the drugs, but they arrived wrapped in a brown paper bag with a return address from a residence in India. This worried more than a little and I have not taken any of the drugs but have continued taking the brand name plavix. Today, I notice your site includes an advertisement for Plavix from discountdrugsfromcanada.com. The drugs I received are from the manufacturer Cipla as indicated on the link from your site, come packaged individually in aluminum 5 pill strips, and then enclosed in a quality plastic case with two latches. It is very professional looking and expensive packaging. Are these drugs equivalent to plavix? I read all I could find about Cipla and they apparently reverse engineer the drugs they manufacture. Is that standard practice by drug companies outside the U.S.? I received the Endeavor stent as part of the Endeavor
IV clinical trial in May 2006 during an MI, and have maintained my dual
anti-platelet regimen since. The brand name Plavix is wearing on me.
I am walking 3 miles in 45 min 5 times a week. I have reduced my cholesterol
to 140, lost 20 lbs and 4 inches in the waist since the heart attack,
but my doc wants me to continue plavix, and continues to try to improve
LDL to <70 and HDL > 50 by upping Vytorin to now 10/40mg. I am otherwise
doing great until I had to go back to the brand name Plavix for the past
couple of months. I'm not sure how much longer I can tolerate Plavix
and will likely take the generic i received from Cipla at some point.
I sure would like to hear that others are taking this drug without adverse
effect. Thank you for all you do • To all who write in asking for advice about
medications and doses -- in our disclaimer we state nothing on this site
should take the place of advice from an MD and we urge all patients to
ask these questions of their cardiologists. Generally speaking, most
interventional cardiologists will prescribe Plavix and aspirin for a
year after the placement of one or more drug-eluting stents. Most recommend
staying on aspirin for life; some prescribe Plavix for longer, assuming
the patient is tolerating it well. For bare metal stents, most prescribe
Plavix for 3-6 months and aspirin for life. But Plavix is indicated for
conditions other than stenting and you should ask you cardiologist these
questions. And certainly if you are not tolerating the drug or having
an adverse reaction, call your cardiologist ASAP -- there are a couple
alternatives, one if Ticlid (ticlopidine) which is what is used exclusively
in Japan. • Received two (2) non-drug eluting stents in
2002 -- one in March during an ACS(STEMI) and one in August -- at the
ripe old age of thirty-seven (37). Have been on the following medications
CONTINUALLY since: Toprol XL 200mg qd, Altace 2.5mg qd, PLAVIX 75mg qd,
ASA 325mg qd, Tricor 145mg qhs, Vytorin 10/20mg qd, Nexium 40mg qd. Should
I still be taking the Plavix and Aspirin combination at this point five
and a half (5.5) years later? Should the ASA level be 325mg? Please advise
-- seems unusual from reading other posts in this forum. • Dear Editor and All: My father, 86 years old,
had 3 stents put in two years ago. He has been on Plavix, Aspirin, and
Lipitor for two years. Does he need to have Plavix for the rest of his
life? Plavix is expensive. I am looking forward to your advice. Thanks
a lot. • Shelley, can't understand why Plavix is so expensive
in USA. I am in Portugal at the moment and here its list price on the
box is 51euros, you only pay that if you are not in the state health
scheme. • Shelly, Sorry to hear about your problem with
Plavix, but I have been through the same situation. I have not worked
in over 2 1/2 years and I am broke. I understand how It feels not to
have Plavix and know you need it. I have recently been in that situation.
I have also already had a stent thrombosis. You cannot afford one. Call
you sponsor, I hope you have one at your Cardiologist office, EVERY DAY.
CALL Bristol-Meyers everyday. Explain your situation and tell them you
are out. Do this often. You will be heard. But most of all, get all the
paper work they request to them immediately. Good Luck. P.S. If you are
thinking about SSD file it now, don't wait. You can't speed up the Government!!! • Last night you posted
a reply regarding Boston Scientific and a program they
recently launched. Today I contacted them via email. They initially
responded to me that the stent I have was made by Johnson & Johnson,
not Taxus and they would not assist me. I copied the article you sent
the link to and emailed them again. I received an immediate reply from
them apologizing. They stated I was the first person to make the type
of request I had, and that they are forwarding my information to the
correct department. It makes me wonder how many may be missing out on
this. Even someone at Boston Scientific isn't fully aware of their program.
It shows persistence does pay off and I hope others will contact them
if they have a need. Thank you again for the information. I will let
you know if I am able to get assistance from them and that too may help
others. Kudos to you!! • Thanks again, and I do fully understand that
you can not give medical advice. You can probably see I am grasping at
straws trying to get my Rx for Plavix. I did see my Cardiologist last
week right prior to my insurance running out, and not being able to afford
Cobra. I advised him of my situation, and he said I NEED to take it somehow!
I do understand that. Hard to do when one only has 50.00 to their name.
I will call Bristol Myers Squibb tomorrow and maybe with a bit of luck
I can speed up that process. Hopefully something will break soon. We
live in the great & wonderful USA, and I am sure I am not the only person
with this dilemma. it's truly sad that our health care system fails so
many, not just me. I will update this forum if there are any significant
changes. Thank you again so much for assistance. You do a great service
to many! • Shelly -- not to panic you, and we do not and
cannot give "medical advice", but most cardiologists agree
that Plavix should not be stopped, especially in the first 6 months after
drug-eluting stenting. If you have any way of getting some, you should
do so ASAP. Call your cardiologist and explain the situation. • Thank you so much for such a timely response!
You misunderstood one thing; I did have insurance which did cover the
Plavix, but not the Lipitor. My insurance has run out and I am no longer
employed. It may be a while before I am covered by group insurance if
I am able to find employment at age 58 with my medical issues. Not just
the heart attack I had but my back surgery prevents me from doing a lot
of things. But, back to the issue at hand. I am presently out of Plavix.
Do you have any idea how long one may safely go without it? I was wondering
if Plavix is stored in the system for a few days while I try to figure
out a way to get my Rx for it. My mind of course is playing tricks on
me right now... anxiety from not having the drug I am sure. I have contacted
Bristol Myers Squibb some 3 weeks ago when I learned I would no longer
be insured and to date no response. I have also registered with the program
Montel Williams endorses >> Partnership for Prescription Assistance at
the same time. (3 weeks ago) and have not heard from them either. I guess
all this takes time. But, I have to wonder how much time I have before
my stent may be affected by not having the Plavix. I did receive a Cordis
Cypher Stent.. Sirolimus-eluting if that is of any help. Thanks again
in advance for your thoughts on the subject. I come to this site several
times a week and it's great the support I see for each other. I wish
everyone the very best in their recoveries. • Shelly -- your cardiologist is right -- Plavix
and aspirin are both important drugs to take post-stenting. If you got
a drug-eluting stent, you need to take them for 6 months-1 year at least
(aspirin for life -- but unlike Plavix, aspirin is cheap). This is a
big problem for this field -- in fact a number of cardiologists ask patients
if they'll be able to afford a year or two of Plavix before they
put in a stent. If patients can't afford that much, then they may
use a bare metal stent which only require 6 weeks of Plavix -- however,
with bare metal stents, the blockage does have a higher chance of reclosing.
In your case, which was an emergency, an extensive interview wasn't possible,
so he made the decision based on his experience. Just an aside -- your
story highlights one of the great successes of angioplasty. 20 years
ago you would have gone to the hospital where they would have given you
pain killers while they watched your heart attack play itself out. Assuming
you survived, you would have ended up with a damaged heart muscle and
a significantly lower quality of life and increased risk of death. So
that's something to be thankful for. Now, back to the present.... It
is outrageous that insurance doesn't cover a drug that is needed this
critically. Try to contact Bristol-Myers or Sanofi-Aventis again -- they
make Plavix. Also try the stent manufacturers. We know that Boston Scientific
(makers of the Taxus stent) announced a $40
million program back in March to increase compliance, part of which
was "a patient assistance program designed to facilitate access
to financial support for anti-platelet therapy for patients who qualify".
This is regardless of which brand stent you received. Contact them and
please let the Forum know the outcome. Good luck. • In June while watching a DVD with my daughter
I began to have excruciating pain in the back of my shoulders. 911 was
called & I was told I was mid heart attack. I have never had any heart
related issues. Upon arrival to the hospital, I was prepped and taken
immediately to the Cardiac Cath Lab; a Cypher Stent was inserted thru
my groin. Other than the anxiety from it all, I felt pretty good other
than my back. I had major back surgery a year ago and lying in one position
for almost 24 hours was unpleasant to say the least. I was sent home
with Rx's for Plavix, Lipitor, Coreg, Potassium, and aspirin. Since then
my insurance has run out! Plavix where I reside is $145.00 a month! YIKES!!
I have signed up for assistance with drug companies but have yet to hear
a thing from anyone. This month I can not afford the Plavix and I am
scared to death what may happen without it. There must be others out
there in similar situations that can not afford all your medications
and I am wondering what people do in these instances. My Cardiologist
did give me all the samples he had in his office, but I have used all
of it now. He states I NEED the Plavix... what to do.. what to do? Anyone
have any ideas? • R. from Buffalo -- itching has been reported
here as an allergic reaction, possibly to Plavix. Your mom's cardiologist
is correct -- that she should not stop taking Plavix. But possibly he/she
could try Ticlid to see if the allergic symptoms go away. Ticlid works
similarly to Plavix, but is not used as much in the U.S. because it seemed
to have more side-effects. However, some physicians (and all of Japan)
find Ticlid works when Plavix doesn't. Remember, this is not medical
advice. You must discuss this with your mother's interventional cardiologist! • My mom had 4 stents put in on September 1st
and another 5 two weeks later. She has been on plavix, aspirin, protonix
for her stomach, blood pressure and cholesterol medicine. Up until two
weeks ago, she has been fine and getting better every day. However, two
weeks ago, she began itching. I called her cardiologist and her primary
Dr. and both said that it shouldn't have anything to do with the medication
she is on and perhaps she is using another laundry detergent....(she's
not). Has anyone else experienced itching from Plavix?...also is there
an alternative? Her cardiologist is adamant that she doesn NOT stop taking
Plavix. Also, is it possible that the medicated stents put in may be
causing this? • To all: any adverse reactions, especially bleeding,
hematomas or bruising, or abdominal pain, etc. should be reported to
your interventional cardiologist. Some patients have allergic reactions
to drugs. And bleeding complications and bruising, are an adverse effect
of Plavix. Weighing the use of antiplatelet meds against the risk of
stent thrombosis is something you should discuss with your cardio. Certainly
do not go off your meds without consulting him/her. We also recommend
looking at related topics in the right hand side-bar column • My husband is a post-stent placement recipient
(6/2006). He has had an increase of spontaneous bruising lately. Large
hematomas on legs, arms and flank regions. The most concerning thing
though that happened recently is that my husband took off a pair of white
socks and noted spot of blood inside the socks. No active bleed noted
at that time but was able to see blood on wash cloth. I talked him into
going to primary MD that day for labs. No active bleed noted at MD or
since that one episode. He also had some reddish mottling and petichiae
on the bottom of his feet. MD had labs drawn. All labs were within normal
ranges. In fact, his PT/INR was 13.2/1.2. I would have thought the those
levels would have been way over therapeutic levels. I was surprised and
now confused. So is his doc. He also takes ASA 81 mg daily. And Lipitor
40mg daily. I am also concerned that some of the hematomas seem to be
spontaneous and without any source of trauma, are his internal organs
at risk of bleed? • Lynn -- have you looked into a virtual colonoscopy??
This is done with CT and is less invasive. However, it's new and is only
done in certain centers. • My sister is taking plavix for PAD. She has
a stent in her left leg that was placed earlier this year. She has already
had to have angioplasty to the stent area since it was placed. She has
been having bright red blood in her stools intermittently for several
years and went to see a gastroenterologist . He told her that she would
not be able to have a colonoscopy unless she was cleared to stop her
plavix. Since she has had her stent occlude after 6 months, I am sure
that her cardiologist will not take her off the plavix. I am sure that
there are alternative testing to evaluate her rectal bleeding, but the
gi doctor didn't offer any others. Any input? • I am a 61 yr. old male who had two stents a
month ago, given 75 mg plavix and big aspirin. I am having severe colon
soreness. Is this some kind of warning sign or bad reaction? I am trying
to get some answer before contacting my Doctor. The doctor and hospital
are already sending me threatening bills. I If some one has a response
I would appreciate it. Thank you for your time. • Dear All: My mother had one drug-eluting stent
put in approx. 3 months ago and is experiencing extreme head tension/pressure,
spasms in neck, (she was diagnosed with cervical distonia, although the
symptoms only started after the stent and her taking Plavix) Almost all
doctors although being helpful have not understood why she is feeling
so bad. She has also received botox injections in the neck to relieve
symptoms as well as myofascial release therapy. None of it has seen to
help. I believe she is allergic to either the stent or to Plavix, but
what do I know, I am not a doctor. The problems seem to be of a neurological
variety. She did not have any of these problems before the stent or taking
Plavix. She is 73, and also diabetic/high blood pressure. These are my
questions/concerns: Am I crazy to think she might be allergic to the
stent or to Plavix? Are there any alternatives to Plavix? Does anyone
know of any alternative therapies that might help with her symptoms even
if only temporary solutions..? Any thoughts, ideas, suggestions would
be greatly appreciated as it is breaking my heart to see her in so much
pain. • In Jan/06 I rec'd 2 coated stents and started
Plavix. 8 mos later I rec'd 4 more stents and was told that I had a completely
blocked artery. I was put on an aggressive medication program: blockers,
inhibitors and long term nitrate. With angina still worsening I took
it upon myself to stop the Plavix. I was gradually able to slowly return
to a increasing exercise program. 5 mos later I stopped the nitrate and
after 3 more months I am now free of any angina that I can feel. I can
exercise to the limit of my physical capacity. The hitch is that I now
have to live with the constant fear of fatal thrombosis due to having
coated stents in me without the use of the preventive medicine. It certainly
appears that in my case at least, Plavix was causing worsening Angina.
I would like to hear from anyone who is having similar experience. • I am a forty nine yr old female with Lupus.
I had a heart attack 4 yrs ago and every yr in the spring they put in
more stents. I know have 6 stents in my heart -- one in my right groin.
They are now saying the Lupus is attacking my blood vessels and heart
that it isn't plain ole artery disease as thought all along. This is
the problem I am dealing with now. I just got out of the hospital for
the second time this yr with my heart (stent placement) and I am taking
Plavix and 325 mg of aspirin amongst other meds they gave me Lovenox
three times not to mention other thinners via I.V. my stomach and my
groin are black almost all the way across my stomach and hips. Which
I can cope with. The problem is to brush my finger across it stings severely.
Not touch it , just lightly brush across it. It hurts to wear underwear.
soft shorts anything that touches it. I noticed the problem before surgery
with bruises any where on my body and no one can tell me why and just
blow me off. Help??? Is it the Lupus or a blood disorder? If the Dr's
cant figure it out what do I do next? • I have a Boston Scientific Taxus coated stent...placed
Feb, 2006. Originally told to stop Plavix after one year. However, Dr
told me later to stay on it with one baby aspirin a day. My blood is
thin anyway with chronically low blood platelets following radiation
treatments 12 years ago following prostate surgery. I do have blood spots
periodically on my skin...especially on the hands and arms. Is it possible
to stop taking aspirin or plavix...or the amount? Every other day? Do
doctors take into consideration blood platelet count? • Michel -- don't know about the genetic link
-- Japan has somewhat different reimbursement rules in medicine, so medications
are used differently there. Plavix and Ticlid are somewhat related, but
you should discuss this with your doctor. Plavix is used for specific
reasons in heart patients. It's use after stenting is one. There may
be other drugs he/she would recommend. Aspirin and Plavix accomplish
similar tasks (keeping the blood "slippery") but they act on
different biological processes, which is why "dual" antiplatelet
therapy is what's been found most effective. • After going through an angioplasty with no stent
implant (it was a Y situation on the RCA and the doc didn't find it right)
and being prescribed plavix, I developed rash and itching. Being told
to get off Plavix and after reading these cases I feel maybe Ticlid would
work for me. I am an asian and knowing that Japanese cardios prescribe
Ticlid, maybe its a genetic thing that Ticlid work better with asians.
Also does aspirin and these meds have the same blood thinning quality?
Does blooding thinning mean declustering of platelets or something else
too? If so why do we need all of them? Any answers? • My father who was very lucid, able to drive
his car and go walking in the mall had a drug-eluting stent put in for
a 90% blocked artery 8 weeks ago. He was put on Plavix immediately. He
began bleeding into his limbs, having swollen limbs and having muscle
jerks within two weeks. By three weeks post-op he could not walk more
than a few steps due to pain. No doctors would listen to us until we
finally got him admitted to hospital when he could no longer walk and
was barely lucid. For a long story made short, he was finally diagnosed
as having Acquired Hemophilia (blood test for factor VIII and inhibitors)
caused by Plavix or Ciproflaxin (taken 6 months before symptoms). He
was taken off Plavix and ASA and the bleeding stopped. He cannot go back
on Plavix and they're not sure about ASA because of the Acq. Hemophilia.
The cure for Acq. Hemophilia is steroids and is currently too dangerous
for him. I'm telling his story in the hopes that it will help someone
else in their search for a diagnosis. • I had stent put in heart blockage may 2007 and
then the doctor said he seen where i should HAVE 2 stents for iliac---I
had that done 1 week ago---I am taking Micardis and Lopressor----plavix
and baby aspirin--also was told to take lipitor or crestor---I took crestor----My
problems are related to lack of sleep (stomach burning--feels like battery
acid at times) Oh I had 60 percent of my right lower lobe of lung removed
the middle of Feb. 2007---I seem to be breathing OK and use oxygen at
times mostly at night--I just started taking nexium for stomach discomfort----I
was wondering why I have to take crestor or lipitor if cholesterol is
OK???I also was told have mild sleep apnea and will treat that with mask
at night----seems like micardis is not a well known drug for hypertension
and I would like to use lopressor instead twice a day. P.S. will be 72
Jan 2008 • Chad -- you've posted on the Forum before, in
the stent
allergy topic. Your concern about nickel is an important one for
patients to be aware of because almost all surgical implants that are
made of metal have some nickel in them, not just stents. All stainless
steel contains nickel. Actually, if you look at a stent, you'll note
that it is extremely small, and it is a mesh, so the amount of metal
involved in a stent is pretty minimal, especially when compared with
things like the metal rods used for broken joints, etc. So the actual
amount of nickel in a stent is very small. But it's not correct to say
that the medical community is "lying" about this -- all package
inserts warn of allergies. The problem is that, as you have noted at
length, how do you know if you are allergic? The cheap earring example
is actually a good one. Patients who may be getting a metallic implant
of any sort really need to be "proactive" and let their doctors
know of any allergies. We would also hope that doctors or nurses stress
this question during the pre-procedure interview. While testing may be
an option, one would hope that the majority of patients who are allergic
to metal would have become aware of that by the time they're old enough
to have coronary artery disease. As for the interaction with smoking,
anyone at risk for coronary artery disease should not be smoking, period. • Dear Readers, Doctors are saying the allergic
reaction is to the Plavix or Ticlid. This is not always the case. Some
of the human population is allergic to the chemical composition (Nickel).
Nickel is also a known carcinogenic. All of the stent studies conclude
at the 6 month mark and are quite free with the fact that they don't
know what happens after 6 months. Also they don't know about the reactions
if more than 2 stents placed. Also manufactures warn of using stents
of different grades. What happens when you have several heart caths with
different stents put in. Answer: Nobody knows cause not enough long term
testing was done prior to the OK for the stent placements. Some of the
toxic effects are listed on the brochures. Muscle and joint pain, IBS,
Chronic Fatigue Syndrome, Fibromyalgia, trouble sleeping, and on rare
occasions Psychotic episodes. My wife is 34. She had the first heart
cath with 3 stent placed. Here we are 9 years later and she has had 13
heart caths for 11 stents placed, a triple bypass(no more stents could
be placed), and the sternal wires removed 7 month later because of the
nickel in the sternal wires. I recently discovered that all 11 of the
stents contain nickel. The medical community (manufactures, Doctors,
Hospitals) are saying the stents are 100% Titanium or 100% stainless
steel. Even when asked if there is nickel in stents the answer is always
the same 100% yes there is no nickel in the stents. WRONG WRONG WRONG!!!!
If you can't were cheap earrings that contain nickel, you have a nickel
allergy. Huh, how many people do you know can't were cheap earrings?
Yet it's OK to put these in to the human population without our consent
to the nickel. And if you do have a reaction in vivo to the nickel in
the stents, Oh well, there is no precedence for removing them. You have
to live the rest of your life with the chronic conditions that come from
being allergic to the nickel. A transplant is the only way to date to
remove the stents. What do you do if you find out the medical community
is lying to everyone about what might actually going on. By the way smoking
cigarettes and being exposed to second hand smoke triggers the nickel
allergy. So with that in mind, what do you think the outcome is going
to be with more people developing heart disease, more stents being put
in, and people smoking anyway. More people will not be properly diagnosed
with ailments relating to nickel in vivo. Remember there is no way to
remove stents once they are placed. Don't you think the manufactures
and the doctors should have implemented a plan to remove offending stents
to those that can't tolerate them? Or how about following the manufacturers'
warning "Some people have an allergic reaction to the Stainless steel
alloy" (contains nickel) or the Titanium alloy (contains nickel). The
only test for a nickel allergy is done on the skin and it's not always
conclusive. The only true way to measure how allergic to metals you are
is through a blood test. Since we are dealing with matters of the blood,
this test should be administered before any metal implants are done.
Doctors and hospitals ignore this warning and do no testing prior to
implantation. For more information on the effects of nickel in vivo go
to www.MELISA.org. They are the only ones that test the blood for how
allergic you are. More people are have a reaction to the nickel in the
stents than either the doctors realize or are ignoring because they are
now held liable for not paying attention to the fact listed right on
the brochures from the manufactures. You can google Nickel Allergy and
Toxicity or any words containing nickel in vivo. One more thing I read
before I go, a nickel solution was injected into a dog heart and a decreased
left ventricle action was noted. Upon more solution more decreased action
was noted. This was not from the solution as it was from the nickel.
Nickel emits the ion constantly. It's the ion that we are reacting to.
Remember the story of ERIN Brockovich, hexivalant chromium. It's a metal
also. Our bodies don't all react the same way. My theory is that more
people are have reactions to the actual stent not the meds. I'm not discounting
meds work, but I believe it has more to do with the metal, especially
if you smoke. Good luck and Lord bless to all who are affected by this.
Chad and Tana. • Hossain -- you should discuss this issue with
your cardiologist -- the one who prescribed Plavix, which is used to
keep the blood "slippery" and avoid clots -- it is prescribed
after stenting and is a very important drug. He/she would be best suited
to determine if any interactions might occur. • Dear Editor, I am 60 years old and I had 1 DES
in June 2006 and the cardiologist put me on Low Plate, Losec, Isoket,
Norvasc,Tenormin. I had again problem in June 2007 and another DES inserted
in my right main artery by another cardiologist. The second doctor prescribed
Plavix, Despirin, Isoket, Tenormin and Norvasc. My question is whether
with the medicines prescribed by the 2nd cardiologist, can I use Losec
as its prevent the stomach and may inside bleeding. I dont know whether
my question would be understandable for you as this is my first attempt
to write to someone. • I'd like to add, although reading my post makes
me sound like a skeptic or frustrated, one action by my former cardiologist
is the basis for this tone and I think it's worth mentioning. My last
procedure was in May of 06, I had experienced very severe pain, typical
to this on-going pattern experienced. This time I was pronounced to be "clear",
that's it. No percentage of blockage was provided. My Cardiologist told
me my heart was fine, looked just super. Subsequently I had the normal
follow up visits. These suddenly became quick less then 5 minute visits,
BP check and listen, you're doing great, here's the door... In May of
2007 I decided enough was enough, this doctor was telling me after I
had reported chest pains on several more occasions.."it has to be something
else other then your heart and you need to go over that with your MD".
This seems like a total disregard for stent thrombosis and my pattern
experienced. I had applied for disability and this Card became angered
and returned a very unfavorable report to SS. I continued to have problems,
very low energy levels, weakness, chest pains whenever I experience physical
or mental exertion, sometimes just on it's own, shortness of breath,
the heat of summer almost makes me non-functional and I can't tolerate
it at all. My new cardiologist has and is running me through test, I
passed a treadmill. I am currently going through pulmonary and lung test
with a specialist, my MD wants a sleep study and is telling me what they
will find is nothing unordinary for what he knows about me, a sleep test
is what I need. I have asked to discuss the stent and plavix issues....
I get nothing, total nothingness...how can it be said to discuss what
to do if several doctors are 100% unwilling to even recognize there could
be something related? It's like a taboo subject. I am having problems,
when I exert they get worse, I have been given reasons, test, and other
things....they will not collectively consider, talk, discuss, or entertain
plavix and medicated stents. It appears that they are more interested
in proving it's something else. I understand the need to eliminate certain
things, but this going to the most extreme lengths of trouble shooting
I could imagine. My new Card is one of the highest rated in my area within
a prominent hospital and medical group associated with a leading medical
university, I like him...except what I have said which makes him like
the other one. • Thanks Roger. If you check the right-hand sidebar,
you'll see a link
to an article about a desensitization study done at the University
of Iowa. This definitely carries the warning "Do Not Try This At
Home!" -- you did the right thing and Scripps is a great place.
Glad they know about this and you are correct. It is not that well known.
Here's hoping we're all helping a little to spread the word. • After having a DES inserted, it developed that
I had an allergic reaction (skin rash) to both Plavix and Ticlid - quite
unusual my cardiologist advises. fortunately for me there is a simple
desensitization procedure for Plavix allergies like mine - a series of
increasing dosages taken over 3-4 hours. I had my procedure performed
at the Scripps clinic in San Diego CA. No rash since (3 months). I got
the feeling from talking with my doctor that the availability of this
procedure may not be widely known so i thought i Would place this post. • Dear All, My father (69 yrs) had 2 cypher stents
implanted at 14 july. Doctor gave him aspirin, Clopidogrel, monotrate.
After one week, he suffered very itched skin allergy on the whole body.
Doctor stop all medicine and watch.But he still suffering allergy. Welcome
any idea. • Marcie and CH -- we hear your frustrations.
Marcie, we also refer you to our topic on "Plavix
and Surgery". This is a complex issue and one which prompted a
joint science advisory from the six major physician organizations
back in January. As we have discussed in our articles and on these Forums,
the science about how long Plavix is needed is not clear. One well-respected
study done in Milan showed no significant prevention of stent thrombosis
for Plavix after six months -- yet the cardiologists in that same hospital
still prescribe Plavix for a year or more, almost as if they didn't totally
believe the results of their own study. While these situations may sound
like a Paddy Chayefsky movie, we can assure you that the issue of stent
thrombosis and Plavix is a rare occurrence, although an extremely serious
one, and now that data have surfaced, dealing with this situation is
on all cardiologists' minds. Marcie -- you are currently two years out
-- our advice is to have your surgeon and interventional cardiologist
discuss the risk/benefit of having your surgeries. Physicians in the
various specialties need to work together to help improve patient outcomes.
CH -- your point about individualized treatment is right on -- and this
is becoming more and more recognized -- that there are "subsets" of
patients whose treatment may need to be X or Y -- for example, some patients
may be more prone to thrombosis than others. The trick, of course, is
in discovering who those people are and what the markers are. Genetics
is one area that may lead to significant advances for patients in the
not-too-distant future. • I was discovered to have high blood pressure
out of the blue in 2003, no history at all before that. I underwent many
test following this. In 2004 I had a heart cath, minimal blockage, less
then 50%. 6 months later I had problems, underwent further test and this
time was found to be over 95% blocked. I was given a stent. 6 months
later more problems, another stent == in that fashion, back-to-back,
clogged at exit of 1st stent. 6 months later more problems, but only
50% clogged and no stent. 6 months later heart attack and another stent
in a whole new artery. 6 months later more problems, found clear and
fine. I have had a definite pattern. Now I'm fine, no test, no caths
since May 2006. Plavix, Metoporyl, Lavastatin, Aspirin that varied 325mg
to 82 mg, Avalide after building a tolerance to Lisinopril. Test proved
inadequate for my condition and was routed directly to the heart cath
lab per my Doctor for any reports of chest pains. I don't agree that
rehab or head issues can solve everyone's problems. We are all individuals
and we react or heal individually. I personally believe that snake oil/poisonous
stents/toxic test performed are adding to a problem not fully understood
that is commonly being treated as "shared" problem when it's actually
a unique problem. "We cure nothing, we heal no one...." George C. Scott
from the movie Hospital in the early 70's. We are being treated like
a herd of cattle and what's good for the goose isn't always good for
the gander. Aspirin - I was told to take 325mg per day for quite a while,
later I was told that 325 mg was too much and no more beneficial then
taking 82 yet I was also told that 325mg caused too much blood thinning
with all the other drugs being applied...can you say.... experiment?
Guinea Pig? Lab Rat? And to think people worry about being abducted by
aliens for medical experiments and probes? I'm now 52 and have been dealing
with heart troubles since 95, first heart attack (that's 12 years). How
many doctors quit on you yet? • Energy level low after 2 stents and plavix treatment. • I have read most of these posting's and can
agree to most. One question I have is nobody says that they are using
vessel due med's. Am I taking something that I don't need or what. Doc
says that it will keep the blood flowing at a better rate and most likely
prevent a heart attack. • I had 2 DES in 8/04, 2 more in 12/04 and one
in 5/05. I later learned that I most likely did not need two of these
DES )-: I have been on Plavix since 8/04. In 2005, I tore my ACL and
Medical meniscus. The pain in my knee at times is suicidal.This has limited
me severely and I am unable to do house work, cardiac exercises, etc.
I cannot have surgery due to the stents in the LAD. (RCA stents are not
in question) The new Interventional is concerned with the LAD stenosing
and causing a fatal blood clot if I am off Plavix for 7 days as is required
for knee surgery. When I had the first DES, I was told I would be on
Plavix for one year ONLY. We had planned on knee surgery last Fall, 2006
but halted when the scare of DES vs. Plavix surfaced. Now, I am told
that I have a Parathyroid tumor and it needs to be removed. I cannot
have this surgery either. I am so livid. I was a believer that within
one year I would be off plavix or if another stent it would be another
year. Now, it could be Plavix, forever. I was told that I could be in
pain for the rest of my life as getting off Plavix to fix another health
problem could kill me. Does a patient have any recourse with the stent
manufacturers? Thanks. • Charles and L.L. -- this is not medical advice,
but many cardiologists prescribe Plavix to their drug-eluting stent (DES)
patients for at least a year, often two and quite a few for life -- that
is, if the patient can tolerate the Plavix and is at low risk for bleeding.
Remember, the Plavix and avoidance of late stent thrombosis is an issue
with drug-eluting stents, which were first approved in the U.S. in 2003,
not with the earlier bare metal variety which you most likely have. Plavix
has other advantages for heart patients, but there are also downsides.
These issues need to be discussed with your cardiologist. Ask questions
so that you are confident as to why you should or should not take these
medications. BTW, most heart patients are on aspirin for life, unless
they have bleeding risks. • ok, quick question. i had a stent put in LAD
in 1999. i was on plavix for 1 month, then told to switch to a full
aspirin. should i be on plavix at this stage of the game? i'm now 53
and have
had no other problems, thanks! • I received two stents 6 years ago and have been
on Plavix all of that time. Now the VA won't give it to me says I don't
need it after one year. My Cardiologist says I must take it. My family
Dr. says I don't need it just take a full grain aspirin. What do I do???? • Dear Angioplasty.Org Staff, thank you for your quick
response. I did, in fact, have an issue with bleeding internally. Colonoscopy
showed "hemorrhoids". Hopefully that is the culprit for the iron deficiency.
Made it through the "iron infusion" yesterday with no side effects. (happy
about that). My question was: will my iron level remain stable after
the next three infusions? Guess I will have to wait that out. If the "bleeding" has
stopped, I'm hoping the iron will increase or at least remain at a good
level. I'm still thinking about the plavix vs. aspirin in October. Hematologist
thinks aspirin would be the better choice to help with "heart" issues
and that Plavix can be safely stopped..Me, I'm not quite sure..For now,
I will stay on both drugs....alternating one every other day....Thank
you again for your quick response. God Bless and stay healthy all my
DES friends.... Rosanne • Rosanne -- have your doctors suggested that
you might be having some bleeding issues? The fact that you have a history
of having bloody noses and a low hematocrit might suggest that. Bleeding
is one of the main complications of clopidogrel (Plavix). As for advice
-- we've often stated, we do not offer specific medical advice and nothing
on this web site should be used as a substitute for medical advice from
a physician. In particular, yours seems to be a somewhat complex situation,
best discussed with physicians who you see in person and who have your
complete medical history. That being siad, our recommendation is to make
sure that any decision to stop Plavix is made jointly by your interventional
cardiologist, hematologist and any other doctor involved in this aspect
of your health care. • Dear Forum Editor. I need your advice. It will
be two years since my DES coming up in October. I start "iron infusions" this
Tuesday, as my Iron levels have not responded to 3x a day IRON pills
(orally). Seems the recent "celiac" disease diagnosed in March of this
year is a malabsorption disorder causing the iron not being absorbed
through my GI tract. In any event, hematologist are saying I can stop
my Plavix in October and stay on my 81mg. of aspirin...I hear these stories
of people going OFF plavix and a year later having "heart attacks"...I
now take my plavix every other day since the onset of celiac and my CRIT
going down to 27..I've finally got that up to 36. I'm feeling much better
off wheat and gluten products but my iron level is still making me tired.
HELP...I have time to think about this, but I am not comfortable going
off my plavix. The bloody noses have subsided and basically I'm feeling
GREAT.... Any advice would be of great help. • MM -- was Plavix prescribed for you after a
stent? If so, we DO NOT recommend that you stop taking it or you are
increasing your risk for a blood clot. In any case, if you were prescribed
aspirin as well, definitely continue with that. You need to contact your
cardiologist right away to discuss any adverse reactions -- these specific
reactions you're having exist, but are relatively rare for Plavix and
may be due to something else -- another medication, etc. Let us know
what you find out. • Can anyone tell me how long it takes to get
this drug out of the system. It's been 5 day since I stopped taking it
and I have really been sick. Is This because my body is detoxing? I still
am nauseated, suffocating, coughing, and worse having the "D" just out
of the blue. Thank you for your time. • I had 3-stents implanted in Nov 03 and all is
fine. Two were the drug eluting type. I am on 75 MG Plavix, 81 MG Aspirin,
5 MG Crestor and 1000 Units of fish oil twice daily. Initially all was
not fine. I had many of the same symptoms others have described, but
my doctor and I discovered my side effects were the result of trying
to tolerate too high a dose of statins, such as 40 MG of Lipitor, Vytorin,
Zocor, etc... to get my LDL to 70. I am now trying a low dose of Crestor
5 MG to see if it will get my LDL to 70, if not we will gradually increase
the dose to from 5 to 10, 15, 20 etc. So far all the muscle soreness,
pain, etc. are gone since switching from a 40 MG dose of Vytorin to the
low 5 MG dose of Crestor. I will take a blood test next week to see how
well the Crestor is working. I recommend staying on your 75 MG of Plavix
as long and you can. • TO TM UK [March 6,
2007] -- Simvastatin update ! - a short time after starting
my simvastatin I noticed a shortness of breath and aching in my legs
, spoke to cardiologist who stopped simvastatin, reverted back to
previous good condition very quickly. I will not be taking statins
again !! - on reflection these drugs that prevent production of cholesterol
by the liver(at night) are not needed if you don't have a cholesterol
problem. my problem was caused by smoking ! not bad diet ! therefore
having stopped smoking 18 months ago improved my fitness levels & improved
diet even further I don't need the drugs. • An update from Span in California. It has been
two months since I had 4 DES put on. Everything is going well. I exercise
for 1 hour at least 5 days a week with no pains, mostly cardio stuff.
I have been asked to taken the Slo Niacin to improve my bad cholesterol
numbers. I am able to tolerate the slow niacin very well as opposed to
the regular niacin, which I just couldn't take. My dentist indicated
that if I ever need to have dental surgery she would do it for me with
no hesitation. She said that she needs to be extra careful because of
the platelet therapy. My energy, happiness are all back into my life
and I feel good. My cardiologist is hoping that sooner or later there
will be a test available that will tell us when to get the patients off
of the platelet therapy. • Temporary stopping PLAVIX - I had 2 DES fitted
in the r/h artery on the 1st Feb 2007 & was put on plavix for minimum
of six months,however I was due to have an 'op' on my eyes on 9th may
- Plavix was stopped 1 week prior to the 'op' but I continued with the
75mg aspirin only twice per day instead of once, the 'op' was carried
out with great success and I went back on the Plavix next day with no
ill effects, eyes have now cleared of all bruising etc. Generic Plavix
- My son is a Pharmacist and he thinks this was withdrawn due to worldwide
licensing dispute with the drug company that produce the original, the
generic was a copy of their product & they stopped the sale of it (allegedly).
P.S. my cardiologist says that Plavix only needs to be taken until the
stent is covered with new cells and is therefore undetectable and will
not cause the "protective" blood clot that can be so dangerous. • P.B. -- This is a b ig problem with DES -- it
is recommended NOT to use a DES if surgery is likely in the next year.
But what happens in an unplanned surgery? Check out our topic on Plavix
and Surgery for more stories about having surgical procedures while
taking Plavix. There is definitely a risk to stopping Plavix and aspirin
prematurely. Does your husband need a hernia repair? If so, you should
have the interventional cardiologist and the surgeon consult with each
other -- so that the cardiologist makes the surgeon aware of the risks.
Maybe a compromise, delay or temporary plan, can be worked out. • My husband had a DES put in his RCA in Feb of
2007. What do we do if he needs a hernia repair? He is on Plavix and
Aspirin. • Dan -- generic Plavix was briefly marketed in
the U.S. by Apotex, but is the subject of a patent suit by Bristol-Myers
/ Sanofi-Aventis and the judge issued an injunction against Apotex back
in August, stopping the sales. They flooded the market with six months
supply, but that's run out now. • I was just informed by my pharmacy that the
generic for plavix is no longer being produced. They said that there
was nothing wrong with the generic but the manufacturer has stopped the
production. Any idea why? Is there an alternative generic drug that can
be used in place of Plavix? • In two months it will be a year since I had
(2) Taxus DES stents placed in my RCA. Whenever I ask my cardiologist
how long I'll need to be on Plavix, she usually says at least a year,
possibly for life. The last visit in December she gave me a little more
information. She said that the most risky period for late stent thrombosis
with my type of stent was from 6 months to a tear after placement. She
said that after 1 year the occurrence drops off dramatically. I don't
mind being on Plavix. I have absolutely no bad reactions to any of my
medication. Sure it's not easy forking over $32/month after insurance
for it, and $35/month for Lipitor, and $25/month for Zetia ... But considering
the alternatives ...my wife will have to pay a lot more than that to
bury me ;) • First, I just want to thank you for this forum
that provides great information and support from those that have 'been
there'. Thank you. In Dec. 05 I had two DES's placed in the right side
of my heart and than a third in Feb. of 06. I was put on Plavix and Aspirin
like everyone else. Now my pharmacy has informed me that they will no
longer provide the generic for Plavix (Clopidogrel). They assured me
there was no problem with the generic but it's manufacturers are quitting
production. If it does the job than why is it going out of production?
My second question is my cardiologist has indicated that during my May
appointment, he will be taking me off the Plavix. I realize that there
still is not enough information or testing that is available to determine
if this is a good course of action. I intend on asking him to let me
remain on Plavix until some test is available that will confirm cell
growth in the DES's. After this amount of time, do you feel that I am
being too cautious by wanting to stay on the Plavix? I trust my Dr. but
maybe not this decision..... Thanks Again ! • Pat -- the "Y" is technically known
as a bifurcation lesion -- and they are tricky to stent. Aspirin and
plavix are both antiplatelet drugs. They prevent the blood from clotting
(which can be the cause of a heart attack). They do act differently,
which is why they are often used in combination. Any specific adjustment
to your mother's drug regimen should be done by her cardiologist -- it
sometimes can take a while to get the right combination. • My mother is on plavix and aspirin. she has
a blockage but no stent due to the difficulty of placing the stent in
the Y where the blockage is. she is always tired. is this a side effect
of both these meds? can she go off plavix and just keep on the aspirin? • It's a Rosanne update: After my hospital stay
it was discovered that I now have "Celiac Disease". While I was admitted
in March 07 for "angina" pain, test revealed Celiac. I had all the symptoms
but no one paid attention. My crit is 27.4, my iron level is 7, my head
was so itchy, I had an abscessed tooth causing major infection throughout
my body. My blood pressure would not go down. My cardiologist suggested
I go off my Plavix and Aspirin, but I am so nervous that I decided to
take them every other day. My problem now is that after my endoscopy
I've developed two polyps on my vocal cords and have lost my voice the
past six weeks. My stomach has never felt so good since I've gone wheat
and gluten free. My blood pressure has been NORMAL for the past four
weeks. I feel like a new person with the exception of being weak from
my anemia. I have blood in my stool (they say from the plavix and aspirin),
which brings me to my question: SHOULD I STOP the Plavix and aspirin
for awhile while I await having my "second" colonoscopy.(I had a normal
one last JULY). I'm awaiting my second one to ensure there is nothing
wrong. I went off Plavix and aspirin for one week after being discharged
from New England Medical Center in Boston and tolerated it well. I'm
in another "catch 22" with my life and would really appreciate your opinion.
My life has surely changed since my STENT in Oct. 05. If I didn't loose
my voice and could get my crit UP..I'd be happy to say I'd be on my way
back to the ME I use to BE... Anyone care to give some advise??? I'd
really appreciate it. • Tom -- you light the way. Your interaction with
your gastroenterologist is precisely the model for physician-patient
teamwork that we discuss so often. As we reported back in January in
our report, "New
Advisory: Will Stent Patients and Their Doctors Get the Message?",
you also have performed an invaluable service for your doctor as well.
Good luck! • All of us who have DES stents are concerned
about procedures or surgeries which may be required in the future, due
to our need to stay on plavix & aspirin. Recently on this site (April
18) I reported that my Gastroenterologist would not perform a colonoscopy
while I stayed on plavix & aspirin. However, this was second-hand info
from his nurse. I have now personally discussed the issue with him, and
he has agreed to do it even while I remain on both drugs, and I am scheduled
for early June. It will be a full colonoscopy, not a virtual one. He
seemed reluctant at first, but after I discussed the possible danger
of stopping plavix therapy and mentioned that now many cardiologists
advise plavix therapy indefinitely, he admitted that he had done the
procedure before on patients under such therapy and would do mine. For
anyone in a similar situation, I would suggest getting past nurses or
assistants who schedule procedures and talk to the doctor directly. • Just to keep you all posted. I'm Paul from New
Hampshire. At the age of 42 I received 7 (seven)...yes...count'em...SEVEN
drug eluting stents. I received them in Sept. of 04 at Mass General Hospital.
I have been on Plavix, Toprol, Lipitor, Cozaar, and Aspirin (ecotrin)
325 since that time. All is fine (knock on wood) I continue to exercise
and hope I can become the poster boy for how long you can avoid a bypass.
I am proud because I did nothing to induce my CAD. I have never smoked,
I don't drink, I have watched my diet and have never had high cholesterol.
I am told it was mainly stress and genetics that were the main culprits.
There is hope. Lets all be appreciative of the medical minds that have
helped us avoid the knife. I love you all. • Shirley [April 12, 2006], I'm so sorry! I can't
help you but I'm with you! • To Span in California, you are right! Most posts
here are from people doing the asking and wondering, and the fantastic
Forum Editor is working tirelessly to answer as much as he can. Here
is my contribution - I am 56, had one DES stent put in at the end of
April 2006 (yeah, one week short of a year!) The same drugs which you
described, seemed tolerable (tolerable .... as long as I ignored the
rash, nose bleeds, bruising, the Lisinopril-induced dry cough and the
nags from the GI doctor) until August. At that time major stomach bleeding.
After few days in a hospital and few blood transfusions, I changed the
prescription from Protonix to Prilosec (over the counter) and then I
changed the cardiologist, because not all are in the top 50%. With the
new doc's guidance, I continue to take Plavix, but no more aspirin. Major
lifestyle change is great! Quit smoking, good diet, lost few pounds,
got into cardio exercises and actually enjoying it. "I can live with
that!" As a result, my BP is down, heart rate is down, LDL is down, all
naturally, and I am gradually eliminating all the "temporary" pills.
The cardiologist is reluctant to let me drop the Plavix. Well, I've got
one week's worth of it left to decide and I just might keep getting refills
until I read some good news on angioplasty.org. After a year, it is becoming
tolerable. Now, the worst part is figuring out how to deal with the GI,
who is bigger pain in the @$$ than what he is curing. • Basavaraj -- great question -- the one that
everyone is asking. Some doctors say at least a year, others say two
years, others, like your cardiologist say "for life" or until
better data come out that can be a guide. We're not trying to skirt the
issue and avoid answering. There is real debate on this issue -- sometimes
within oneself. My favorite story is this
exchange from the December 2006 FDA panel. • I am 56 year old male underwent PTCA to distal
RCA & implanted TAXUS Drug Eluting Stent 3x32 mm. I am keeping fine without
any problems. I am on Clopidogrel and Aspirin medication for one year.
Now my cardiologist advised me to continue these drugs for life. What
is latest finding on exact duration of this medication after implanting
DES. How long I should be on this medication? • Thanks Tom for your post. As regards Michael
C's posting I agree that all aspirins are meant to be the same and they
are not! I have tried the following safety coated aspirins: Ecotrin,
St. Joseph's and Bayer. The one that doesn't really screw up my stomach
and cause itching was St. Joseph's. I couldn't tolerate Ecotrin at all
and Bayer was in between the two. I am glad I listened to my wife, before
trying it out I thought all aspirins are the same. My advice is try different
brands to figure out what suits you. My observations were all for baby
aspirin. Also interestingly I did not find any difference between plavix
and the generic clopidogrel, except of course the whopping price increase.
Once I again pls try both to figure out which suits you best. • Interesting posts re allergies. After receiving
a stent in the RCA, my wife purchased a large bottle of 325 Mg Aspirin
to take home, along with Plavix and Altace. A month later, my legs began
to itch intolerably, especially in the shower. We tried changing from
generic plavix to brand name, and from generic altace to brand name,
with no effect. My cardiologist and my allergist were baffled. Which
left the aspirin - we changed from the generic stuff to Ecotrin, and
bingo - no more itching. I think it must have been the binder(s) or dye
in the generic aspirin that caused the problem. I hope this helps someone. • Rick -- this was discussed by the FDA panel
we attended in December -- the consensus was that if the patient had
gone off for any length of time and hadn't thrombosed, that the healing
had probably happened and they wouldn't recommend going back on. Of course,
Plavix has other indications and might be useful for other reasons. It
also has downsides -- surgery, for example. • Just curious, if say one year after stenting
one goes off of Plavix and then because of all of this news regarding
Plavix a year after stopping, can it do any good to restart the plavix
or does the one year off nullify the benefits of restarting? • Tom -- there's been talk on these Forums, both
in this topic and the one on "Plavix
and Surgery", about the problems of getting, say, a colonoscopy
while you are still taking Plavix. (To find a word on a text-heavy web
page, do a "Control-F" and then type in, for example, "colonoscopy").
No great solutions were presented, other than finding a doc who does
the "virtual" colonsocopy -- which some feel isn't quite as
thorough. If you find a doc who will do the standard procedure while
you're still on Plavix, let the Forum know this option exists. Thanks
for the post. • Span from California wants to hear from others
who have had no problem with drug therapy after drug eluting stent placement.
I had 2 DES and 1 BMS placed in February of 2006. I have been on 75 mgs
of Plavix, 325 mgs of Aspirin, Lisinopril, Metotoprol, Lovistatin, and
Zetia ever since (14 months). Fortunately, I have had no meaningful side
effects. I just bleed a little more than normal, if I receive a small
cut or scratch. My Cardiologist wants me to stay Plavix indefinitely.
He believes that at some point a test may become available to determine
who might be relatively unlikely to develop in-stent thrombosis when
stopping Plavix therapy. My Internist, I am sure to make the point of
staying with the therapy, jokingly said I can go off it "post-mortem".
My only concern, is that I am overdue to have a colonoscopy. and the
doctor who did the last one for me wants me to go off Plavix for it.
My Cardiologist suggests that I find a doctor who will do the colonoscopy
while continuing Plavix. He says there are ones that will. I haven't
starting searching yet. • Shirley -- your husband's experience highlights
one of the problems of stents, and drug-eluting stents in particular
-- the need for long-term Plavix. If a patient is at high risk for bleeding
complications, a DES should probably not be used, because of the greater
tendency towards blood clots. The problem is how does the cardiologist
determine "high risk for bleeding"? Of course, even bare metal
stents have a thrombosis risk in the first few months. We would suggest
consulting an interventional cardiologist at a major center since he/she
would be the most familiar with the risk/benefit situation. And Span
from California -- we also would like to hear from patients who have
had no problems with the required regimen -- and you ARE in the majority. • I had 5 des put on March 16, 07, 3 cordis and
2 driver stents. I have been taking clopidogrel, plavix, vytorin, baby
aspirin, metoprolol and lisinopril. I have been doing fine, ever since.
It looks like my stomach is able to tolerate the super aspirin strategy.
For how long is the question. Studies have clearly shown that des causes
late stage thrombosis. It is at a different time for different people.
People who suddenly stop plavix seem to show a faster rate of thrombosis.
If you can tolerate it then continue with it. If you cannot speak with
your IC before stopping it. I do have slight itching, like an earlier
poster has pointed out, only in the areas where clothes touch the body.
Mostly in my lower back. It is so mild I can easily tolerate it. I am
soon going to try plavix instead of the generic to see if the itching
goes away. I'll feedback to this forum. It would be good to hear from
people who are doing well with plavix and baby aspirin, that would be
a good feedback to the rest of us. I keep hearing only from people who
have unfortunately run into one problem of the other. I am a 53 year
old Male living in California. • My husband had a CYPHER drug-coated stent on
Jan 7, 2007 because of a 70% blockage and was put on Plavix and 81 mg
aspirin.Soon after he began to feel weak and very tired.His family doctor
ran blood tests and found his blood count 8.5 which meant he was bleeding
somewhere. A few days later he began bleeding from his colon badly. We
were out of town and after arriving at the emergency room of the nearest
hospital, they took him off of all his blood thinners to try to stop
the bleeding. After missing three doses, he had a blood clot to block
the stent and he had a heart attack. They immediately put him back on
Plavix and aspirin. The bleeding stopped for awhile, but is now recurring
again. He has just been released from the hospital and now four days
later he is bleeding again. He needs to know if anyone out there knows
where he can go for HELP as his doctors are at a loss of how to help
him. He is 66 years old and very active. I am afraid I am going to lose
him if we do not find help soon. Please advise. • My husband and I moved to Az from Pa in January
of 2005.I had a cholesterol problem for 3 years which I continually tried
to address. It seemed everything I tried I had reactions to. I went on
Red Rice Yeast pills and one aspirin a day. After moving to Az, I started
walking like I used to in pA. I started getting a burning sensation which
would last about 5-10 minutes during and after I walked. Finally I went
to a family doctor for an exam and told him about it. He sent me to a
Cardiologist whom told me I had Angina. The next day, I had a stress
test. Two days later, I was in for angioplasty and received three stents.
That was Jan 13, 2006. I went in for four more stents April 5, 2006.
During that procedure, the Cardiologist discovered that I had an Aneurysm
on the very first stent he inserted. He told me later, he thought it
was caused from an infection. He had tried to put the line for the stent
in my arm and could not get it to insert past my elbow. I got an infection
in it and ended up back in the hospital for two days. May 31, 2006, My
Cardiologist did another angioplasty to see if the aneurysm had grown
and it had not. Of course I will always have it and I will have to be
on Plavix the rest of my life. I hate it. I have a memory problem which
I think is from the Plavix. I get stomach pains also. Needless to say,
I am full of bruises continually. I also get chest pains if I try to
work out too much. Is there anyone who has experienced the same occurrence
as me? I would love to talk to you. • Editor -- Many thanks for the rapid response
to the question. Is the supposed issue then limited to the polymer coating
on the Cypher stent and not any retained drugs? To a layman, with a mechanical
background, it would appear that the arterial tissue would be more acceptant
to a polymer than stainless steel. Is there any concern over the porosity
of the polymer used? To a degree, it would appear that the systematic
continuation of the Plavix & Aspirin is more a function that, if it does
not harm the patient, there is no solid reason to discontinue. For example,
if it does not harm and could potentially help, there is no solid reason
to discontinue the drug. Limited experience with the medical profession,
but have been seeing this trend. • Steve -- Supposedly the Cypher stent has a "nominal
elution period" of 90 days, although most of the drug is eluted in the
first 30. The Taxus also elutes a controlled dose in the first 30, although,
depending on the version used (slow or moderate release) 70-90% of the
paclitaxel drug stays in the polymer (is never eluted). But the drug
is eluted from a polymer (plastic) coating on the stent, and for the
Taxus and Cypher, the polymers are permanent -- they do not degrade.
Some second and third generation stents, not yet on the market, have
biodegradable polymers (like the Conor, now part of Cordis / J&J)
which will turn into a bare metal stent after about 6 months. • Greetings. Rather new to this game, installation
of a Cypher in the RCA October, 2006. Might be a rather basic question
on my part, but just how long do the DES stents continue eluding their
coating? At that point, does it effectively turn into a bare metal stent?
Thanks. • Randy -- scroll down to January 29, 2007 where
a couple Forum posters had a discussion about this. And Pbenge in Florida
-- talk to your GI doc as well -- there is a non-invasive diagnostic
test called a "virtual colonoscopy", but it's very new. • After my 5th DES I am back on Plavix, this time
for an undetermined time. I also have an AVR and am on Coumadin for life.
My doctor increased my aspirin to 350 mg per day. My question is how
common is it to be on Coumadin, plavix, and aspirin, possibly for life?
What are the long term risk? My age is 52 male. • My husband had a heart attack in Feb-2006. A
DES was put in his RCA. He has been having GI problems and was scheduled
to have a colonoscopy to diagnose the problem. The cardiologist says
we need to wait on any invasive procedures. Are there other diagnostic
tests that can be done that would be safe while still on Plavix and aspirin?
Thank you • My brother in India had 2 drug coated stents
implanted on March 5, 2007. The doctor forgot to prescribe aspirin and
Plavix and after 2 weeks put him on those drugs. Would the anti coagulants
still be effective and prevent blood clot formation? • To both Rosanne and David from England -- when
is it safe to stop Plavix? That's the big question. First of all, this
is something which needs to be answered for each patient by their interventional
cardiologist. This was the topic of discussion at the FDA panel in December
and will be next week at the American College of Cardiology meeting.
The most oft-repeated general recommendations we've heard for DES patients
are aspirin for life, Plavix for at least a year -- both assuming that
the patient is not at risk for bleeding complications. (Rosanne -- it
sounds like you have been having such complications.) In patients who
are not having problems with Plavix, many cardiologists are now recommending
Plavix for longer than a year -- but each patient is different and has
different clinical situations. It is highly recommended that the decision
about Plavix and aspirin be made by your interventional cardiologist.
This is the specialist who knows the most about whether you need to continue
dual antiplatelet therapy -- and can best weigh the risks of stent thrombosis
against the risks from bleeding or other blood problems, which can be
very serious. • Dear Editor. I am in need of some major advice.
I was admitted to a Boston hospital last Saturday. This is Rosanne from
Stoneham. 55 year old non smoking female who had DES procedure October
2005, LAD. I have ITP (platelet dysfunction) and have been on 81mg baby
aspirin and Plavix Blood counts were down to 114,000 (plts), 28.0 hematcrit.
I have been extremely fatigued and blood was found in my stool. Had stress
test done on Monday (normal), Had Endoscopy done on Tuesday (two biopsies
were taken. they are thinking "Celiac Disease). Sent home with advice
to stop my aspirin and Plavix until I see cardiologist, April 10, 2007.
Now comes the "abscessed tooth" that needs to be pulled asap. HOW LONG
CAN I SAFELY BE OFF BOTH ASPIRIN AND PLAVIX? I ASKED TO BE PUT ON PLAVIX
IN JANUARY AND HAVE BEEN TAKING ONE OTHER DAY..I WISH I THOUGHT OF TAKING
ASPIRIN THE SAME WAY. IT IS VERY FRUSTRATING TO HAVE TO THINK EVERY WAKING
MOMENT IF WHAT I'M DOING IS GOING TO AVOID A HEART ATTACK..why did I
have to suggest this to my doctor when he knows my history. I brought
him an entire copy of some of your Forum studies and he was not interested
at all...I was very sad as I wanted to share with him all the knowledge
I've learned.....ANY THOUGHTS that might help me sleep better..? As always,
so appreciated for any advice you may have... FYI...my "roommate" was
a 68 year old women who had DES 2 years ago..Doctors took her off Plavix
after one year and there she was ...back at hospital with heart attack...I'm
scared.... God Bless and Thanks • I am 63 years old, over-weight but otherwise
quite fit, generally healthy and very active. I haven't ever smoked and
I rarely drink alcohol. I had a bare metal stent fitted four years ago
in England and a drug-eluting stent (DES) fitted two years ago in Florida.
After the first I was put on aspirin and simvastatin, after the DES on
Plavix, aspirin and Carvedilol (my cholesterol was then at an all time
low, so no simvastatin was required). When testing me prior to the second
stent, my first stent was found to be fully open. I started having heart
fibrillations (rapid heartbeats and excessively strong pulses) about
2 months after having the second stent fitted. They occurred infrequently
but were very worrying although they lasted only about a minute every
time. I guessed that the medication cocktail was to blame but my US doctor's
simple solution proved correct, I had to stop drinking coffee (I was
then drinking about 6 to 8 cups a day). Perhaps I have been lucky but
in spite of switching between originals and generics many times, after
two years medication, I can't report any side-effects at all from the
Plavix and aspirin combination :-) Unfortunately(?) my new National Health
Service doctor has just decided that I don't need the (free of cost to
me) Plavix any longer, citing a "normal" 12 months term for this medication
and the high cost to the NHS! I am very concerned but after reading this
forum I intend to ask my doctor to give me Plavix and a referral to visit
a cardiologist with a view to having a nuclear stress test to establish
my current condition and recommendations on future medication. Am I doing
the right thing? • Dr. Dixon -- the study reported in NEJM that
you refer to is the CHARISMA study. You can read our "Patient
Alert", issued the morning after the results were announced
at the ACC meeting last year and which were then mis-reported by the
popular press (not the NEJM). The patient population for whom there was
no significant benefit were those who had no evidence of coronary
artery disease. The CHARISMA study was undertaken to see if there
was a preventative effect from the combination -- and, as you note, there
wasn't an additional benefit over aspirin alone. However, the results
DO NOT apply to patients with drug-eluting stents -- quite the opposite.
All DES patients should continue their Plavix and aspirin until their
cardiologist recommends stopping. Doctors have reported to us that unfortunately
some patients read the popular press headlines back in March 2006 and
stopped taking Plavix on their own, some with unfortunate results: heart
attacks from stent thrombosis. • The New England Journal of Medicine of March
12, 2006 reported a large study on the plavix/aspirin controversy. Their
conclusion was that there was no significant benefit in taking plavix
over aspirin alone. Not only was my cardiologist unaware of this (and
disbelieving), but he had prescribed 500mg of aspirin with the expensive
Plavix. For those who cannot tolerate low dosage aspirin, there are some
very benign alternatives, such as Vitamin E and also nattokinease. Unfortunately
your doctor will likely not be aware of these either. Some promising
answers to the plaque problem include anti-inflammatories as preventative
and ellagic acid or citrus pectin for removal. • Well I knew it wouldn't last forever. Walgreens
stopped offering generic clopidogrel, stating that the court injunction
against Apotex required them to clear their shelves. So it's back to
the ultra-expensive name-brand Plavix for me. I suppose I shouldn't complain
- I was able to use the generic from 8/06 until a few days ago. So I
saved some money at least. My share of the cost after insurance was $12/30
pills for generic. Now it's $37/30 pills for Plavix brand. • Paul -- the recommendation for uncoated stent,
also known as bare metal stents, is antiplatelet therapy (Plavix and
aspirin) for 4-6 weeks. This differs from the drug-eluting or drug-coated
stents. So your aunt is pretty much at the stopping point. That being
said, we always suggest that the surgeons and interventional cardiologist
consult about stopping antiplatelet therapy. We would recommend consulting
the interventional cardiologist who implanted the stents regarding when
or even if she should resume Plavix. Each patient is an individual case,
and some patients are at higher risk for bleeding than others. • My 80 year old Aunt had three cardiac uncoated
stents implanted about 5 weeks ago. She is scheduled for vascular surgery,
in one week, to clear blockages (with stents) in her leg. She was told
to stop taking, aspirin and Plavix, 5 days before the currently scheduled
vascular procedure. Does the risk of excessive bleeding during the vascular
procedure outweigh the risk of blood clots forming in the cardiac stents
due to the stoppage of aspirin & Plavix? • To:
Dave W , England Yes I too am in the UK, and was started on Simvastatin
after my first Stent back in Dec 2005. Although I never thought my
chol was particularly high. I`m still on it at 20mg day, last Tot chol
was 155 with LDL at 99, which although not ideal is i feel as low as
i can get it, without upping statin dose which I don`t want to do. • D.M. -- a quick reaction is that numbness on
the right side after an angioplasty/stent procedure would seem more likely
a result of the femoral puncture (if the catheters were inserted through
the right groin area). Reactions to Plavix tend to be more of a rash
or bleeding. See our Forum Topic on "Femoral
nerve damage or other complications from angiogram or angioplasty" for
more info. This may be due to a nerve trauma and should pass, but definitely
report this to the cardiologist who did the procedure. • After placement of one drug-eluting stent, I
am experiencing numbness on my right side (only) from mid-chest down
to my toes. The right foot is very tingly. The fingertips on my right
hand are slightly tingly. If the numbness is related to the Plavix, is
this a side effect that may go away in time or is it likely to persist
as long as I am on the Plavix? I am on the following drugs: Plavix (75
mg), aspirin (325 mg), Lisinopril (5 mg), Isosorbide ( mg), Lipitor (
mg). • To
Corrine B (Malta) on the eye bleeding. After my DES in Oct. 2005,
I had a nose bleed for 24 hours resulting in going to the E.R. and
having my nose packed. The next morning I woke up with a blood clot
in my left eye...Seems my left side was affected by my angina attack.
The clot covered my entire eye and lasted six weeks. CT scans were
done to be safe brain was not bleeding. I just want to stress the need
to "check out anything" that you are not comfortable with, with you
Dad..Plavix can cause bleeding and bruising. I've recently (after my
first year anniversary of DES) now take my Plavix every other day and
the nose bleeds are less frequent..Good Luck and God Bless... • P.B. -- bruising is another name for hematoma
-- which means bleeding beneath the skin surface. It is a known side-effect
of Plavix. It may not be serious, but you should contact your prescribing
physician and let him/her know what's happening. An alternative antiplatelet
drug is Ticlid (ticlopidine) which may have similar effects, but let
your doctor know -- and let us know what they say. • My 41 yr old husband has had a mild MI a few
weeks ago. He has a DES in Right Coronary Artery. He was ok'd to return
to construction work which is physically demanding. He is getting fairly
large bruises on abdomen (size of tennis ball), arms, etc. Should I be
alarmed? Plavix mentions bruising as a side effect. When should I be
concerned? I feel like I need to call them everyday. Thanks for any advice. • "Educated" -- quite right you are.
Angioplasty.Org posted a "Patient
Alert" the morning after the CHARISMA study results were presented
last March -- and the news media did a horrible job of mis-reporting
(we mean they did a great job of MIS-reporting!) and headlines like "Plavix
and Aspirin: A Deadly Combo" went flying around the country. Wrong!
And we've been told by more than one cardiologist that a patient of theirs,
reading the headlines, decided to stop taking Plavix, and proceeded to
have a heart attack. By the way, it took the American College of Cardiology
and the American Heart Association four more days to issue their own "Alerts" and
another day or two for the press to acknowledge the error. • Harold - The media that you might be referring
to could be results from the CHARISMA study that was released a year
ago. The study looked at two different groups of patients. The first
group were patients that have had a stroke, MI or PAD (Peripheral Arterial
Disease) and the second group were patients that had the risk factors,
but haven't had an actual event or PAD. Plavix did not fair well with
the second group and is not recommended for that group. Which Plavix
is not indicated for the second group of patients to begin with. • To
John from New Hampshire...your story sure sounds like my life in
Oct. of 2005. Same situation..I live in Stoneham MA..Just want to say
thank you for sharing your thoughts as I can only share my concerns
with other DES patients. Family members really do not "get it".....Stay
well and stay educated on the effects of our meds....My prayers for
all of us to remain well..... • Harold, I am also on Plavix for DES Stents,
and have been on it for a year. It looks like I may stay on it indefinitely.
If I were you I would consult immediately with my cardiologist about
stopping it! I certainly wouldn't stop anything based on ads from attorneys
who have a big financial interest in suing! You may be seriously risking
sudden heart attack or worse without plavix. • My aunt died from a massive GI bleed just two
weeks after being put on plavix and aspirin. She was scheduled for her
angioplasty at the end of this month. Her blockage was very small according
to the cardiologist. We are still in shock. Anyone heard anything like
this happening before? • The media articles I was referring to that instigated
my choice to stop taking Plavix were the TV ads by attorney's stating
that it has been known to cause strokes, heart attacks and death. Than
some of the newer ads are stating that its Plavix and drug eluding (?)
stents. Which was what I had installed in Feb. '06. If I remember correctly
the first newspaper article I read was out of the Chicago area regarding
the Plavix problem. I searched for more info but wasn't able to find
much. Afterwards I began to see those TV ads from attorney's. I usually
measure my emotional response to new medications by what I perceive physically.
Even though they may not be accurate. • Just had 4th angio. Like prior 3 I was put
on Plavix despite my protest. Like the other times I developed rosacea
in my eyelids within hours of taking Plavix. I have purple circles around
my eyes and my vision is blurred. I have to take this stuff for 7 days.
I am on a rosacea drug Orecea which was working but is now being defeated
by Plavix. I was told I have acne in my eyelids from Plavix. • Hi i am from Uk i had stent angioplasty in 2000
after a heart attack. I have have been on plavix since and been told
i will be on plavix for the rest of my life,i was also on aspirin but
after 4 years my stomach couldn't take it anymore the Doctor said it
was a risk either way but he thought it would be a bigger risk if i carried
on taking asprin.is there anyone on here who knows how much risk i am
running by not taking aspirin. God Bless • Harold -- what media articles motivated you
to STOP Plavix. Most of the news has been how you need to stay on it
longer than originally thought -- assuming you are not at risk for bleeding,
many cardiologists are prescribing it for life. If you are experiencing
angina, now a year since you were stented, you should contact your cardiologist.
He/she can also look through all your med (including over-the-counter)
and assess whether you're having any drug reaction. • Had angioplasty performed Feb. 20, 2006. Doctor
prescribed Plavix 75 mg an Aspirin 81 mg. afterwards. Except he stated
instead of being on Plavix for only two months (which was average) he
stated that he wanted me on it for at least nine (9) months. Well it's
been a year today and I'm still taking Plavix. However, I have stopped
taking it at least twice for two weeks up to a month on my own volition
because of articles I read in the media. Am currently taking Isosorbide
to also help with any angina I have. Along with CAD I have COPD or emphysema
and the medications that go with that problem. At times I'm not sure
if medication(s) for one problem isn't causing problems for the other
one. I have experienced strange flutterings or sensations in my chest
or breathing almost every morning. Lately, more minimal angina the last
week. Causing me to use Nitro tabs to be safe. • Had DES x2 fitted
02.02.07 in closed R/H coronary artery (dominant)prescribed Plavix 75mg
+ 75mg aspirin (dispersible) + 40 mg Simvastatin (anti cholesterol) all
seems to be well apart from slight cold/flu symptoms, had quick look
through post's is anyone else on SIMVASTATIN ? everyone on the ward was
put on this after 'op', I was told I will take this for rest of 'Life' • did anyone have
any side effects on the eye like bleeding while on Plavix? I am concerned
about my father who says that he is seeing certain shadows. DOn't know
what symptoms one can expect with bleeding of the eye. • Hi all...Just caught up on everyone's concern.
It sure is scary thinking about our DES and meds taken daily. I am still
experiencing high blood pressure numbers..bottom number is always 90+.
Saw some info on Caduet and will ask cardiologist if maybe taking this
drug along with my diltiazem aka Tiazac will be helpful. I have been
in bed and not feeling well at all for the past two weeks. Blood test
show low crit, very low iron level due to nose bleeds from Plavix.(remember
I have platelet dysfunction (ITP) and am in "catch 22"...I would like
to know if the weird sensation I've been experiencing on my left side
(I had 99% blockage and DES in Oct. 05) could be blockage from 60% that
they did not stent? Stress test of a few months ago was normal. NO ONE
(except my fellow stent patients here) know exactly what I'm saying when
I say, MY LIFE HAS CHANGED SO MUCH since Angina came into my life. I
am now taking Plavix, 81 mg baby aspirin, lipitor, 2 protonix (and yes,
thank goodness for them), two iron pills, vitamin C, Tiazac for HBP,
and I just started a multi vitamin (one a day for women) as I would like
to have some energy to play with my grandchildren...I can't express my
thanks enough to this Forum for all the information received as "doctors" do
honestly "forget to tell us" all the side effects of the meds they put
us on. MY doctor says I am so "side effect sensitive", it's difficult
for me to try new drug. I am interested in Caduet...any comments????
any reaction if I should take two blood pressure meds to control my high
blood pressure..AS ALWAYS, GOD BLESS... Rosanne • In July 2007 I was scheduled for a stent. Going
on Plavix 30 days before that. The day before going into the hospital,
I had a severe reaction to Plavix, i.e. swelling in my hands, itching
and red whelps all over. Similar to allergic reaction to penicillin.
After the stent, the Dr. put me on Ticlid to be taken for 3 months. Then
on aspirin (baby). I have been highly allergic to aspirin all my life.
I have been on the baby aspirin for one month and just lived a week of
living hell from headaches, throwing up and extreme pain in my upper
back. I am not taking anything now to thin my blood and I am concerned
but I had rather die than live with the results of aspirin. I will be
calling my Dr. on Monday 2/19/07 to let him know I had to stop the aspirin.
What are my risks? • If you get a rash after angioplasty, how do
you know if it's from plavix allergy or contrast (iodine) allergy? • I am a 47 year old male. I've just had my second
angioplasty where I was given stent(s). The first was in January, 2004,
when a 100% blockage was found in my Left Anterior Descending Artery,
and I had a mild heart attack (MCI). I actually drove myself to the hospital,
not seriously believing that I had a heart attack. Maybe some Angina,
I thought. Two drug eluting stents were installed, must've been the Cypher
because FDA hadn't approved the Taxus just yet. I was put on Plavix and
I continued on Aspirin, which I had already been taking. I had to fight
with the insurance company to stay on Plavix after my cardiologist recommended
it. I needed a special letter to say "yeah, we weren't kidding with that
prescription there, it's necessary." Other than those days when my prescription
expired and three minor (knee and dental) surgeries where I stopped for
three days each, I always took my Plavix and my aspirin. Over a year
ago, I asked the Cardiologist, whom I had been seeing and paying out
of pocket because he's "out of network", how do I keep an eye on another
artery, the Right Coronary, where I had 60 per cent blockage at the time
of my Angiogram, but not enough to warrant a stent. He said "next time
we'll do a nuclear stress test". In December, I got a referral to an "in
network" Cardiologist to do this test. He called me back and said there's
blockage, better schedule another Angiogram. My old stents in the LAD
were 100per cent blocked again, and the RCA was now 90 per cent. The
new cardiologist told me point blank that if this got to 100 per cent
also, "you would die". He said there is nothing that can be done about
the blockage where the old stents are. 'It's like concrete" he said.
So I'm relying on some collateral arteries to deliver blood to the left
side, front of my heart, as the LAD is blocked, and if this new stent
blocks up like the last one, I'll be dead in three years. He did say
to get a nuclear stress test every year, but this is driving me crazy.
Anyone else experience anything like this? • J.J
in New York........I have been on plavix and aspirin 325 mg since
February of last year (One full year in one week.) In October of last
year I was admitted with some GI symptoms and was advised to undergo
a colonoscopy along with other GI procedures. Based on what I have
read, since this was not an emergency and my symptoms resolved, I elected
not to undergo the colonoscopy at that time because it required stopping
the plavix and aspirin for five days before and after the procedure.
It is obvious now that we are dealing with a relatively new problem
(late stent thrombosis) and until that problem is more understood and
resolved, drug-coated stent patients should play it safe and follow
recommendations of at least one year on anticoagulants and always check
with your cardiologist before stopping those meds for any kind of medical
or dental procedure. • I just had a medicated stent put in on January
24, 2007, where I had an 80% blockage. Presently i'm taking plavix (75mg),
aspirin (325 mg), metoprolol, crestor, and lisinopril. My body is accepting
all of the medications, except for the plavix. Within 2 hrs of taking
I have a severe headache where the spine goes into the skull, weakness,
slight heaviness in the chest, and can't think very clearly. Does anyone
else have these symptoms when you take the plavix? • J.J. -- please read about the latest "Science
Advisory" from all the major physician organizations regarding
drug-eluting stents, Plavix and surgery. • My hubby has had 2 open
heart surgeries and 5 stents-- now he may need a prostate biopsy- he
would need to discontinue his plavix- and aspirin - i am so concerned--
he's really borderline for the biopsy- but it's been repeated a couple
of times and it's always a little above what its supposed to be and he's
64 • I spoke to my father and received answers to the questions in your email:
Ellen B., New York, USA, February
2, 2007
• Thank you for your quick response! Dad began
the generic clopidogrel immediately after the second stent, in August
- probably one of the first recipients of the generic. Up until six weeks
before the heart attack, he had been on (non-generic) Plavix for the
requisite one year after the first stent. Helping him investigate this
has been an eye-opener (albeit a 20-20 hindsight kind of thing)! If his
first stent had been put in less than a year ago he, most likely would
never have been taken off the Plavix, which may very well have meant
he would not have suffered the heart attack. Which could also have not
given the doctors reason to switch him to a generic in the first place.As
for your other questions, I will have to call him for the answers and
get them to you. The site is great - I have already printed some info
to mail to Dad (sadly, he's not computer savvy). Again, thank you for
response! • Ellen B. -- Sorry to hear about your father's
experience.We have heard reports that generic clopidogrel and Plavix,
even though they have been judged as being equivalent, seem to have different
responses in some people. We've seen no studies to date with any data
about this. A few patients on this Forum have reported allergic reactions
to one and not the other. You say all his problems started with the generic
clopidogrel, but when did he start taking that?? He had a heart attack,
but had he been on generic clopidogrel before that? Curious, do you know
what stent was used, Taxus, Cypher or a bare metal? Also, did the cardiologists
give any cause of his heart attack. Do you know if it was caused by stent
thrombosis (they may have been able to see this on the angiogram). He
would be classified, given the new definitions for stent thrombosis,
as probably having had this, especially since it was just six weeks after
he stopped antiplatelet therapy. Finally, do you know what type of stent
the second one post-heart attack) was? And how long after his MI was
it put in? • My father, age 78, had a quadruple bypass 20
years ago. About 18 months ago, after a check-up, he had a stent put
in and was taking Plavix for one year. They took him off Plavix last
June or July and, within six weeks, he had a (his first ever) heart attack.
They put in another stent and put him back on generic clopidogrel, beginning
sometime in August of 2006. Since then, he has had a bout of severe groin
pain with some blood in his urine, which seemingly has resolved itself.
However, a couple of weeks ago he began having chest pains while exercising
and he is scheduled for a stress test next week. I have been doing some
research for him, and have read about all the hoopla around the Canadian
generic clopidogrel, injunction, and BMS/Sanofi, etc. Obviously, his
drug source has enough generic on hand to keep giving it to him, at least
for the near future. My question is: Since all the problems have occurred
since he was put on generic clopidogrel, wouldn't it make sense to put
him back on Plavix? Might not he be one those few patients who respond
better to the original version? Has anyone had an unfavorable (or parallel/similar)
experience with the generic version of the drug? • John -- glad you're feeling well -- you certainly
did the right thing by getting to the hospital immediately. And you were
lucky that the hospital performed angioplasty within 2 hours. Done in
time, this procedure can save the heart muscle from dying -- something
that was not really possible a couple decades ago. So you have already
greatly reduced the problems you could be facing for the future. As for
the drug cocktail, many are on similar regimens -- obviously you should
report any suspected adverse reactions to your cardiologist. But there
have been many benefits seen in numerous studies, especially for statins
and clopidogrel. They do have downsides, and one for clopidogrel and
aspirin is a tendency for bleeding. So this should be watched for. Unfortunately,
raising the DES issues in the press is difficult on patients who have
been given these. The reality is that the problem of late stent thrombosis
is pretty rare -- and the incidence that has been seen would be even
lower if all patients stayed on dual antiplatelet therapy longer. This
is not to say there is no risk or that Plavix and aspirin will completely
eliminate the risk. But it's very small. Also from your description (90%
blockage in a single artery) you are the ideal case -- one that would
be considered "on-label" and the incidence of problems would
be even lower. So take all the steps you can to reduce your risk factors
(diet, exercise, no smoking, etc.) and stay well. Keep in touch and let
us know how you're doing. • I'm a 54 year old
male in good health but a bad family history of heart disease who had
one DES Cypher stent implanted in October 2006 for a 90% blockage in
one artery. I was rushed to the hospital in an ambulance with chest pains,
which subsided when given Nitro in the ambulance, and the procedure was
done locally within about 2 hours of my initial pain. Daily, I'm taking
75 Plavix, 20 Lipitor, 25 Atenolol, 10 Fosinopril, and 325 aspirin. Aside
from the anxiety resulting from reading about the DES stent issues, I
feel well and am back to normal. My concern is the effect of taking so
many medications virtually indefinitely. Have there been any studies
regarding the long term health effects of the standard drug cocktail
that many of us are taking? • To
Rick: Ref Coumadin/Plavix/Aspirin Hi mate, I have been on all 3
drugs (5mg/75mg/80mg) per day. I too have 24/7 AF and now 2 stents.
In the UK no-one has told me to stop any of these, so I continue to
take all 3 daily. I do have the odd bruise from nowhere, but to date
not so bad.... I am of course ultra careful. After the last DES i was
told to take 325mg Aspirin per day for 6 weeks which I did, and didn`t
seem to be any different to when taking 80mg day. • My cardiologist recommends that I NOT take generic
Plavix (clopidogrel bisulfate). Has anyone else received the same advice?
Is the generic as good as the branded Plavix, or is there some problem
with it that causes it to be less effective or more dangerous than the
branded Plavix? • I am feeling horrible, cold hands pains in both
legs and an electrical charge through my body. I had a medicated heart
stent put in a year ago and it has been down hill since then. I have
lost 50 pounds. I now have nerve damage and I believe it is from the
stent procedure. It was excruciating pain when they removed the wire
from the angiogram.The plavix is killing me making me so cold and freezing
especially at around 7 at night. Is anyone else feeling these symptoms. • AVALIDE..has anyone had neurologic side effects
on this drug, stoke like migraine, tremors, stuttering, any times of
mental deficit? thank you • A reply to Janelle
in OK: Yes, I am having the swollen veins in my legs. I have had
huge clots form. The cardiologist said they were only surface clots
and not to worry..! Easy for him to say! One bruised from mid calf
to ankle and the lump was as big as the end of my thumb. I have had
several since my DES in June. I am on Plavix, Aspirin and Vytorin. • Since my stenting I have been on plavix/ aspirin
for two years now and feel fine. I will continue on plavix as I think
the worry that would result in me stopping the drug would cause me undue
stress. Stress I believe is one thing that produces so many unwanted
side effects. • Rick -- very timely question. A study in the
current issue of Annals
of Internal Medicine reviews the current data about combining aspirin
and an oral anticoagulant (OAC) like Coumadin in what's called a meta-analysis.
The authors conclude that there seemed to be no benefit to the combo
over the OAC alone, except in patients with a mechanical heart valve.
The downside was the increased risk of bleeding complications. This was
not a study involving drug-eluting stents, however, but one would probably
rightly conclude that Plavix, Coumadin and aspirin together would put
a patient at more risk for bleeding. What combination of drugs are best
for a DES patient with AFIB? This is something each patient needs to
discuss with his/her cardiologist and it sound like you've been doing
this. Your doctor knows you best, and as Dr. Eric Topol recently said, "There
are guidelines, but then there is still the art of medicine." • Where does Coumadin fit
in as far being useful in place of plavix. After 14 months on Plavix
and aspirin I am on 7.5 Mg Coumadin and 81 MG Aspirin daily. The coumadin
is to treat my AFIB but the cardiologist stopped the Plavix stating that
the Coumadin and the Aspirin was sufficient. Is this a reasonable approach
or would all three be too much (i.e. Aspirin/Plavix and Coumadin)? • Lynn -- coincidentally enough, on January 17, the various professional medical societies published a joint "Science Advisory" about caution in stopping antiplatelet therapy. One of the organizations was the American Dental Association. The document states:
Guess the Advisory has not found its way to your dentist.
We certainly suggest, as does the "Advisory", to go back on
your Plavix immediately. You should also call your dentist and educate
him/her. Someone has to. • I am curious-I have been on Plavix/Aspirin since
MI in 12/2004. Several stents later, my original DES started to close
in 10/06. Another DES was inserted to re-open. Now I have been off Plavix
for 5 days for dental work. Someone pointed out that it had not been
6 months since last stent. Is this increasing my danger for thrombosis?
My dr. says one more time and it is open heart for me. I have a total
of 7 stents-5 DES and 2 BMS. Any answer would be appreciated. • Reply
to Sally in England - Went back into my cardiologist today with
the similar issue - itching, rash from Plavix. It's interesting that
my itching and rash only affects me where clothing touches the body.
No rash on face, forearms, etc. He told me that Plavix can cause an
increased sensitivity in the skin than can trigger to a rash with clothing
washed in certain types of detergents and fabric softener, with the
product Bounce being a common culprit. Came back today - rewashed the
clothing in plain water, I'll let you know how it goes. You also might
want to try something like Claritin or Benadryl for the itch. Good
Luck • S.M. in NY -- Ticlid (ticlopidine) and Plavix
(clopidogrel) are related, but allergic reactions are not necessarily
the same. Most cardiologists we've talked to will try Ticlid if the patient
cannot tolerate Plavix. One reason Plavix became widely used is that
Ticlid did tend to have more adverse reactions. But In Japan, Ticlid
is the antiplatelet therapy of choice. One cardiologist recently told
us that he was surprised at how well a number of his patients tolerated
Ticlid. Have your wife's doctors ruled it out? As for IVUS (intravascular
ultrasound) being "dangerous" inside a stent...that would be
news to highly-regarded angioplasty pioneer Dr. Antonio Colombo of Milan,
who recently stated he will now use IVUS on every stent case he does.
Cardiologists who use IVUS specifically use it to inspect stent placement
-- in other words the whole point of IVUS in these cases is to look inside
the stent. What your wife's doctor may have meant was that using IVUS
is done during an angiogram, and in your wife's case, there was no reason
to do that because no new information that would help your wife would
be gained. (Question: does her cardiologist have an IVUS system? -- only
12% of cath labs currently have this capability). See if a different
drug relieves some symptoms. But if she is still having adverse reactions,
you might want to look at our topic on Allergic
Reactions to Drug-Eluting Stents. • Update
on wife. She had three taxus stents in July. She developed severe
reaction (burning muscle pain insomnia, upset stomach, feeling close
to death) to plavix after about one month in. Has been off now for
two months. She feels fine now except for residual burning pain and
general weakness. One doc says she has just a 1% chance of a clot another
says she has little protection with just aspirin. Also one doc says
using the IVUS can be dangerous to use especially inside stented areas.
Also she did have another angiogram and doc said they couldn't check
collateral values because of no blockages. What alternative options
are there for a patient with taxus drug stents who can't tolerate antiplatelet
drugs except aspirin? I hear if you are allergic to one you are to
all because of ticlid molecule. • I've had a problem with my RCA now for 10 years.
Balloon angioplasty in 96 and 98, two stents in 02, two more cobalt stents
plus brachytherapy in 03, and most recently 3 DES Jan 11 07. In 03 I
was given Plavix for a year with no negative effects. I was put back
on Plavix after the DES, and now look like a well done Maine Lobster
from neck to knees. Heading for the doc tomorrow for desensitization
discussions. My cousin is an internal medicine guy, and says that it
is not unusual to take a drug with no ill effects and then develop a
problem later on. In all my other cath lab encounters I felt much better
immediately following the procedure, after this one much worse. I believe
it is the reaction to Plavix. From what I read, I MUST stay on Plavix,
Ticlid probably not a good substitute. I'm fiddling now with Benadryl
and Pepcid. I read a post somewhere that someone had success with Altarax.
Anyone had any similar issues? • George, you are correct -- there have been documented
cases of Coenzyme Q 10 (ubiquinone) interacting with Warfarin, reducing
the anti-coagulant effects of Warfarin below the therapeutic level. Haven't
found specific studies on Plavix, aspirin and ubiquinone, but one might
be concerned that it could negate some of the antiplatelet qualities
of those. You can get an INR (International Normalized Ratio) test done,
to determine if in fact the ubiquinone is affecting your thrombin levels. • My cousin had a medicated stent implanted 2
months ago and was put on 75mg Plavix and 325mg aspirin daily along with
Zocor .. unknown mg .. and has just spent the last 3 days in the hospital
after coming down with a horrific rash with blotches all over his body
and then started to shake uncontrollably! They took him OFF of the Plavix
and switched him to Ticlid .. and while he is still in the hospital,
is beginning to see the rash and blotching subside. BE CAREFUL PEOPLE!!
Doctors don't always know what the meds will do to you. ASK QUESTIONs
and KEEP A DAILY LOG ON WHAT YOUR SYMPTOMS OR LACK THEREOF ARE as you
take new meds. I myself have 5 stents, 4 without meds and the last one
with meds. Nobody ever told me what kind, so I can't relay that info.
I take 75mg Plavix and 81mg coated aspirin along with a Protonix to keep
the BURNING sensation out of my esophagus and abdominal tract!! Thank
goodness they discovered Protonix .. I was in agony before taking it.
I also take a Cozaar and 1/2 of a bisoprolol every night before bed.
I experience several situations from these meds. Insomnia, mild headaches,
some ear ringing (not continual), extreme mouth dryness upon waking (IF
I was able to sleep!), lack of energy, eye irritation, NIGHTMARES and
continual stream dreaming if I can sleep. I used to take a 100mg Co-enzyme
Q 10 daily along with Folic Acid and 50mg B-complex and 1000mcg B12 ..
after my second heart attack and starting on the Plavix/Aspirin combo
.. I read somewhere that taking the Co Q 10 could cause either CLOTTING
OR SEVERE BLEEDING .. so I stopped taking it. NOW I FEEL SO RUN DOWN
.. when I took it, I felt like I was 10 yrs younger. IF anyone knows
the truth about taking Co Q10 with Plavix/Aspirin .. PLEASE LET ME KNOW!
Thanks • 48 yrs old, DES Stent
10-06, 80% LAD blockage. On Plavix, Aspirin, Vytorin. Had blood vessel
swell huge on inside of forearm then hematoma spread out about half dollar
size. Happened also on leg below knee. Doctor thinks it has to do with
my meds + my workout program (body builder, but nothing extreme). Has
anyone else had this thrombosis vein swelling problem? Curious, Janelle • I had a stent inserted
after an angioplasty on the 11th Dec. 2006. Three days later I couldn't
stop itching. As I have R. Arthritis I was on an anti inflammatory which
I thought might have caused this. I stopped this and the itching continued
for a few days then stopped, though my skin feels sensitive. Everything
I eat tastes strange and metallic. My arms and hands are so bad with
R. Arthritis that I now can't dress myself, do my hair or look after
myself. As I am registered Blind with Glaucoma this is very worrying.
I was not told about needing Plavix before the procedure and am now worried
that I could have more problems with my eyes . I am 53 years old and
have had many ops to keep my sight. I am hoping to see my cardiologist
to help with my not being able to look after myself. As I live on my
own my boyfriend and young daughter are trying to help me. Has any one
had similar problems? • Ellen -- the FDA-mandated labeling for drug-eluting stents states that Plavix (clopidogrel) and aspirin should be taken for 3 months if you have a Cypher (sirolimus) stent and 6 months if you have the Taxus (paclitaxel). That's the FDA, and whether or not to change this language was the subject of a major debate during the recent FDA stent safety panel meeting. The current recommendations from the three major professional organizations (the American Heart Association, American College of Cardiology and the Society for Cardiovascular Angiography and Interventions, collectively known as the AHA/ACC/SCAI Guidelines) restate these minimums, but add that ideally patients at low risk for bleeding complications should be given Plavix for up to a year. Some cardiologists now prescribe Plavix for longer, some for life. Again, this assumes the patient is at low risk for bleeding. Paul from New Hampshire (posted on November 28, 2006) wrote in again regarding two questions that have not been addressed in the Forum. So we'll try. The first, "is it possible to check to see if all the stents have properly endothelialized?" Short answer: "not easily". There is a technology called intravascular ultrasound, which takes ultrasound images from inside the artery. It's sometimes used during stent placement by cardiologists who feel it offers reassurance that the stent has been fitted correctly (for more on this, read the recent feature on Angioplasty.Org, titled "Intravascular Ultrasound (IVUS) Imaging Technology May Help Lower Rates of Late Stent Thrombosis"). It should be possible with this technology to also go back in later on and see if the stent struts have been covered by the endothelial layer. This would have to be done during an angiogram, so it's an entire interventional procedure, done in the cath lab. Theoretically this could be done if there is a strong enough reason (there are risks associated with all medical procedures, even minimally invasive ones) not to mention the expense. Paul's second question was "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?" Bypass
surgery is major surgery with risks associated with it. Unless there
is an urgent reason to have it, I doubt if any physician would recommend
doing this on a "voluntary" basis. Certainly not, considering
the risk of late stent thrombosis is very small, much lower than the
mortality/morbidity risk of any major operation. • how long after stent deployment should patients
without a heart attack patient without any further problems take plavix? • Jane -- couldn't agree with you more. Unless,
of course, it's an emergency situation, patients should be consulted
and queried strongly PRIOR to stent placement about allergies, ability
to tolerate aspirin and Plavix, etc. What does your cardiologist say
about your husband's allergy to aspirin. Plavix and aspirin act differently
as anti-platelet drugs. Secondly, all package inserts for all stents
(bare metal AND DES) clearly state that stents are contraindicated in
patients with known allergies to stainless steel. Finally, how to tell
the difference between drug allergies and drug-eluting stent? We are
participating in a study (see sidebar) to find a test that will do just
that. If you think this might be the case, send an email for more info. • On Jan 30th, 2006 my
51 year old husband has a des stent put in (Cypher). He had a triple
bypass 3 years ago, but the artery they did not bypass was slowly closing.
He has been on Plavix the last 3 years and now he is red from head to
toe. He is itching and feels like he is going crazy. He is very angry.
As a Registered Nurse he felt that he should have been consulted regarding
what they would put into his heart (this should be for any patient) before
and not after the fact. We have an appointment with his primary care
dr. tomorrow. I called the Cardiologist today and they told me to get
him to his primary care Dr. WHY? I feel the cardiologist should see the
after effects of his work. I am not blaming the Cardiologist. My husband
is a diabetic and this is supposed to be the best stent for him. I do
have a couple of questions though. My husband is highly allergic to aspirin,
goes into shock if he takes it, so if he goes to another drug like plavix
without the benefit of aspirin will that be enough? The second question,
has anyone ever had a reaction to the metal in a stent (des or bare metal)
The reason I am asking is there are times when a metal watchband will
make my husband's arm break out, and this rash was on his body within
8 hours of the de stent being put in. I guess i have 3 questions. How
does a physician tell the difference between a plavix reaction and a
person's body actually not tolerating the stent for what ever reason.
Thank you very much. • J.B. -- we're assuming you're not talking about
a coronary stent, but one connected to the dialysis. Have you reported
this pain to your physician? Specific foot pain may be an indicator of
some type peripheral disease. Various tests can be done to diagnose the
cause, but we haven't heard of Plavix causing a pain in such a specific
location. We advise you see your doctor. • My husband is a dialysis patient. He has a fistula
and a stent had to be inserted two weeks ago. He now has severe pains
in the foot arch on both feet. It feels like razor blades are cutting
him. The only thing different is Plavix. Could this be the cause? • I am writing in response to my mother. She had
2 stents put in in July 2006. Three weeks later everything she ate or
drank tasted metallic. After more that than 3 months of testing and a
36 lb. weight loss we were to an end and did not think we would ever
find an answer. After talking to the cardiologist again and again I begged
him to take her off of Plavix and try something else. He put her on Ticlid
and I am so happy to say my mother is much better after being off Plavix.
It took about 3 weeks or more for the metallic taste to leave, but she
can eat or drink most anything. I don't know if this will help anyone
else, but we never dreamed it would be the Plavix. • Wil --
not taking Plavix and aspirin after implantation with a drug-eluting
stent is definitely not recommended. Just read any of the many articles
on this site -- the main risk factor for late stent thrombosis is non-compliance
with aspirin/Plavix. There is no data to suggest that aspirin has a negative
effect on healing -- it's main function is to keep platelets from gathering
together and forming a clot. And Gary, 50% blockage is a very grey area.
Most cardiologists probably would agree with yours. The question is whether
the blockage has a functional effect -- i.e. is it stopping blood flow,
causing ischemia to the heart muscle or putting you at risk for a heart
attack. Each case has to be evaluated individually. For example, a 50%
blockage in a alrge vessel probably isn't having a great effect, where
a 50% blockage in a narrow one might. • A generic company started to sell the generic
version of Plavix, Clopidogrel, against the patent in August 2006 and
should be off of the shelves by February. The generic version has caused
many issues with serious itching and rash. If you are having an allergic
reaction check your bottle and make sure you are on Plavix and not Clopidogrel.
Have your doctor write you a new script that has "Dispense as Written" on
it. Comment to Salim - Your cardiologist has kept you on Plavix and asa
for a reason and you see what happened with your brother. If you start
cutting the Plavix tablet in half it will not reach it's steady state
and will not have the effect that it has for you already. Plavix slows
the healing process with your stents and prevents the blockages. Also,
if you were to have a plaque burst inside your artery it would help to
prevent a heart attack or stroke. Please talk to your cardiologist before
you start changing your medication. • To all patients with possible Plavix allergies
-- try Ticlid. It was the drug used before Plavix, but some patients
tolerate it better (and some worse). Ticlid is the antiplatelet drug
of choice in Japan. Certainly, do not go off your prescribed antiplatelet
medication by yourselves. If you are having problems, talk to your doctor.
Ask if there are alternatives. And share your knowledge by letting us
know. • I started Plavix after triple DE Stents in Jan.
2006. I was not aware of related problems until a urinary infection 11
mos. later. But now after stopping Plavix, other problems like flu or
allergy syndrome, itching, wheezing, are all gone. I have not felt this
good since the DES procedure. • Started Plavix Sept 30, 06 and 81 mg aspirin
daily, have had a headache everyday since. No HB pressure, MRI, CT scans
all normal. Dr's don't know what is causing the headaches. Tempted to
go off Plavix and see if there is a change. Cardio is adamant that i
stay on Plavix and is convinced that Plavix does not cause headaches.
In general, they don't, but maybe in my case, they have. Your thoughts. |
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