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Plavix, Effient, Aspirin and Stents

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Wondering about the normal dosage and length of treatment with Plavix (clopidogrel) or Effient (prasugrel) and aspirin after having a stent? Have you experienced any allergic reactions or side-effects? Read the comments below for firsthand treatment experiences from people in similar situations, ask questions, and share your story to support others in our patient community.

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Current Postings on This Page (171):

• Plavix Question in Ohio - Current U.S. guidelines are for one year of Plavix and aspirin to prevent stent thrombosis (clotting of the blood inside the stent). Stent thrombosis is an acute total blockage of the artery which results in heart attack or death a third of the time. It is not recommended to stop this medication without consulting your cardiologist. That being said, check out the recent study of the Resolute stent, showing that there is no increased risk with early cessation of these antiplatelet medications at one month. Again, we strongly urge all stent patients to consult with their cardiologists before making ANY alterations to their drug regimen.
Angioplasty.Org Staff, Angioplasty.Org, July 22, 2013

• I had to have a single stent placed on May 22nd 2013 and there are also two 50% blockages remaining. I have gone through a stress test and had no ill effects. I had taken myself off and was off for two days July16th before this test. I'm having arthroscopic surgery on my knee tomorrow July 23rd and shall remain off my Plavix until after. Will there be a "Huge" increased risk? I also stopped my multivitamin and baby aspirin for this surgery.
Plavix Question, Springfield, Ohio, USA, July 22, 2013

• Hi Dubbs in Kamloops.(Nice place by the way, visited last year) Sorry if I offended you but I had my first MI in 1988, when there was no Plavix and precious little else in the way of heart help. But, my Doctor said ' It is up to you how this works out, I can't say you will not have more MIs (and I have) but keep positive. I have tried to do that and my comment about Plavix really reflects that. Be grateful for what we have, there are many that have gone before us that did not have the options. Take care.
JJ, United Kingdom, July 1, 2013

• To "JJ" in the U.K., nobody in this forum is "whining", it is just a good feeling to share concerns and get some good advice from others who share a common illness. As well, the observations help others cope with annoying side effects, it is a battle (heart disease) that we are all in together. The information really helped me, I was ready to stop certain meds., however seeing others in severe situations giving their opinions and sharing tips is certainly helping more than just me. I am happy you are tolerating what you are taking, and love your attitude about appreciating each day - that is the kind of response many of us need to cope with this disease. Take care, appreciate your strong spirit.
Dubbs, Kamloops, British Columbia, Canada, June 27, 2013

• Louise - your medical condition is out of our area, but suffice to say that one complication of Plavix and aspirin therapy is gastric stomach upset, or possible bleeding complications. You should definitely consult with a specialist in your disease and see if they think the aspirin dose can be reduced to the baby aspirin of 81mg. Also, if you need to keep taking these medications, there are drugs called Proton Pump Inhibitors (PPI) that can help counter-act some of these stomach issues.
Angioplasty.Org Staff, Angioplasty.Org, June 25, 2013

• Have been taking Plavix 75 mg and 325 mg aspirin since 2003 for blood clotting, lupus anticoagulation. But have not had any tests since 2003 now I am having stomach problems. Drs want to know why I am on 325 aspirin? Dr prescribing retired. My family Dr just keeps telling me I have to take it???
Louise, Richmond, Virginia, USA, June 25, 2013

• To all these people that constantly moan about Plavix. OK stop taking it...........downside = DEATH. Been there, done that, I have had 3 stents over 3 years and guess what..........I am just so glad to still be here.
JJ, United Kingdom, June 20, 2013

• Looking for Advice in Australia - This is not an "Ask-the Doctor" forum so we can't give you medical advice. We can, however, suggest that your mother consult with her cardiologist. Swelling can be a result of medications (for example certain blood pressure meds, such as amlodipine, can have this effect). But also you want to check out that she is not suffering from peripheral artery disease (PAD) which is essentially the same disease, atherosclerosis, that she was treated for in her coronary artery, except it's occurring in the arteries of the leg. Atherosclerosis is a chronic and systemic condition, which is why complying with prescribed medications and reducing all modifiable risk factors is a very important part of the total therapy.
Angioplasty.Org Staff, Angioplasty.Org, June 20, 2013

• Dear AO staff My 65 years + mother got her cardiac angioplasty around 2 months ago in India. She was feeling all good and healthy except that she used to get her legs at unrest especially at night. She needs to tie them with a cloth tightly, otherwise would not be able to sleep. Also she complained about heavy medication. Recently in last 2 weeks, she is getting swollen feet and knees with no pain. Is it usual or serious complication? Is it something to do with heavy medication affecting kidneys? Please reply, I really need a genuine advice. Best regards,
Looking for genuine advice, Sydney, NSW, Australia, June 16, 2013

• Concerned Wife 216 in Florida -- Effient (prasugrel) and Plavix (clopidogrel) and more recently Brilinta (ticagrelor) are antiplatelet drugs: they keep the blood from clotting inside the stent. Because of this, they also have similar side effects such as easy bruising, gastric upset, bleeding complications, etc. Effient is considered to be a stronger antiplatelet drug which can be both good and bad because, while it may offer somewhat greater anti-clotting effect, it also is associated with increased bleeding complications in some patients. Additionally, certain patients are non-responders to Plavix, due to a genetic variation, and for those patients Effient or Brilinta are prescribed. Plavix is no longer under patent protection and so, as you noted, it is much less expensive. Is your husband having new side effects from Plavix? Also, the zone of concern for drug-eluting stents clotting up is one year and your husband is now more than two years out.
Angioplasty.Org Staff, Angioplasty.Org, June 14, 2013

• My husband had a heart attack in January, 2011. Stent was placed (LAD) and he's been on Effient ever since with no real ostensible problems. After his latest appointment with his cardiologist, he is now on Plavix (second day) and I'm starting to worry that maybe he shouldn't have switched. The doctor said it was less expensive, and of course it is, but I would much rather keep paying for the Effient if Plavix (from all I've seen here) can cause so many side effects. Should he switch back to Effient? I don't want to wait to see if he starts experiencing side effects of Plavix Thank you for your input.
Concerned Wife 216, Tampa, Florida, USA, June 10, 2013

• Kaay in Missouri -- Unclear from your post when your husband's stent was placed, but bottom line is that you should ask his cardiologist (the one who placed the stent) this question. The answer will depend on several things: which stent it was, the length and exact location of the stent, your husband's clinical status, etc. The issue at hand is that DAPT (Plavix and aspirin) is recommended for one year after drug-eluting stent placement; the reason is to prevent stent thrombosis - clotting of blood inside the stent, which can result in a heart attack and is fatal a third of the time. While recent analyses of some of the newer generation drug-eluting stents have shown no increase in thrombosis when DAPT is stopped early (for example, in our coverage of Medtronic's Resolute stent) these are not recommendations, only observations. Unless necessary, it is suggested to stay on DAPT. There is more information in our topic on Plavix and Surgery. Also read our coverage of the Science Advisory on Discontinuation of DAPT, issued way back in 2007. If there are still questions, we always suggest having your cardiologist and the physician wanting your husband to stop Plavix talk to each other. Hope this helps.
Angioplasty.Org Staff, Angioplasty.Org, June 10, 2013

• Husband needs pain shot for back and legs - 4th stent in 12-2013 needs to be off Plavix for 7 days--is it safe?
kaay, St Charles, Missouri, USA, June 10, 2013

• A few weeks ago, I had a stent put in for an 80% blockage in a branch artery of the LAD. I had to start taking generic Plavix four days before. The first day I was told to take 4. The next day I had the runs and vomiting. But after that, it wasn't so bad. But some days I do feel nauseous. I've found that eating some organic yogurt really helps. Also have been taking a teaspoon of organic apple cider vinegar with "the mother" (the cloudy stuff) in it in a glass of water helps my digestion too. I did have weird pain in my left shoulder and arm for about two weeks after getting the stent. But that's gone away now.
MillieNeon, Chicago, Illinois, USA, June 8, 2013

• jillg55 in Florida - It's possible it's the medications. Coreg is a beta-blocker which has definite side effects of fatigue and lethargy, possibly even shortness of breath. But you should discuss these medications with your husband's doctor, preferably his cardiologist and do not take anything you read on the internet as "medical advice in place of a doctor." Perhaps a different blood pressure medication might help his BP without the side effects.
Angioplasty.Org Staff, Angioplasty.Org, June 8, 2013

• My husband had quad by-pass surgery Oct 2010- then in Jan 2 of his by-passes failed and he had 5 stents placed in one artery and another 2 stents in 2 different arteries. He is now 53 years old and has never been the same. Both physically and emotionally. He has shortness of breath and feels like there is a lump in his throat very often. He is tired and seems quite frustrated at not knowing what is going on. Can it be the meds? He's been on Effient, takes Coreg for blood pressure and Crestor as his statin. He's so young and I wish I had answers for him. Please let me know if anyone has advice.
jillg55, Boca Raton, Florida, USA, June 8, 2013

• Are Plavix and aspirin a harmful combination? Plavix and aspirin are the standard dual antiplatelet therapy (DAPT) given to patients after stent implantation. Read our blog post from 7 (yes that's 7!) years ago, titled "Plavix and Aspirin -- Stent Patients, Don't Stop Taking Your Meds." So you should be taking both. Additionally, there is little or no data to suggest that a lower dose of Plavix will be effective as an antiplatelet medication. Did your cardiologist discuss the strategy of taking a full dose every other day? Plavix stays active in the circulation for several days. But clearly you are experiencing a bleeding reaction to the DAPT. Little red veins, vascular pain, bruising, are all side effects. What model stents were implanted (you should have a card telling you)?
Angioplasty.Org Staff, Angioplasty.Org, June 8, 2013

• I had 2 medicated stents put in my heart on April 13, 2013. I am diabetic type 2. I am on Clopidogrel (Plavix) 75mg, 81mg Aspirin, Metoprolol, Atorvastatin, amlodipine, and Nitrostat Pills if needed. After a few days starting Plavix my stomach turned green, my navel red from some bleed. My leg and foot got purple areas and a bunch of little red veins. It eventually cleared up. I told the cardiologist....no change to meds. Now My foot has a burning spot inside. I thought I broke it but is a vascular pain. Also my foot and leg had purple areas again and little red veins. Once again I told the cardiologist and he said to cut the Plavix dose in half to 27.5mg, stay on aspirin 81mg.Is this safe? I mean will this low dose still work? I don't know what is best. I have also read that Plavix and aspirin can be a harmful combination. Is it?
robertg2007, New Haven, Connecticut, USA, June 8, 2013

• I too had a heart attack on April 27, 2013. I am a 54 year old female, not over weight, good blood pressure, but I do smoke. Cholesterol was 214 at the hospital. They put in 1 stent then and 2 more 4 days later. They have me on Clopidogrel 75mg, 325mg Aspirin, Metoprolol, Atorvastatin, and Nitrostat Pills if needed. Had a bad reaction to the Metoprolol so doctor had me stop that. I have had chest pressure/pain since I started talking all these meds, am light-headed 24/7 and nauseated. Doctors says it is from anxiety and wants to put in on 2 different anxiety/depression drugs. I do want more drugs, I just want the chest pressure/pain to stop and I know the anxiety would stop, but doctor says I have to take Plavix for the rest of my life! I don't want to feel like this forever!
doll0712, Knoxville, Tennessee, USA, June 2, 2013

• Mary in Massachusetts -- Stopping smoking is a major risk factor eliminated. That's great and do everything you can to stay off tobacco. It's a very big risk factor for coronary disease. Have you discussed trying a different antiplatelet drug with your cardiologist? Two others are Effient (prasugrel) and clopidogrel (Plavix, although now available in generic form). These may or may not carry similar side-effects, but worth asking about. BTW, Brilinta and the other antiplatelet drugs don't exactly prevent restenosis (re-blocking) of the artery over the long term. What they do is prevent blood clotting (different than restenosis) inside the stent within the first year or so, which can be a very serious acute event. We hear your problems, however, and very much sympathize with your chronic Lyme disease diagnosis. Has this been eradicated? Chronic Lyme can have all kinds of bizarre symptoms, fatigue and mood changes to say the least. We'd suggest seeing an LLD (Lyme literate doctor) about this issue. Try the International Lyme And Associated Diseases Society website for more info.
Angioplasty.Org Staff, Angioplasty.Org, June 1, 2013

• I had a myocardial infarction (heart attack) on April 20,2013. They put 2 stents in one heart artery. Went back few days later for another stent in another artery in other side of heart. Been on Lisinopril, metoprolol, atorvastatin, aspirin & Brilinta. Did ok for few weeks, gradually getting more fatigue. Then after about a month, fatigue overwhelming & mood changes (anxiety, etc) so bad I told doc I have to stop meds. He said stop everything but Brilinta & aspirin . Been trying but when stop Brilinta for a day, feel good. When try it again (I don 't want to die after all) I get the bad fatigue. & mood changes. It's intolerable & I can't stay on Brilinta. & I see Plavix has problems too. I am 53 year old female, history of chronic fatigue syndrome/chronic Lyme disease, HELLP syndrome with 1st pregnancy at age 38, overweight, smoker. What else can I instead to stay alive? I am now NOT smoking, watching diet better (had been doing the primal/paleo diet which is obviously not a heart healthy diet!) maybe the improved diet & not smoking will be enough? Maybe take herbal blood thinners like Lumbrokinase. &/or nattokinase? Please help. How long before my stents would clog up w/o Brili?
Mary, Bolton, Massachusetts, USA, May 30, 2013

• Concerned daughter in Florida -- You didn't say if your mother was prescribed Plavix after having a stent placed. If so, the current guidelines in the U.S. are a minimum of 12 months of Plavix (or equivalent) and aspirin and then aspirin forever. But many people are prescribed Plavix for other reasons. She really should discuss issue this with her cardiologist. As for the generic clopidogrel vs. brand-name Plavix, we have gotten a few posts from patients who feel they are not equivalent. If she is having adverse reactions to the generic but didn't with the brand-name, we're sure the F.D.A. would be interested in this.
Angioplasty.Org Staff, Angioplasty.Org, May 4, 2013

• Darlene in Florida - hard to think that any of these drugs or the stents could be causing a reaction like this after two years of no reaction. We don't give out medical advice, but we'd suggest that your husband consult with his doctor about these sweats.
Angioplasty.Org Staff, Angioplasty.Org, April 30, 2013

• My husband is 52. He had two stents put in about two yrs ago. He's on Plavix, Lipitor, and Lopressor. Well about 6 months ago he started having sweats. It was not hot outside about 50 degrees. Last night he broke out in a cold sweat his hair was wet. Is this from the stents, Plavix, or is it something else?
Darlene, Macclenny, Florida, USA, April 30, 2013

• After reading posts, I'm interested to know how many people that have been having the side effect of "rash" "itchy" may be on the generic version of Plavix? My Mother was on Plavix and aspirin for about the past 6-7 years. Her arms basically remains one big bruise. All she has to do is touch her arm up against something and has a huge black and blue mark. My worry was she was going to end up dying from all the bleeding internally. I guess it was last summer when a generic version of Plavix came on the market. She started with a rash and severe itching. It is still going on and she's been to the Dermatologist a couple of times. Now that this study has been completed. Do you think she can ask her doctor if she can stop taking Plavix? If nothing else, how can she insist on getting the "real" thing and not the generic? Perhaps she can continue aspirin by itself??? Did I understand someone to say go "cold turkey" when getting off Plavix? Or would you recommend every other day w/aspirin? Can't believe it took 10 years to come to the conclusion that 2 years on this stuff is sufficient!
Concerned daughter in Florida, Palm Beach Gardens, Florida, USA, April 23, 2013

• How long do u have to take Plavix and aspirin after a minor heart attack and stent implanted?
Deb P., Spring Valley, Ohio, USA, April 21, 2013

• My 77 year old husband had a drug stent put in about 2-1/2 months go. He does yoga and walks a few miles a day. Aside from being more tired, he said his legs are stiff before he walks. He also takes 1 aspirin daily. His blood pressure is down from 145/70 to 115/70 or so. He's also on Micardis. Sometimes he won't feel like himself. He had a prickly feeling in his leg once. Any suggestions from Plavix/Micardis users?
Concerned wife, Monmouth County, New Jersey, USA, April 15, 2013

• 2 DES stents placed in 2006. Cardiologist kept me on Plavix and 81mg aspirin all these years. I had to change cardiologists due to plan change in 2012 and when I asked about the Plavix he indicated that he never kept patients on it more than 2 years when they appeared to be in as good a health as I appear to be. He did not recommend any tapering off (as I have seen in some posts) nor an increase in aspirin level. I am nervous about going off abruptly, but would welcome relief from the high bruising level as well as the problems caused in dental work.
Rochelle, Los Angeles, California, USA, April 12, 2013

• Ken in Michigan -- We've discussed this issue before. The Plavix "rebound" was only an observational study. There has been no clinical proof that such an effect exists. That being said, Plavix definitely has side-effects. Some patients tolerate it very well, some not so much. Brilinta has some of the same side effects (bleeding risk is present with any antiplatelet/blood thinning medication). Brilinta (ticagrelor) and Effient (prasugrel) are both newer antiplatelet drugs. They have been seen to be very effective, although they may present a higher bleeding risk. Currently one year of dual antiplatelet therapy (DAPT) is recommended in the U.S. (only six months in Europe) and the newer drug-eluting stents (Xience/Promus and Resolute) have been given label updates in Europe that no increased risk of stent thrombosis has been seen when DAPT has been stopped after 3 months (Xience) or 1 month (Resolute). But you should still take these meds exactly as your cardiologist recommends.
Angioplasty.Org Staff, Angioplasty.Org, March 28, 2013

• Hello again, Are there as many side effects with Brilinta as there is with Plavix? I have not seen anything about a Brilinta rebound. Does Brilinta have a rebound like Plavix? They switched my wife to Plavix after 6 months on Brilinta. She is not feeling as well. I think she is going to go back to Brilinta and take the bruises over other side effects she is already having after 30 days on Plavix. Oddly enough, no bruising on Plavix. She was covered with bruises on Brilinta. They are gone after 30 days. I have been off Plavix for 6 months and still have the rash. It stopped burning 3 days after I stopped taking Plavix, as per Cardiologist's approval to stop. Out of 18 months 12 of them were just awful with side effects. I was having a lot of chest pains as well as burning rash on back, brain fog, short term memory problems, tired, and I'm sure I suffered Plavix rebound. The 1st 90 days off it I had terrible angina, rapid, irregular HB, felt just terrible. Everything pretty much back to normal now, 6 months off it. No chest pains since about 90 days after stopping Plavix, HB normal (68-74 resting).
Ken, Saginaw, Michigan, USA, March 27, 2013

• JC in Houston -- Looking at your story, we'd have to say that your husband's cardiologist is giving him what seems to be advice born out by experience, unfortunately not good experience in your husband's case. Part of "optimal medical therapy," besides just the drugs, is reduction of all modifiable risk factors. These would include diet, weight control, eating healthy food (see Mediterranean diet), certainly stopping smoking (which we assume he has done) and exercise -- not necessarily vigorous workouts, but even just regular and long walks are very helpful. Lipitor is a statin which lowers cholesterol but also has other benefits in terms of endothelial health (lining of the artery). Effient (and Plavix) are antiplatelet drugs, which keep the blood from clotting and forming a thrombus which leads to a heart attack. Normally these drugs (plus aspirin) are prescribed for one year plus aspirin for life. In your husband's case, his doctor is using your husband's negative experiences to recommend Effient and Lipitor for life as well. Stents can keep a blockage open, but they are not a cure for coronary artery disease, which is essentially a biological problem.
Angioplasty.Org Staff, Angioplasty.Org, March 26, 2013

• My husband has had 3 heart attacks. He has 3 stents. His first heart attack was in 2005 and two stents were placed. At that time he was put on Lipitor and Plavix. He had high cholesterol and was a smoker. In 2007 he had another blockage (not a heart attack) put another stent in. In 2010 in a routine blood work found low white blood count, neutrapina. The cardiologist and Hematologist/oncologist decided to take him off lipitor and Plavix to see if his white count would go back up. Within a week he had a heart attack. They found that one of the original stents put in, in 2005 had closed. They told him never to get off Plavix again. After that the doctors put him back on lipitor and Plavix but switches his Plavix to Effient (a new blood thinner) they could never find out why his white blood count was so low. The did two bone marrow biopsies and both times came back negative. At this point, my husband and I decide to go behind the doctors back and consulate a Chinese medicine doctor. She was going to help my husband slowly get off lipitor and Plavix and replace them with herbs. We started the herbs in march of 2011. He stayed on his prescription medication at the same time he started on the following herbs: cordyceps, circulation P, Puerarin and Copmine. His white count went up eventually in range. After several weeks she cut down a Lipitor and then an Effient...til after 18months he was only taking one lipitor a week and 4 Effients a week. At the 18month mark, he has another major heart attack. This time he had gone in to cardiac shock, he sustained muscle damage this time. He was on an aortic pump for 4 days also. This time, the original two stents that were placed in 2005 had closed up again. The cardiologist said don't EVER EVER stop lipitor or Effient again. He said he will have to be on them for the rest of his life because of those stents. Is this true? are these stents going to require him to be on those two drugs for the rest of his life?
jc, Houston, Texas, USA, March 24, 2013

• This Forum helped me through my MI, Stent and 18 months on Plavix. The Cardio first told me a year on Plavix. After a year he said due to the Plavix Rebound another year on it. After 1st year I got more side effects, not feeling well and developed a terrible burning rash. Cardio said shingles, 2 other Doctors said it didn't look like shingles. I told the Cardio I wanted off Plavix and he took me off. The burning went away in a few days but I still have the rash a year later. I think I had Plavix rebound, chest pain, PVC's, felt really bad. I put my wife on a plane for 2 weeks at 90 days off it. I really didn't know if I would be alive when she got home, felt that bad, didn't tell her, didn't want to spoil her trip. After she got home she had a 99% blockage in the exact same spot as me and got a stent. She was on Brilinta and did ok. They put her on Plavix at 6 months for surgery, don't know why. Here is my question, does Brilinta have a rebound too? I don't want her to go through what I went through. Cardio said she may as well stay on Plavix but could go back to Brilinta if she wanted to. She has been on Plavix a few weeks. I'd rather see her on Brilinta but don't want say it.
Ken, Saginaw, Michigan, USA, March 21, 2013

• Just had second stent angiography, been on Plavix since last procedure month ago with no problems. Now cardio doc wants to add baby aspirin and I'm concerned which brought me to this helpful forum. Thanks everyone for sharing. This is new (since Nov 2012) for me, an active, slim lady with no prior history for heart trouble. I believe I've avoided gastro troubles because I swallow meds with mouthful of kefir. I take one mouthful, then drugs' mouthful, followed by "chaser" of another mouthful of kefir. It's cultured milk with probiotics that I buy at Trader Joe's. Until a month ago I was on pradaxa (blood thinner) and it didn't fry my gut as the doc warned me, suggesting using PeptoBismol which I cannot stand and never use.
Joann, Seattle, Washington, USA, March 12, 2013

• I just have two large brain aneurysm worked on February 7th. I also feel the pressure in the heart like everyone has been mentioning. I have been on Plavix for about 7 weeks and it's like i will be getting off of it in a couple of days but i am scared from all the posts i have been reading. Does any one have any suggestions?
Annie, Newport Beach, California, USA , March 12, 2013

• Tania in France -- We do not and cannot give medical advice, but seeing as your problem was not a build-up of plaque, high cholesterol or high blood pressure, you should ask your cardiologist why he has prescribed Bisoprolol, which is a beta-blocker used to treat high blood pressure, and Crestor, which is a statin used to lower cholesterol. Your cardiologist may have good reasons for these prescriptions, since these drugs have other beneficial effects for heart patients. The main thing is for you to understand exactly why you are taking these meds, so that you can be a full partner in the management of you health. As for Plavix and aspirin, these are antiplatelet drugs, used to keep platelets in the blood from clumping and forming a thrombus or blood clot in the stent. Because stent thrombosis can be very serious, these drugs are very important to take after stent implantation. For a drug-eluting stent, the recommendations are for one year minimum, assuming there are no serious side effects. Hope this helps.
Angioplasty.Org Staff, Angioplasty.Org, February 28, 2013

• Hello,I'm on Bisoprolol (twice a day), Plavix, kardegic (powdered aspirin) and Crestor. I had an angioplasty last April. My artery was 100% blocked and I had a drug eluting stent put in. I'm worried about taking the Crestor - it seems a dangerous drug. One doctor said take daily, one every other day. My artery collapsed due to radiation due to breast cancer. I don't smoke, no plaque, not fat. How long should I take the Crestor and why would I have been given it? Could it be that since plaque is generally the reason for an angioplasty???Also what is the standard time to take Plavix? to take a Bisoprolol? or will this be for life?My blood pressure is 120 over 60 as it has been all my life. I'm 67.Also what tests can I have to check my heart that are reliable but don't use too much radiation since I've already had a radiation induced heart problem and have a damaged lung also due to radiation?I did apparently have a heart attack due to this damaged artery - I was suffering chest pains in cold weather which is how it was discovered. Sorry for so many questions and I know you've probably answered some but since mine was radiation caused I don't fall into your usual profile.
Taniafrance, Var, France, February 28, 2013

• Have something else to put out there. Just had a stress test and did very well. Since then I been having some pressure in the chest area. Comes and goes. I just ran 3 miles and feel pretty good and no pain. Does that make any sense?
Tom, Palm Beach Gardens, Florida, USA, February 11, 2013

• Tom in Florida -- From the tests you report, it looks like your stents are okay and that you're not suffering from ischemia (lack of blood supply and oxygen to the heart). We would again suggest that you may be having reactions to the drugs. But, very important, do not stop taking any prescribed medication with discussing it with your cardiologist. Especially Plavix and aspirin -- these are two anti-clotting drugs that are very important in keeping blood from clotting inside the stent, a very serious potentially fatal complication. We have gotten posts from a number of patients who have found that they cannot tolerate statins, for example, and, after their cardiologist adjusted their dose or changed to a different drug, they felt much better. By the way, it's great that you are staying active and running.
Angioplasty.Org Staff, Angioplasty.Org, February 10, 2013

• I have the five stents but when I started taking the Plavix and statins, I just don't feel myself. I was always on the go. Now just don't want to do anything. After the five stents in a year i still this day have pressure in chest area just had my last cath at Aug 2012 and just had a stress test and stress test was normal and cath had no changes, but I have always felt horrible since I've been on the statins and Plavix.
Tom, Palm Beach Gardens, Florida, USA, February 10, 2013

• Tom in Florida -- Have you discussed this issue with your cardiologist? Are your symptoms similar to angina or are they more like tiredness, muscle fatigue, etc? Some people are quite sensitive to some of the medications that are prescribed for heart disease, especially statins. We'd recommend discussing your symptoms with your doctor and maybe he/she can adjust or change your meds to help you feel better. But don't make these adjustments on your own; make sure you discuss this with your doctor. After all, what this is all about is feeling better, not worse.
Angioplasty.Org Staff, Angioplasty.Org, February 9, 2013

• I have 5 stents. I am 47, run 3 miles a day but since I've been on the blood thinners and statins, I feel horrible. Any one else?
Tom, Palm Beach Gardens, Florida, USA, February 9, 2013

• I agree with Dawn J. Plavix is a nasty drug. It is causing significant muscular skeletal problems for me (I am not on a statin--only Plavix and aspirin). Since starting the Plavix 15 months ago, I have given up golf due to terrible pain in both shoulders, feet hurt, knees hurt, elbows hurt, etc. Can't lift weights, can't swim, can't play any sports except riding a bike which is becoming more and more difficult. I warned my cardiologist before my stenting that I am very sensitive to drugs but he went ahead and put two DES in me anyway. With hindsight, a minimally invasive CABG would probably have been much better. I would be off the Plavix by now and probably enjoying life. The Plavix has almost destroyed me. Docs,not all, but in general, do not listen to their patients due to big egos. I think my doc simply thinks he is great at stenting and really didn't consider any other options because that is his very narrow area of expertise. Oh well. Nothing I can do about it now.
Charles, Florida, USA, February 7, 2013

• Ken in Michigan -- We can't give you medical advice other than to refer you to the same articles that were in our response about Xience being approved in Europe (not the U.S.) for three months of DAPT and the other studies showing relative safety if surgery is done after 6 months of DAPT. Keep in mind that the original recommendation from the FDA for drug-eluting stents was six months -- this was increased to a year or more in 2006 when concerns about stent thrombosis appeared with the first generation of DES. Most studies of second generation DES have shown significantly increased safety regarding stent thrombosis. One issue may be where the stent is, the anatomy of the artery, length of stent, etc. These specifics may place your wife at a higher risk for stent thrombosis, sparking her cardiologists's concern, although again, this is a relatively rare occurrence. Have your wife's cardiologist and gynecologist spoken with each other? Ask them to do a consult, if they haven't, and they may come up with a clearer solution that will put you and your wife at ease. Also, remember that no information on this Forum should be viewed as a substitute for medical advice or as a consultation with a medical doctor. Good luck and let the Forum know how things turn out.
Angioplasty.Org Staff, Angioplasty.Org, February 3, 2013

• Question for Angioplasty.Org Staff, regarding response to J. Eaton in Texas August 8, 2012.The Cardiologist and the gyno have discussed my wife's case and the 2 ovarian polyps they found weeks after she got her XIENCE V, 3.5mm x 33mm DES. The cardiologist wanted her to wait 6 months to get them removed. The 6 months will be up in about 30 days. The Gynecologist says she is comfortable doing the procedure but, wants her to switch from Brilinta to Plavix a week before the surgery. The Cardiologist at first wanted her to take a loading dose of 8, 75mg Plavix. When I grilled him about it he changed his mind and said take 4 Plavix as a loading dose. She has tolerated the Brilinta well, but she is a bruised mess. She looks like she has tattoos all over her body. I read that Brilinta is pretty much out of your system in 24 hours, with a 7-9 hour half life. Why not stop the Brilinta 24 hrs before surgery and take the Plavix or Brilinta when she wakes up? Should I see a different Cardiologist? The Gyno will use a rubber dam or something and blow it up internally if bleeding occurs. I'm very worried about my wife and bleeding. I forgot my Plavix a few times, I'm OK 2 yrs post stent.
Ken, Saginaw, Michigan, USA, February 3, 2013

• Wong in Malaysia -- As we wrote last week, all these drugs have similar side effects in terms of stomach irritation and possible bleeding. Cutting a pill in half is not recommended because the drug may not be evenly distributed in each half.

Shmoolik in Israel -- Have you discussed these issues with your cardiologist. If you are having a reaction to Plavix, perhaps he/she would consider putting you back on Effient. And yes, having a stent-in-a-stent can put you at a somehwat higher risk for stent thrombosis, so a longer regimen of DAPT might be called for -- but we cannot give medical advice; these are questions that need to be answered by your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, February 2, 2013

• Effient 5mg not available in Malaysia. can i split the 10mg into two and whether it it safe to take that way. i heard a lot about Effient link to blood and skin cancer...are they true ? can 5mg Effient be taken as lifetime maintenance dose to replace aspirin since i cannot bear the side effects of aspirin and Plavix. do Effient cause more bleeding and gastro damage compare to aspirin, Plavix, Grendis, Brilinta?
Wong, Malaysia, February 1, 2013

• Hi there, I am a male 59 yo,I had a large MI December 2011, and got an implantation of a bare stent . after 7 months - June 2012 I had an elective implantation of a drug-eluting stent, into the edge of the bare stent, I took Effient for 12 months after the mi,(6 months after the medicated stent) which was changed to clopidogrel, about a week after switching to clopidogrel I had problems in digestion with fatigue,about a week now, but for only 7 hours after waking, the evening and night is completely normal, could it be withdrawal symptoms from the Effient? (I used to take the Effient in this time span)since it is a stent partly inside the other stent, should I take the DAPT for a longer period of time? I also take 100mg aspirin and 12.5 mg normitten and 10 mg Lipitor, Thanks
Shmoolik, Jerusalem, Israel, January 26, 2013

• Wong in Malaysia -- You should discuss your medications with your cardiologist. The guidelines call for aspirin plus another antiplatelet drug (like Plavix, Brilinta or Effient) for a year after drug-eluting stenting. All of these drugs have the side effects of stomach upset and even bleeding. They can be somewhat lessened by using a proton pump inhibitor, but again -- consult your cardiologist about your specific situation.
Angioplasty.Org Staff, Angioplasty.Org, January 24, 2013

• How long should i have to take Brilinta ? I've been taking nearly a year and recently develops pan gastritis, my stomach really cannot take it. is there any alternatives. i got problem taking Plavix and aspirin. What should i do. can Effient be taken for life like aspirin ?
Wong, Malaysia, January 13, 2013

• Joan in Pennsylvania -- It's possible you are having a metal allergy reaction to the stent. Most stents have a significant amount of nickel. There's been very little research, most of it conflicting, about whether a metal allergy can come into play with a stent, but, as we have noted many times, all stents carry a caution in the package insert that they should not be used in patients with an allergy to nickel or other components. See our Forum Topic on Metal Allergies.

And Tommy in Florida -- All the powerful antiplatelet drugs (Plavix, Effient, Brilinta, even aspirin) have the side effect of gastric upset (sometimes severe) and possible bleeding. Management of patients post-stenting is a balancing act between enough antiplatelet medication to prevent stent thrombosis (blood clotting) but not enough to cause bleeding. H2 blockers, like Zantac, or more potent gastric remedies like Proton Pump Inhibitors (Prilosec, etc.) are prescribed to reduce these side effects.
Angioplasty.Org Staff, Angioplasty.Org, January 10, 2013

• I had 1 double sized stent put in my main coronary artery found during a stress test, May 1, 2012. I was discharged the the next day. I was put on 80 milligrams of Lipitor, Effient, 81mg aspirin as well as my BP meds I've been taking for 10 + years. Lipitor reaction was severe. High liver enzymes. Put on Crestor and they are still high normal. I was taken off Effient at 7 months and was replaced with Plavix. I have severe abdominal pain and blood in my urine. I was placed on Zantac I was at the ER today and after lab results all was normal and I was discharged. Referred to urologist. What causes severe abdominal pain after eating, or drinking coffee, alcohol intensives the abdominal pain in the smallest drink. I very concerned about the blood in urine. All bladder test came back negative for infections, positive for blood.
Tommy, Patient, Palm Beach Gardens, Florida, USA, January 4, 2013

• I had a stent implanted on Dec 4, 2012 and this week have developed severe itching pretty much all over my body. It is making me crazy. I've read tons on this forum however everything seems years old. Any new information on allergic reactions after stent implant? I am taking aspirin, Plavix, Cozar, Simvastatin and metoprolol tartrate. I am allergic to Nickel
Joan, Milford, Pennsylvania, USA, December 27, 2012

• Wkstat in California -- Here's a link to a BBC news article about the man from Scotland. As is often the case with news articles, some crucial information is left out. The patient in this case had been fitted with an LVAD (Left Ventricular Assist Device) which is a mechanical heart pump. As a result, he was on anticoagulant therapy with warfarin (a.k.a. Coumadin). Plavix (clopidogrel) is not an anticoagulant, but an antiplatelet medication and it acts differently than warfarin. Brussel sprouts, Swiss chard and other cruciferous vegetables, contain high levels of vitamin K1 which is known to reduce the effectiveness of certain anticoagulants, such as warfarin. This is important information, however, because warfarin is also the standard drug given to patients with mechanical heart valves, much more common than LVADs. So those patients should be aware of this interaction. However, In our research we have not found any evidence of reduced clopidogrel potency due to vitamin K1 levels.
Angioplasty.Org Staff, Angioplasty.Org, December 27, 2012

• I see that a man was taken to hospital in Scotland because his blood was clotting even though he was taking his anti-clotting med. Turns out that he had been eating brussels sprouts. Seems that eating green leafy vegetables causes the med. not to work. Good to know since I am on Clopidogrel (Plavix).Small portions of leaves from now on for me.
wkstat, Long Beach, California, USA, December 26, 2012

• What exactly is the plavix allergy and what is the best time of the day to take it? Many thanks to whoever will answer me.
Mohammad, Jordan, December 6, 2012

• I am on Plavix 75mg & Bayer aspirin 325mg everyday. I had stent put in brain for an aneurysm in June 2012. I have been experiencing flu like symptoms Headaches, nausea, motion sickness, chest, neck, arm & leg pain. I have talked to Neurosurgeon he said I have to stay on medicine. I am at the point where I can't take the sickness, fatigue, anxiety & depression. I also have bruising, purple spots all over & my arms constantly itch. PLEASE HELP!
Brown, Pasadena, Maryland, USA, December 1, 2012

• I am a slim year old female who had a massive heart attack not quite 3 weeks ago. I was 100% blocked in my right coronary artery, i had a drug eluting stent put in and was placed on Plavix and Lopressor, though i do not have high blood pressure, also do not have high cholesterol. (2 Years ago i had my right carotid endarterectomy, my carotid was 90% blocked)I had horrible hallucinations on Plavix! Horrible! i am now taking Effient, praying that i am able to tolerate it, they should warn you that you have to be on blood thinners after stenting, they would have known my sensitivity to Plavix (we found out with the carotid) and perhaps open heart would have been a better option. HERE IS WHERE YOU WESTERN MEDICINE DOCTORS NEED TO WORK WITH NATUROPATHS AND YOUR PATIENTS! YOU GOT ONLY 2 DRUGS FOR THIS? I WANT TO GO OFF THIS STUFF AND GO ON NATTOKINASE AND EDTA, BUT I NEED A CARDIOLOGIST TO FOLLOW ME WHILE I DO IT, AND YOUR EGOS PREVENT THAT, SHAME ON YOU, EVERYBODY CAN'T TAKE YOUR MEDICINE.
DAWN J., Twin Falls, Idaho, USA, December 1, 2012

• NVD - See our interview with Dr. Eric Topol, world renown cardiologist whose specialty is genomic testing.
Angioplasty.Org Staff, Angioplasty.Org, December 1, 2012

• Don't know if this has already been covered - my husband had a small stroke in 2010, and was put on Plavix by his neurologist. Two years later, his cardiologist had a cheek swab taken to see if my husband was one of a small percentage of people for whom Plavix doesn't work, because they have a genetic variant. Guess what, he fell in that group. So, he took Plavix for 2 years without knowing that it wasn't working. He is now on Ticlid, and recently had two cardiac arteries stented.
NVD, Seattle, Washington, USA, November 20, 2012

• Recently I posted a query as to information about how long I would have to stay on dual antiplatelet therapy after a very late stent thrombosis in Dec. 2010 (6 Cypher stents in the RCA). I mentioned that I felt I was headed to a bleeding episode because the 10 mg dosage of Effient I was taking was obviously too much for me - terrible bruising, skin problems, longer bleed times for minor cuts, etc. I also mentioned that I was having a difficult time convincing my cardiologist of this. Well, it happened! Minor flu which quickly progressed to GI bleeding and hospitalization. Thank goodness it was resolved when I was taken off the Effient and aspirin temporarily. I now take the 10 mg dosage every second day, on the advice of another cardiologist, and I feel great!! I also alternate my aspirin as well. Can't believe the difference!!
Queen of Cups, Vancouver, British Columbia, Canada, November 18, 2012

• It has been 90 days since the Cardiologist said I could get off Plavix and take 2, 81mg aspirin a day. I still have a rash on my back that started at almost 1 year on Plavix. My back has the texture of a country road but the pain went away after a few days off Plavix. I have been under a lot of stress, my wife had to get a stent since I got off the Plavix. I have been taking her to Drs and Cardio rehab, running around a lot and neglecting my exercise and feel it just this week. My heart rate is running from 75 to 98. BP is a tad high. Never should have slowed down on exeresis. Metoprolol takes my HR down to 54 so I had to split 25mg and that works, I don't want to stay on it, so I have only taken it once this week. Some numbness in L arm and shoulder a few times. Going to make sure I exercise and hope for the best. It's my own fault, I could have made time for it, hindsight being 20/20. Pretty sure I can get everything back under control. I have not been eating right either, I do eat Oatmeal with Blueberries in it every day and a light dinner, no appetite. I have lost 35 pounds in the past 1 1/2 yr without trying. The Heart Attack diet,, can't beat it. I'm a lean 170 pounds now.
Ken, Saginaw, Michigan, USA, November 8, 2012

• I had 4 DES put in thee weeks ago, they also told me to take aspirin with Effient which I have an allergy to. Is it going to make a difference if I don't take the aspirin? I am also on 90mg 2x a day of Lovenox.
Auntier, Fishertown, Pennsylvania, USA, October 31, 2012

• After 3 hours of reading these informative posts and responses, I have 2 questions. (a) is there such a thing as "Effient rebound" - - like the apparent Plavix rebound? And (b) what are the benefits (beyond "stent care") of remaining on Effient past the 1 year or 3 year mark of stent implantation? I ask these, because today cardiologist said I could discontinue my Effient and I am anxious about this. Even tho I have been taking it for 38 months already! Had an MI in August 2009 with 100% blockage in one coronary artery (I don't recall which). Three PROMUS Everolimus Eluding were inserted into this same artery. Card has told me different lengths of time regarding taking the Effient Right after the procedure, he said I would need to take the Effient for 2 years. At the 2-yr mark, I 'reminded' him of this and asked if I could come off. He said unless for $ reasons, I should stay on, apparently indefinitely, as there was no real answer as to how long one needed to stay on. I think part of his decision today was because he knows of my not-so-great finances. But he also said my stents had healed (I should hope so, after 3 years! But my reason for posting is my 2 questions to you.
Joseph, Austin, Texas, USA , October 23, 2012

• My husband had angioplasty three weeks ago and two drug eluting stents were put in. He is doing well BUT first a large bruise appeared under one arm and the arm muscle hurts like heck and radiates into his shoulder. Now the bruise is fading. However, today, another bruise, again the inner arm, but on his other arm. He feels it is nothing. I am concerned. He is taking Effient and a Baby Aspirin among other things.
Penny, Victoria, British Columbia, Canada, October 15, 2012

• queenofcups in Canada -- You've brought up one of the most difficult questions in interventional cardiology: how long should a patient stay on dual antiplatelet therapy (DAPT). We have written about this many times on Angioplasty.Org. The current recommendations are for one year minimum after drug-eluting stents (longer if the patient can tolerate it with no problems). Having six stents in one artery is definitely an indicator for increased risk of stent thrombosis, but you went for over three years without a problem. But it happened. This is known as Very Late Stent Thrombosis (VLST) and is the subject of many research papers. It is not clear at all whether remaining on DAPT would have prevented this, because the thrombosis may be due to other causes, such as something called late-remodeling (where the artery wall slowly moves outward from the stent) etc. Longer periods of DAPT are being tested in a very large study, called DAPT, but the results won't be out for several years. We would, however, discuss this with your cardiologist who certainly has more specific information about your clinical situation. Perhaps a lower dose. Perhaps changing to a different drug, like Brilinta. But bleeding is a complication of all antiplatelet drugs. Have you had any platelet reactivity or genomic tests? Dr. Eric Topol discusses these, and the issue of clopidogrel non-responders in his interview on Angioplasty.Org
Angioplasty.Org Staff, Angioplasty.Org, October 14, 2012

• I am a fit, slim, non-smoker female. Mild heart attack in 2007 at 54 yrs, for which I received 6 drug-eluting stents in one 90% blocked artery. Stayed on Plavix for 6 months but could not tolerate the horrible bruising so stopped, but have kept up the 81mg aspirin. In 2010, 3 1/2 years post-stenting, developed a thrombosis and another heart attack. Made it through that with lots of complications/allergic reactions from the initial high dose of prasugrel and other things, and now two years later I am still on the 10 mg dose of prasugrel. It is too much drug for me and I am contending with terrible bruising, skin that is a mess and sometimes cuts will take a long time to stop bleeding. I KNOW that I am heading towards bleeding problems the longer that I am on this drug, but I can't get my cardiologist to listen. As far as he is concerned, I should just be happy to be alive. I should add that I have virtually no damage to my heart after two heart attacks, for which I am eternally grateful. No one has ever looked at these stents to see what is going on. There must be alternatives. Does anyone have any insight into this? Am I going to have to take Effient until something terrible happens?
queenofcups, Vancouver, British Columbia, Canada, October 11, 2012

• eljoan in Michigan -- check out our Forum Topics on Allergic reaction after drug-eluting stent -- DES hypersensitivity and Metal (Nickel) allergies to stents. The reactions you describe are pretty strong and may be a drug reaction. Definitely discuss this with a doc. Anyone else have these reactions??

And Ken in Michigan -- Brilinta, Plavix (generic or not), Effient -- all these are antiplatelet drugs -- all of which the OB/GYN will probably want her to stop. Check out our Forum Topic on Plavix and Surgery. We recommend that her OB/GYN consult directly with her cardiologist on this. Some of this may depend on exactly what stent she received. While a year is recommended for most, there are studies that show these drugs may be safely stopped earlier. Based on these, the EU has approved the XIENCE for three months of antiplatelet therapy; but the FDA has not. Certainly longer is better.
Angioplasty.Org Staff, Angioplasty.Org, October 10, 2012

• Mother, age 94, just got drug eluting stent- six days later started to be sick, throwing up and dry heaving. This has gone on for 40 some days. Has had every GI test known to man. Said she must now go to U of M for more. Her first stent was metal-no problems. Does anyone think this could be the stent ?? She was on Plavix after 1st stent and has continued. Has this happened to anyone??
eljoan, Royal Oak, Michigan, USA, October 7, 2012

• 18 months after I had a heart attack and just got off Plavix, my wife of 40 years had to get a stent. I took her to the ER twice and she passed the blood test, EKG and stress test. They all came back normal. She was still having chest pains and they did a Heart Cath 2 weeks later. The Dr said she had a 99% blockage and was in going to have a massive Heart Attack. We both had blockage in the exact same spot in RCA. Cardiologist put her on Brilinta. This was 3 weeks ago. Now the Gynecologist found polyps on her ovaries and wants to do a D&C. Of course the Heart Dr won't let her stop Brilinta. We are at a loss, don't know what to do.

Is there something wrong with the new Generic Plavix? Why would he put her on a new drug? Money? Trips? New Flat Screen TV's? She is diabetic. If the polyps turn out to be cancer, a year could cost her life. We have a Dr shortage here in Michigan, now that we are the armpit of the Country. Heard on the news Saginaw is the most violent city in America (percentage wise). She is going to Oklahoma City in a month. Should she see Cardio there? Her Sister has a friend that's a Cardiologist and will see her. I am beside myself with worry. Is Brilinta better?
Ken, Saginaw, Michigan, USA, October 3, 2012

• Hey John - You are so right. For me, I had a heart attack in 2004, 80% blockage - tried the natural way, quit smoking, exercise, lots of no-flush niacin. 8 years later had eight events in ten days, finally had angiogram. Had a 90% blockage just behind the 80% I originally had. My choices were open heart or stents. In hindsight I would have been on a Statin. One brand reduces the plaque, won't name but may have saved me from my present situation. Do your own due diligence people as John says.
Dubbs, Kamloops, British Columbia, Canada, October 3, 2012

• My wife had four stents in 2007.One of which was not drug coated. She went on Plavix but could not tolerate it. She became extremely ill while on it. Now she has numerous food allergies one of which is gluten. She is on one aspirin a day and has some cardiac discomfort at times. Patients should be given all non surgical options before any surgery. She only had stable angina before the stents.
john14505, Rochester, New York, USA, September 26, 2012

• Hi, I see you mentioned to someone getting a Nuclear Stress test? Just a note, In September, 2012 I had such a test at our Hospital, I was having almost daily heart attacks, some leaking Troponin, some not. The Nuclear (MIBE) Test was negative. Days later after being rushed to another Hospital which has an Angiogram available - I was told there was an 80% & 90% blockage in the same artery. Needless to say "two stents were inserted", I too am on Plavix & ASA. Just wanted to mention the Angiogram is a much more reliable test, in my case it sure was. As for the Plavix - severe stomach cramps, constipation, shortness of breath... will be a long year!
Dubbs, Kamloops, British Columbia, Canada, September 24, 2012

• H in Saudi Arabia -- Dr. Olsen addresses the question of aspirin in the article. Aspirin, while technically an NSAID is cardioprotective, and is not implicated. Life-long aspirin is, as you said, very important for heart patients. Another strategy if a pain reliever other than aspirin is necessary is to use naproxen, which showed the least risk.
Angioplasty.Org Staff, Angioplasty.Org, September 24, 2012

• Worried after this alert "Don’t Take NSAIDs After a Heart Attack". Aspirin which is life long medicine after heart attack also NSAID. Not sure is low dosage of aspirin daily (81mg) is safe?
H, Kingdom of Saudi Arabia, September 24, 2012

• I have been off Plavix almost 7 weeks, Cardio said I could stop after 17 months. Put me on 2, 81mg aspirin. After 5 days my rash still felt rough, but the itching and terrible burning was gone. Brain fog starting to clear, memory returned to about as dumb as I was before my heart attack and stent in RCA. I can say I am about back to normal now, for me. I still have other problems and will never feel 21 again (obviously since I'm 60). I think Plavix caused the rash that drove me crazy and brain fog until I stopped taking it. Another study said out of the people that had Plavix rash, 100% of them still had it while on Plavix. It also said 100% of the people who stopped Plavix still had a rash (the gift that keeps on giving). Back is still rough, no pain, a little occasional itch but not too bad. It was smooth as a baby's hiney before my MI. I'm still unmotivated, have to force myself to my recumbent exercise bike that I am pretty proud of. It is a NuStep, just like I used at Cardiac Rehab. I bought it at a Police Auction for $20. They are over 4k new. I think the thing that helps the most is exercise. I feel good again, finally off that poison. There is hope for us. Keep the faith.
Ken, Saginaw, Michigan, USA, September 16, 2012

• H in Saudi Arabia -- Read our September 4 reply to Annie in South Africa.
Angioplasty.Org Staff, Angioplasty.Org, September 16, 2012

• Does new study displayed on the front page of this website means its safe to discontinue Plavix after one year based on doctor's advice?The reason I am asking this question is obviously you don't want to take any chances against your heart.
H, Kingdom of Saudi Arabia, September 12, 2012

• Very interesting. Thanks and please report back to the Forum on this.
Angioplasty.Org Staff, Angioplasty.Org, September 12, 2012

• Update: Father 82. 9/4, my father has been back on regular Plavix since 8/29 and has seen great improvement. Vertigo has decreased significantly. He is able to walk around on his own without fear of falling. His energy level has also increased. Appointment with his regular internist today and his doctor felt that his "episode" was a result of the generic Plavix not working for him. The blood test they did at the hospital to access how the generic Plavix was working (or in his case, not working) was the P2Y12 Assay. He is going to have this test again after a month back on the regular Plavix to compare results.
Daughter, Minneapolis, Minnesota, USA, September 4, 2012

• Annie in South Africa -- There have been recent studies that with the newer generation of stents, it may be okay to stop dual antiplatelet therapy (DAPT) earlier than one year, mainly because these stents are so much improved over the first generation. The Xience V is one of these newer stents and, in fact, the European Union just approved the Xience V for a minimum of only three months of DAPT. This is not to say you should stop after three months, because each patient has a different situation, different anatomy, etc. Your cardiologist and you should make these decisions together.
Angioplasty.Org Staff, Angioplasty.Org, September 4, 2012

• I had what drs called a "mild" heart attack December 2011. had a 70% blockage, and a DES Xience V stent placed. On clopidogrel , aspirin , statins ( which I have stopped now due to severe side effects from all brands) I told cardiologist, I want to take supplement coenzymeQ10 (for statin side effects) but apparently coenzyme Q10 could work against blood thinning medications, to which he then told me that I can stop the clopidogrel, and take the coenzymeQ10 supplement was under the impression clopidogrel (Plavix) must be taken for 12 months with DES, yet my cardiologist told me that a recent meeting attended revealed that patients who received drug eluting stents, now now safely go off clopidogrel (Plavix) after 6 months. I am terribly afraid and confused, don't know what to believe or do. I am female 61yrs.
Annie, Durban, South Africa, September 4, 2012

• Chef in Dubai -- you should ask these questions of your cardiologist. The standard recommendation for Plavix and aspirin after stenting is one-year, if you had a drug-eluting stent. The dizziness might be due to one or more of your medications. Perhaps the dosage could be adjusted -- but this is something you should discuss with your doctor.
Angioplasty.Org Staff, Angioplasty.Org, August 31, 2012

• Dear doctor i am 45 year old i had angioplasty 10 month a go and i am still taking aspirin Plavix and Crestor 10 mg and Concor 5 mg sometime i get chest pain when i relax well its goes away. Now i would like to know how long i should take Plavix aspirin and Crestor and Concor tablet i feel better and some time i feel dizziness thanks i am waiting get positive response kind regards
Chef in hotel, Dubai, United Arab Emirates, August 31, 2012

• This Board has helped me and obviously hundreds of other people tremendously. I thank you so much for everything you guys have done.
Ken, Michigan, August 30, 2012

• Father, 82, admitted to hospital on 8/26, vertigo-like symptoms. Blood test done that can tell how the Plavix-type drug is working. Results of test showed generic Plavix not doing its job. Doctor said, according to test, my "father's blood not where supposed to be." He needed to switch back to regular Plavix That was likely the cause of his dizziness. Father had been on generic for 21 days. Looking back, symptoms started earlier - dropped energy level, suddenly didn't have energy for things he normally did. My mother, retired RN, said he rested more and napped more. Energy level way down. Noticeable changes. And then the dizziness. He received a regular Plavix in the hospital on 8/27. On 8/28 took generic again. Got new prescription for Plavix on 8/29 through regular internist and took on 8/29 and will take from now on. Dizziness is less today 8/30. I'm upset. The generic Plavix sold as if it's the same. It is not. The doctors at hospital said something about how the active ingredient in generics can vary from 75%-125% of the original. Really? Huge variance! Praying he didn't suffer stroke while on generic. Will see what next scan shows. Will keep you posted.
Daughter, Minneapolis, Minnesota, USA, August 30, 2012

• Thanks to everyone for information to help me make some decisions. It has been 16 months after 5 stents and I want to be off DAPT but after talking to cardiologist and reading comments, it looks like I need to continue the course at least until the newer studies which cover up to 3 years of DAPT.
BobT, USA, August 25, 2012

• 5 days off Plavix, Cardiologist approved. Dull Headache on L side for the past couple days. Has anyone else experienced this?
Ken, Saginaw, Michigan, USA, August 14, 2012

• Marco in California -- the antiplatelet properties of Plavix after stenting have been studied in many thousands of patients and, while these other drugs/supplements may have some blood thinning properties, they are not as powerful as Plavix (a.k.a. clopidogrel). There are other approved drugs that are alternatives to Plavix, such as prasurgrel (Effient) and ticagrelor (Brilinta) but they the same as or even more powerful agents.
Angioplasty.Org Staff, Angioplasty.Org, August 12, 2012

• I had two stents put in early 2012. I was put on Plavix and 81mg of aspirin. Why can't I stop the PLAVIX and switch to niacin, coQ10,flax seed and other blood thinners that do not have side effects? Doctors will not look at alternative methods, and yet they do not want you to take other thinners with Plavix. It's either Plavix or the "highway". I don't buy it!
Marco, Hayward, California, USA, August 10, 2012

• I have been on Plavix since March, 2011 when I had a MI and DES in my R Coronary Artery, 98% blockage at 59. I am still trying to figure out what blocked my arteries. I think it was the glass of milk I drank daily for 40 years with dinner. Many side effects as I mentioned earlier. Rash, hives, weak, fatigue, nausea, hot throat and eyes, visual disturbances, etc. The final straw was when my hands swelled up like Mickey Mouse and my throat was closing. Allegra helped but the over the counter ones are 180mg, made my heart race, 1/3 of a pill worked. The only way to know if it was the Plavix and not something I caught in the ER was to take matters into my own hands. I stopped taking Plavix for 3 days, by the 4th day felt much better. I took 3 days off, then 2 days on, then 3 days off again to be sure. I wouldn't stop without my Cardiologist's ok. I saw him today after almost 1 1/2 years on Plavix, he said to stop Plavix and take aspirin. I have to say I'm a little scared with all the horror stories but I'm not going take anymore Plavix. If I'm alive in 90 days I'll let you know. Good riddance to that poison. It's like the Roach Motel, You check in, but you can't check out.
Ken, Saginaw, Michigan, USA, August 9, 2012

• J. Eaton in Texas -- When you were discharged from the hospital, you should have been given specific instructions for how long you need to stay on DAPT (Dual Antiplatelet Therapy, which is Plavix plus aspirin). For drug-eluting stents, the recommendations are for twelve months; for bare metal stents, less. However, some feel that with the newer generation of stents, it is not necessary to stay on for a year -- the European counterpart of our F.D.A. just approved a three-month course of DAPT for Abbott's Xience stent (read "Abbott's XIENCE PRIME™ and XIENCE V® Drug Eluting Stents Receive Indication in Europe for Minimum 3-Month Duration of Dual Anti-Platelet Therapy"). As for surgery and Plavix, read over our Forum Topic on that question. But all questions regarding how long you need to stay on DAPT should be addressed to the interventional cardiologist who placed your stent. A recent study showed no downside to having non-cardiac surgery six months after stenting, but showed higher complication rates when that surgery was done earler than six months.
Angioplasty.Org Staff, Angioplasty.Org, August 8, 2012

• I must say that this forum had my attention for over 2 hours last night. I must say all I know is I had a stent put in an 80% blocked LAD that was first diagnosed as lung infection. Doctor was made to do heart cath by my young daughter, thank God. My problem is I do not have all the facts I see everyone here does. I do know Plavix has kept me from having neck injections for a recent fused neck pain and now I have just found out my knee is history and needs surgery. Thus bringing me to your site searching for an answer. My Stent was put in June 2012. How long do I have to endure pain because of the Plavix? Also how do I make a doctor give me the information you all seem to have? I am 52 and fixing to get married again after 6 yrs alone. I want to be pain free and also alive to enjoy the rest of my life.. HELP!!!
J. Eaton, Katy, Texas, USA, August 2, 2012

• Hippy in California -- The "Plavix rebound effect" has been seen in observational studies, but has not been proven to exist in any randomized clinical trial as of yet. Read our post from May 2, 2012 for more info on that. Although again there is no scientifically proven need for or method of weaning off Plavix, some readers and physicians have suggested taking one every other day, for a couple weeks, then one every third day, etc. Again, no proof it helps (or is necessary) but also "it couldn't hurt."
Angioplasty.Org Staff, Angioplasty.Org, August 2, 2012

• Had a TIA in 2005 (No deficits) CT brain scan and bilateral carotid Doppler studies were also normal. EKG normal. Never an explanation of what caused the TIA. Have been on Plavix 75mg for 7 years now. No TIA, chest pain, blood pressure well controlled on Toprol 25 mg., pulse rate strong and regular at 64 (I exercise regularly on an elliptical machine) cholesterol in normal ranges. I am an active 73 year old male with the only complaint is severe right hip pain diagnosed as moderate osteoarthritis. I am preparing for a total hip replacement. I would like to get off Plavix prior to surgery but I am scared of having a rebound effect resulting in an MI or stroke. Since taking Plavix for 7 years I have thrombocytopenia and leukocytopenia. I have had a hematologist do a bone marrow and blood work. He doesn't have an explanation for the low platelet and white blood count. Where can I go, what expert, to tell me how to wean myself safely off of Plavix?
Hippy, Shingle Springs, California, USA, August 1, 2012

• Jack from Cali -- Glad you've gotten helpful information from our site. If you read through the posts below, you'll see that there is a wide spectrum of opinion about how long to take Plavix and aspirin after stenting. We, and many others, believe dual antiplatelet therapy needs to be individualized because every patient reacts to and processes these drugs a bit differently.
Angioplasty.Org Staff, Angioplasty.Org, July 21, 2012

• How I wished I had the knowledge I just gathered from here in 1 hour. I received a stent on my RCA because of blockage caused by a thrombus. Was doing yard work and I over exerted myself I piece of plaque came loose and caused a 100% occlusion. I was put on Plavix aspirin etc etc, and the Dr who performed the procedure told him I had to stay on for a year. However the Dr. on my insurance plan said " for life" How can two Dr. have different views ? Again i wished I had time to study, but hard to do in a hospital bed.
Jack from Cali, Los Angeles, California, USA, July 18, 2012

• Perplexed in Washington. Read our "Drug Eluting Stent Overview" and some of your questions hopefully will be answered.
Angioplasty.Org Staff, Angioplasty.Org, July 17, 2012

• Got a drug eluting stent in an artery after a heart attack recently and should be on Effient for at least a year. My question is: If bare metal stents that were used years ago required only five or six months of using Plavix, why is it that the next generation of stents (DES) require a year or more of the same drugs that are known to have lots of side effects ? Is seems to me that the losers are the patients and the only winners are the drug companies. Can you give me a plausible explanation?
Perplexed in Washington, Washington State, USA, July 17, 2012

• Ira in Nashville -- you should discuss this with your cardiologist. We do not recommend stopping or changing your meds without discussing it with your doctor. Not clear from your post if you are taking these meds after getting a stent or not.
Angioplasty.Org Staff, Angioplasty.Org, July 15, 2012

• HELLO MY NAME IS IRA. I USED TO TAKE PLAVIX AND SWITCHED ME TO EFFIENT BUT I NOTICED THAT I AM STILL GETTING PURPLE PATCHES ON MY BODY AND I AM LOSING MY MEMORY AND HAULLUCINATING. WHAT SHOULD HAPPEN IF I STOP TAKING MY MEDS?
Ira, Nashville, Tennessee, USA, July 12, 2012

• TC in Ontario -- We certainly can't give you medical advice in place of a doctor. We can say that the length of DAPT is a hot topic in cardiology with much disagreement. There is a very large trial going on right now, called DAPT, to determine if there is any difference between 12 months and 36 months of Plavix and aspirin. The good news is that the Xience stents are second generation drug-eluting stents and like other second generation stents (Promus and Resolute) they have shown much less risk of stent thrombosis -- which is the main reason for taking Plavix and aspirin. But you should discuss all the pros and cons with your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, July 6, 2012

• I am 69 F with a dilemma. May/31/1910 I had 2 stents Xience prime ll 2.3 x 38 placed in the proximal circumflex and OM1 (both had total occlusion) and an intervention in proximal lad (50% stenosis). I also had ostial RCA lesion 40% and proximal RCA 60% lesion and other smaller smaller ones (high burden of CAD according to the surgeon). I have learned to live with the meds (Plavix bruising, etc.) and improved my already healthy life-style. I am not overweight, eat heart healthy, I exercise regularly (love cross-country skiing) and I am non smoker. My family doctor told me that I can stop taking Plavix I have been on DAPT since the procedure. He advised me that he has seen studies that Plavix is no longer effective after one year of use. I was delighted to hear it, but had some doubts. I phoned my cardiologist and according to him I should be on Plavix for life, as my situation is risky - however he said I could stop taking Plavix if I wanted to ...If I had known about this situation I would have opted for the bypass I plan to continue on Plavix and to "avoid" operations/accidents. Or is there some different helpful advice/suggestions. Thanks.
TC, Ontario, Canada, June 15, 2012

• Ray in Phillippines -- Six stents five years ago -- hard to say. But if you are having symptoms of angina, and have had a perfusion stress test (not clear if you have) then an angiogram might be the next step -- have you had a perfusion (nuclear) stress test?
Angioplasty.Org Staff, Angioplasty.Org, June 15, 2012

• Hi,i am 56 yrs. old male.... i have six stents, done in Saudi Arabia in July 2007, still I'm taking clopidogrel/aspirin..it's 3 months now i felt chest pain, muscular spasm to my left shoulder and chest heaviness sometimes...i consulted a doctor here in Philippines no sign of heart attack after series of blood/laboratories investigations...he advised me to take new drug {vastarel} and i felt comfortable with very mild pain on and off..my doctor advised me to undergo angiogram again...does this mean that there is an occurrence of stenosis again? is there any problem with the stent?
Ray Villa, Iloilo City, Philippines, June 10, 2012

• Hedy -- you are probably referring to the 2008 observational study discussing a "rebound" effect with Plavix. Read our post from May 2, 2012 for more info.
Angioplasty.Org Staff, Angioplasty.Org, June 10, 2012

• dear sir,I have been on Plavix six years, and low dose aspirin no side effects. what guarantee do I have I will not have a blood clot if I now stop Plavix what long term study is there to prove it is safe to ever stop Plavix because I read there is a"rebound effect" with Plavix thank you.
Hedy, patient, Forest Hills, New York, USA, June 9, 2012

• Tommy K in Indiana -- We had not heard of FruitFlow, but we found the European FSA decision on it here. This body is not the same as the FDA or its European counterpart. The decision, while saying it seems safe, is really based on relatively small studies in very specific populations. There has been no study we are aware of published in a peer-reviewed scientific journal. We would not think it is the equivalent of aspirin in its antiplatelet properties, but there's not much evidence either way. One good thing is that you are 5 months out from your stent, and DAPT is usually considered necessary only for 6 months or so. But you should discuss your Dual Antiplatelet Therapy with your cardiologist and see what he/she says regarding FruitFlow. Print out the information on the supplement and bring it in. He/she may not have heard of it either!
Angioplasty.Org Staff, Angioplasty.Org, June 9, 2012

• I had a bare metal stent put in February 9, 2012. I tried Plavix and aspirin, I am allergic to both of them. I am now on Effient 10mg every other day plus taking 400mg of EPA (fish oil) there is a new product which is called Fruitflow and it has just been approved by the European food and safety authority. “Fruitflow(tm) is scientifically-proven to inhibit platelet aggregation, a known cause of heart attack, stroke and venous thrombosis. It became the first product in Europe to obtain an approved positive health claim under European Food Safety Authority regulations”. (Available at Swanson Vitamins). I am trying to find out if this would be as good as a aspirin regimen.
Tommy K, Crown Point, Indiana, USA, June 6, 2012

• Johanna -- Do you know which brand/model of stents you received in 2007? Having multiple stents in the same artery gives you a higher risk for restenosis, as well as thrombosis. Early cessation of DAPT (Plavix and aspirin) is associated with stent thrombosis, although your thrombosis occurred a couple years after you stopped. You are correct that your stent thrombosis was serious; it is fatal 30-40% of the time. We certainly do not recommend changing/lowering your dosage without discussing this with your cardiologist, especially since you are at risk for thrombosis. You might want to discuss getting a platelet reactivity test or a genomic test to see if you were a Plavix non-responder. That might explain the thrombosis and mght open the discussion to lower your dose of prasugrel, given your reactions to the drug. The new movement in medicine is to tailor therapy to the individual and, in your case, certain tests might guide this therapy (for more about genomic testing, read our interview with Dr. Eric Topol). Unfortunately, the risk of very late stent thrombosis, especially with the first generation of DES, seems to persist, although at a very small percentage.
Angioplasty.Org Staff, Angioplasty.Org, June 5, 2012

• In 2007, I had a heart attack at age 54 and was treated with 6 drug eluting stents in one artery. I was told the artery kept collapsing. The reason for the heart attack was a mystery, as I present as very fit, with no risk factors (except stress). I stayed on Plavix for six months (along with aspirin and some other drugs) but could not stand the side effect of terrible bruising. I also experienced lots of discomfort with these stents, but was told "you can't feel stents". I also developed GERD at this time. In 2010, at a fitness class, I had another heart attack due to a thrombosis at one of the stents. This one was nearly fatal, and I was placed on 10mg prasugrel, in addition to the daily aspirin I already take. I have reduced my dosage interval to every 36 hours, as the bruising and other skin problems are terrible, and this dosage is way too much for me. I am also worried about eventual problems with bleeding the longer I stay on blood thinners. My cardiologist seems to want to keep me on this forever. How long would it be safe to stay on prasugrel (1 1/2 yrs now) and how long after receiving stents does the risk for a thrombosis remain (almost 5 years)?
Johanna, Vancouver, British Columbia, Canada, June 2, 2012

• Architect from Saudi Arabia -- Yes. Concor is a beta-blocker for high blood pressure. Three three drugs are often prescribed together.
Angioplasty.Org Staff, Angioplasty.Org, June 1, 2012

• HELLO,CAN I TAKE PLAVIX, ASPRIN AND CONCOR AT THE SAME TIME.
Architect, Riyadh, Saudi Arabia, May 29, 2012

• Dear Caramba in Israel -- was this operation on the carotid an open surgical procedure (called an endarterectom) or was a stent placed? In either case,you should ask your cardiologist, or the doctor who prescribed Plavix and aspirin to you before stopping. Also note that there has been some observational evidence that suddenly stopping Plavix and aspirin may increase the chance for blood clots (see our post of May 2, below).
Angioplasty.Org Staff, Angioplasty.Org, May 6, 2012

• hi, I had a stroke and was operated twice carotid in my neck, about 16 months ago and since then i take one Plavix and one aspirin. I have to undergo a scs inserting 2 electrodes in my back with a machine that prevents the pain. my question is can i stop the Plavix and aspirin a week before the operation. Thanks for the answer.
Caramba, Eilat, Israel, May 6, 2012

• Retired in Cupertino -- Recommendation after drug-eluting stent is one year of Plavix and aspirin, and aspirin thereafter. This is mainly to prevent blood clots inside the stents. However, a number of cardiologists recommend staying on Plavix as well, unless the patient is not tolerating the drug well. There are concerns that the earlier drug-eluting stents may still have a risk of blood clots beyond a year. There are also benefits to Plavix beyond the specific task of reducing blood clots. So this is a question for your cardiologist. You and your cardiologist together should determine if you should stop Plavix.
Angioplasty.Org Staff, Angioplasty.Org, May 6, 2012

• I had three stents put in left PDA, LRDA, and proximal left anterior descending artery in August 2009. I am taking Plavix since then but stopped aspirin in 2011 sometimes in March due to internal bleeding. In UGI endoscopy multiple linear ulcers were present. Aspirin and Plavix were immediately stopped. Second UGI report did not show linear ULCERS. Plavix was restarted after two months. It is almost two and half years i have been taking Plavix. Aspirin i have totally stopped. Please advise if i need to stop Plavix. Too much of itching causing bruises.
Retired, Cupertino, California, USA, May 3, 2012

• Ken in Michigan -- Interesting. For more information on the so-called Plavix rebound effect, read our report, "Stopping Plavix Doubles Risk of Heart Attack or Death for 90 Days, With or Without Stents." You'll notice, at the end of the article, Dr. Rumsfeld, co-author of this 2008 study, specifically refers to this Patient Forum -- which he and his co-authors have used in their research. Dr. Rumsfeld has since written us that they have documented even more observational evidence of an increased incidence of adverse events in the period right after clopidogrel (Plavix) cessation. But he stresses that they still cannot say that there is a rebound effect -- something that can only be proven with a randomized clinical trial. Some patients and physicians have recommended tapering off clopidogrel, taking a tablet every other day, then every three days, etc. While again there is no evidence that this mat help, Dr. Rumsfeld told us:

"Open questions still remain about whether there is or is not a rebound phenomenon with abrupt clopiodgrel cessation, at least in some patients. Finally, until there is further confirmatory evidence of a lack of a rebound phenomenon, there is no obvious down-side to tapering clopidogrel off once patients have taken their prescribed course."

So there you have it, directly from the investigators who first wrote about the Plavix rebound phenomenon.
Angioplasty.Org Staff, Angioplasty.Org, May 2, 2012

• Betty in North Carolina, Are you still on the Plavix? When I got on it they said I could get off it in one year, now he says another year due to Plavix rebound. So,, what you are saying is that there is nothing you can do about it? Have you seen a Dermatologist? Have you found any relief? Thank You Betty and the Forum Advisor
Ken, Saginaw, Michigan, USA, May 2, 2012

• Betty in North Carolina -- Just a point of fact: the polymer coating on a drug-eluting stent doesn't wear off. It is permanent. What does happen is that the endothelial cells in the body start to cover over the coated stent. Once that is complete, it is thought that Plavix can be stopped, because the stent is "healed" and no longer in contact with the blood.
Angioplasty.Org Staff, Angioplasty.Org, May 2, 2012

• To Ken in Saginaw, Michigan: My allergy started up one year after I had the stents. I think it is when the coating wore off the metal. I had 2 stents in 4/10, allergies started in 4/11, worse of all in 4/12 my back - like hot coals on it, like a hot iron from the inside.. Good Luck!
Betty Boop, Sr., Cary, North Carolina, USA, May 2, 2012

• Ken in Michigan -- Are we correct in assuming that the rash started mid-February 2012?? In that case, we would agree with your cardiologist that it probably isn't connected to Plavix or aspirin, since the rash didn't show up for almost a year. Sometimes it takes a while for an allergic reaction to manifest, but that's usually a couple of months, not a year. The fact that the rash's appearance coincides with your visit to the ER would steer us to think that you may have contracted some type of infection, or dermatitis there.
Angioplasty.Org Staff, Angioplasty.Org, May 1, 2012

• I had an MI March 23, 2011. I have been on Plavix and 81mg Aspirin until my one year follow up, when the Cardiologist took me off the aspirin because I was complaining about a rash on my back. Being off the aspirin did nothing for the rash. It feels like someone is putting out lit cigarettes on my back. The bumps are deep below the skin and there are a lot of blisters. None of it is red. Going to a skin Dr. in a couple days. I have seen 5 doctors about it. I came down with the rash 2 days after being in the ER from my blood pressure going up to 205/150 from taking Alka Seltzer Plus for a bad cold. This is one of the most painful things I have ever had happen to me. The only time I ever had worse pain is from a motorcycle wreck and broke over 20 bones. Could the Plavix cause tiny pustules with blisters,, all clear, or maybe milky color? It is mostly the upper R quadrant of my back, to the wing bone and hurts deep. Same texture as a country road. I have had this rash for 2 1/2 months and it's not getting any better. I call the cardiologist and they just blow me off. They say it's not related to Plavix. I don't believe them. Any input would be really appreciated
Ken, Saginaw, Michigan, USA, May 1, 2012

• Aya K. in Palestine -- Plavix and aspirin are both antiplatelet drugs -- blood thinners -- and they are very important to take to keep blood clots from forming inside the stent, potentially fatal. However, antiplatelet drugs do have a side-effect of bleeding, and you mother is clearly having that problem. There are drugs, called Proton Pump Inhibitors (PPI) that can alleviate some of the gastric problems. There has been some concern that these drugs lessen the effect of Plavix, but the jury is still out. See our Editor's Blog, PPIs and Plavix -- Confusion Reigns Supreme. In any case, talk to her cardiologist about these issues. Hope this helps a bit and your mother's problems get resolved.
Angioplasty.Org Staff, Angioplasty.Org, April 30, 2012

• Aya Palestine- hi my mom had a history of peptic ulcer dz with recurrent attacks of UGI bleeding. 2 months back she had a PCI and she was on Plavix. Today she developed another attack of bleeding >>>> what to do ????
Aya K., Palestine, April 29, 2012

• Big Mac -- Check out our Forum Topic on Exercise, Sport, Physical Activity After Stent. There are a number of runners, etc. there. Also, although it's a different type of stent, look at Abdominal Aortic Aneurysm (AAA) Stent Grafts. As for future surgery, it depends what type, but, if you get a drug-eluting stent, the recommendation is to stay on antiplatelet drugs Plavix and aspirin for one year. Stopping before then, even for a week or two, may increase the risk of stent thrombosis, a blood clot inside the stent, which can be very serious, even fatal. Check out our Topic on Plavix and Surgery for more info there. A recent study did show the possibility of a new antiplatelet drug that is a quick on-off, called cangrelor, that could be used as a bridge for surgery in situations like this, but it's not yet approved in the U.S.

And Annie in Iowa -- The main adverse effect of Plavix (or any antiplatelet med) is bleeding. And, of course, cost. What type of stent did you receive?
Angioplasty.Org Staff, Angioplasty.Org, April 29, 2012

• I found out I was allergic to aspirin after about 2 months of taking it following receiving a stent. I now have to stay on Plavix forever. Are there any harmful effects? I also take blood pressure meds, a beta blocker, and cholest. meds. BP: 112/60 Cholest. 134.
Annie, Iowa, USA, April 26, 2012

• I am taking Plavix and 81mg aspirin with two stents coming for insert in three days. My concerns is future need for surgery and the need to go off these blood thinners, how to manage this, risks, etc. The other interest is that I am a marathon swimmer and looking for comments on endurance training and these drugs, including Crestor. Check our my blog One Stroke at a Time, on Google.
Big Mac, One Stroke at a Time (Swimming not heart), Barrington, Illinois, USA, April 24, 2012

• Otto in the UK -- research has shown that a small number of patients in clinical trials (around 3%) have reported fatigue as a side effect of clopidogrel (Plavix) so you may be in that group. And, if you are, the 300mg loading dose might have accentuated it. Plavix is, as you know, an important drug that reduces complications of thrombosis, or blood clotting, during angioplasty and stent placement -- and needs to be continued for a year after drug-eluting stents implantation. The fatigue may be short lived -- you'll have to see. There are also alternatives to clopidogrel, namely ticagrelor (Brilinta) and prasugrel (Effient) which may or may not have the same side effects. The main complication with any of these antiplatelet drugs is bleeding, and we're assuming you are not having any internal bleeding that might cause weakness and fatigue -- a standard blood count would show this up. And we're glad to hear you cardiologist is using the pressure-wire. We have written extensively about the use of Fractional Flow Reserve and how it can aid in decision-making and improved outcomes.
Angioplasty.Org Staff, Angioplasty.Org, April 21, 2012

• I'm due to have an angioplasty next week and probably can expect up to 3xDES depending on pressure wire results. I was started yesterday on Plavix with a loading dose of 300mg and a daily one of 75mg. My reaction to this was some tiredness and a feeling of fullness along with shortness of breath. I do a great deal of singing, and the immediate effect has been that a breath lasts just over half the time it normally does. This is of concern to me since I perform in public, and the dog only got half the normal walk this morning as I'd had enough. I've been pushing my food round the plate as I'm not hungry, which is probably no bad thing as I could do with losing a few pounds!I can't find any reference to any of these side-effects for Plavix, and when I phoned my doctor, he had no more clue about it than me. Are these recognised side-effects and are they short lived? If not, I shall be a breathless stick insect in the fullness of time!
Otto, Wiltshire, United Kingdom, April 19, 2012

• I had 3 DES inserted May 2010. The cardiologist that put the stents in my arteries had me on Aspirin 325mg & Plavix every day. New cardiologist I saw in 2011 reduced my medications to 81mg ASA & Plavix daily. Beginning 2012 it now had been almost 2 years, I switched to Plavix every other day on my own & still take 81mg Aspirin every day. The 25 mg tablet of clopidogrel is available in Japan, it helps the Japanese cardiologists find the best dosage for individual patients with the least risk of bleeding and thrombosis
Julian Phong, Honolulu, Hawaii, USA, April 17, 2012

• Merri in Florida -- Sensitivity to bruising is a known side effect of any blood-thinner (both Plavix and aspirin are in that category). Basically these drugs keep your blood from clotting, so small capillaries near the surface of the skin don't clot when impacted in any way, leading to "easy bruising". While it is known that early stopping (before one year) of dual antiplatelet therapy (called DAPT, basically aspirin and Plavix or equivalent) can increase the risk of stent thrombosis, there's no evidence yet that staying on DAPT beyond one year has benefit. That doesn't mean, however, that there isn't a benefit; it just hasn't been proven. There is a major trial of 20,000 patients in process (called, of course, the DAPT trial) which will compare outcomes at 12 months and 30 months, but results for that won't be in for several years. Your cardiologist is being cautious...also, the risk of stent thrombosis can vary from case to case, affected by the patient's "platelet reactivity level", the number of stents, length, diameter and specific location of the stents, etc. We suggest you discuss this issue with your cardiologist and ask him/her about the risks/benefits of staying on DAPT.
Angioplasty.Org Staff, Angioplasty.Org, April 4, 2012

• Hello, I have been on Plavix and 81mg aspirin for two years after DES. Cardiologist advises to continue this regimen, although says it's okay to reduce Plavix to 3x a week due to frequent bruising. Since the guideline is Plavix for one year, why do some drs say to continue? Is there a benefit to the reduced dosage? Primary care dr says it's probably the aspirin causing the bruising. What is the guideline for aspirin? Thanks!
Merri, Florida, USA, April 4, 2012

• Yes. My father's cardiologist believes it is due to Clopidogrel and aspirin (caused by both of them individually and together). He was recently taken off Clopidogrel and put only on Aspirin dose and the ulcers continued. He was then put on only Clopidogrel and taken off aspirin but the ulcers still continued. He was taken off both for 3 days and the ulcers vanished on the 4th day. He is coming very close to 1 year period so he will be off DAPT but starting next Monday he will have to be put back on Clopidogrel.
A Desai, India, March 28, 2012

• TNBubba in Tennessee -- check out our topic on Plavix and Surgery. Guidelines recommend one year of dual antiplatelet therapy (DAPT, usually aspirin and clopidogrel). Premature cessation of DAPT is associated with an increased risk of stent thrombosis (blood clotting inside the stent). Most surgeons ask their patients to stop taking blood thinners before surgery, but in the case of stent patients, this is not a good idea. It is recommended that elective surgery be deferred until after the one-year period. You should have your cardiologist and surgeon talk to each other and determine the best way forward for you.
Angioplasty.Org Staff, Angioplasty.Org, March 27, 2012

• If I am having a non-cardiac procedure done less than 1 year after having a drug eluding [eluting] stent placed, should my hospital have a cath lab available to rescue me if I develop chest pain perioperatively?
TNBubba, Tennessee, USA, March 27, 2012

• A Desai in India -- Does your father's cardiologist think that the oral ulcers are being caused by the clopidogrel or aspirin? Bleeding can be a side effect of these drugs, but it's possible the ulcers may be caused by something else completely unrelated to the drugs or his heart disease (for example, there is a strain of herpes that causes such problems). He is near the recommended 12 month mark for dual antiplatelet therapy (DAPT) so removing the drugs may be possible, but we would think that your doctors need to determine the cause of these ulcers before making any decisions.
Angioplasty.Org Staff, Angioplasty.Org, March 26, 2012

• My father (72 years) had a heart attack in April 2011 and as a result he had a DES placed in LAD. He has been on Aspirin and Clopidogrel treatment since then. However since August 2011 he started ulcers in his throat and mouth (cheek, gums, tongue, everywhere inside mouth). It started slow but now it is just getting intolerable for him. He now cannot eat anything solid from last couple of months because of the pain ulcers cause and he is getting into a very bad mental state (being very depressed and talks about dying all that time to get rid of the pain). His cardiologist has now put him on only Aspirin 300mg dosage (no Clopidogrel) from last 3 weeks. And it has still not helped with the ulcers. Is there anything that can be done about this? I know Prasgurel metabolizes differently so could be used. However, it increases the risk of bleeding in older patients (75 or more). Correct? Is Ticagrelor the answer?
A Desai, India, March 14, 2012

• Judy in Florida -- We always tell patients to consult with their cardiologist BEFORE changing or stopping any medication, no matter what another doctor may ask them to do. If you were taking Effient because of a drug-eluting stent placement, the guidelines states that patients need to take Effient or Plavix and aspirin for at least one year. So, while you are past that point, you should call your cardiologist about the Effient. It may be fine to have stopped, but only he/she is in a position to make that recommendation. And good luck with the surgery.
Angioplasty.Org Staff, Angioplasty.Org, March 7, 2012

• I had a heart attack in December 2010. My cardiologist put me on Effient. I have an upcoming Thyroid surgery. I stopped taking the Effient...is that okay?
Judy, Crestview, Florida, USA, March 7, 2012

• PR in Chicago -- It's amazing to us that five years after this issue was dealt with in a joint "Science Advisory" by six major professional medical groups, such as the AHA, ACC, SCAI, ACS, etc., physicians still have not yet gotten the message! Patients who are on dual antiplatelet therapy (DAPT) after implantation of a drug-eluting stent need to stay on that therapy (aspirin plus clopidogrel, prasugrel or ticagrelor) for a year and surgeries or elective procedures should be delayed until after that time. In any case, patients should not stop and their non-cardiologist doctors should not require them to stop DAPT because the danger of stent thrombosis is significantly increased by early cessation of DAPT...and stent thrombosis is fatal 30-40% of the time. That being said, your cardiologist may feel it is safe to stop in some cases where the risk of stent thrombosis is lower: long stents, multiple stents, overlapping stents, complex anatomy -- all these are higher risk situations. We think that stents in your bypass grafts (if that's where they are) would be included in the high risk subset. If the colonoscopy must be done before August 2012, perhaps your cardiologist can devise a "bridging strategy" with a different drug. A recent paper showed that Cangrelor, a fast acting antiplatelet drug, might serve as a bridge for cardiac surgery, so that the time for loss of antiplatelet therapy and the risk for bleeding are both minimized. See "Bridging Antiplatelet Therapy With Cangrelor in Patients Undergoing Cardiac Surgery". What brand of stent and how many stents were implanted?
Angioplasty.Org Staff, Angioplasty.Org, February 27, 2012

• I had a CABG in 2007 and stents placed in August, 2011. I have been on Plavix since my CABG. I now need to have a colonoscopy and the GI told me to go off Plavix for 3 days prior but my cardiologist says no, I can't go off Plavix. I am worried about what happens if there is a problem and I bleed. I have asked the my doctors what the plan would be and they told me not to worry that won't happen. Problem is I work in medical malpractice insurance company in the claims department so I know this does happen even in the absence of negligence. I need some reassurance.
PR, Chicago, Illinois, USA, February 27, 2012

• Discuss with your cardiologist about cilostazol as substitute of or in addition to aspirin/Plavix after coronary intervention and/or stent.
Julian Phong, Little Rock, Arkansas, USA, February 26, 2012

• David S in California -- Bruising is a side effect of Plavix. Muscle pain can be a side effect of statins, e.g. Crestor. Plavix is recommended for a minimum of one year after drug-eluting stenting in order to allow the metal stent to be covered by endothelial cells and to prevent blood clots inside the stent while this happens. Although the Endeavor stent has shown very high safety and rapid healing (coverage of the stent struts) whether or not to stop taking Plavix (or any other drug) is a decision you need to make WITH your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, February 26, 2012

• I had 5 Endeavor stents put in 1 year ago. I currently take Plavix, aspirin, Crestor, naispam. The last month the top of my hands started to hurt and my right hand now is bruised and hurts a lot. Do you think Plavix could be the cause? I want to stop taking the Plavix Is that safe?
David S, California, USA, February 24, 2012

• Ahmed in Egypt -- Our Forum cannot recommend anything, but the U.S. (and European) guidelines are for one year of aspirin and Plavix or Effient and drug-eluting stent.
Angioplasty.Org Staff, Angioplasty.Org, February 19, 2012

• for how long you my respectable Dr recommend to treat the patient with Aspirin after using the multiple drug trio stent ?
Ahmed K, Egypt, February 19, 2012

• Wes in New Jersey -- Check out our Forum Topic on "In-Stent Restenosis". Curious what brand stent was used the first time? And which one was the second?

And Betty M in North Carolina -- Not sure whether the stent could be causing an allergy if the first symptoms did not occur until mre than a year after implantation. Curious as to what the allergist tested you for? The metal in the stents? And what brand of drug-eluting stents did you receive? See our Forum Topics on "Allergic Reactions After Drug-Eluting Stent (DES)" and also "Metal Allergies to Stents."
Angioplasty.Org Staff, Angioplasty.Org, February 19, 2012

• In April 2010 I had 2 drug eluting stents implanted. In May, 2011 I started getting a burning in my back which gradually intensified. Discussed this with Cardiac docs and primary care docs but after numerous blood tests and x-rays, they had no results. I went to an allergist and found I am allergic to the stents. He has no treatment for me. Does anyone have similar experience? I need help badly.
Betty M, North Carolina, USA, February 19, 2012

• I had a DES stent inserted 1 year ago. because of the build up of endothelial cells i just had another stent inserted inside the first. i was and remain on Plavix and am moving from 81mg to 325mg aspirin. the chance of the first stent clogging was 5% what is the chance of the second clogging? i feel it must be greater because of my bodies tendency to produce excess endothelial cells as indicated by the first stent clogging.
Wes, Freehold, New Jersey, USA, February 15, 2012

• Sue R in Florida -- Guidelines are Plavix (or equivalent) and aspirin for one year following drug-eluting stent (DES). This is called dual antiplatelet therapy (DAPT) and is important to prevent blood clots inside the stent. Bruising can be a side effect of antiplatelet therapy (a.k.a. blood thinners). You are on triple therapy because of your valve and you are correct that there are varying opinions on this, to say the least. This is definitely a topic for you to discuss with your cardiologist. There really have not been large scale studies on this issue. The guidelines for Plavix and aspirin have the caution that one year is recommended, if no bleeding complications occur. Whether or not the bruising is a serious issue is something you should decide together. Depending on the type of stent, the length and diameter of the stented area and the anatomy of the artery, your risk of stent thrombosis (blood clotting) may be higher or lower than average.

And Romeodt in Wisconsin -- blood thinners, or more specifically antiplatelet drugs, are important after stenting because they can prevent a blood clot forming inside the stent. For bare metal stents, only 4-6 weeks is required, but still your liver may not be able to tolerate that dose. There might be an option of angioplasty without stenting (known as POBA, or plain old balloon angioplasty) -- the recurrence rate is 40% or more, but that may be a path to explore. Our advice is to have your cardiologist and surgeon talk to each other and try to resolve this Catch-22.
Angioplasty.Org Staff, Angioplasty.Org, February 15, 2012

• Is it absolutely mandatory that blood thinners be taken after angioplasty? Are there any other options? I need 2 Stents put in me, but I cannot take blood thinners as I have cirrhosis of the Liver. And I can't have a Liver transplant until I have Stents Installed. Talk about a catch 22! Are there alternatives to taking Blood thinners?Thank you for any advice or information.
Romeodt, Green Bay, Wisconsin, USA, February 14, 2012

• I recently had a circumflex stent implant (drug eluding) and I am taking Plavix, Adult strength aspirin in addition to Coumadin (lifetime regime for an artificial mitral valve). I am experiencing a large amount of bruising on my arms. I would like to know the recommended drug therapy for someone who is already taking Coumadin. There seems to varying opinions on how long the Plavix/Aspirin regime should continue.
Sue R, Delray Beach, Florida, USA, February 13, 2012

• Cramping is not a normal side-effect of Plavix -- the cramping could be related to the peripheral artery disease that your mother was treated for. Have you discussed these issues with the physician who did the stenting procedure??
Angioplasty.Org Staff, Angioplasty.Org, February 9, 2012

• Mom had stent in left leg 3 wks ago on placid [Plavix?] has been in hospital 3x's since. On Plavix has Severe cramping starts in leg and progresses thru entire body. Took placid few yrs back for stent and had to be taken off because of rash and itching. Doesn't itch or have rash now, could placid still be the culprit..she is in the ER as I write this. 81 yrs old relatively good health otherwise.
Mary in Florida, Titusville, Florida, USA, February 9, 2012

• Rick in Phoenix -- Bleeding and bruising is a well-known adverse effect of Plavix (clopidogrel). If you are suffering from anemia, it would seem that Plavix might be suspect. Talk to your doctor about why you are on Plavix and whether or not you can go off it.
Angioplasty.Org Staff, Angioplasty.Org, February 9, 2012

• I did not have any stents or bypass surgery and have been on Plavix for three years now. I bleed all the time and I have developed a serious case of anemia for which my doctors at the VA cannot determine a cause. I have to carry New Skin and Band-Aids with me everywhere. I feel like a hemophiliac. I can be standing there talking to someone and a pore with open up under my shirt or on my face and just start bleeding. People are often concerned with my health. I don't know what to do.
Rick Lindroos, Phoenix, Arizona, USA, February 8, 2012

• Some cardiologists feel that taking Plavix and aspirin indefinitely can prevent stent thrombosis. Clinical data are not definitive on this. However, there are other beneficial effects from these drugs for heart patients, asuming there are no adverse reactions. Your concern about lifelong Plavix is a conversation you should have with your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, February 6, 2012

• I had 2 stents put in one artery 8 years ago and have been taking Plavix (75mg) and aspirin (81 mg) since. My cardiologist is making me understand I'll always be on this regimen. I take BP medication, and Simvastatin also. My concern is the Plavix, and aspirin for the rest of my life. Is this common?
Susan C., Brooklyn, New York, USA, February 6, 2012

• I had 2 bare metal stents 4/11 and took Effient for 7 months of hell. swollen lips, burning ankle, continual rash,& sore mouth. I went to Plavix for a month and the same results. After stress test pics showed an anomaly, catheterization indicated restenosis in both stents. Medicated stents were inserted into the old stents and I was put on Brilinta and after several days the same ill effects are present. Am I to expect this hell for the rest of the time required to take these pills? Am I the only one to experience this type of side effects?
Clark, Retired, Palm Beach Gardens, Florida, USA, January 22, 2012

• Serious side effects in New Jersey -- Clopidogrel (Plavix) is known to cause bleeding as a side effect in some patients, so it's important to monitor blood counts, etc. in those patients. Gastric upset is another side effect -- there are other drugs available beside Plavix (Ticlid, Effient, Brilinta) but they too have similar side effects. The recommendations are that patients should be on dual antiplatelet therapy (aspirin plus Plavix or equivalent) for a year after drug-eluting stents, provided they are not experiencing adverse effects from the drugs. The decision on how long is a risk-benefit decision on weighing the risk of a stent thrombosis (blood clot in the stent) vs the adverse effects of the drugs. By the way, Plavix doesn't prevent restenosis (reblocking of the stent with tissue) per se -- it helps prevent blood clots -- these are two different things.
Angioplasty.Org Staff, Angioplasty.Org, January 15, 2012

• 2 weeks after a medicated stent placement and taking Plavix my mother developed severe stomach pains and vomiting. This has been going on for 9 months. My mom lost 70 pounds. After 2 endoscopies and bleeding from stomach biopsies she was admitted to hospital. Gallbladder had stones so we thought that might cause vomiting after meals. MD took her off Plavix for surgery and miraculously the vomiting stopped and she was able to eat for the first time in 9 months. Well her surgery was cancelled, echo cardio test was not good. They put her back on Plavix and Toprol and the stomach pain started again. I believe the medications are causing side effects, plus the stent closed 40% while being on Plavix. I wish she could just take ASA. I think the Plavix is killing her. And the cardiologist will not take her off the drug for 12 months. Meanwhile she has to stay with this gallbladder and stomach pain. Now they suspect a intestinal ischemia .What's next, more weight loss and vomiting...I am frustrated ..what do u think...?
serious side effects from plavix...vomiting , Nurse at Robert Wood University Hospital, Bayonne, New Jersey, USA, January 15, 2012

• Thank you for your response. I have an appointment with my Cardiologist on 6th February 2012 (I am having my annual Stress Test.)I would discuss it with him again (Taking Plavix)
kalip, Florida, USA, January 14, 2012

• Kalip in Miami -- current recommendations and guidelines from all major cardiology professional societies, as well as the FDA, are for one year or more of DAPT (e.g. Plavix and aspirin) following implantation of a drug-eluting stent, unless the patient is not tolerating the medications (for example, is experiencing bleeding complications). This is in order to minimize the possibility of stent thrombosis (blood clotting inside the stent). Although stent thrombosis has been seen past the one-year mark, it is not clear whether Plavix can prevent that beyond the one year mark. There is, in fact, a major trial going on right now to determine this. However, there are a number of other reasons why Plavix (clopidogrel) is prescribed and can be beneficial to heart patients. You should ask your cardiologist why he is prescribing it to you, so you understand the reasoning.
Angioplasty.Org Staff, Angioplasty.Org, January 13, 2012

• I had angioplasty and had two cypher stents inserted in my LAD in June 2004 I have been taking Plavix ever since. I read online that the use of Plavix is normally discontinued after a year or two.( it is now going into 8 years). However Cardiologist and he said I would have to be on Plavix indefinitely (for the rest of my life). Is it normal to continue taking Plavix indefinitely after stenting?
Kalip, Miami, Florida, USA, January 13, 2012

• Ada in Florida -- A person can overdose on almost any medicine. What makes you think she did and what were/are her symptoms? The normal dosage is 75mg/day, although in some cases 150mg or more have been administered for short periods.
Angioplasty.Org Staff, Angioplasty.Org, January 10, 2012

• Can a person overdose on Plavix? I think my mom did.
Ada, homemaker, Lakeland, Florida, USA, January 10, 2012

• I am seeking answers to a couple questions. I underwent a cardiac cath a week ago that turned out clean, chest pain with nausea, shortness of breath, dizziness and near syncope continues. My cardiologist have been pressing me to start Plavix and aspirin because I am a Type I diabetic of 43 yrs. and the cardiologist states that I have "micro vascular" disease. Now, my question is, is Plavix/aspirin necessary? My last two EKGs reported left axis deviation greater than -60, ST/T wave abnormalities, a new finding since 2008. Does any of these findings warrant Plavix/aspirin? Diabetics already have fragile vessels; I am worried about an intracranial bleed. Is anyone else in this position. Thanks
JadedRN, Lexington, Virginia, USA, January 9, 2012

• Angioplasty.Org Staff, I'll give it a couple weeks and if they haven't subsided will get with the card. thx for reply....
Hackbagger, Milwaukee, Wisconsin, USA, January 3, 2012

• Hackbagger -- The question is whether or not the pains you are experiencing could be called angina (men and women experience this differently, and everyone has a slightly different description). Have you had any type of perfusion test, like a nuclear stress test, to see if there is any deficit of oxygen feeding the heart muscle?? This might indicate either a re-narrowing of the artery, or a progression of disease elsewhere. But the pain would not be from stopping Plavix -- the fear there is one of late stent thrombosis, a sudden clotting of blood inside the stent. It's very rare, and it is also an acute event -- it doesn't come on slowly. There are also relatively rare reports of hypersensitivity to the stent polymer -- see our topic "Allergic Reactions After Drug Eluting Stent (DES)" -- what type (brand/model) of stent did you receive?? As for stress, if you see a cardiologist and rule out a progression of disease, that would certainly help relieve any stress. Let us know what you find out.
Angioplasty.Org Staff, Angioplasty.Org, January 3, 2012

• i had three med stents inserted in late 2009 and was put on Plavix and aspirin for a year. i then volunteered to participate in a clinical (blind) study after the one year mark. placebo or Plavix AND adult aspirin. I'm now at two year mark and am having some odd issues. a moderate cramp like pain in right front shoulder that moves around to back and across chest into left arm..never right arm. if i recline or lie on my left side i get a pretty good pain in right upper chest when taking a deep breath. now it seems to have settled into the front of my chest on both sides and is more of a pressure type pain that comes and goes. DR's are stymied after MRI/X-rays blood tests etc. no evidence of heart attack, masses. I'm certain I had Plavix for quite awhile (after a year) since i was bruising easily, bleeding etc. I'm no longer noticing bruising or bleeding so I'm thinking that the study has stopped Plavix and started placebo. could these odd pains be a result of that occurring? blood pressure is up, night sweats occ, achy left arm sometimes weird stuff. three regular md's...no solution. one told me it was stress..not buying it...
Hackbagger, Milwaukee, Wisconsin, USA, January 3, 2012

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