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Plavix, Effient, Aspirin and Stents (2005 archive)

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What is 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?

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Archived Postings from 2005 on This Page (52):

• How is the wife with blockage in brain doing? Did they put her on plavix? Did she get the stent? Did she have a stroke? Was there white matter visible in the MRI and How much blockage does she have? Thank you in advance.
Monique, daughter, Houston, TX, USA, December 19, 2005

• My mother was prescribed plavix after a stent procedure. The doctor emphatically states the need for use. Six weeks after the procedure, she swears she feels MUCH worse than before--EXTREME weakness & unbearable joint/back pain (had to see an orthopaedic doctor), always sick at her stomach, VERY, very depressed. Why didn't the doctor have her use plavix for more than one week prior to the stent to check possible side effects first??? What do you do?? Help!!
Kristy, concerned daughter, tulsa, OK, December 13, 2005

• Last year I had 7 drug coated stents installed in my left decending conary artery.druing the instlation process my artery kept disecting, each time causing the need for another stent to be placed inline, all during this time I was having a heart attack, that lasted 3 hours, I was placed on plavix 75 Mg & asperine 325 mg daily. So far it's working!
John Paul, self, new jersey, December 10, 2005

• I had a terrible rash on my groin, arms and arm pits due to plavix. They put me on Ticlid and I have not been feeling well. I now notice pin dot rash on my palms. What medication is next? I had two Cypher stents placed in October with another to be placed in two weeks
Lew, New York, New York, November 18, 2005

• Dee, you've hit on a controversial topic -- we just attended a symposium at this year's TCT that discussed this situation and one of the interventional cardiologists on the panel reported having this argument with his wife all the time -- she's a surgeon! This is a call that must be made by the surgeon doing the procedure in partnership with the cardiologist who has placed the stent and prescribed the antiplatelet drugs -- the sense seems to be that if the surgeon is aware of and able to manage the possible bleeding complications, he/she should not stop the Plavix/aspirin because going off the antiplatelet therapy, especially if drug-eluting stents were used, can increase the risk of stent thrombosis (which can result in infarction -- heart attack). The length of time since the stenting is also important. However, no one, especially on the internet, can say which way to go. This decision must be made by the medical professionals who know the patient and have all the patient's records in hand. Just make sure they talk to each other -- sometimes not an easy task. Many non-cardiology physicians are not aware of the critical importance of coninuing antiplatelet therapy after drug-eluting stenting. Good luck, and please let us know what happens.
Angioplasty.Org Staff, Angioplasty.Org, November 11, 2005

• My husband is on plavix and aspirin with two cardiac stents due to blockage. He was recently diagnosed with an irregular prostate and needs a biopsy. Can he come off the plavix for this procedure and if not, what are the alternatives?
dee scarpellino, reg. nurse, gaiensville, georgia, usa, November 11, 2005

• Ex-husband was taking 80mg Zocor, Cardiologist found three blockages, 2,80% and one 70%. Stents were put in the two *80% and balloon used in the 70%. After he was told by the Cardiologist to take 75mg. of Plavix and 325mg aspirin, but not to take Zocor, his Primary Dr. told him to stay on Zocor. Cant figure this out, one says take Zocor the other says not to. Help!
Kathy, Texas, November 07, 2005

• My mother had an inferior wall MI on 22nd March 2005. Angiography showed two blockages - RCA 99% and LAD 70%. PTCA was done on 5th April 2005 with Taxus 3.5 X 30 in RCA and Cypher 3.0 X 18 in LAD. She was prescribed Clopidogrel 75 mg twice a day, Aspirin 150 mg twice a day along with blood pressure and cholesterol lowering drugs. After 3 months Aspirin 150 mg dosage was reduceds to once a day. After 5 months, around 4th Sept.,05, my mother had inflammation on the knuckles of the hands and the feet and was accompanied with severe pain. I spoke to the cardiologist and he advised that the dose of Clopidogrel 75 mg be reduced to once a day. After doing that, the pain reduced a bit but the inflammation was still present. I looked up in the net and came across two articles of BMJ.indicating arthritis like symptoms being induced by Clopidogrel and Ticlopidine. I informed the cardiologist about this and since he was not aware of any such side effect in any of his patients, he advised us to continue clopidogrel till atleast 9 months since PTCA. The pain would not go away and after consultation from two orthopaedic surgeons we were told that the symptoms are not the signs of any new joints disease and is most probably a side effect of a drug. We also saw two black patches under the skin one on the hand and one on the leg. We decided to discontinue Clopidogrel and observe. In a about 7 days after discontinuing Clopidogrel the black patches disappeared and the pain and inflammation reduced substantially. Apart from the small joints the pain had also started to occur in the right elbow and left shoulder before we discontinued Clopidogrel. After 7 days we started Clopidogrel 75 mg once a day. After 4 days of continuing this dosage the inflammation and pain returned and after the 5th day we stopped Clopidogrel. After 11days of being without Clopidogrel we spoke to the cardiologist who advised us to take Ticlopidine 250 mg twice a day instead of Clopidogrel. After 4 days of starting Ticlopidine the small joint pains increased a bit and I could see a small red spot of 3 mm dia below theskin of the left feet of my mother. I spoke to the Cardiologist and he asked us to continue taking the medicne and said that the joint inflammation is probably another disease. On the 7 th day of taking Ticlopidine my mother had pain in both her knees which was bearable. After 12 hours of this beginning of pain, the pain had become severe and my mother had to use a stick to walk (which she never had used). She took the one Ticlopidine 250 mg even at this stage. After 1 hour of this, she also had headache. This was post dinner and she could not sleep wel that night. We decided to discontinue Ticlopidine. The pain was there the whole of the next day and night. She had pain when she would be trying to bend her knees or trying to get up or sit down. The pain in her elbow nad shoulder which had started at the time of taking clopidogrel also turned severe. I also noticed a black patch under the skin of her right leg above the knee. After two days of discontinuing the medicine the pain started to reduce and today after 8 days of discontinuing Ticlopidine, the pain is still there but has greatly reduced. My Mother's age is 59 and she is 64 kgs in weight and 5 feet in height. It seems that she is hyper sensitive to both Ticlopidine and clopidogrel. The cardiologist says that it is very important to continue taking this drug till atleast 9 months post PTCA. Is there an alternative to Ticlopidine/ Clopidogrel which could be prescribed for my Mother at this stage. What would be the outcome of discontinuing these drugs? I would be greatly thankful if someone could find a solution to this problem.
Ramesh Shukla, Mumbai, India, November 05, 2005

• Prior to having had two cypher stents fitted I was on... 75 mg Aspirin 40 mg Simvastatin 10 mg Nicorandil 5 mg Bisoprolol Post stenting I dropped to 2.5 mg Bisoprolol (to reduce the tiredness) and started 75 mg Plavix. After a few weeks I dropped the Nicorandil and started on 2 mg Perindopril, with the intention of increasing the dose if I can take it. I have a bit of dizziness, tend to feel the cold more, bruise very easily and have a metallic taste in the mouth. None of this is unbearable, just an embuggerance.
M.P., Shropshire, United Kingdom, November 04, 2005

• I am a 67 year old male . Eighteen months ago I told my Dr I had neck and back pain but I was still in good shape strong as an ox and working hard .I took a stress test and they told me I had a blocked artery but I was never short of breath. The hospital then did an angioplasty and put in place three stents in my RCA which was completley blocked, the cardiologist said the chances of the stents closing up was high but he also said what is in your faviour is the fact you have very larg arteries. All this was in June 2004 and I am still on Plavix 75 Aspirin 100mg Coversyl 2mg Minax50mg and Lipitor 10mg and have no side effects do not bruse and all this never cost me a penny --Good onya Oz
William Davidson, Taree NSW Australia , November 03, 2005

• Regarding my mother and lack of Plavix with stent. Upon admission to the hospital she was presented with the option of participating in a double blind Plavix and an investigational drug study. We opted not to participate in the study due to recent medical problems with my father, need to travel some distance for the followup evals and the fact that they usually leave to head south for the winter. The request to participate in the drug comparison study and then no Plavix was a pretty clear tipoff. Thanks for your timely response.
David B, son, Lincoln, NE, November 02, 2005

• David -- good work! We've discussed often on this site the crucial importance of Plavix/aspirin antiplatelet regimen after implantation of a drug-eluting (a.k.a. medicated) stent. The reason it's used is to keep thrombus or blood-clotting from occuring inside the stent (platelets in the blood see a foreign object like a stent and tend to start gathering to cover it). We don't know what, if any, effect having a four-day non-treatment occur. We do know that a "loading dose" of 300mg of Plavix is often given to the patient 4-8 hours before stent placement. Recent studies have shown that an even higher loading dose of 600mg is safe and effective, and results in better outcomes. It may be that because this was an emergency procedure, there was no time for the Plavix loading dose. We're curious as to how you knew or where you learned about the need for Plavix after stenting?
Angioplasty.Org Staff, Angioplasty.Org, November 1, 2005

• My 80 yr old mother who was active and in good health (on no medications for anything) had a heart attack last Wednesday. On Thursday they placed a medicated stent, 28mm to open an 80% blockage of the LAD. She was discharged and 3 days later I discovered she was discharged on crestor, beta blocker and 325 mg Aspirin but no Plavix. Contacted Cardiologist office and found that they had messed up in not sending her on Plavix. She was contacted by the Cardiologist office to take four Plavix today and then one a day beginning tomorrow. Any consequence of this that we should watch for or be aware, including both the lack of Plavix initially and the four Plavix on the first day? Thankyou.
David B, Son and Respiratory Therapist, Lincoln, NE, November 1, 2005

• Hospitalized for sepsis. Also needed two stents for closed heart vessels. Post stent is 75 mg plavix, and 325 mg asprin. Also taking 40 mg Lasix and 50 mg toprol. Just one month out now.
Ron Williams, Newbury Park, CA USA, October 26, 2005

• I had three stents which started to close. I was on plavix and aspirin. Is it a practice not to stop plavix and aspirin before double bypass surgery or any kind of surgery? In June I had a double bypass and was not taken off of plavix or aspirin as a result I experienced bleeding around my heart and had to be brought into surgery for the second time within a few hours. Doctors believe my heart problems were a result of radiation which caused scar tissue.
diana tavares-parker, framingham, massachusetts, October 25, 2005

• I had three stents inserted into my right coronary artery just over three weeks ago. I am taking Plavix 75mg Aspirin 325 mg Toprol XL 25mg Lisinopril 5mg Lipitor 80 mg Initially I broke out in a rash which covered most of my body, now I am getting back spasms, have no appetite, feel as if I am in a fog, hence slow thinking. Is this the best that i am going to feel for the rest of my life? I am 5 ft 2 inches tall & weigh around 125 pounds.
Marie Lamoureux, Washington DC, October 23, 2005

• Sue -- You're right that Lovenox (enoxaparin sodium) is basically an anticoagulant and not an antiplatelet. There are a few studies around to suggest that Lovenox combined with antiplatelet therapy can lower certain adverse events, late lumen loss, etc. Of course, your husband is on aspirin which is an antiplatelet drug. We will be posting some documentation that Sanofi–Aventis, manufacturers of both Plavix and Lovenox, is sending us. But the company stresses, and rightly so, that the use of Lovenox in stenting is NOT an approved use and any information should NOT be considered a recommendation for the use of Lovenox in a manner which may be inconsistent with approved product labeling. WE, of course, cannot dispense medical advice, but we will post the studies. Please keep us informed as to your husband's progress. This is an occurrence that a number of patients, as you can tell from this Forum, have written about, and it will be most helpful to others to share experiences.
Angioplasty.Org Staff, Angioplasty.Org, October 21, 2005

• two weeks ago my husband had a drug eluting stent placed for restenosis of metal stent that was placed in aprox. 6 years ago. Was on plavix for a week prior to implantation, developed acute reaction to plavix within 48 hours after stent placement; received high doses of prendisone and antihitamines with no effect. Was Changed to ticlid and remains on high doses of prendisone only to have acute serum sickness from this. He is now going to be placed on lovenox and aspirin. I can not find any literature that details how effective or ineffective an anticoagulant not antiplatelet therapy yields post des placement....
sue oconnor, peabody ma, October 19, 2005

• Dear A.R. -- First of all, congratulations on your post-stenting weight loss and your resumption of physical activity -- most important! As for your question, perhaps you didn't have a drug-eluting stent placed. Let us know what type it was. These two drugs work separately to make the blood (platelets) "slippery" and keep them from congregating -- like around the stent. The problems with taking these drugs is mainly due to allergies to one or both, the need for some type of surgery (in which case you can't be on drugs that will keep your blood from clotting) and cost -- Plavix is not cheap. The standard recommendation from device manufacturers and cardiology associations, and this is based on a number of clinical studies, is that a combination antiplatelet therapy of Plavix (clopidogrel) and aspirin has shown to reduce the occurance of late stent thrombosis for drug-eluting stents. And stent thrombosis is a very serious complication, although it occurs infrequently. Most cardiologists recommend this combo for 6-12 months post-stenting. Was there a reason your doctor took you off Plavix after four months? We'd be curious to know. (And by the way, try releasing your caps lock -- writing in all caps is the electronic equivalent of shouting....) Meanwhile keep up the good work!
Angioplasty.Org Staff, Angioplasty.Org, September 24, 2005

A. R. SMITH, ST. LOUIS, MO, September 24, 2005

• Walter -- very good point! Have you asked this question of your cardiologist? -- the one who prescribed Plavix/aspirin. He/she should be the one to make this call since your cardiologist has your medical records to consult. We haven't seen any data regarding time-to-thrombosis after stopping antiplatelet therapy but you raise an interesting question and we'll see if we can get an answer.
Angioplasty.Org Staff, Angioplasty.Org, September 23, 2005

• The question: Can Plavix & asprin dosing be safely suspended for one week prior to dental surgery? Gleanings from the Internet: Plavix: platelet aggregation and bleeding time gradually return to baseline values after treatment is discontinued, generally in about 5 days. Asprin 81mg/day: platelet lifetime 10 days. How soon after stopping Plavix & asprin did the 1% experience stent thrombosis?
Walter Gerstmann, patient, LAD stent,, Brooklyn, NY, September 23, 2005

• I had an Atrial septal defect closure device put in in May 2005 and I am taking 100mg Aspirin and 75mg Plavix a day since to stop stroke and blood clotting. Since taking it I feel hot flushes than usual. Does anyone else have this problem especially with plavix?
Cherie, Wisconsin, September 12, 2005

• I take Plavix 75mg once a day and 81mg aspirin once a day. I've been taking the aspirin for 3 years. Had an annual stress test 6 days ago and they sent me straigt to angioplasty w/95% in two places in my RCA. Feel 100% now and will get back to exercising today. Lost 12 pounds this month and stopped smoking/drinking 3 weeks ago. My numbers have all dropped dramatically. This is the key people. Don't smoke, don't drink, eat healthy and exercise. All the medicine in the world can't replace that!!
SteveA, Jacksonville, FL, August 29, 2005

• In the past 2 weeks, I had 2 stents put in, after an angiogram, I had a positive stress test. I am now taking 75mgs of Plavix and 325 mgs of ecotrin along with my sectral 400 mgs and avapro 150 mgs. I find bruises on my body and checked with my Dr. and he said that is what the drug does and I have to stay on it, hopefully for a short time. I have not experienced any unusual bleeding except for a little blood in my nose while blowing and then it stopped. Tell me what is your opinion? I also watch my diet as far as cholesterol and trans fats.
Annette S., Brooklyn, NY, August 26, 2005

• I took a full aspirin (325mg) for about 6 months after my 4 stents. After that my doctor dropped my aspirin down to 81 mg. I also take 75mg of Plavix.
JIm Morris, Wesley Chapel, FL, August 25, 2005

• Plavix 75 mg q day
ASA 81 mg q day
lipitor 80 mg q hs
David Gens, Univ of Md Med Center, MD, August 21, 2005

• I am taking 75mg Plavix after having a stent put in. I am bruising all over my body epecially my legs. I even have a black eye. Is this common? Will it stop? It is an allergic reaction to the Plavix? Should I be on a lower dosage? Does anyone else have this problem. It really bothers me. I look terrible!
Jackie Omdahl, Hendersonville, TN, August 14, 2005

• In Aug. 2003 I had Taxus2 stent in LAD (75%) and prescribed 75 Plavix and 75 Aspirin. After 3 months I was advised to stop the apsirin as it was thought that I might be mildly allergic to it. A recent stress echo suggested I could still have a problem but due to a small VSD the results could not be considered conclusive so I was referred for an angiogram. The consultant could not agree to a stent if needed (but proceeded with the angiogram) because of recent recommendations that aspirin and clopidogrel should be prescribed for 12 months post procedure; and as I was possibly allergic to aspirin I would need to undertake an allergy trial for several months just to make sure. I was unaware of this new recommendation so it came as a surprise and shock that any stenting would be delayed. The good news from the angiogram is that I don't need another stent. I now plan to take a course of aspirin along with the still prescribed plavix just to check the allergy thing for the future. Anyone know whether plavix can be taken indefinitely? I'm 71, train regularly and asymptomatic. Problem was first revealed following EBCT scan.
Reggie Dickinson, UK, August 04, 2005

• I am trying find the new combination medication of adding 81 mg of ASA and Plavix 75 mg in a single tablet. The patients can take the combo tablet instead of two individual tablets for one to 12 months. Any coments on my idea
Aravinda Nanjundappa, East Carolina University, Greenville, North Carolina, USA, July 30, 2005

• i have been taking plavix since 7 jan 2005 and i noticed some spots all over my back,chest and neck i need to know the right treatment for this case,and to check the right dosage of plavix to be taken and for how long?
fouad sarwat, Cairo,Egypt, July 30, 2005

• My husband had his stent done more than a year ago. He was then taking plavix and aspirin. After sixteen months, he was advised to have colonoscopy because of his age. His doctors did not inform him to discontinue plavix and aspirin.During the process of colonoscopy they found out that he had a polyp so they took a sample from it for biopsy. After a few days he hemorhaged and had to stay in the hospital intensive care for a week. He had blood tranfusion and I thought I'll lose him. Now it's almost three months, his primary doctor wants him to take plavix again when he is also taking aspirin. I'm very concerned.
Lily, Mother, Naperville, Illinois, July 25, 2005

• I am taking 75 mg. plavix, and 325 aspirin. I bleed now like a stuck pig when I have to do my finger pricks for my diabetes daily monitoring. Was told at least min. 6 mos. on blood thinners. Not thrilled. Anyone nauseous with plavix?
Gail H, Franklin, NJ, July 21, 2005

• A recent MRA confirms my wife has a blockage of a vein in her brain. Doctor is exploring the possibility of installing a stent. Years ago she took Plavix to relieve a cholesterol problem. Later, she had surgery to correct a problem in her shoulder and afterwards began to display large areas over her body where the skin blackened. Doctor took her off the Plavix and the conditon corrected itself. Now they are cautiously suggesting the use of Plavix again in an attempt to relieve the present condition in her brain in lieu of surgery. She can not take aspirin as she is highly allergic to this substance. Has anyone heard of this procedure involving the placement of a stent in the brain. It causes us to shudder.
Bert Quillin, Retired, Tigard, Oregon, June 30, 2005

• Is there any justification to use 75 mg Plavix as opposed to say 35 mg Plavix. The idea of a one size fits all doesn't seem obvious. I'd like to use the minimum amount necessary, but can't find any reseach on the effect of different doses. BTW, my doctor agreed that Plavix, and Coumadin may be sufficient to prevent the cardiac problems I face. Therefore I discontinued the 325 mg of aspirin that was previously included in my medication regimen. I'm much more comfortable with that.
Derek, Palm Harbor, Florida, USA, June 30, 2005

• My Husband had a Stent put in on May 8, 2005 the new medicated stent was used for a 90% blockage. He is taking Plavix, Ectotrin 325mg, Vasotec, and Lipitor. Recently he was brought into the emergency for an Inflammation of the Heart Muscle, which was treated successfully with Indocin. The Doctor in the ER told me this was a common Syndrome that some people develop after a Stent is put in, My husband had the same pain the day after his Heart Attack and at that time was treated again with Indocin, successfully. Can some one please explain this to me, why this happens. Thank You
JoAnn Wicker, The Valley Hospital, Ridgewood, New Jersey, June 27, 2005

• I had a stent to open a 99% blocked heart artery. It was just in time to prevent a major stroke. Prior to the stenting I was on Coumadin for 10 years to prevent TIAs caused by Atrial fib and clotting. The Coumadin was discontinued to implant the stent and all was fine for 15 days using 75 mg plavix in conjuction with 325 mg aspirin, but then I had a minor TIA. It was just like I used to get before taking Coumadin. An emergency physician advised taking Coumadin as well as Plavix and Aspirin. I'm just hoping it won't cause a bloody problem! More later . . . with luck!
Derek , Palm Harbor, Florida, June 27, 2005

• I am 73.After years of stable angina of effort in 2004 my angina became unstable. My blood pressure had always been 140/75. Following angiogram in Feb 05 a single stent was inserted at position of 87% lesion and there was a less than 60% lesion left alone. Within a few days my blood pressure became unstable occasionally 210/110. Four weeks after angioplasty at night I had recurring chest pain in spasm and after four hours went to emergency. My blood pressure was sky high and I was kept in for two days and a further angiogram was scheduled. I reuested first a stress test on which I did 15 minutes with no pain and top blood pressure of 165/80. I continued to have erratic blood pressure and spasm but generally good exercise tollerance. I went on holliday to Switerland where I suddenly had severe spasm and highly variable a of e. I went to hospital where they recorded very high blood pressure and sent me by ambulance to Bern University Hospital. In view of my history and possibility of the stent having blocked I had another angiogram which showed the stent clear but the other occlusion was also fitted with a stent. Over three days the hospital could not stabilise my blood pressure and concluded that this was the cause of my angina and spasm. All this time I was taking Plavix. I have kept a blood pressure chart since May 1. Four days ago following ten days of angina of effort and spasm I discontinued Plavix. Immediately my blood pressure has fallen and stabilised at around 140/80 no spasm and improved exercise tollerance. Now how do I protect against platelet aggregation. Clearly my second angioplasty was an unnecessary intervention. I hope this report will save some other patients a lot of stress.
Malcolm Adams, Spain, June 27, 2005

• I had stent implanted May 25/2005. I have been prescribed Plavix, 325 mg aspirin. Also take Altace,Lipitor(10),Bisoprolol(5)daily. Comment on drawings supplied "63yo male,prior CABGx4. Known occluded SVG to ramus,DI, and LIMA to LAD. New 90%lesion at anastomotic site of SVG to distal RCA. PCI 3.5/15 Biodyvisio, post with 3.5/8 Quantum. Good results. OM2 90% chronic. Angioseal RFA. Plavix>1m. Integ. JS/VH(Drs.)" I feel great!
R JUohn Smith, Retired., Vancouver, BC Canada., June 20, 2005

• If patient is already taking Coumadin for a previous DVT/pulmonary embolism, is it still OK to take 325 mg of aspirin, along with the usual plavix, beta blockers, etc. after drug-eluting stents installed on an emergency basis out of town while on vacation. Back home (in Chapel Hill), it takes 2 months to get an appointment with an interventional cardiologist. Meanwhile, how do you determine the proper dosage? Ask your cardiologist is not an option for 2 months. Any idea who to ask to get an immediate response?
Evelyn Glatt, Chapel Hill, North Carolina, USA, June 16, 2005

• I have just had 1 Cypher (RCA Bypass) and 2 Taxus stent implants in the LCA with one causing serious LIMA bypass spasm. Having a St. Jude aortic valve, I am also on Coumadin but still required to take Plavix 75mg and Asp 81mg. Is anyone on these 3 anticoagulants and how do you manage them?
ChrisR, retired, St.croix, USVI, June 13, 2005

• I take 81mg and 75mg plavix 10mg crestor all once a day along with 25mg metoperol twice a day
Wayne Lanthier, June 13, 2005

• MB -- only your cardiologist should be making the decision as to whether you should continue with any prescription medication. Plavix is prescribed for 3 months to a year to avoid the problem of stent thrombosis, but Plavix also has other benefits and reasons for use.
Angioplasty.Org Staff, Angioplasty.Org, June 7, 2005

• I had an angioplasty exactly year ago. I had three stents in my arteries, of which doctors recommended one stent of cypher. I was prescribed aspirin 75 mg, plavix 75 mg, zocor 20 mg, zestril 10 mg, beta blocker 50 mg, I am diabetic so i take diamicron MR 10 mg, and two tablets of glucophage 500 twice a day. I am really curious whether should I stop plavix as its been 1 year that I've been taking. Plz do advice me.
MB, Business, Pakistan, June 05, 2005

• J.P. -- Sorry about your situation. As you read in my blog, Dr. Eisenberg's article in Lancet (sorry -- subscription only to read) cautions doctors to think about the clinical consequences down the road of implanting drug-eluting stents. But with a 90% blockage, it's possible you may not have had much choice and been at high risk for a coronary event. As for medical advice on what to do, that is something we do not and cannot give. Your physician is really the best source for that type of advice. And it sounds like your cardiologist is quite aware that early cessation of antiplatelet therapy post drug-eluting stent implantation is not such a good idea. Over half of the voters on an April 5 poll conducted by CRT Online, a professional-only cardiology site, said that they prescribe Plavix for a year or more after stenting (not a scientific survey by any means, but you get the idea). So I would not just stop this course of medication -- any change needs to be discussed with your cardiologist and you should discuss with him/her the implications of any decision in this situation.
Angioplasty.Org Staff, Angioplasty.Org, June 1, 2005

• My stents were installed in February ( 2 in the decending coronary artery) following a kidney stone and subsequent dehydration effects. I had been walking around with a 90% blocked DCA. But, my problem is I still have the kidney stone because my cardiologist doesn't want to discontinue the anticoagulants (Plavix and Aspirin) long enough to do the Lithotripsy (sonic kidney stone blast technique). The stone was secured with a urinary track stent in my ureter. Also, Plavix is expensive and a nasty tasting pill thats hard to swallow. Do I want to discontinue my anticoagulants so I can get rid of the kidney stone and urinary stent? Sure, but I'll wait. The devil is always in the details.
J.P., USA, June 1, 2005

• Aspirin 325mg 1 per day
Zocor 10mg 1 per day
Plavix 75mg 2 per day
Lisinopril 10mg 1 per day
Metoprolol 50mg 1 per day
Julie Hood, Corpus Christi, Texas, May 30, 2005

• Colleen, as for aspirin and Plavix, before changing the dosage of aspirin from what your mother's cardiologist prescribed, you should check with him/her. Both drugs can cause bleeding, especially when used together. So I would not increase your mother's aspirin dose without checking first. Most cardiologists prescribe Plavix for 6 months after a drug-eluting stent -- some feel a year is better. Again check with your cardiologist (general practice physicians are sometimes not aware of the importance of Plavix and drug-eluting stents -- do not stop taking it without your cardiologist's approval). As for the drug on the coated stents, paclitaxel (used on the Taxus) is a cancer drug, and sirolimus (used on the Cypher) is an immunosuppressive. Both have the characteristic of slowing-down cell growth, thought to cause restenosis or re-clogging. But they're not anti-platelet drugs (Plavix and aspirin are). Paclitaxel or sirolimus are eluted (given off) by the stent in a very small dosage (compared to taking a pill systemically) over time. While there have been instances of hypersensitivity to the drug itself, they are relatively rare (you can read about allergic reactions our readers have reported in a different topic -- there's also a phone number there to report/discuss concerns about any reactions to the Taxus stent) . Sometimes rashes, coughs, etc. may be due to medications being taken by the patient (heart patients are usually on several). And yes, it is true that elderly people react differently to medications, usually they are more sensitive. Hopefully another procedure won't be necessary (that's the concept behind drug-eluting stents -- they've cut restenosis from the 20+% range down to 5%). But if one does, you should discuss these concerns with your mother's cardiologist (patients often have more than one stent implanted during a procedure).
Angioplasty.Org Staff, Angioplasty.Org, May 29, 2005

• My mother was told to take plavix and one aspirin Started with full strength aspirin, then cut to baby aspirin after a month, along with taking plavix. She has drug eluting stent (paclitaxel). i didn't know about different kind of stents and when she developed rash, started researching and found out. I am concerned that this is a chemotherapy drug that is implanted in a persons artery where a minute amount will supposedly remain of this drug. Elderly people have compromised immune systems just from the natural aging process, so I don't understand why a company would use this particular drug to keep platelets forming. Being a lay person of course doesn't give me full insight, but, common sense would tell me that a chemo drug, that can have highly allergic side effects, was not a great choice of drugs to use on elderly people. Now I've read that this stent is not to be used on people who are allergic to plavix. Well, if you never were a heart patient before, how do you know if you are allergic? My other concern is from what I have read, there hasn't been any studies of effects of this stent in a persons body beyond a year. That is scary to me. Her rash has calmed down somewhat, but still no one can pinpoint why she has it. Is there any one else out there that has experienced this? Getting back to meds, she is to continue plavix for 6 months with baby aspirin. After that continue with aspirin Personally, I think one whole aspirin and a baby to say the least. My grandmother took 2 aspirins (whole) everyday and lived to 97 years. If you can give me any info regarding rash, I would appreciate it. Also, her electrocardiogram is still not normal, which was the original reason she had stent implanted. The doctor told her that this is probably the way it will read from now on and to carry a copy with her in case of emergency.Yet, I read that one of the signs of side-effect from stent is electro cardiogram abnormal. Hope I am just overly concerned and worrying too much.What if a patient with a paclitaxel eluting stent, God forbid, needed another procedure down the road. What kind of stent would be used? I don't think it would be good to have chemo again eluting into an elderly person?
Colleen D., Bergen County, New Jersey, May 25, 2005

• One Aspirin 81mg and one Plavix 75mg. Both to be taken in the morning. Aspirin should be after meal, but Plavix no difference. Hope this is of use. Good health to you.
Adel, I am a patient, Bahrain, May 20, 2005

Ellen -- check out this article on our "News" page about a study published in the February "Annals of Internal Medicine". They studied a combination therapy of clopidogrel (Plavix), 75 mg per day, plus aspirin, 325 mg per day for 1 year, followed by aspirin only (lifetime) and compared that with aspirin only (lifetime) and found that the combination, although more expensive, was also more cost-effective, since it was better in preventing more vascular events. This study was in patients with acute coronary syndrome. Post-stent patients need to be taking aspirin, probably lifetime, and Plavix certainly for 3-12 months -- this can prevent stent thrombosis, a not frequent (< 1%), but very serious complication with stents. As for the exact dosages, while you are correct in noting different strengths quoted in different articles, your doctor is the best source of this information, because he/she needs to look at your whole clinical situation and determine the best, most effective dosages (there may be some side-effects to anti-platelet medication, but this varies with individuals).

We are curious as to what medications/dosages other readers have been prescribed post-stenting. Post your comments below regarding aspirin, Plavix, etc.
Angioplasty.Org Staff, Angioplasty.Org, April 24, 2005

What is the normal dosage of Plavix, aspirin given after having a Stent. I hear one aspirin, over and over, but is this 325 mg or 81? Please let me know as soon as possible.
Ellen, Dayton, Ohio, USA, April 23, 2005

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