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Plavix, Effient, Aspirin and Stents (2006 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 2006 on This Page (222):

• I had been on plavix for 6 years due to clotting caused by a lupus antigen in my blood. I am also taking 5 mg. coumadin 6 days a week. Dr. recently discontinued plavix due to a second episode of bleeding inside my eye. Should I be concerned about platelets beginning to stick together and causing clotting?
Z., New Jersey, USA, December 29, 2006

• On 20040410 I had a 100% blockage in the mid LAD coronary artery. After 3 hours, a drug-eluting stent was placed. For 6 months I have taken aspirin and Plavix. In sept 2004 I felt more and more out breathing. On 17 nov the cardiologist found a 90% blockage at the edge of the stent(caused by connective tissue). He placed a second stent in front of the old one to open it. The cardiologist prescribed again ascal(aspirin) and Plavix for 6 month. But I had a thought of "Deja Vu" and decided to take no "medicine" at all. At 5 dec 2005 the cardiologist found both stent 100 % open but I had another blockage 70% in an other branch. He won't give me a new stent because I had no damage of it (He said) and because of the trouble I had had with the first stent. I had not agreed I think that the use of aspirin after stent placing prevents the natural healing of the arterial wall when it has a little damage by placing a stent. I think that there is no scientific research about the influence of aspirin on damaged tissue in the coronary artery. It is even possible that in some cases the "wonder medicine" Plavix repairs the damage of the use of aspirin. My cardiologist ( a professor) called me a fantasist. Am I? (ps. I am a biologist)
Wil van B., The Netherlands, December 28, 2006

• I had the drug eluting stent (Taxus) inserted in an artery in March 2006. I was initially told I would need to take Plavix and 81mg aspirin for 6 months. After my six months checkup which included another thallium test, my cardiologist said I would need to stay on this medication for another six more months. I recently had a nose bleed and cough up some blood daily. I have many other health problems such as TMJD, degenerative Scoliosis,asthma, vertigo, Tinnitus,GERD,arthritis,possibly fibromyalgia. I am 54 years and I have noticed that when I take Plavix either with aspirin or without aspirin I get severe Tinnitus(ringing in the ears) which affects my equilibrium and concentration. I am currently still working, hoping I will be able to work till I am eligible to retire at 55 in 2007. I did not know about the side-effects with drug-eluting stents until recently. I don't think I can take the Plavix for another 5 months because it is making my Tinnitus worse and difficult for me do my work on the job. My ENT specialist told me several years ago that aspirin, and too much salt aggravates Tinnitus. If I stay on Plavix for 5 more months I will probably have to retire sooner. Could you please give me some advice what to do here. Is there another substitute for Plavix which may not aggravate Tinnitus? SJY
SJY, Maryland, USA, December 28, 2006

• My husband had 5 Cypher stents inserted into 1 artery in July 2005 (2 procedures). In Sept 2005, he had an emergency quad bypass after doctors realized that the 5 stents had clotted and that his other lesser blocked arteries had progressed significantly (despite all of the meds he was on). He was on Plavix right up until the surgery but he hasn't taken it since. He is on Toprol and Lipitor and baby aspirin only. Even though he had the bypass, should he still be on Plavix because of the stents? He is just 49 yrs old and was very active prior to all of this. Although he is back to working full-time, his stamina has been greatly reduced since his first heart attack and the insertion of those stents. The bypass has helped a little but he is still is not the same.
S.M., Massachusetts, USA, December 28, 2006

• Dear educated -- you're right in many respects. And Ticlid and Plavix are similar, but they are different drugs and some patients who are allergic to Plavix, are not allergic to Ticlid, and vice-versa. Ticlid was the first antiplatelet drug used. Then Plavix, which touted less side effects, came on the scene and Ticlid was relegated to second place. But some doctors find it works as well if not better. Also in Japan, Ticlid is the antiplatelet drug of choice. As for aspirin dose, the current AHA/ACC guidelines state: "Patients who have undergone percutaneous coronary intervention with stent placement should initially receive higher-dose aspirin at 325 mg/d for 1 month for bare metal stent, 3 months for sirolimus-eluting stent, and 6 months for paclitaxel-eluting stent."
Angioplasty.Org Staff, Angioplasty.Org, December 28, 2006

• This is so frustrating reading so many of these comments. For one, Ticlid is Plavix. Plavix is derived from the Ticlid molecule. So if you have an allergic reaction to Ticlid it will most likely be the same for Plavix. You will not have the same success with Ticlid as you will have with Plavix because it's not the same isomer. What so many of you are missing with the frustrations with having a DES and needing to be on Plavix for the rest of your life, is the fact that if you had a blockage in the kitchen, you probably have blockages in the basement and top floor too. Plavix will prevent you from having a heart attack from other areas where you don't currently have stents. There have been so many cases that stented patients were taken off Plavix after one year and they show in the ED [Emergency Room] with a heart attack and 100% blockage in the artery that was clean 10 days before. The time frame of how long to be on Plavix is a big issue just like a previous writer stated. Many cardiologists feel like I stated in the previous paragraph that you will have more problems. Why would take a risk with your life if you know that Plavix can help prevent that? Also, the bleeding factor-it is Aspirin dose driven. You should NEVER be on 325mg of asa and Plavix together! You should be on no more than 162mg of asa. Many trials have shown that the bleed rate is dependant on the asa dose.
Educated in this area, Concerned for your health, Saginaw Michigan, USA, December 27, 2006

• Salim -- you and your twin brother are a clinical trial of two! Just curious. I assume your bother did not get a drug-eluting stent (they were not yet on the market in 2001) which may be a testimonial to the benefit of these devices.
Angioplasty.Org Staff, Angioplasty.Org, December 27, 2006

• I had a Taxus Stent put in my LAD in 2003. My Cardiologist told me to go on Plavix/Aspirin for the rest of my life. My twin brother had a Stent implanted in 2001, unfortunately his Cardiologist told him to stop Plavix after few months . Well he had a severe Heart Attack due to a Blood Clot. Both of us are very active and jog everyday . I went for another angiogram on 2006 and fortunately My Stent is only 30% blocked due to tissue build up . I am now planning to cut Plavix to 1/2 a tablet and continue taking ASA (81mg) until further data is released on the safety . We had blocked arteries because of genetics. Thanks to my Cardiologist to keep me on ASA for life .
Salim Mohamed, Calgary, Alberta, Canada, December 27, 2006

• To all who report an allergic reaction -- Plavix definitely can result in an allergic reaction, often a rash. But it is difficult to discren exactly the cause of the allergic reaction without systematically withdrawing each drug, step-by-step to determine which one, if any, is the cause. This is NOT something patients should attempt on their own. There could be significant and adverse consequences. But an ongoing study of the possibility of stent allergies is now being conducted and a protocol for determining what is causing the reaction has been developed. If you think you may have a stent allergy, email us at to get more information.
Angioplasty.Org Staff, Angioplasty.Org, December 27, 2006

• My wife had stents in july 2006. has been on plavix since. Has had multiple problems mostly pain in legs and insomnia, also upset stomach constantly. She got so bad she went off and has started to live again .Well while she was so sick she must of had a another blockage form and will know more tomorrow. She tires more now than before stents. keep her in your prayers guys and girls, she's a wonderful person much too young for this trouble. We also want to thank the producers of this forum, we would be in the dark about all this going on without you.
S.M., New York, USA, December 27, 2006

• 10 years ago, I underwent by pass surgery and have been doing well since. About 2 months ago, I went thru a battery of tests where a blocked artery was discovered, I then had a stent put in and the Doctor prescribed Plavix, 75 mg 1 X day. I have been taking the Plavix for 42 days. 3 days ago, I suffered intense pain in my right wrist. I went to emergency and the Doctor upon seeing a red streak going up my inner wrist, put me on an immediate IV of Cipro and prescribed Cipro for another 10 days. The next day, the red streak was gone but the pain was still there. By the evening, the pain was completely gone. In the early morning hours of the third day after the original wrist pain, I woke up with extreme pain in my right knee right at the knee cap. As I lay in bed, I thought something must be causing the pain and wondered if it was the Plavix because that was the only thing I have started taking in the previous 7 months. I then did a search on "Plavix Reaction" and low and behold, I found this forum. I hobbled to the Doctors office this morning, and he was completely stumped and ordered X Rays of my knee and an ultra sound of my right leg. Nothing was discovered. Today, I stopped taking Plavix and tonight, the pain in my knee is going away fast and I can now walk again without pain. I am now convinced that the Plavix was the problem. Needless to say, when I told the Doctor in today's visit about this web forum, he doubted me and told me to continue with the plavix. Fat Chance! Can anyone here tell me if I am on the right track about Plavix Reaction?
Herb G., Indiana, USA, December 22, 2006

• In November or December, 2003, I had 2 stents (1 drug inducing) placed in my heart at --------------------------------. The Doctor prescribed Plavix, Metropoal, Crestor aspirin, (I have always been able to aspirin on a daily basis without any side effects). When I went home, I was feeling good. After having the prescriptions filled and initial use, I believed I had a stroke. I had very severe headaches, Severe acid reflux, my eyesight became very bad and I had to start wearing glasses, rectal bleeding, ringing in my ears, numbness on my right side and back. I became cloudy and noticed that I could not spell and think as I did before the operation. I also started having severe pain in my thighs from nerve damage (I have had this type of pain before taking plavix or other medicines which later was diagnosed as nerve damage from unknown causes) which seemed to be exacerbated. I felt it was one of the medicines I was taking so I took my self off Crestor but the symptoms remained, I then tried taking myself off Metropoal and the symptoms remained. Then I took myself off plavix and the headache, and acid reflux disappeared and I became more active. I called Dr. ------------office and let them now of the results. I was told by the Doctor to immediately get back on the Plavix or I could have a blocked artery. I went back on the Plavix and the symptoms returned.

Later in the month, I visited Dr. -------- and told him that I was allergic to plavix and believed I had a stroke. He told me that it was nonsense and that plavix was necessary for my well being. I told him that I couldn't t take it any more and that I will not take the plavix. He was very upset and because of my refusal and prescribed ticlopidine. I started feeling better and the acid reflux disappeared. I cannot recall the date and think it was just before my Doctors visit that I checked myself into the -----------. This time it was for what I believed was a stroke and severe acid reflux. They performed a cat scan and mri which came back negative; They did not do anything for the acid reflux. I went to my personal Doctor in __________ who prescribed Nexium and some other medicines. I started feeling better and was even jogging. In December of 2004, I had 2 more stents placed in my heart (drug inducing). My cardiologist again put on plavix (I told ------------- of the side effects of my taking plavix but she insisted that I take it. After starting plavix again (I still take it) my symptoms returned and I have to live with them I guess.

Because of the side effects I have not been able to work and my whole life has been turned around. On Nov. 20th 2006 (approx.) I fell in a store and suffered a concussion and stroke. Currently, I do fall down and my right side is partially paralyzed, I do not think as clearly. Last week I visited a new cardiologist who prescribed sucralfate and protonix (helps with my acid reflux) and I will be visiting him in a couple of weeks and go over my symptoms and the side effects caused by plavix. I will be seeing my neurologist. regarding my stroke. Previously he had prescribed Cymbalta and Gabapentin for my nerve pain (works well) and recently prescribed butalbital for my headaches.
R.D., Virginia, USA, December 21, 2006

• Feb. 2005 my husband had triple bypass. Nov. 16, 2006 he had balloon angioplasty and received a nickel drug eluting stent. He was put on Plavix and Isosorb mono. Nov. 18, 2006, he started Ranexa. Two days later he began having hives and unbearable itching. Because of the different dates of the medications we don't know what to suspect as the source of the hives and itching. Could an allergy to nickel cause these symptoms too? Thanks.
T., Louisville, Kentucky, USA, December 19, 2006

• Tom Higgins and Brian M. -- generic is Clopidogrel Bisulfate -- the FDA says it is equivalent to Plavix -- we've gotten some differing opinions from patients. Your doctor is right. The area could not be grayer!
Angioplasty.Org Staff, Angioplasty.Org, December 19, 2006

• I am a 40 y/o male with 3 cypher stents in my coronary arteries. My cardiologist recently refilled my rx for plavix and was very specific that I use branded plavix. Could you aid me in a third party justification for the specification. We are a military family and the rx is free if I use generic as opposed to $150.00 a month for branded. It really isn't about the money but more about why a federal pharmacy would carry a generic form of a drug that may not live up to it's branded brother. Thank you
Brian M., USA, December 17, 2006

• I am 62 years old. I had a Cypher stent put in, in May 06. I have been on plavix since then. This month I started taking the generic (clopidogrel) it does not say bisulfate. Two questions 1. are they the same? 2. How long must I stay on this. My doctor says its a gray area. Its just that the drug makes me feel lousy.
tom higgins, manteo, North Carolina, USA, December 15, 2006

• Tom -- we have actually gotten reports both ways. Some who were allergic to Plavix seem to not be allergic to the generic.
Angioplasty.Org Staff, Angioplasty.Org, December 15, 2006

• I seem to recall that one or more patients have complained that the Plavix generic drug caused them allergic reactions while the Plavix brand did not. Can this really be true? If a generic is supposedly chemically identical to the original brand, I would think that any reaction would be the same for the brand product or the generic. I have been on Plavix for 10 months now, and am giving thought to switching to the generic to save money.
Thomas T., Arizona, USA, December 13, 2006

• Maureen -- bruising can be a side effect of Plavix (capillaries in the skin not clotting) and while it may not be serious, it should definitely be reported to your husband's cardiologist, as you have done. Let us know what happens.
Angioplasty.Org Staff, Angioplasty.Org, December 13, 2006

• My husband is a 60 year old healthy man. On November 06 he recently had 3 stents put in with a 99.9% blockage. He never had any heart attack. His cardiologist put him on Plavix. Just this past week we noticed 2 large bruises, one on his leg and one on his arm. We called his doctor today and have yet to hear from him. Is this normal? In the little pamphlet that came with the Plavix it said to contact the doctor immediately.
Maureen, New York, USA, December 13, 2006

• I'm a 67 year old male, never smoked who had heart attack Oct. 1, 2006, two Cordis/Cypher coated stents placed in right side of heart. Taking Plavix (75mg) aspirin (81mg) and Zocor (20 mg) & Lopressor (25mg 2x da). I had no indications of heart problem and blood work was good. hmmmm, it's in the genes with father and younger brother. So far, I'm having no side affects from meds or stents. Interesting reading, I, with Google's help found this forum.
Phil James, Leesburg, Florida, USA, December 10, 2006

• At the FDA Stent Meeting this week, someone from Accumetrics presented information about a simple FDA-cleared blood test called VerifyNow that can be used to tell whether or not your aspirin is working and potentially adjust the dose.
R.H., California, USA, December 9, 2006

• I am 43/Male..Had a heart attack Sat 12/2/06 after a workout. RCA was 100% blocked and had non-coated stent put in within 2 hours of attack. All other arteries appear to be fine. Since being released Wed 12/6/06, I am on Lisinopril 5mg, Atenolol 25mg, Clopidogrel 75mg, aspirin 325mg, Lipitor 40mg (up from 10mg preattack), Zetia 10mg, Prevacid 30mg(5 years now). I soon developed a rash on my feet and buttocks which seems to get worse each day. On 12/8/06 my GP and cardiologists suggested dropping the Zetia and Lisinopril which I did today, however the rash still covers my feet and has spread to most of my torso. It doesn't itch a lot but is warm. I suspect it is the Clopidogrel causing it though. Should I try brand name Plavix instead if that turns out to be the case? or should I switch to ticlid? Is ticlid as effective?
Michael B., Ohio, USA, December 9, 2006

• to Anonymous, USA, May 4, 2006. Just reading this now and wonder if you are seeing the same young, cocky, opinionated, self centered, holier than thou, cardiologist that I have been seeing. Is he at the med center in Houston? Do you have the bare metal stents? If so, "I" do not believe you need to be on blood thinners for BMS as long as you do for Drug Coated Stents. Good Luck To You.
Davis, Houston, December 9, 2006

• Prior to my four DES and 2 years on Plavix I always had normal blood work, i.e. Electrolytes, CBC, Liver and Kidney function. I have not felt well since these DES and Plavix and do not know which is the culprit. For the past 14 months, my albumin is high and serum globulin is low. My Ferritin is also low. On the advise of my hubby, I saw an Endocrinologist as TSH was also a little high. This doctor ran a battery of tests and called me the other day and told me my Parathyroid Levels are thru the roof and and my Vitamin D levels are in the cellar. I have secondary Hyperparathyroidism and with symptoms. I have been placed on a strong RX of Cacitrol with repeat testing. This doctor asked me what meds I have been taking over the past year or so consistently. HELLO!
Carla, Texas, USA, December 9, 2006

• Hi, I'm a newbie to this site, found as the result of googling after widespread publicity about possible dangers of DES stents. I am a 64-year-old white male, had 2 stents implanted at VA Hospital in Madison, Wis., September 2004 after nuke stress test found 75% of two arteries blocked. Cardiograms previously proved normal, but doctor said stress test much more determinative. Pictures don't lie, do they? In the wake of the FDA's announcement about DES stents possibly raising risk of clots, I'm naturally concerned. I was put on Plavix after procedure for a couple of months, then taken off. No episodes in past two years, but I did have gastric bypass surgery in January 2005 and lost 150+ pounds since then. Down from 351 to 199 currently. Also had knee replacement in November 2005. The trauma of two major surgeries, the weight loss plus the stenting has me worried that this ol' bod might be a bit traumatized. I don't want to worry about these coil springs in my heart but can't help feeling that there may be a ticking time bomb ready to go off any day. Contacted VA for follow-up consultation to see if I should take Plavix again or get retested. Awaiting appointment, which could take weeks at the VA, which isn't known for adopting a sense of urgency in even the most severe cases. Would appreciate any info, anecdotal or otherwise, from DES patients. I wonder whether Plavix or equivalent is worth the risk. Sometimes the cure is worse than the disease. All comments help appreciated. Post here or email me. Thank you!
Joe Costanza, St. Germain, Wisconsin, USA, December 8, 2006

• I am new to this forum. I have 8 DES Cypher stents and I am on nine medications (testim, tricor, crestor, clonazepam, generic plavix, 85mg aspirin, lexapro, prescription vitamin D, and norvasc). I am only 39 years old, but I have none of the issues or drug reactions noted above, other than a widely dispersed itching and rash. My cardiologist recommended zyrtec, and allergy medication, which cleared up the rash issue and I was able to stop taking that after about one month with no return of symptoms. I exercise now every day and my total cholesterol is below 100 (my triglycerides were at 1200 at one point). Soon I will be off the Norvasc. I can't stress enough the role that multiple major clinical depressive episodes had on my health. Controlling stress is one of the most important aspects of any recovery so I urge the readers of this forum to not shy away from visiting a Psychiatrist if you feel it is necessary. It has really made a difference for me. I am able to work and live a normal life, and have no anxiety whatsoever about the 8 stents residing is my chest. If anyone is interested, I have a picture of the LAD blockage (100% blocked - needed 5 stents) on my site I wish all of you well and hope that knowing of a 39 year old with 8 stents is doing well and living a wonderful life will encourage you.
Gerald M., Austin Texas, USA, December 8, 2006

• Thanks for the compliment Linda!!
Angioplasty.Org Staff, Angioplasty.Org, December 8, 2006

• My husband went to the ER three times and was hospitalized due to a reaction from Plavix. He had many of the symptoms that others on the forum had mentioned- hives, swelling in hands and feet, severe joint pain, worse at night. Each time, despite telling the doctors about this forum and the fact that many people had reported the exact symptoms as my husband, they refused to accept that it was the Plavix. The reason being, "he should have had a reaction right away" despite what I had told them about other patients mentioning their symptoms did not start until two to three weeks after starting Plavix. Finally, after copying many of the comments from this forum and showing it to the 5th doctor they accepted it was the Plavix and determined it was actually not an allergic reaction but "serum sickness" which can develop 7 to 21 days after exposure and can be induced by blood products. Finally, they took him off the Plavix and he is now recovering. If it were not for this forum, the clueless doctors would probably still be grasping at straws and insisting it's not the Plavix. Thank goodness for the Internet and sites like this. BTW~the doctors felt it was a rare reaction, however judging by the number of patients on this forum with similar symptoms, I doubt it. H
Linda, San Diego, California, USA, December 8, 2006

• Rick -- boy, your question could not be more timely! I am in Washington (DC, not Seattle...) attending the special FDA panel meeting on stent safety and your question was actually discussed at some length just yesterday afternoon. Now remember, in this room of 500 people were some of the most prominent cardiologists in the world (yes, well-known physicians from The Netherlands, Italy, Japan, etc. as well as the U.S.) And the question of whether to restart a patient on Plavix after they had successfully completed the usual 6 month course went back and forth. There is also significant debate on whether there is any benefit to be derived from more than 6 months anyway. The resolution was that it should be left up to the individual cardiologist and his/her patient. This wasn't exactly a "cop-out" because it is a very complex issue. Long-term Plavix therapy might not be a problem for some; for others, there might be a risk of bleeding or other adverse reaction -- one that might outweigh risks of the late stent thrombosis. And, to some extent, that risk of thrombosis after 6 months can be impacted by specific information about your particular medical situation, where the stents are placed, the characteristics of the artery, all things your cardiologist may be looking at.

The panel couldn't agree on a consensus statement (of course, the meeting continues today -- maybe one will emerge). A perfect example of this situation can be seen in an exchange that took place between Dr. Christopher White of The Ochsner Clinic (New Orleans) and the panel chairperson, Dr. William Maisel of Beth Israel Deaconess (Boston). When debating if the FDA label for antiplatelet therapy with Plavix or Ticlid after drug-eluting stents (DES) should be changed from 3 months (Cypher) and 6 months (Taxus) to a year or more, Dr. White quite forcefully said, "No" -- these are minimum recommendations. The actual duration should be up to the individual physician. Dr. Maisel then asked, "Dr. White, if you had a DES and no bleeding risk, how long would you take Plavix?" Without hesitation, Dr. White responded, "Indefinitely!" and the room rippled with laughter. Not that this is funny, Rick, but it had been a very long day! Of course, having been allergic to Plavix, you're taking the older drug Ticlid (ticlopidine) which has other adverse events (by the way, yesterday we heard that in Japan, Ticlid, not Plavix, is the antiplatelet drug of choice). So you can talk more to your Cardio Guy -- or you could talk to the room full of Cardio Guys here in Washington -- they don't have a one-size-fits-all answer either. Hopefully your doctor can explain his reasoning to you and his analysis of your risk/benefit assessment so you are comfortable with the decision.
Burt Cohen, Angioplasty.Org, December 8, 2006

• I'm a 66 year old white 230 lbs male. 2 Cypher stents placed 5/19/2006. Began a banquet of new meds in recovery area to include Plavix, 325 mg aspirin, Toprol, Uroxotral & Crestor. Within 2 days a skin reaction occurred, (severely itching red blotches) Cardio Guy suspended Crestor and switched me from Plavix to Ticlid. I say he could not have known if I was allergic to Plavix under those conditions. Now after 6 months and 14 blood tests I am off both Plavix and Ticlid. Under the new JNJ Cypher news I'd like to begin a regimen of Plavix until definitive news, the Cardio Guy says'"No". I say "I don't like the odds of 1 in 200 of post stent thrombosis" Should I find another Cardiologist??
Rick Fouke, Seattle, Washington, USA, December 7, 2006

• On Nov. 28, 2006, Paul from New Hampshire was concerned about his 6 DES stents, and asked whether a voluntary bypass would protect him against stent thrombosis occurring after the bypass (suspenders and a belt, so to speak). I was wondering the same thing, but I have seen no opinions posted regarding his question. An additional question: If such surgery would protect one against stent thrombosis, would that likely be considered "urgent" and therefore covered by many health insurance plans, or be considered "elective", and therefore probably not covered?
Tom T., Arizona, USA, December 7, 2006

• In March 2006, I was enrolled in a clinical trial (which was recommended as I lay in the bed from the cardiac cath in the recovery room) The DES was implanted and I also take the Plavix and Aspirin. Now the fear has started to kick in....and no one has the answers....I am planning to attend the FDA meeting to learn what all of this really means.....I feel duped.
R., Maryland, USA, December 6, 2006

• why don't the doctors ask the patient before the angio procedure which stent we want. I was never given a choice and now look what I have to live with: drugs the rest of my life and I had no choice. I think we are all being used as test dummies and its not right. Oh well, I hope I live a long healthy life because I'm suing the bastard and he better have a good insurance company -- my turn to ruin his life.
H.D., USA, December 6, 2006

• Erna, it's not Angioplasty.Org that suggests Plavix or Ticlid -- the package inserts, required by the FDA for both Taxus and Cypher stents, specifically state that the recommended antiplatelet therapy is either Plavix or Ticlid with aspirin. Perhaps there is some reason why your cardiologist doesn't think ticlopidine (Ticlid) will work for you. Have you asked him/her?
Angioplasty.Org Staff, Angioplasty.Org, December 4, 2006

• I have severe reactions from Plavix severe tiredness, bruises, bleeding from my nose stomach ages and nausea and on and on. I asked the doctor to put me on Ticlopidine (Ticlid), like suggested and the cardiologist asked me if I wanted to die?? And I was going to die if I did not take Clopidogrel. I explained that I had stopped Plavix several times for one to two days and I was feeling completely healthy. I had energy to work and more. The first time I was on Plavix 3 years ago, I had my platelet count dropped so low that they wanted to do a transfusion. The cardiologist also said he most all people tolerate Clopidogrel. So, what do I do now?
Erna, Washington U.S.A, December 4, 2006

• Follow up to December 1 posting: The Rash seems to be subsiding at day 3 off of Plavix. I had taken Plavix for 7 days prior to the procedure. I'm new at this and still caught up in some fear but the rash does seem to be retreating. At day three on Ticlid I am experiencing what I am guessing is simply thinner blood. Kinda warm maybe flushed now and then. Reminds me of niacin and the tingle and warmth when capillaries open up. I am sympathetic to anyone trying to manage new and fearful sensations surrounding these procedures. Thank you for your comments and I will keep you posted as to my progress.
James Ohge, Washington, USA, December 4, 2006

• Just wanted to call everyone's attention to Thursday's blog entry from "Voice in the Ear", written by Burt Cohen, Editor-in-Chief of Angioplasty.Org. It's called "The Catch-22 of Plavix and the FDA: Not My Job" and talks about the unbelievable and little-known fact that the use of Plavix for stent patients in a non-emergency situation, is technically speaking "not an approved indication" from the FDA.
Angioplasty.Org Staff, Angioplasty.Org, December 3, 2006

• Posters are describing some of the problems with long-term antiplatelet therapy: bleeding, complexity of scheduling surgery, etc. And one can't stop taking these drug because of the higher risk of stent thrombosis. No easy answers here -- possibly the FDA meeting later this week will lay out some clearer procedures.
Angioplasty.Org Staff, Angioplasty.Org, December 3, 2006

• James -- Sorry for your problems. Your reaction showed very quickly after the stenting, but is possibly Plavix-related. Sometimes drug reactions take a while to show up and it may be coincidental that it showed up right after the angioplasty. We'd be very interested if the rash goes away after the switch to ticlopidine (Ticlid). Ticlid is the drug that was used as an anti-clotting medication before Plavix came on the market. Most cardiologists moved toward the newer drug because it had less side-effects. However, cardiologists today often put patients who show a sensitivity to Plavix back on Ticlid -- one recently told us he was surprised at how effective Ticlid was and the allergic reactions of his patient went away. Please let us know if this occurs in your case. By the way, your cardiologist's quick action (and his taking your symptoms seriously) are a sign that you have a very good cardiologist!
Angioplasty.Org Staff, Angioplasty.Org, December 1, 2006

• Angiogram 8 days ago two blockages 90% and 70 %. I had 2 Cordis Cypher stents implanted 11/29. I was on Plavix for 7 days prior to procedure and felt no reaction to the drug. Early next morning following the procedure I awoke with an aggressive rash spreading over my body. It was open and oozing in two locations nurses put it off to possible allergic reaction to laundry detergent. I called my cardiologist and told him about the RASH and he wanted to see me immediately and subsequently concluded I was having an allergic reaction to PLAVIX and changed my prescription to (TICLID) with the warning that it to may cause an allergic reaction. It's late at nite and I have been researching on the Internet for several hours as I have grown a little frightened about this whole issue as it pertains to me. Am I allergic to the Stent itself ? (I asked that question and was given a pat answer) "NO" that just doesn't happen. Will the alternate thinner TICLID do the job and are the possible bone marrow issues, mentioned by my doctor life threatening. Just like most lay people I really don't know what to think. I expected the whole thing to be under whelming namely because of the almost "routine" air around all aspects of this procedure. I'm scared that my quality of life is going to plummet if I am allergic to the Stent itself or the medications or both. I am not done living quite yet.
James Ohge, Washington, USA, December 1, 2006

• I'm a 45 yo male that never smoked, was always in the gym, had normal chol. numbers. In Sept of 2004 I received 6 DES and 1 BMS. I hit the jackpot. I've been on Plavix, toprol, lipitor, cozaar and full a dose aspirin since the stent placements. I am heading for a stress test tomorrow. It will be the second one in the past two years. My big question is, Is it possible to check to see if all the stents have properly endothelialized. Also, I'm wondering if a voluntary bypass might be a good idea considering the DES danger? Would a bypass make a difference if the stents thrombosed later on?
Paul, New Hampshire, USA, November 28, 2006

• In April this year I had three DES (Taxus) emplaced after a series of stress tests and a couple MRI procedures. I m 60 yrs old. Besides being a tad husky (6 ft and 220 lbs) and consistently sedentary, I'm in pretty good health. Upon walking out of the hospital after the procedure I felt noticeably better. I was prescribed a modest drug regime (Plavix, aspirin and some little ones to lower cholesterol) but felt I was good for another 10,000 miles! Because of Plavix I noted excessive bleeding when I nicked myself shaving, but discounted any further problems. Well, sometime in August '06 I had a couple bleeders in my head (probably the result of banging my head while moving a 20 ft boat) which resulted in a hemorrhagic stroke and a follow-on hard surgery. Immediately prior to this surgery I had to have platelet replacement--four units-to allow the craniotomy to go forward. Then, per my neurosurgeon and against the better advice from my cardio surgeon I was taken off the Plavix for better than a month!! Well, I've recovered from most of the effects but am back on Plavix as the medicos assess I am in more jeopardy for a heart attack--thanks DES-- than a follow-on stroke although I was told I am a likely candidate for a stroke given my history and current drug regime. As I assess all this I guess I've landed on a question of timing. I do wish my cardio had taken more time and laid out the risks as known then and given me more of a choice. I would have elected to go on the drug regime without the stenting for a while as I suspect the stents were premature. But like many in the arrogant physician community, they know best and I'm just a layman. What to do?? I guess make my peace with those around me, tell my family I love them and don t sweat the small stuff and most of it is small stuff.
J F M, , Fairfax, Virginia, November 28, 2006

• I had a Cordis DES with angioplasty on Oct. 17, for a 95% blockage in the LAD. Was put on plavix 75 mg, toprol 25 mg, aspirin 325 mg. After 4 weeks by continuing cardiologist (not the one who had performed the procedure) stopped the toprol. On plavix and aspirin, I had severe nosebleeds on Nov. 14 and 15. The second one couldn't be stopped and after 5 hours I went to the ER and they ended up packing one nostril. Saw my GP's assistant the next day and she recommended stopping the aspirin, which I did. Saw an ENT on Nov. 20 and he recommended saline washes. Resumed aspirin on Nov. 23 and had another severe nosebleed that sent me to the ER at 5 in the morning of Thanksgiving day and ruined my family's holiday. I stopped the aspirin again. Talked to my continuing cardiologist on Nov. 27 and asked if there is any alternative to the plavix-aspirin combination, but he was completely adamant that I go back on that same regimen. He didn't mention any other possible drugs and before reading this forum I didn't know to ask about any. He views the nosebleeds as somebody else's problem to get under control. I live in dread of when the next one will start and send me to the ER for a further several days of lost work and abject misery. I have an appointment with the ENT guy in 13 days and just hope my nose holds out that long so that he may be able to cauterize the site of the bleeds. This is no way to live.
Keith D., Massachusetts, USA, November 28, 2006

• Tom L., aspirin and Plavix (or Ticlid) work differently, inhibiting platelets grouping together in different ways. That's why both are prescribed. There has been evidence of "aspirin resistance" and there is a test for it, although many feel it is not that accurate.
Angioplasty.Org Staff, Angioplasty.Org, November 28, 2006

• Follow up appointment today with Cardiologist. Put me on Ticlid. Hope I don't get the same rash that I had with the Plavix. Went three weeks with only 325mg aspirin and no Plavix. I am still here. Read that aspirin doesn't work to thin blood in some people. Is it possible that the aspirin/Plavix combo or the aspirin/Ticlid combo works better than aspirin alone because of the percentage of people who don't get the blood thinning with aspirin or is there something else going on? Should people be tested to see if they respond to aspirin? Apparently this is an easy test. Articles I have read say it doesn't matter how much aspirin you take - it all works about the same, that is, 325mg works as well as 81mg. If that is true why take the 325mg and risk more stomach irritation?

Does ones level of physical activity and other metrics (blood pressure, cholesterol levels, openness of other vessels in the heart, etc.) make any difference in the outcome of the aspirin/Plavix or aspirin/Ticlid regimen? That is, if one is on an exercise routine after the stent surgery is one less likely to get a clot? It seems to me that if one is physically active and there is more blood being pumped through the heart there would be less chance of a clot forming at the stent site. Are there any studies about this?
Tom L., California, USA, November 28, 2006

• S.M., you might want to check out the topic on stent allergies (to the right) as well. There is a new study being done and there is information in that topic about it.
Angioplasty.Org Staff, Angioplasty.Org, November 28, 2006

• My wife had taxus stents in August. She is on plavix and aspirin. Had to come off zocor because of muscle deterioration She has had numerous shingle attacks since. Also she suffers from diabetes she didn't have before treatment.(burning muscle cramp)s.We have a friend who also had stents two years ago (non drug eluting) and he also has numerous shingle attacks and diabetes trouble. Would like feedback on this.
S.M., New York, USA, November 27, 2006

G.G., Florida, USA, November 25, 2006

• We've been on a short hiatus, so some quick multiple replies:
Tom L., -- read the AHA/ACC/SCAI guidelines for antiplatelet therapy. Minimum recommendation for the Cordis CYPHER stent is 3 months of Plavix and aspirin. If you have any questions about antiplatelet therapy (this applies to all stent patients reading this Topic) ask your interventional cardiologist -- the specialist who should be most current with the latest news about antiplatelet therapy. Aspirin and Plavix act differently as antiplatelet drugs, which is why they are prescribed to be used together. You obviously had an allergic reaction to Plavix. There are other agents, such as ticlopidine (Ticlid) which can be used instead. Let us know what your cardiologist said.

Remy -- we have discussed patients attempting to desensitize themselves to Plavix at home directly with Dr. Walker and others and it is definitely a no-no! First off, headaches can be caused by a number of things -- Plavix allergies usually take the form of rashes. Nevertheless, any desensitization should only be done under the supervision of an M.D. -- there exists a possibility of an anaphylactic allergic reaction which could be fatal if not done in a controlled setting.

Finally, Soames -- you must have a prescription for Plavix. However, a large number of cardiologists have been prescribing Plavix for life, until more data are in (see our Patient Advisory -- especially the quotes in the sidebars). There are side effects from Plavix, not to mention the increased risk for bleeding, so it needs to be taken in conjunction with your physician -- ideally your interventional cardiologist should be involved in the decision.
Angioplasty.Org Staff, Angioplasty.Org, November 22, 2006

• I have been off of Plavix for over a year. when I took plavix for the 1 year following my angioplasty I had no side effects. I was considering taking plavix along with my 325mg of aspirin in order to make sure I do not have another blockage. Have you heard of anyone voluntarily taking plavix for life? and if so, what do you think? I am 42 years old and want to make sure that stents are not part of my future?
Soames F., California, USA, November 19, 2006

• I just wanted to know how I can test the desensitization conducted by Dr. Nicholas Walker of the University of Iowa Healthcare. shall i cut the Plavix in 8 and take each with 15 min intervals. I have 4 DES since last week and I have a severe headache, this might be a Plavix reaction.
Remy, Ontario, Canada, November 17, 2006

• Oct. 27th went to ER because of irregular heart beat after my usual 10k run on treadmill. Hospital kept me overnight and next day did angiogram. Found 1 narrowed artery - all others wide open. I am 60 yr. old runner - excellent physical condition and diet. Cardiologist put in 1 Cordis DES and put me on Plavix and Aspirin. Several days later I developed a head to foot major rash. My doctor (not cardiologist) took me off the Plavix but said to continue the 325mg aspirin only. He said that aspirin was statistically about as effective as the Plavix as a blood thinner and because of my general physical condition I shouldn't be concerned. I have low blood pressure, good cholesterol readings (slightly high LDL). I have an appointment with my cardiologist next week. After reading posts here I am concerned that I am ONLY on the aspirin. Should I be concerned?
Tom L., California, USA, November 14, 2006

• I've had 3 stents placed in the last 2 years in my LAD. I'm on Crestor, Plavix, Aspirin, Niaspan (2000 mg), Toprol. My cholesterol is normal, my blood pressure 120/80, but my Lipoprotein A is 225. The Dr said it should be 75 and he can't seem to bring it down. I'm told it may be hereditary and it can't be verified because my Dad died at 29 of cancer. I'm not very clear on what the Lipoprotein A issue means? I'm 53 yrs old and in relatively good physical shape, never smoked and I always have run 2 miles every other day. Thanks.
Mike, Florida, USA, November 14, 2006

• I am on plavix, have a small rash on my checks (not bad). Was wondering if tingling of the fingers, feet (not every day) is a side effect of Plavix?
Jerry Hunter, Arcadia, Florida, November 13, 2006

• Thank you so much for the update. After taking Plavix every other day I am happy to report I have NOT had any major nose bleeds. Small ones here and there but nothing like I was experiencing. I was apprehensive as I was thinking the nose bleeds stopped but am I now MORE at risk of a heart attack? I have been having shortness of breath the past two days and will probably go to the ER tonite if it does not go away. I was away in New York City last weekend and definitely "overdid" it with walking and staying up late. I'm hoping this is the reason for the shortness of breath and recent "little" nose bleed tonite. Overall, I like taking the Plavix every other day!
Rosanne, Stoneham, Massachusetts, USA, November 11, 2006

• I had a drug eluting stent inserted on Tuesday Nov 7. Was released from the hospital after 2 days and was treated with plavix 75mg, toprol xl 25mg, vytorin 10/20mg and aspirin When I came home for the hospital I purchased the generic form of plavix - clopidogrel bisulfate 75 mg. After taking my first round of meds this AM I am having a sensation of mild choking or inability to swallow, but am actually having no trouble swallowing at all ... only the sensation. Am I having an allergic reaction to the stent or one of the meds or is this part of the healing process after just 4 days.
Mike, Interlachen, Florida, USA, November 10, 2006

• Terry, you've surfaced another big problem -- the cardiologist prescribes Plavix for a year, but the general practioner (or surgeon) says it's okay to stop. We have interviewed many of the top interventional cardiologists in the U.S. and have attended the major international meetings and they all agree on one thing: Always ask your interventional cardiologist what you should do and for how long. It's a complex and confusing topic (see the posts below) and non-cardiac physicians are just not current with what is happening in this field. The AHA/ACC/SCAI recomendations are listed here, but bifurcation stents are a specific case and your interventionalist should be your best guide.
Angioplasty.Org Staff, Angioplasty.Org, November 8, 2006

• Following BiFurcation stent in February this year (BMS) I was told (in writing) by the Cardiologist that fitted the stent to take Plavix and Aspirin for 12 months. It comes on prescription in the UK. Have just requested the prescription for November, and have been told by my Doctor that I should only have it for 9 months and that the prescription will not be issued. (In the UK that means you can`t get it at all) Have yet to consult with my Cardiologist, but what a shambles???????? Don`t they read each others notes?? In any event I'm scheduled for another stent in December, when regardless of what stent is fitted I will be placed back on Plavix for sure. What is the general recommendation for Plavix/Aspirin for BMS?
Terry, UK, November 8, 2006

• boy oh boy. i am on my last month of plavix before the prescription runs out. My cardiologists says thats it i should stop. as i have a des stent it sure seem like a scarey issue. i think i will call him up and ask for another year since so far i have been tolerating it. just seems to be no downside to continue. i am 50 years old.
Michael K., Quebec, Canada, November 7, 2006

• Anneand R. from Ohio -- your questions hit the nail on the head. It is confusing for physicians as well as patients. The FDA has called a major two-day meeting on December 7-8 to discuss drug-eluting stents and the recommendations for Plavix and aspirin will hopefully be discussed. Who is responsible for educating patients and physicians about the implications of long-term antiplatelet therapy is a subject that Angioplasty.Org will be posting a feature about shortly. Keep tuned!
Angioplasty.Org Staff, Angioplasty.Org, November 5, 2006

• Hi, I had 3 stents implanted four weeks ago and am now on the usual medication regime. I am taking Vitamin C since years, however, have heard that when on Blood thinning medication one should not take Vitamin C. Your comments will be appreciated. Thanks.
Frederick P., Germany, November 4, 2006

• My question is what if any clinical data studies have been done that provide guidelines for recommendations regarding plavix and ASA 81 mg or 325 mg? It seems to me that guidelines based on clinical studies should be given to Cardiologists rather then just base it on the patient??? I too had the Taxus II stent inserted for 99% LAD blockage and told Plavix 75 and ASA 325 daily . I too have had bruising and now 2 episodes of Epistaxis . My problem is that I get advised to stop Plavix and continue ASA, to stop ASA and keep taking Plavix and or just take baby ASA instead of regular. Now please help me I just want to do the right thing and stop the bruising and bleeding.
Anne T., North Carolina, USA, November 2, 2006

• I am 57 and now have 5 stents - 2 metal and 3 coated. I received the 3 coated stents in January 2005 and continue on Plavix and a 325 mg aspirin. It appears I may be on this regimen the "rest of my life". Plavix is not cheap - and now they blocked the distribution of a generic plavix! I am on a drug insurance plan through my employer, so the extra $50 per month is tolerable now. I feel for those who have to pay out-of-pocket! Those who cannot afford the drugs are the ones referred to in the articles that stop taking the medication - and become statistics. Has any work been done to have Boston-Scientific and J&J provide Plavix and aspirin to those now required to take the meds so long due to their lack of product testing?
R., Ohio, USA, October 31, 2006

• Walter -- we always recommend that patients consult their interventional cardiologist about ANY adjustments to medications prescribed after stenting. Going off Plavix won't negatively affect the way you "feel" (except to reduce any adverse effects of the drug) but the reason Plavix is prescribed is to prevent blood clotting inside or around the stent. You're almost two years out which is good, although you did have five stents implanted. We strongly recommend that you consult with your interventional cardiologist (not just any doctor) about your Plavix regimen. That being said, congratulations on your turn-around and recovery from a heart attack, something that was very uncommon only a couple decades ago, before angioplasty and stents.
Angioplasty.Org Staff, Angioplasty.Org, October 30, 2006

• I am a 55 year old male that had an MI in Dec. 04, I received 5 cordis eluting stents in one artery. I was given Toprol XL 100 MG, Plavix 75 mg, 325 Mg Aspirin, Lisinopril 10mg, crestor 20 mg, I reduced my own crestor to 10 mg after about 6 months due to the sharp drop in all my numbers, got tested 4 months after reduction and bad LDL was 82, I have now taken my self off Plavix, I have been off of Plavix since July 06 with no visible effect. Still feel fine except do not bruise as easily.
Walter Shell, Litchfield, Illinois, USA, October 30, 2006

• Lacy -- well, instead of the Wall Street Journal, start by reading our Patient Advisory (link on the right sidebar). It's free and no subscription is needed! (We posted our advisory over a month ago -- we just returned from the Washington meeting, along with all the other reporters, and can say that our advisory remains a good summation of what many cardiologists were saying.) Have you tried to contact Dr. Kandzari? We posted the story of his appointment to Cordis a couple of weeks ago, but he doesn't start there until December. As for Dr. Califf, his opinion on this issue was quoted by us in a previous post. He said, "In my practice, if you get a drug-eluting stent, you're going to be on clopidogrel for life until more data come in." Last week's Washington meeting of the TCT didn't add much to this particular debate. In fact, an Italian study, presented by Dr. Alaide Chieffo, showed that there was no benefit to dual antiplatelet therapy after 6 months. Interestingly, when asked what her institution's current protocol is, Dr. Chieffo said dual antiplatelet therapy for one year, almost as if she didn't believe her own study. Dr. Sigmund Silber of Germany called all the conflicting studies "totally confusing". So for you, facing surgery, we can say that most cardiologists probably would feel okay about your stopping briefly for the surgery (but staying on aspirin, if possible) and then resuming. Mainly because you are two years out. But this is NOT medical advice for you. You should definitely be in touch with an interventional cardiologist about this. Your clinical condition, etc. can only be judged by a physician (which we are not) who has your complete medical records and history. Some cardiologists talk to their surgeons about this problem as well and surprisingly, when surgeons hear that there may be a chance of a stent thrombosis or heart attack, they are persuaded to do the surgery without taking the patient off Plavix. These are only reports which we have read or heard. Please talk to your interventional cardiologist about this. And let us know what he/she says!
Angioplasty.Org Staff, Angioplasty.Org, October 29, 2006

• I am a first time reader. Had 3 stents (2 Cordis, 1 Taxus) done at Duke U. August of 2004. Plavix 75mg, 81mg aspirin, 5mg Altace were follow-up meds. I'm doing well but am not assured as to new danger with DES as my cardiologist is leaving to head J & J Cordis division! It seems the only information (I noticed Rob Califf can't be reached by mere patients) is such as in this forum. My last admonition was to remain on Plavix for life, but I face surgery which will require my stopping it for a week. To Plavix or not to Plavix? Can't we do better? my god! i just went to read Wall St. Journal's report only to find i must subscribe to do so!!!
Lacy, North Carolina, USA, October 29, 2006

Rosanne (from earlier in October) -- your situation is one of the reasons that there has been a rethinking about drug-eluting stents and long-term antiplatelet therapy. We have heard all week about these problems from cardiologists at the TCT. I spoke with one who has recommended to a patient the same course, take one Plavix every other day (the drug stays in the system) -- but nothing on this board should be substituted for medical advice, and it sounds like your cardiologist is aware of these controversies. The problems you are having are a trade-off against the benefits of drug-eluting stents -- the big question is how much of a trade-off and are there alternatives for some patients. We're "on" this topic, so keep tuned to our site.
Angioplasty.Org Staff, Angioplasty.Org, October 29, 2006

• My mother takes Actos Plus for her diabetes. She started taking Plavix because we were traveling and all of a sudden her blood sugar was way out of line. It shot up to over 170. She didn't change her eating habit while we were away. While at home before taking Plavix, her blood sugar was generally below 100 every morning.
Susan Bristol, USA, October 28, 2006

• How quickly the questions build up. We have been attending the TCT meeting in Washington this week and we can assure all posters that the topic of dual antiplatelet therapy (aspirin + Plavix) was one of the most discussed -- and that there is anything but a consensus of opinion about how long patients should stay on it after stenting. We'll be writing more about this soon, but we'll try to give some quick answers to some of the questions....

Melissa in Indiana -- depression and heart disease are very closely associated: the causes range from reactions to medications to psychological adjustments that people need to get used to. It's a complex issue and a patient support group might be helpful -- many others feel this way and depression has the unfortunate characteristic of closing one off from others. Your doctor, hospital or local heart association may be able to help you find one. Good luck and let us know what you find out. As for allergic reactions to Plavix, they are well-documented (just read the postings on this board) and physicians may switch patients with such reactions to ticlopidine (Ticlid). If the allergic symptoms remain, it could be an allergy to any number of other drugs, or to the stent -- a phenomenon which has NOT been well-documented but does exist. We urge any readers who have good reason to suspect the stent to read the Forum Topic on that subject and to post your story there.

M. in Georgia, you discuss starting and stopping Plavix, but you don't mention having a stent? Did you get one or was Plavix prescribed for other reasons? If you got a stent, especially a drug-eluting stent, you definitely do not want to stop antiplatelet therapy -- call your interventional cardiologist, the one placed your stent, about this.
Angioplasty.Org Staff, Angioplasty.Org, October 28, 2006

• Plavix....Ugh!~! Since I have been on Plavix for a little over 2 years now for my 4 DES Cypher stents, I have had a very low Ferritin reading. WBC is OK for now. The diarrhea is a hit and a miss but leaving me very weak on the days it hits. I normally pop a potassium pill on those days. I have developed cataracts. A rare side effect to Plavix but none the less it was the Plavix (determined by the MD Ophthalmologist as drug induced) I have now developed an uncontrollable itch. I have scratched myself to death and have scabs where I have dug into my arms and legs. be rid of Plavix. Doctor said I need to take it for life...I don't think I can take much more of that drug.
Macy, Texas, USA, October 26, 2006

• Has anyone had an allergic reaction where there nose stopped up and they had a hard time breathing through their mouth after their stent? I had a Taxus II, drug eluting stent on June 13, '06. The next day I had the reaction listed above. The Drs. do not know if it was the Plavix; the polymer coating the stent; or the Paclitaxel on the stent. The problem began to diminish at about 2-1/2 mon., but has not gone away completely yet. The Drs. prescribed several medications during this time, but none worked very well. I am still on Ticlid and a Baby Aspirin a day and after going to a health food store, I'm taking ALJ which is for respiratory problems. That has helped a lot.
Lewann, Missouri, USA, October 24, 2006

• I started Plavix about a month ago, had noted for about 2 weeks my feet feeling hot. This week I started getting a red rash on the top of my feet and mid-way up the legs. Not really itching but burning and uncomfortable, tight. I have been taking 25 mg Benadryl plus I take Zyrtec for allergies. Today it became more severe, looks like a heat rash or diaper rash and tonight some of the places looked red-red and bright orange. I called the dr 2 days ago and they said to try stopping the Plavix, I was also started on Crestor. This scares me as I had an anaphylactic reaction to aspirin about 20 years ago. The dr was to call back today about further plans but received no call so I assume I need to stay off of it until I hear from them, I am thinking about stopping the Crestor too until I talk to them. My heart problem is attributed to coronary spasms and I also have an abnormal EKG which reads out always like I am having a severe ischemic attack. I have not had hives/welts but this severe rash. As in the last few days, tonight it went away after about 3 hrs on the Benadryl. I just hate the Benadryl because it makes me feel so bad.
M., Georgia, USA, October 21, 2006

• I am 38 yrs old. I had a heart attack in july, went into cardiac arrest twice. I had an angiogram, angioplasty, and 2 stents put in. My dr. has me on Plavix 75mg, aspirin 325mg, and metoprolol 50mg. I have been feeling very depressed. It is not everyday but it is about 2-3 days a week. My husband and I have only been married 6 months and this is been very difficult for us. Is that normal or could that be a side effect of the plavix or one of the other medications I am taking? Should I contact my dr.?
Melissa H., Hobart, Indiana, USA, October 20, 2006

• Have been on 75mg Plavix o/d since first angioplasty in Oct 2005 - original planned regimen was 9 months - however had a second one in June 2006 and will be on Plavix till at least June 2007. Only significant side-effect is frequent nose bleeds (pretty much every day). These can take some time to stem. Compared to the risks of not taking Plavix after two DES angioplasties, this is something I'm happy to LIVE with. PS. This forum is a great resource and reassurance - keep it up. Thanks.
JJ, Lancashire, UK, October 20, 2006

• Also a quick addendum to Ted in New Zealand who experimented with desensitizing himself to Plavix, as a study in Iowa is currently doing. I've mentioned his experience to the doctor heading the Iowa team -- he was impressed that someone would do this successfully in this manner, but also sounded a strong note of caution, seconded by Dr. William O'Neill of University of Miami yesterday in a conversation -- doing this at home and not under medical supervision could be dangerous. If you have an allergic reaction and go into anaphylactic shock as a result, you could stop breathing and with no medical personnel around, you'd be in trouble. So it's a great story, but we'll strongly caution our readers: "Don't Try This At Home!"
Angioplasty.Org Staff, Angioplasty.Org, October 19, 2006

• Roseanne -- glad the Forum has been of some comfort. Bruising and bleeding problems can be side effects of blood-thinners or antiplatelet drugs -- it's why many surgeons ask their patients to stop Plavix and aspirin several days before a procedure -- something which no stent patient should do without consulting their interventional cardiologist. We can't give specific medical advice to anyone and only your cardiologist can adjust dosage, as it seems he has. Given that your stent is now past the one-year mark may be one reason. The problem is that the data about when one can stop antiplatelet therapy is not strong. Current recommendations in the package insert for the Taxus say six months; most cardiologist give it for a year or more (see our Patient Advisory). Both Plavix and aspirin can cause bleeding, or the combination of the two. But both act as antiplatelet therapy in different ways, which is why they are used together. Unfortunately people like yourself who have bleeding or allergic proplems get caught in this Catch-22.
Angioplasty.Org Staff, Angioplasty.Org, October 19, 2006

• I received a Taxus stent in September of 05 in my LAD artery because of an angina attack. Blockage showed 99% also 60%. They did not stent 60%. I am 55 now and have never smoked. I've had ITP (platelet dysfunction) the past 30 years making Plavix really difficult for me. My continuous bloody noses having to be "packed" this past June have caused me to ask if taking Plavix every other day "appropriate" and safe for me. Cardiologist said to try it and I have. Blood noses have stopped for the most part with one this morning as I'm writing to you for your advice. I love your website. It has been of great comfort to me hearing stories that sound like me when I've had no one to talk to about my feelings of uncertainty in knowing what will happen next. I am full of bruises but can deal knowing the Plavix is helping along with aspirin. Is the aspirin or the plavix causing these bloody noses? thank you for this Forum..It's my comfort zone for sure..
Rosanne G., Stoneham, Massachusetts, USA, October 19, 2006

• Michael -- the only other antiplatelet med discussed is ticlopidine (Ticlid). Don't know if that has the white cell problem as well, but it is what was used before Plavix became available and while it tends to have more adverse reaction than the newer drug, some cardiologists we have talked to find that some patients tolerate Ticlid just as well. Let us know what else you find out from the doctors. Meanwhile, anyone out there have some comments??
Angioplasty.Org Staff, Angioplasty.Org, October 18, 2006

• My friend Jeff had 3 Cypher stents inserted at the end of August. He was put on Plavix. Prior to the angioplasty his blood work was normal. After the procedure his white blood cell count was decreased. He has had his blood tested again since then and his white blood count is still low. His primary care doctor was concerned and told him to schedule an appointment with a hematologist. My friend's sister told us to ask the doctor about the Plavix because one of the rare side effects is that it can cause decreased white blood cell counts. We asked our pharmacist about that and she confirmed that Plavix can cause that effect. My friend saw the hematologist today and asked whether the Plavix could be responsible for the low white blood count. The doctor confirmed that it could be the reason and recommended that my friend speak to his cardiologist. The hematologist also wants to schedule a bone marrow test.

Does anyone in the forum have any experience of Plavix causing a decreased white blood cell count. Also, if the Plavix is responsible is there an alternative to Plavix that my friend could take? Obviously he is going to follow the advice of the cardiologist, however, we just want to educate ourselves on alternative medicines. We have been told that if the drug coated Cypher stents are implanted it is important to stay on the Plavix for at least a year. Any feedback or advice would be greatly appreciated. Thanks.
Michael Loftus, Mastic Beach, NY, USA, October 18, 2006

• My 86 yr old mom was given the generic Plavix. She broke out in a rash around her neck, had severe stomach problems, and no appetite. Stopped the generic and got back to normal. GENERICS ARE NOT THE SAME! But a lot more money for the money hungry.
L., Florida, USA, October 17, 2006

• Ted in New Zealand -- that's great that it worked for you. We've posted a link to the full story about desensitizing patients to clopidogrel in the right-hand sidebar. Sounds like we should do an interview with the doctors who did the study. And Martha, glad you've been able to lessen the adverse symptoms as well. We would caution patients that benadryl is a vasoconstrictor -- it can narrow blood vessels, so you want to be careful self-medicating with it, especially if you have high blood pressure. You might want to check with your doctor, but it's great that its working for you. We'd like very much to thank patients like Ted and Martha who are writing in with solutions to some of these problems!
Angioplasty.Org Staff, Angioplasty.Org, October 17, 2006

• Looks like I am not alone with allergic reaction to Plavix. But, I think I've found relief. I started taking a 25 mg. Benadryl tablet one hour before I took the Plavix. I did this for about a week. The itching and hives was substantially reduced. I started today to take Plavix without the Benadryl and I seem to have overcome the allergy. Also, I found out that you need to take the Plavix with a full glass of water; no more stomach pain or diarrhea. Anyway,I am much better.
Martha, South Carolina, USA, October 16, 2006

• Yes it was from our Forum that I heard of this procedure. It was an article you posted dated May 12 2006 about "a study just presented at the annual meeting of the Society for Cardiovascular Angiography and included the results of an experiment in desensitization conducted by Dr. Nicholas Walker of the University of Iowa Healthcare."
Ted G., New Zealand, October 16, 2006

• I have given this quite a bit of thought. It certainly appeared to me that the difference was due to the change from Plavix to generic Clopidogrel. However, I started taking the generic in the 4th month after having received an endeavor IV stent as part of the clinical trial. Perhaps I was experiencing a reaction to the DES and the 4 month time frame is about the time the stent became covered with my own cells. I have had a lot of problems and I am still much worse overall from a feel good perspective than I ever was prior to the MI and stent placement. I am slowly starting to feel better though, five months after the incident. At least now I have hope, even if I never know for sure why I have felt so bad. The doctors are very little help when your tests are normal, but you feel terribly.
S.M., Georgia, USA, October 15, 2006

• S.M. from Georgia -- most interesting, since we've gotten a few postings with just the opposite reaction: patients who were having allergic reactions to the generic clopidogrel, but were OK with brand-name Plavix. Supposedly the two are equivalent. Anyone out there care to give an opinion or relate a story?
Angioplasty.Org Staff, Angioplasty.Org, October 14, 2006

• Yes, I was having a fairly severe reaction to Plavix. I received 3 months worth of the generic from my mail order prescription service last month. The itching, sores in the mouth, bad taste, are all much better or gone altogether.
S.M., Georgia, USA, October 12, 2006

• My father has has a history of AMI 23 years ago subsequently treated with angioplasty, CABGx3 with mitral valve repair 11 years ago, an additional coronary stent and a stent in his subclavian about 3 years ago. His following Cardiologist has prescribed Coumadin and Plavix but the Cardiologist who rounded on him at the hospital told him this combination was not recommended. Is there ever a situation where both of these meds are recommended in conjunction with one another and if so, is there more frequent testing needed?
Roxanne, New Hampshire, USA, October 10, 2006

• Ted -- great to hear this self-desensitization worked for you. Where did you hear about this? Was it on this Forum?
Angioplasty.Org Staff, Angioplasty.Org, October 10, 2006

• Was having serious side effects on Plavix 75mg plus Aspirin 300mg daily. Welted rashes all over, severe joint and muscle pain, etc. Tried self-desentisation by cutting up one 75mg tablet of Plavix, taking very small dose first, then increasing every 15 minutes over two hours until whole tablet was consumed. Within 24 hours all joint and muscle pain and rashes had disappeared! Will inform my cardiologist next time I see him.
Ted G., New Zealand, October 9, 2006

• Stephanie -- your report of a difference between generic clopidogrel and brand-name Plavix is most interesting -- first report we've had of this. Anyone else out there seeing a difference??
Angioplasty.Org Staff, Angioplasty.Org, October 9, 2006

• My husband went back to his cardiologist after having a reaction to the generic Plavix and he wrote a script for Plavix only no generic. He started the Plavix a couple days ago and hasn't had any problems with hives and itching since so we know it was the generic. The insurance company charged us for the difference in the Plavix and the generic and we are trying to get that resolved. Looks like the generic is a little different than the real Plavix or at least it affects my husband differently.
Stephanie Doty, Cocoa, Florida, USA, October 8, 2006

• My husband had angioplasty and 2 Taxus stent placements in mid August. He developed a rash immediately which became hives within the first week post procedure. After medications review with the cardiologist and primary care physicians and eliminations or changes of possible causes; he was left with topicals and antihistamines for any relief. These were of minimal help until he tried Noxema. THIS WORKS!! For anyone suffering from the severe itching, apply Noxema after showering or in between. Available not only in a cream, Noxema wipes can be used when the cream is not an option, and relieves the itch as an 8-9 on a a scale of 1-10.
Dorise, Arizona, USA, October 8, 2006

• hi i had to have a stent put in a couple of weeks ago, got was was tried but fine I'm on plavix and a aspirin. have started breaking out in hives. called heart dr. nurse said to stop taking the plavix for the weekend my question is how long after stop taking the plavix will the itching and hives stop per say that is the cause ? anyone have any thoughts on it? you can email me at thank you
Joan B., New Jersey, USA, October 7, 2006

• Can someone give me some advice on this: I am a 55 year old non smoking, non drinking woman who has a drug eluting stent (Taxus) procedure last year. I had 99% and 60% blockage. I also suffer from a "bleeding disorder called is a platelet dysfunction disorder. I've been on Plavix for one year now, with baby aspirin. I've had to have my nose packed from 24 hours of bleeding. At times, the black and blues on my body make me look like a "battered women". I am so tired at times although my hematocrit is in normal range. Last blood test showed low platelet count. Had cardiologist visit last week. He will not take me off Plavix for all the reasons stated..He did suggest I could maybe take Plavix every other day.. What do you think? I am on high blood pressure medicine, Lipitor, Plavix and two Protonix's a day...Would the change to every other day be a good one for me? It may stop the gushing of bloody noses once a week. Will it be safe for my heart and the chance of a blood clot? I have not been without boxes of tissues besides me since this procedure..Thank you for any advice and help!
Rosanne Giiulaino, Stoneham, Massachusetts, USA, October 6, 2006

• L.C.D. -- Isn't this the problem with drug-eluting stents? And it's one which just seems to be getting addressed. First of all, remember not to take anything you read on this or any website as "medical advice" or as a substitute for seeing a doctor. That being said, we have spoken with some interventional cardiologists who say that they make a practice of talking with their surgical colleagues to explain the need for blood-thinners. Some surgeons, once they understand the implications of stopping antiplatelet medications prematurely, will go ahead with some minimally invasive surgical procedures where the risk of bleeding may be lower (we don't know if a biopsy would be in this category). Since your mother's situation seems time-sensitive, perhaps your cardiologist and surgeon could discuss this option. Some cardiologists stop Plavix briefly, but stay on aspirin, then resume Plavix immediately after surgery. As for a different drug, any antiplatelet drug has the downside of allowing bleeding to occur -- in fact that's the point. Good luck and please write back to the Forum to let us know how you fare.
Angioplasty.Org Staff, Angioplasty.Org, October 3, 2006

• My mother just had two stents put in her right coronary artery which was 100% blocked three weeks ago. She just had her second stent procedure, putting stents in the left anterior coronary artery and one other which were 70% blocked. Her mitral valve is damaged but seemed to repair itself between the two stent procedures. They did not do open heart due to a growing spot on her lung and several enlarged lymph nodes in her mid chest area. The lung spot was first detected in late July and now shows to have grown along with now the enlarged nodes. A bronchoscopy was done but yielded no results due to the difficulty in reaching the spot with a brush or with a flush. The next procedure to attain tissue to biopsy would be surgical and the thoracic surgeon and her cardiologist won't do it for a minimum of four weeks due to her being on plavix and the new stents. Isn't there an alternate blood thinning drug to use in the interim while the biopsy is performed? There seems to be significant change in the lung and now the nodes to indicate immediate action is necessary. Please advise.....thanks.
L.C.D., USA, October 3, 2006

• Jing -- the decision to revascularize (unblock) an artery is something that is a judgement call by the interventional cardiologist. It is not recommended to angioplasty a blockage less than 50% blockage. Over that, it really depends on many factors: which artery, clinical status of the patient, etc. Diet and exercise is important for all people. It may not prevent heart disease (or reverse it) but it certainly helps. There is less and less importance being put on stress as well. Everyone has stress, but not everyone has coronary artery disease. Smoking -- definitely the worst thing you can do. As for aspirin, it has a number of benefits and most cardiologists recommend a baby (low-dose) aspirin a day for life for all male patients, assuming there are no bleeding problems.
Angioplasty.Org Staff, Angioplasty.Org, October 2, 2006

• My wife had stents following angiogram.The doctor told her before the procedure she would need plavix for a short time till they healed. Afterwards they told her a year and she better take it or she would have a heart attack. Same doc afterwards told her to work on stress control. Where do they get people like that, from Hell? I guess. Better go to church and be poor give all your wealth away and follow Christ. Must be something about never hearing about stents, angioplasty or drugs in the bible. I myself have lost all faith in medicine today. Especially since our youngest son died last year from the propofol infusion syndrome. The Christian Scientists have a point.
Rick Fields, New York, USA, October 1, 2006

• I had an angioplasty in '03 after showing abnormally in a stress test when I was only 34 :(   I had placed two bare metal stents for two arteries that were 70% and 50% blocked. I have always wondered about the necessity of the surgery. I had high cholesterol (HDL+LDL = 300) at that time and the doctor has never given me an option to have diet and/or Lipitor first. In fact taking Lipitor a while after right before the surgery has lowered my cholesterol quickly to normal. My heart problem is mostly due to stress. No family history of heart problems. Was the doctor too quick to make the decision? I had Plavix for a couple months, and been having 81mg Aspirin and 10mg Lipitor ever since. Now 3 years after the surgery, I am wondering if it's necessary to continue to take aspirin for life? The earlier discussion seems to indicate that it may not need to take antiplatelet drug for too long if it's bare metal stent. I am always more interested in trying natural method like exercise, Chinese herb and acupuncture to recover the heart problem.
Jing Fung, September 30, 2006

• What is the new news on the Generic drug Plavix. I have read where the FDA and the US drug makers were screaming about the sale of drugs coming from Canada and Mexico, well what about the generic drug Plavix. The reason i am concerned is the last script i had filled were filled with the generic Plavix and i questioned the druggist about the drug and they hum-haw around and did not give me a straight answer, only saying my insurance would pay for the generic and it was only $20.00 less than the brand. What is your, or all people taking this drug think about this. Thanks
Ronnie, Flatwoods, Kentucky, USA, September 21, 2006

• Stephanie -- we haven't heard reports of allergic reactions to the generic version of clopidogrel from patients who have been fine with brand-name Plavix, but this experience is just starting up. I would definitely report this reaction to your interventional cardiologist. Possibly try going on brand-name Plavix for a while and see if the hives subside. If they do and they return when switching back to generic clopidogrel, you will have made a discovery (and please let us know). Another possibility is a reaction to the polymer coating of the drug-eluting stent. While allergic reactions to these devices are rare, they definitely do exist. See that topic in the right-hand column.
Angioplasty.Org Staff, Angioplasty.Org, September 20, 2006

• My husband received 3 stents in August 2001 and was put on plavix and lipitor. He again had a heart attack in November 2003 and received 2 more stents, the newer and improved version. He started taking the generic plavix 2 1/2 weeks ago and now has the hives. Called the pharmacy and was told it couldn't be the generic but that is the only change in his diet, soap, etc. Any one else having problems similar. He is allergic to aspirin.
stephanie doty, cocoa, florida, September 17, 2006

• My doctor prescribed 325MG of aspirin for life and Plavix 75 MG per day for six months. I had a bare stent inserted 8-18-06 after an acute MI. Everything I have researched states aspirin in women deters strokes but not heart attacks but the opposite results for men. I will take the aspirin for stroke protection even though it is not going to head off another MI.
Phyllis R., Pennsylvania, USA, September 16, 2006

• KJ -- a year is a pretty good distance, but of course every patient is different. You've done the right thing by consulting your interventional cardiologist before scheduling surgery. We can't say do or don't go off Plavix -- that's your cardiologist's call -- but if there are any questions, he/she may take you off briefly, and then put you on again post-surgery. Have your cardiologist discuss the situation with the surgeon as well. Let us know how things go and good luck with the knee replacement.
Angioplasty.Org Staff, Angioplasty.Org, September 16, 2006

• I had a Cypher stent placed on 10/05 and have been compliant on meds since -- toprol 25XL, plavix 75 mg, asa 325 mg for 6 weeks, and 81 mg since, and lipitor. I need knee replacement surgery -- cardiologist wants to wait until stent is in place for 1 year -- In light of World Cardiology Congress concerns in Sept. 06, is this a safe waiting time? Normal chemical stress test in July 06.
KJ, USA, September 9, 2006

• Don from Texas -- generic Plavix (clopidogrel) is the subject of our recent news article, "Court Grants Injunction Against Generic Plavix", so get it while you can. The current supplies on the shelves will continue to be sold until they run out. As far as we know, there is no difference in the generic and the branded version (otherwise the FDA would not have approved the generic).
Angioplasty.Org Staff, Angioplasty.Org, September 3, 2006

• I had a drug-eluting stent put in on Sep 7. I'm on 81 mg aspirin, 75 mg. Plavix, 240 mg diltiazem ext. release, 90 mg. generic Imdur (isosorbide MN ext. release), 10 mg. Lipitor. I don't know brand of stent - I will find out from cardiologists' office Tues. after Labor day. My question - I can get generic Plavix at my pharmacy for next several prescriptions, which will save me some money, not a huge amount. I want to know if generic is equally effective and safe.
Don H, Houston, Texas, USA, September 3, 2006

• RJ, had your aunt been implanted with a drug-eluting stent?? Is that why she was on Plavix?
Angioplasty.Org Staff, Angioplasty.Org, September 3, 2006

• My aunt was on plavix, she had a dentist appointment, and her doctor told her to go off plavix. That was a friday by next thursday she had a massive stroke. Was it just bad timing or was it because she was off plavix for those days.
rj, Pennsylvania, USA, September 3, 2006

• Some quick replies -- Christina in New Jersey -- as we always say, you should discuss any medication with your physician (including over-the-counter meds and "nutraceuticals" from the health food store) -- just because a pill isn't a prescription med doesn't mean it can't have a significant effect. Sounds like your doctor is responsive. If you had written before you saw your doctor, we also would have suggested that perhaps the statin is causing you the muscle pain (a known side-effect) but we still would have recommended consulting your doctor. Congratulations also on your increasing stamina (many people much younger than you couldn't do 10 laps in a pool). By all means let us know how you fare and if the cramps subside or if you continue to have problems. As for others who have been having reactions to Plavix, there are a few other antiplatelet agents: aspirin, ticlopidine -- we have also heard of physicians using persantine and dipyridamole, but none of these (except aspirin which you should be taking anyway unless it's contraindicated) seem to work as well as Plavix.

The question as to why physicians implant drug-eluting stents in patients who have a known allergy to Plavix is an excellent one. Perhaps the physician is not aware of the allergy, which is why it is vitally important for patients to bring any allergy to their attention. And strongly. Drug-eluting stents have been shown to work very well, but bare metal stents, which do not require Plavix beyond 1 or 2 months, can work very well in many cases and they avoid the long-term antiplatelet therapy.

Don in L.A. -- if your doctor told you to start aspirin before the procedure, and you had questions if that was wise, did you ask this of your doctor? The reason he/she prescribed aspirin was to keep your blood thin -- something which will aid in reducing possible complications during the angioplasty. If a stent is placed, you'll most likely be prescribed Plavix as well. If you have an allergy to Plavix, tell the doctor BEFORE the procedure.

Finally, there have been some small studies at the University of Iowa in desensitizing patients to Plavix -- a very small dosage is given, then it is increased slowly every 15 minutes. After 2 or so hours, the full 75mg dose has been reached without the allergic (hypersensitive) reaction taking place. Almost all the patients that have been in this study no longer had allergic reactions to Plavix.
Angioplasty.Org Staff, Angioplasty.Org, September 3, 2006

• In May, 06, I had a Cordis Cypher Sirolimus Eluting Coronary Stent placed in LAD artery, which was 70% blocked. I was given a handful of plavix pills to take before the procedure, and was then placed on 81 mg aspirin, 75 mg plavix and 40 mg lovastatin daily. Afterward I had severe headaches at home which gradually stopped. I have been puzzled at the variety of complaints I have had and felt the need for a support group, wish I had found this site earlier. I have had episodes of chest pain, weakness, breathing difficulty, extreme fatigue after exertion and interspersed with these, episodes of increased strength and ability to do things. I have been an active person, swimming and walking for many years, now in my 70's. Have been able to return to both although I could barely swim 4 laps in July, now doing 10 in August. A follow up stress test in July showed no dec. blood flow to heart. During the past month or so I have developed pains in different places in my body which weren't there before, and really bad cramps in my legs at night. The last episode of leg cramps was really horrible. Saw my internist for routine visit a week ago and he advised that I should go off the lovastatin, which I did the next day, but had blood testing first for lipids and muscle enzymes. Now I am stuck in the Labor Day holiday, unable to call my dr., (I believe he is on vacation anyway) and I want to keep the good gains in my lipid profile since my cholesterol usually runs high. I would like to start taking non-flushing niacin and lecithin granules for the latter problem. I wonder if this would be ok with the plavix. Any info appreciated.
Christina, New Jersey, USA, September 2, 2006

• I suffered a heart attack in 2001 and had Angioplasty and two drug eluting Cypher stents were implanted in June 2004. I have been taking 75 mg every day clopidogrel 75mg and 81 mg Aspirin ever since.
R. K., Trinidad, August 31, 2006

Sherry's Response to Editor: yes, I am taking a muscle relaxer. Let me report this to my physicians to see if there is any possibility this may be one of the root causes. I am afraid to come off of any of my medications as we still do not know what caused the closure of the subclavian. Thank you for the tip.
Sherry Garrison, Philadelphia, Pennsylvania, USA, August 31, 2006

• I am set to have a angioplasty in 6 days. Catheter with possible stent/angioplasty. The Dr. told me to start aspirin NOW. I thought that a procedure like this one would stop aspirin before. Also does anyone know the failure rate of stents?
Don, Blue Cross, Los Angeles, California, USA, August 30, 2006

• Hi, I had three Cypher plants implanted 3 month ago, I also have three stents from three years earlier when I had a heart attack. Now I am a 53 yr old female. With no high cholesterol and my blood pressure is usually below normal. I had a severe allergy the first time to Plavix and almost needed a blood transfusion. Since I do not believe in blood transfusion, the doctors at the time let wait two days and my white or red blood cells came back right away after discontinuing the plavix. This time I have been on plavix again the doctor ignored the fact of my last experience with plavix and told me I would die if I would not take this medication. This time I have been severely tired my legs are shaking when I lay down after just 4 hours of work. I am almost depressed because of not being able to work. And having so many bruises that people believe I have a husband that beats me. I live by myself so this is not true and I am not a self abuser (laughing). My pharmacist hardly will give me the plavix and says I should for sure not take the aspirin. Right now the pharmacy can also only give me the generic form of plavix (Clopidogrel) 75mg. Now my tiredness seems even more extreme. I have no clue what to do since my doctor says I will die if I do not take these pills and have to take them for the rest of my life. I cannot go on like this, not exercising is not going to be helpful for my heart either. Thank you.
Erna, Washington, U.S.A, August 30, 2006

• I have been on plavix since April, 2004. I had 2 drug eluting stents put in -- both taxus. I have gained 45lbs and am tired, achy and depressed all the time. My Dr. said I would take the plavix all my life.
Alice S., Indiana, USA, August 29, 2006

• I read pages and pages of your comments. Same here. Husband only 62 had stent three weeks ago. Just found it was the plavix with the shakes and fever and pain. His allergists suspected it. It started with his second resting heart test with nuclear agents. His blood pressure plummeted. But 10 minutes at home and chill and fever. He also had just reduced his steroid pills to back down to normal (only small dose). High dose of Prednisone was probably stopping any symptoms. He stopped plavix almost whole day and he was back to his exercising body. Took it last night and within 5 hours chills started up and fever went to 103. He is in bed now, drained, and pain in ankles and some parts of body. He would have been better off with an artery transplant. I am also worried about statins which he is not on now because some of you are also having effects from those.
Carolyn D., Ohio, USA, August 29, 2006

To Kathy. Hi from Portugal. Yes I too have AF 24/7 and have been on Warfarin (Coumadin) for 7 years, When artery problem came to light end of last year, I had a bare metal stent (bifurcation) fitted in UK, Put on Plavix (75) + Aspirin 75mg and still take Warfarin 5/6 mg. Have been like this for 6 months now, need further angiogram next week cause now getting chest pains and AF seems to me to be worse, so needs checking out what might have happened. As far as all meds are concerned, haven`t really noticed any difference, but for sure you need to be extra careful at least with any cuts; internal is, of course, something a bit out of our control.
tel, PORTUGAL, August 29, 2006

• S. in India and Michael in UK -- only your physician (cardiologist) should advise you to change a prescription medication, especially something like Plavix (clopidogrel). For drug-eluting stents, many cardiologists now recommend clopidogrel for at least one year post DES and many, depending ont he patient's clinical situation, recommend it for life. S. -- Did you have an angioplasty or stents (bare metal or drug-eluting) after your heart attack?
Angioplasty.Org Staff, Angioplasty.Org, August 29, 2006

• Diabetic MI June '05, 3 DES and 2 BM stents. Clopidogrel 75 mg, Aspirin 75mg, Bisoprolol 5mg, Atorvastatin 80 mg, Metformin 2 gm bd + Insulin. MI July 06 1 week after stopping Clopidogrel. Angio no change with good LVF. Should I continue Clopidogrel for life?
Michael B., UK, August 29, 2006

• Sherry -- we haven't heard from other readers of any differences between Plavix and the generic version. Are you taking any statins (this class of drugs are known to cause muscle aches and pain in some patients). If anyone out there is taking generic clopidogrel and has experienced any differences, please chime in.
Angioplasty.Org Staff, Angioplasty.Org, August 29, 2006

• I received a stent implant in 11/05 of the subclavian artery and four days later underwent a thrombectomy of the left wrist. Recently my medication was changed from Plavix to Clopidogrel (75mg) and I have had tingling in both legs, feet, and left arm prior to the change, but now have joint pain in both shoulders, wrists, elbows, and knees. I am trying to understand if there are any significant differences between the generic and name brand of this blood thinner. As I am a type 2 diabetic taking oral medication, I cannot distinguish what may be related to clotting problems or diabetic problems. I would appreciate your input on this. (I have seen various doctors, but all are unable to give a fixed response to the root of this condition).
Sherry Garrison, Philadelphia, Pennsylvania, USA, August 28, 2006

• I had MI in FEB 2004. I am on Aspirin 75 and Clopidogrel 75. My EF even after MI is 65. Can I discontinue Clopidogrel and continue Aspirin 75.
S., INDIA, August 27, 2006

• Sheila, we assume your mother is also on aspirin, which has antiplatelet properties of its own. How long ago were the stents implanted and what type were they (Taxus or Cypher). Minimum recommended times for Plavix (clopidogrel) are 3 months for the Cypher and 6 for the Taxus. In many articles throughout Angioplasty.Org, we note why antiplatelet therapy is so critical for those with drug-eluting stents -- which is why your mother's cardiologist is insisting. Sometimes ticlopidine (Ticlid) can be used instead of clopidogrel (Plavix). It is what was used before Plavix became available. It has its own set of side effects and may or may not be better. We have heard of physicians using other antiplatelet medications as well. Plus, there has been some research in desensitizing patients who are allergic to Plavix by giving them a very small dose and increasing it slowly over two-three hours, every 15 minutes, until the full dose is achieved.
Angioplasty.Org Staff, Angioplasty.Org, August 23, 2006

• My 72 year old mother had two stents and was prescribed Plavix. She had a severe allergic reaction, a complete red body rash with severe itching. There was no question of her not taking the medications. She also experienced a persistent cough, runny nose, joint pain and severe cracking of the skin on her feet. She was constantly tired and depressed - she had become like a stranger to us. She stopped taking Plavix and her symptoms disappeared. Three weeks ago she had an appointment with her cardiologist who insisted she go back on the medication and she has developed all of the same symptoms again. Her life is a misery on this medication and when she asks her doctor about adverse effects she is made to feel that she is crazy.
Sheila Quealey, Austin, Texas, USA, August 22, 2006

• Ralph, these types of reactions are difficult to connect to causes. While stent allergies are rare, they are known to exist. If you can determine that your reaction is not drug-related, this may be the case. We urge you, however, not to stop any of your prescriptions to test this. Talk to your physician and definitely check out our Forum Topic on Stent Allegies.
Angioplasty.Org Staff, Angioplasty.Org, August 21, 2006

• On May 5th I had 6 stents installed and am on plavix, aspirin full strength and other meds. About a month ago I got very tired, no get up and go, my hands joints hurt all the time, can't even wear my wedding ring. any one have any suggestions what may be wrong? any suggestions are welcome. Thanks
Ralph, Pasco, Washington, USA, August 19, 2006

• I am Male 53, who thought was in good health until I experienced MI in May 2006, although I did smoke, until the day I had heart attack. I was treated with drug eluting stent to one artery 90% blocked, I am unsure of which stent was used, although I do know I am included in a special trial of a new stent. I have been back to my cardiologist 3 times complaining of fatigue, some chest pain, lack of energy, etc. I feel much worse than I did prior to the MI and subsequent treatment. Subsequent tests indicate echocardiogram is normal, nuclear X-rays of blood flow in heart is normal, and EKG appears almost normal, with one small spike in the signal. My cardiologist says I had a very mild heart attack, with miniscule damage to the heart muscle. I did walk into the emergency room on my own.

Drug therapy includes, 75 mg plavix, 81mg aspirin, 50 mg Toprol XL, 40 mg Lipitor, and 10mg Lisinopril. Doctor changed Toprol to Coreg 6 mg twice a day on my last visit, but it made me feel worse and I went back to the Toprol. Chest pain has since subsided, but I have otherwise continued to feel much worse. In the past few weeks I began experiencing itching, starting with inside of nose and mouth, some sores in the mouth with the itching being the roof of my mouth. The itching has since spread to back, arms, hands, feet, face, especially forehead, and genital area. My hands are ultra sensitive to the touch of leather, paper, and other smooth surfaces. I had a similar reaction several years ago to niacin, prescribed for high cholesterol.

I went out of town last weekend and accidentally went without my medication, so I missed Friday night, Saturday morning, night, and Sunday morning regimen. I had up until this time thought I was depressed, causing the fatigue, lack of energy symptoms.

However, after having missed medication doses, I felt much better by late Sunday afternoon. I resumed medication on Sunday night when I got home, Monday morning and by late Monday all of the symptoms were back, with itching seeming to be much worse.

I made an appointment to see my cardiologist this Thursday afternoon (tomorrow)as soon as I could get the appointment. My question is: how much risk would I be taking to stop my medication for the next two days, or could I skip one or more of the medications short term without risking restenosis? I think my reaction is due to the plavix, but of course I am not certain of that. I do know that one of the drugs is causing the itching, even if the other symptoms are due to another problem. Thank You.
Steve Shirk, Atlanta, Georgia, USA, August 16, 2006

• My husband just had a stent put in on Friday. He has atrial fibrillation and has been on Coumadin for 2 years. Now he has to take the Coumadin along with plavix and a baby aspirin every day. Has anyone else heard of such high doses of blood thinners?
Kathy, Pennsylvania, USA, August 12, 2006

CAROL C., Illinois, USA, August 9, 2006

• To all users of Plavix, this breaking news should be of interest: Apotex has launched a generic version of Plavix. Cost is estimated to be 30% lower. Read all about it in our news feature: "Generic Version of Plavix® (Clopidogrel) is Launched by Apotex".
Angioplasty.Org Staff, Angioplasty.Org, August 9, 2006

• Thanks for the clarification on the dosing. I suspected I might have found a few isolated sites that recommended 100mg, and that seems to now be the case. My cardiologist has expressed her desire to keep me on Plavix perhaps as long as 1 year after the procedure. Cost isn't an issue since the insurance pays 80% ($149/30 tablets list, ~$30 my cost after insurance). It certainly seems like a good investment to me, and I am not at any risk for bleeding problems.
Kevin, Albuquerque, New Mexico, USA, August 4, 2006

• Six days without the Plavix and now the joint inflammation is traveling between varied fingers, usually getting worse in the evening. I'm glad to say I think the worst is over and I should be back to normal in a few days. I did see a general physician who did a full blood workup on me.....all was normal. She believes that this was an adverse reaction to the Plavix also. I'm very curious to know how it turned out for John N. from Wisconsin, who posted on July 18 with almost the exact symptoms as myself. This will be my final post, barring any unusual developments. I wish everyone in the "Stent Club" good health.
Ricky, Bonita Springs, Florida,USA, August 1, 2006

• Kevin, the American College of Cardiology, American Heart Association and Society for Cardiovascular Angiography and Interventions issued the ACC/AHA/SCAI 2005 Guideline Update for PCI last fall and it states:

"In patients who have undergone PCI, clopidogrel 75 mg daily should be given for at least 1 month after bare-metal stent implantation (unless the patient is at increased risk for bleeding; then it should be given for a minimum of 2 weeks), 3 months after sirolimus stent implantation, and 6 months after paclitaxel stent implantation, and ideally up to 12 months in patients who are not at high risk of bleeding."

As we have noted here and many other places, these are recommended minimums -- while we believe that 75 mg is the usual clopidogrel (Plavix) daily dose, the length of time most cardiologists now recommend is one year, sometimes for life. This depends on the cardiologist, and also the patient's clinical situation.
Angioplasty.Org Staff, Angioplasty.Org, July 31, 2006

• I have CAD, had an MI and (2) Cypher stents placed late in 2004 and have been on Plavix and ASA since then. I recently asked my cardiologist what the long-term outlook for the plavix is, and he stated that he preferred that I stay on it permanently, but if cost is a factor (and it is since my meds are no longer covered by insurance), that I can reduce it to 3 days per week, Mon., Wed & Fri. Thought this might be helpful, since I haven't seen any prior postings on similar dosings.
Jo, Michigan, USA, July 28, 2006

• I am a 51 year old male in otherwise good health. I had an ischemic episode with unstable angina July 9 and subsequently had (2) Taxus Express 2 Paclitaxel-eluting stents placed. One in the RCA (99% blockage) and another in the CX (~50% blockage), via angioplasty by way of the femoral artery. The improvement was miraculous. But I have some confusion about the drug regimen I am now on. I understand that the main concern after stent placement is acute or subacute thrombosis - a potential show-stopper, to say the least. I was discharged on 75mg clopidogrel (Plavix) once a day, metoprolol 25mg twice a day, aspirin 81mg once a day, and Lipitor 80mg, once a day. All the internet research I've done has shown the recommended anti-thrombotic regimen of clopidogrel to be a minimum of 100mg/day. Am I concerned over nothing here? I'm new to heart issues, but I have great faith in my cardiologist.
Kevin, Albuquerque, New Mexico, USA, July 28, 2006

• I'm wondering what the outcome was for John N. who left the July 18 post.... I only stopped the Plavix, not the Lipitor and at the 3rd day without Plavix, I can't move my right wrist and the ring finger on my left hand.....
Ricky, Bonita Springs, Florida,USA, July 27, 2006

• Well, it's three days since my last post when I stopped taking the Plavix and although the inflammation in my joints is not as severe, it's still there, especially in my fingers. Also I'm still itchy. It still amazes me to read John's post because the time periods and symptoms are almost exact to mine from the three weeks to the Hives to the joint pain. These forums are important so that someone who is suffering these reactions can read and identify with other posters, and not be so frightened. I will write again to let the readers know how many days it took to feel normal.
Ricky, Bonita Springs, Florida,USA, July 26, 2006

• I am a 51 yr old man that was told to add Plavix to my medications that include Lipitor, Lopressor, Zestril and aspirin. I had a stent put in 5 years ago and I started taking the Plavix just 3 weeks ago. A week ago I broke out in hives all over my upper body and especially painful on the palms of my hands. I chalked this up to stress from moving.Then three days ago I had such intense pain in my shoulders and arms, I couldn't lift them up. This seemed strange to me in that I didn't recall doing anything to strain them. The next day the pain moved to my left foot and my right hand. I couldn't move my hand at all....then it hit me...maybe it's the Plavix! I did not take it tonight and as I sit writing this, I can hardly move my left feels broken! After reading other posts, I'm confident that this condition will get better soon.
Ricky, Bonita Springs, Florida,USA, July 23, 2006

• My husband had a Taxus Express 2 Paclitaxel-eluting coronary stent placed 4 weeks ago. He was placed on Plavix, Aspirin, Metaprolol, Lipitor, and Protonix. After 3 weeks, he broke out in hives necessitated his first trip to the E/R. He received a shot of Benadryl and a burst of Prednisone. He continued with a severe rash and was back in the E/R less then 24 hours with the reaction threatening his airway. We contacted his cardiologist the next morning to report the event. He took him off all meds except Plavix and Aspirin and added a regular regimen of Benadryl and Prednisone. As if things weren't bad enough, now he had severe joint pain and swelling and the rash coming and going in waves,strangely worse at night. Trip 3 to the E/R with the addition of Oxycodone for pain. Over the next 3 days the joint pain and swelling became so severe he could not even lift himself up to stand. Finally he had an appointment and Plavix was removed and Ticlid took it's place. He also added the rest of his meds except Lipitor. It's been 4 days now and he's just starting to feel a little better. We're hoping it was the Plavix causing the allergic reaction. We're praying it's not the stent and the Paclitaxel it contains. I hope this helps someone out there as in this period of time 4 doctors told us they've never seen a reaction to Plavix this severe.
John N., Stevens Point, Wisconsin, USA, July 18, 2006

• Dwight -- as you can see from other posts in this topic, rash seems to be the most common side effect of clopidogrel (Plavix). Ticlopidine (Ticlid) is an alternative, but often has more side effects and is not as effective. There has been some research done at University of Iowa that we'll be reporting on soon that involves de-sensitizing patients to Plavix by administering very small doses, and slowly increasing them every 15 minutes. The amount of sirolimus is many times lower than the dosages used for immunosuppression in transplant patients, although our related topic on DES Hypersensivity is very popular and good data about allergic reactions to drug-eluting stents are just now being studied.
Angioplasty.Org Staff, Angioplasty.Org, July 18, 2006

• I got a very bad rash after angioplasty with three stents. My eager librarian daughter looked at the official prescribing information for all of my medications that listed rash as a possible side effect and in the adverse effects sections, took the percentage of patients with rash and calculated the difference between the incidence with the medication and the incidence with the placebo to get the percentage of patients with a rash caused by the medication: Sirolimus 14% (from the stent) Lipitor 0.4% Plavix 2.7% Lisinopril 0.8% Initially, the sirolimus looks like the likely candidate, but the figure above is for the dosage given orally to kidney transplant patients, I could not find any side effect information on the stents themselves and I am unsure how the dosage and metabolism differs between the two ways of administering the drug. Plavix is the next likely candidate. Hope it was the Lipitor because there are a lot of other options for statins and it is probably the least critical of the meds early on. This ignores interactions of the drugs, and any other changes in foods or detergents or other influences.
Dwight R., Washington State, USA, July 14, 2006

• Since my original post last week, the doctor phoned and said start the Plavix again (even though I have been off it now for some time) according to a new study he read about. But still no aspirin.
Brenda, New Jersey, USA, July 11, 2006

• I had a Cypher stent put in early in May of this year. With it I had to take Plavix. This was the only change in my meds. after the stent. I could hardly move, slept all the time, had no interest in anything. Doctor felt this could not be a side effect. Then I started bleeding thru all opening in my body over a weekend, stopped taking, bleeding stopped. Doctor put me on every other day, bleeding got so bad had to go into hospital for two days. Stopped taking, now on Ticlid, no bleeding and feel like a new person. If your older parent tells you about this, don't tell them it is all in their head, listen to them. I have a feeling that a lot more side effects of Plavix are going to come out.
Barry C., Pennsylvania, USA, July 7, 2006

• Hi i am a 54 year old female who had angioplasty in the year 2000. I was on aspirin as well as clopidogrel. After 3 years i started to vomit my doctor was called who stopped the aspirin straight away, I was told it was a risk stopping the aspirin but a bigger risk if i carried on taking it. i have been on clopidogrel since the year 2000 after a heart attack which left me with unstable angina, i would like to know why i have to take clopidogrel for the rest of my life when some patients only take it for a year after their operation.
S. United Kingdom, July 6, 2006

• The stents were drug eluting. Taxus (3) and then the thrombosis and 3 more Cypher stents and the rest of the stents are Cypher. I am aware of the 3 month ruling on Plavix but worry about not taking the aspirin. The dr. said there is no rule of thumb on the aspirin. As far as I know, I am not at risk for bleeding.
Brenda, New Jersey, USA, July 4, 2006

• Brenda, the FDA-required IFU (Instructions For Use) on the Cypher drug-eluting stent recommends a minimum of 3 months of Plavix; for the Taxus, it's 6 months. But stent thrombosis in drug-eluting stents is a hot button issue and many cardiologists prescribe Plavix for a year or more, and aspirin for life, to avoid the thrombosis problem which is extremely serious when it occurs. Just last week, a cardiologist-only website ran a poll asking "How long do you prescribe Plavix after drug-eluting stents?" The results reveal the sentiment in the cardiology community: 75% of the respondents said 12 months to life; 23% said 6 months; only 2% said 3 months. Perhaps you didn't receive drug-eluting stents (a.k.a. drug-coated stents or medicated stents) -- antiplatelet therapy is not as critical with bare metal stents. Perhaps there is some other reason why your doctor is taking you off Plavix and aspirin -- such as you're at risk for bleeding, etc. We can't and don't give out medical advice -- only your doctor can do that -- but we can point you to this information and urge you to ask your doctor to explain his decision clearly to you, especially since you seem at risk for thrombosis if you already suffered from an incident only a month post-stent.
Angioplasty.Org Staff, Angioplasty.Org, July 3, 2006

• After multiple stents in the last year in the RCA due to restenosis and at 1 point an MI from a thrombosis 24 days after stent implantation, the dr said no more plavix or aspirin necessary because enough time had passed since the last stent (4 months). Isn't aspirin a must?
Brenda, New Jersey, USA, July 3, 2006

• My dad had a stroke. He was taking coumadin and then his doc changed him to plavix. He was still taking a baby aspirin a day with his plavix, my dad never suffered a heart attack nor did he have a stent put in. The doctor said that he artery was too little. thanks
Heather, Pensacola, Florida, USA, June 30, 2006

• Hello all. I am a 70 years old woman and was put on Plavix prior to receiving the Stent for poor blood circulation, but got off of it after 2 months. Went to another doctor and they said why are you even on Plavix? I had a reaction to Plavix at that time and got blood shot eyes and major pains in my eyes. I told my cardiologist that I was allergic to Plavix and that I would have to take something else, but he went ahead and put one stent in for 50% blockage. I now have blood shot eyes every now and then and my skin is itching and I am braking out with red marks and bruises. Does anyone else have this problem? oh by the way I have a cypher drug eluting stent. When can I stop this medication? I'm sick of it and it is driving me crazy. I feel like I am going to have to see a therapist. Signed, very unhappy camper. Please advise?
Bessy F., California, USA, June 28, 2006

• I had a stent in my RCA, my meds were 75 Plavix, 325 asprin for three months then 81, plus other meds, to this day, 6 months later, my blood is so thin it runs like water when I get scratched or cut working in garden
Jim S., Pennsylvania, USA, June 22, 2006

• Buffered ASA 325mg and Plavix 75mg daily. No heart problems or stents. A lot of congenital deformities like small carotids gortex graft in R subclavian from aneurysm surgery and old venous sinus thrombosis. Good cholesterol and low blood pressure. Do I need to take both of these meds? Bruising a lot and angioedema in hands. GERD as well.
S., Pennsylvania, USA, June 16, 2006

• Husband reacted to plavix following 4 stents into 3 main arteries. Taken off plavix due to severe rash. Put on ticlid. Reaction to ticlid includes swelling of joints spreading and extreme pain. Started in pinky on left hand, proceeded throughout fingers and wrist in first left, then right hand. Currently ankle and knee now swelling and painful. Condition worsens throughout evening into night. Beginning to think Plavix is lesser of two evils needed for treatment.
Cj, wife, hagerstown, md, June 15, 2006

• Dear H. -- Plavix (clopidogrel) is an antiplatelet drug which doesn't exactly "attack" your platelets -- we all need platelets, a main component of blood -- but it suppresses their clotting action, working as a kind of "lubricant" to keep them from sticking together around a stent. Clopidogrel is the standard therapy prescribed for 3-6 or more months after drug-eluting stenting, along with aspirin. Sometimes another antiplatelet drug, ticlopidine (Ticlid) is prescribed instead of clopidogrel. In your case, if you are experiencing the side-effect (a known one) of clopidogrel which is a low platelet count, then your cardiologist should discuss alternatives with you. Not staying on your prescribed medications (especially for heart attack victims) can definitely raise your risk level (see our June 12 news article about this topic).

As for the Flextome Cutting Balloon, a device made by Boston Scientific, it was recalled back in December 2005 for a defect that allowed the catheter shaft to separate -- it occurred in eight reported cases, and if it didn't occur in your procedure (we're assuming it didn't because it's a major problem that you'd definitely have known about when it happened) then the recall doesn't affect you. But since the cardiologist who did your stents stated that the earlier Cutting Balloon procedure put you at risk, you might want to ask him for more detail about "why". One of the reasons a Cutting Balloon was invented was to use in the case of a very dense hard plaque -- a situation where expanding a regular balloon inside the artery might rupture the plaque and tear through the artery wall (a dangerous complication). By making small incisions (cuts) in the plaque first, the Flextome eased the tension inside the artery, kind of "tenderizing" it and making for a safer procedure.

As for your medical records, every hospital has their own policy, but we believe you should be able to have them transferred to another doctor who's caring for you. We would hope you could call the cardiologist who did the stent procedure and explain your concerns, previous platelet situation and current fears. It's very tough sometimes because doctors in our current healthcare system are given very little time to speak with patients. Before you call, make notes, try to deliver the information to him/her efficiently, but get it all in -- just be as brief as possible. And let us know what you find out. Other patients may be in similar situations.
Angioplasty.Org Staff, Angioplasty.Org, June 15, 2006

• I just had an three implants Cordis Cypher Sirolimus Eluting Coronary Stents. While during the implants the coronary vascular surgeon was upset because the other physician had in October of 2005 opened an artery with a The Flextome Cutting Balloon. While I was under surgery he told me I had to take Plavix. A drug I know attacks my platelets. I had a heart attack in February of 2003. While taking Plavix and several other medications, I was sent home -- within a week my platelet count was to the point that I had to have a transfusion. I did not want a transfusion and was told they would give me one two days to see if the my blood count was normalizing again naturally -- it finally did and was told never to have Plavix. While searching for the stents I have had put in now, I understand why this doctor wanted to put me plavix. This cardiologist was also during my surgery telling me how my heart was jeopardized because of the Cutting balloon and may needed to have open heart surgery. I am confused what to do. I am afraid to take the plavix and the doctors seem not to respond in a normal ethical interaction with me. I was not allowed to get my own copies that I normally have during a procedure and keep them with me if I travel. I also was not allowed to keep a copy of all my blood work. I feel endangered by all the non information by my heart doctors and searched on the internet for information. Now I am even more concerned and do not know what to do. Will I take the plavix which also endangers my life; I was told I surely would die if I did not take the plavix. Discharged from the hospital yesterday in distress of not being able to know what the heck is going on. Where and how do I find information, since the doctor is not practicing any longer on what Plavix will do to me. I know that within one week there I was without platelets and they wanted the doctors wanted to do a blood transfusion. Only next week they will do a CBC, I am truly scared if I do not take Plavix I die and when I do I might die since I live by myself.
H., Arkansas, USA, June 13, 2006

• My husband had a heart attack on 5/28/06. Doctor put a stent in the blood vessel leading into the circumflex artery. (100% blockage). Now he was taken off the Plavix due to allergic reaction and only on 325 mg. asp....also Lipitor 20mg. My question is: His right leg (thigh and below) has a severe pain whenever he moves the leg. Is this normal? What can be done? We have gone back to doctor and had a doppler x ray done but to no avail.
Susan C., Texas, USA, June 11, 2006

• Hi -- after having 2 stents put in and going on plavix, lipitor, and small aspirin, etc., 6 months later I develop (they say) ulcerative colitis. I never had a stomach problem, ever till now. My new gastrointestinal doc was mortified with the plavix. Asked if I have read the newer studies on the major bleeding and stuff it can cause to stomach, rectum, intestines, etc. I am not on it any longer, and from her look, never will be again. This is much worse than the heart attack, and it's not getting better. Ii'm wondering if I have permanent damage from this or what is going on!!!!!!!!! My life has just turned so bad with constant jolts to the bathroom with blood, etc. and hospital stays. Anyone else have any help or similar issues? Thanks so much
Joe, North Tonawanda, New York, USA, June 6, 2006

• Roe -- aspirin is prescribed specifically to prevent a heart attack (via its antiplatelet action). Clopidogrel (Plavix) does something similar, but in a different way. For stent patients, they are usually prescribed in combination. You should check with your physician regarding dosage of any drug.
Angioplasty.Org Staff, Angioplasty.Org, May 29, 2006

• they say that aspirin can cause heart attack just use one baby aspirin a day.Would it be better if i used one plavix a day or maybe a half of one. thank you.
Roe H., New York, USA, May 27, 2006

• G -- haven't heard of plavix causing seizures -- is this information from your doctor? There is an alternative drug called ticlopidine (Ticlid) which is similar but tolerated differently in different patients. Let us know more.
Angioplasty.Org Staff, Angioplasty.Org, May 16, 2006

• My brother is 57 yrs old has had 2 stents put in. He is a severe diabetic and has 2 to 3 seizures a week due to plavix. He can't tell when his sugar drops and it drops fast. He takes plavix and aspirin. His blood is too thin and the dr. won't tell him to stop taking it. He lives alone and has seizures in his sleep. We are so afraid we are going to lose him. what do we do? HELP.
G., Georgia, USA, May 15, 2006

• Congratulations Dick!
Angioplasty.Org Staff, Angioplasty.Org, May 15, 2006

• I was placed on 75mg plavix & 81mg aspirin in March '02 when I received a Cordis non-coated stent. In Sept 05, I had a Taxus coated stent inserted. Am still on same plavix/aspirin dose. Of course, I bleed easily, have become fat and happy, have to rest a lot while doing work like heavy-duty gardening....but then again, I turned 80 last month!
Dick Weigler, Venice, Florida, USA, May 14, 2006

• today i my doc says i have atrial fibrillation that comes and goes. i never had a stroke or heart attack. never had problems with my heart. the doc says since i take levothroid for my thyroid that my levothroid med is way too much and in the mean time to take two aspirins and one plavix a day. i'm really terrified of taking plavix i guess it's because of know it's dealing with my heart. until my thyroid level is back to normal and my arterial fibrillation is gone i have to continue to take plavix once a day and two aspirins a day. is anyone in the same boat as me? i'm really hesistant in taking plavix.
kumi, killeen, texas, USA, May 12, 2006

• A study was just presented at the annual meeting of the Society for Cardiovascular Angiography and Interventions (SCAI) that demonstrates a potentially successful method for reversing hypersensitivity reactions to clopidogrel (in English, an allergy to Plavix). It consists of a "densensitization process" where patients who have exhibited the symptoms are started with a very small dose of clopidogrel (0.02 mg) that is then increased slightly every 15 minutes until the full daily dose is achieved -- takes about two hours. Dr. Nicholas Walker of University of Iowa Healthcare has done this with 8 patients and every one was a success. More on this later.
Angioplasty.Org Staff, Angioplasty.Org, May 12, 2006

• I had terrible itching, and some swelling in the hands. My doctor took me off LISINOPRIL, and so far not much itch, swelling went down as well. I'm on MICARDIS far, so good!
Steve J., Illinois, USA, May 10, 2006

• My doctor ordered plavix 75 mg and aspirin 81 mg, plus isosorbide dinitrate 20 mg BID.
Harold L. Percell, Salem, Oregon, USA, May 7, 2006

• Anonymous -- you've happened upon one of the big controversies in interventional cardiology: the question of when to stop clopidogrel (a.k.a. Plavix) after drug-eluting stent placement. It is in fact the subject of this month's "thumbs up, thumbs down" discussion between Drs. Eric Topol and Rob Califf on -- and it's currently the "Question of the Week" on -- both these websites are restricted to healthcare professionals (mainly cardiologists) so you can see that this is a subject very much in debate. On the "Question of the Weekvote so far only 57 doctors have voted, but 53% say a year and 30% say for life. We can't give you medical advice -- your doctor must do that -- but we can point you to resources. One is our coverage (and referred to documentation) of the BASKET-LATE study presented on March 14, 2006 at the annual ACC meeting. This study raised much concern and almost a shouting match in the conference hall. The study showed an increase in thrombosis-related events up to a year after stopping clopidogrel (the study only went that far, so these late events might continue beyond a year). The package inserts for drug eluting stents recommend 3-6 months of clopidogrel. Most cardiologists today recommended a year. Many feel like Dr. Rob Califf of Duke, who stated, "In my practice, if you get a drug-eluting stent, you're going to be on clopidogrel for life until more data come in." The reason cardiologists would like to see their patients stop clopidogrel is the increased risk of bleeding and the complicated situation if you have to get surgery. Then there's the cost. The biggest problem right now is that, as of yet, there is no way to tell which patients are at higher risk for thromotic events after stopping clopidogrel.
Angioplasty.Org Staff, Angioplasty.Org, May 4, 2006

• I just visited my new cardiologist today (my former one left the group without informing me and I hesitated to go back to that group). My new cardiologist is young, cocky and opinionated. I noted I was taking Plavix and enteric 81 mg ASA and he said "Current wisdom is that you should stop taking Plavix a year after your last stent". Well, my second of 2 stents was implanted 3 years ago and I'm not comfortable discontinuing the Plavix, and told him so. Any thoughts?
Anonymous, USA, May 4, 2006

• To Fred of Mississippi- I also have recently had 2 angioplasties consisting of 2 drug-eluting stents each. Like you, I experienced a severe rash with leather-like skin on my groin and buttocks and was prescribed Atarax for the allergy caused by Plavix. The Atarax worked exceptionally and within 2 days vanished completely at which time, I ceased taking the Atarax and have not neede3d it again.
Bryan, Florida, USA, April 29, 2006

• My father is 73 years old and has 5 stents. He has been on Plavix for about a year and last October his doctor tried to wean him off the medicine. However, after 10 days he had a mild heart attack. At this point his heart doctor told him he would be on Plavix for the rest of his life.

Fast forward to April 19, 2006 and my father has a mild stroke. A stroke caused by a massive blood clot (really pool of blood) in his brain. The brain doctors asked if he had hit his head lately and, in fact, he had getting out of the car about a week prior. Nothing hard. Just a hit on the head as he was getting out of the car.

After removing the blood clot (really a pool of blood), his heart doctor now says he can no longer take Plavix. Apparently, there has been an increasing number of cases just like this. While Plavix does wonders to keep blood flowing through the heart, it simply makes the blood so thin that if a person hits their head the chances of a pool of blood forming in their brain is huge.

The point is, Plavix is a wonderful drug for a heart patient. However, one of the risk is that if you hit your head (and not real hard) you may experience the same thing that my father did. While in the Hospital there were 4 or 5 other patients with the same condition.

My hope now is to find an alternative drug to keep his blood flowing.They are talking about putting him on an aspirin a day. The effectiveness of an aspirin seems to be considerably less than that of Plavix. Therefore, I am greatly concerned that within a very short time my father will die of a heart attack. Anyone with suggestions, please let me know.
John, Sugar Land, Texas, April 27, 2006

• I just underwent angioplasty and drug-eluting stent surgery and was prescribed an aspirin-plavix regimen. After only four days, I developed a severe, itchy skin rash that covers most of my torso, legs and thighs. I intend to see my physician today to investigate alternatives, if any, to Plavix.
Fred D., Mississippi, USA, April 26, 2006

• After doing elective heart scan...showing increased plaque...then took results to Doctor...followed by angiogram and I had stent implanted in February...taking one Plavix and one full strength aspirin daily. Question whether I should take 325 aspirin since I have had low blood platelets for a number of years (after radiation for prostate cancer 10 plus years ago) Has anyone on 75mg Plavix and aspirin seen changes in blood platelets, blood counts or hemoglobin?
Joe, Georgia, USA, April 21, 2006

• Diane -- the FDA-required IFU (Instructions For Use) on the Cypher drug-eluting stent recommend 3 months of Plavix; for the Taxus, it's 6 months. But stent thrombosis in drug-eluting stents is a hot button issue and many cardiologists prescribe Plavix for a year or more, and aspirin for life, to avoid the thrombosis problem which is extremely serious when it occurs. It is usually recommended that elective surgery wait until Plavix can be discontinued, to reduce the risk of bleeding. But these decisions should be made with your interventional cardiologist who is probably best-informed about the Plavix / drug-eluting stent issues.
Angioplasty.Org Staff, Angioplasty.Org, April 20, 2006

• I want to have bariactric surgery, but I had an angioplasty done so my doctor says I have to wait. How long do I have to be on plavix and asprin? My sister had the same thing done and she has had carpel tunnel and back surgery three months after the stents were put in. My doctor says that mine is an elective surgery. What do you think?
diane v. berkey, klamath falls, Oregon, USA, April 14, 2006

• I am a 34-year old female who was diagnosed with a hole in my heart (atrial septal defect) and had a catheter procedure to fix the problem. I have been on Plavix for about two months and have started to experience severe itching and a rash on my hands, feet, arm pits, abdomen, thighs, and just today my upper lip has swollen up. I am so glad that I logged on to this site because I was so afraid it was the device I was allergic to which is similar to a stent.
Lisa M. Fiorello, Liverpool, New York, April 14, 2006

• He had five blockages. Three stents on the left side. Two total blockages on the right side that they could not unblock. Yes, he is on Plavix.
Barbara M., Florida, USA, April 9, 2006

• Barbara -- not to add to the extensive list of medications that your boyfriend is taking, but is Plavix one of them? It's usually prescribed after a drug-eluting stent to prevent stent thrombosis (blood clotting in the stent). Muscle ache and pain is sometimes a side effect of some statin drugs. Your cardiologist should be made aware of these reactions. Some advances are being made in the treatment of chronic total occlusions (CTO) or the 100% blockage, but it's a tricky situation. Every patient's condition is different, which is why only an experienced interventional cardiologist should make a decision on whether or not to treat in these situations -- in your case it sounds like he did. Managing the medications can also be tricky -- we recommend that you work closely with your doctor and report side-effects to him/her, etc. so the best and most effective combination can be achieved.
Angioplasty.Org Staff, Angioplasty.Org, April 9, 2006

• My boyfriend had three medically coated stents put in 1/6/06. He has 100% blockage in the RCM The Dr. attempted angioplasty but stopped because of risks to the left side. He has only one leg and was concerned about having a by-pass and the recovery after, so the stents was a good option. He is breathing much, much better. However he suffers from shoulder, arm, and leg pain. Has a feeling of numbness in his hands. He presently is taking glipizide, norvasc, tricor, coreg, avalide, furosemide, ecotrin(325 mg), potassium, isosorbide and zocor. He sees his cardiologist in May. His primary Dr. said he will always be on this medication, because he did not have the by-pass. Needless to say, he gets discouraged. Is this right?
Barbara M., Florida, USA, April 9, 2006

• Dr. N -- a clopidogrel-eluting stent. That's an interesting idea. One of the problems is that the blood circulates throughout the body quite swiftly, so any "eluted" clopidogrel would be extremely diluted and probably not have much antiplatelet effect. This is different from the type of localized drug eluted by the stents to prevent proliferation (growth) of muscle cells that can become stenotic and cause blockages. These eluted drugs act on the endothelial layer on the inside of the artery, only around the stent area. Blood thinners must act on the entire bloodstream. But you're right. There must be a better solution. One such idea we'll be hearing much more about: bioabsorable polymers or bioabsorbable stents. In this case, the coating, or possibly the stent itself, will be absorbed into the body and will in effect disappear. Conor has a stent being used in Europe now that has a bioabsorbable coating. We'll soon be posting a feature article on these new emerging technologies.By the way, the drug on the Endeavor is ABT-578, made by Abbott. Abbott is using the same drug on their Zomaxx stent. If you search our site for these terms, you'll come up with more information. Thanks for your contribution.
Angioplasty.Org Staff, Angioplasty.Org, April 8, 2006

• i am 61 year-old male with an EndeavorRx 2.5x12mm put on December 22, 2005. Why should we expose the whole circulation to clopidogrel? can't we invent a clopidogrel-eluting stent which can create a ''clopidogrel pool '' within and around the stent? The aim is to reduce the occurrence of bleedings and other adverse reactions to clopidogrel also to shorten the duration of its use. By the way, I couldn't trace any info or studies regarding my Endeavor eluting stent and its active ingredient? Greeting to all fellow sufferers.
Dr. N., Khartoum, Sudan, April 8, 2006

• My husband had a heart attack in January, 2006, and is taking many meds, including Plavix. He has shaking chills and feels very cold for hours every day, but three different doctors have said no medications can cause this. Does anyone else have these symptoms or are we both crazy?
Susan P., Georgia, USA, April 3, 2006

• husband had heart attack on 3/26/06 one artery 100 % blocked..stent put in ..prescribed plavix, aspirin 325 mg. corag and blood pressure meds... pharmacy (error) filled with 81mg aspirin and he had another heart attack 3 days later....clot formed..could the wrong dosage of aspirin contributed to 2nd heart attack and blood clotting.. any connection
joanne, California, USA, April 2, 2006

• I am on non-eluting 3 stents since 11 months ago. I take plavix 75 and no aspirin because I am afraid of bleeding with the combination. I am 55 and have no other health problems. With time, the chest pain comes lighter and less frequent. My LDLs are at the minimum limit with lescol . My Question is for how long I have to stay on plavix? Should I take Aspirin too? I also take Concor 2.5 mg tablet per day. My heart rate is regular (60/min) and bp is 100/70 even before stenting. Should I contiue on that beta blocker? Thank you very much. Sincerely, Sayed
Sayed I., Egypt, April 2, 2006

• Kathy from Illinois -- did the doctor determine the source of the bleeding? Did it have anything to do with the femoral artery where the catheter was inserted?
Angioplasty.Org Staff, Angioplasty.Org, April 2, 2006

• i am age 25 a suffered a stroke after a car wreck. I had a stent put in Nov. of 05 and now taking plavix and aspirin everyday. I am very tired a lot and so much bruising now.
Nancy Jilek, Billings, Montana, USA, April 1, 2006

• I have had an episode of internal bleeding 2 weeks after my heart stent was put in. It came on suddenly and I developed severe burning pain in my lower right side, went to the E.R. and was given a CT Scan that showed the bleeding. Nothing was done other than pain meds. Now my cardiologist has taken me off of Plavix and the 325 mg. aspirin and is having me take only 81 mg. aspirin. Has anyone else had this problem and what was your outcome ? The pain is unbelievable. Any help you can give me to help me cope with all of this will be appreciated.
Kathy, Illinois, USA, March 31, 2006

• Drug coated stents and aspirin allergies. My father just had a stent put in and he is allergic to aspirin. Will Plavix trigger the same allergic reaction?
Teresa Feeser, Hanover, Pennsylvania, USA, March 22, 2006

Within the past three days both the American Heart Association and American College of Cardiology have issued alerts, basically stating what we've written here, if you are currently taking aspirin and clopidogrel (Plavix®), don't stop without consulting your doctor. Like we said....). Our Editor has also chimed in with his view on what happened with the news media last week.
Angioplasty.Org Staff, Angioplasty.Org, March 19, 2006

• I am 38 and had an angioplasty and 2 non-drug-coated stents placed 4 years ago. I've been on aspirin 80mg and Lipitor 10mg. Actually I have reduced the dosage on aspirin myself in the recent year to like one pill every the other day. My heart feels normal. I am wondering after 4 years, is it still necessary to take aspirin?
Chung, San Francisco, CA, USA, March 18, 2006

• I had a heart attack about 6 months ago at age 52 and had one stent put in due to 100% blockage. I am taking Plavix (75mg) with aspirin (81mg), Metoprolol (25mg) and Vytorin (10/20mg). During the first 90 days, I realy could not do much. I was always out of breath, light headed and sleepy. Then I attended a rehab 3 times a week for six weeks and everything changed. Whatever you do make sure to go through a rehab session after a heart attack. Primarily because it builds confidence. Getting hooked up and monitored while exercising for 3 hours a week does wonders to the mind. All those funny little pains and burning sensations that I used to feel, blaming my medicines for not feeling good etc. kind of went away. Being physicaly conditioned feels great (and I have not been exercising for over 15+ years!) I truly believe that the biggest damage from a heart attack is in ones head (off course excluding legitimate complications). I try not to wory about the side effects, or little pains here or there anymore...important things is I am still alive and know a lot more about how to take care myself now than I did before. I think the first 4-5 months is the hardest then things get better.
Mustafa, California, USA, March 18, 2006

SHAWN, DES MOINES IOWA, March 17, 2006

• I am a patient with the VA who has had stent placement as well as angioplasty. Following my stent placement I was prescribed Plavix initially, and then its generic or counterpart, Ticlid. I am allergic to both. We have consulted with an allergist who has determined that to work for desensitization would possibly interfere with medications now prescribed for Hypertension, diabetes, Cardiac Disease and Cholesterol. Where does that put me?
H. H., Tennessee, USA, March 15, 2006

• Just a note -- Monday, which was the day we issued our News Alert about the misleading headlines stating that Plavix and aspirin were a risky combination, this page received the most hits of all of the 500-plus pages on Angioplasty.Org. To boot, our site traffic was 50% above normal. Just another indication of consumers using the Internet for health information. See our Editor's Blog for more info.
Angioplasty.Org Staff, Angioplasty.Org, March 14, 2006

• I have had shoulder burning and shoulder pain bilaterally at times. My stress test is negative. Could the med be causing the pain and burning . I am currently taking ASA 81 mg and Plavix 75mg qd. since my Non q wave MI April 27 2005.
G.P., March 13, 2006

• In 1994 I had Angioplasty for 3 blockages. In July 1998 I had a quadruple by-pass. Jan 2004 went through 55 EECP visits, with no benefits from therapy. In Aug 2004 2 stents. After the stents (non medicated) Driver MX Medtronic, he put me on 75 mg Plavix and 325 mg aspirin. In May 2005 I had a double by-pass. I ve been on Plavix for 19 months. I keep reading that you should take it for 3-12 months after a stent is put in. Should I question my cardiologist about the 19 months or could it because of my by-passes that he keeps me on them? My history is pretty poor. My triglycerides stay extremely high. The lowest they have been in 16 years are 625. Last month they were 1800. They have been as much as 2200. All this while taking medication. I'm 52 years old and feel like I'm 80. I take: Lisinopril 10mg, Toprol XL SA 50mg, Cartia XT ER two 180mg (360mg), Pravachol 40mg, Tricor 145 mg
Mike, Cumming, Georgia, USA, March 13, 2006

NEWS ALERT! If you are an angioplasty patient, don't stop taking your meds. Readers have expressed concern about stories in today's news reporting that Plavix and aspirin may be dangerous when taken together -- for example, the Houston Chronicle's headline reads "Study: Using Plavix with aspirin is risky" -- this is very misleading and not the point of the CHARISMA study, presented yesterday at the annual meeting of the American College of Cardiology. The study was, by the way, funded by the manufacturers of Plavix.

First of all, if you're reading this, you or a family member may have already had a coronary event or intervention. You may well have a drug-eluting stent in your coronary arteries. The CHARISMA study does not apply to you. There have been many studies which have shown definite benefit of Plavix (a.k.a. clopidogrel) and aspirin combination therapy. In fact, if you have had a stent put in, especially a drug-eluting stent, Plavix and aspirin are mandatory. They prevent the blood from clotting inside the stent -- an event that is extremely dangerous. So for those of you in this population, DO NOT stop taking Plavix and aspirin on the basis of these headlines. By all means, discuss this with your cardiologist if you are concerned.

The CHARISMA study was meant to see if adding clopidogrel to aspirin was better than aspirin alone in preventing heart attacks in patients who did NOT already have Acute Coronary Syndrome (ACS) or who had NOT had an intervention (balloon, stent, etc.). And the answer was no -- it didn't help any more than aspirin alone. What all the headlines are referring to was the "subset" of patients (about 20% of the total) who were asymptomatic (had no symptoms of heart disease) -- the rate of heart attack and death in the clopidogrel plus aspirin combination in these patients was actually higher (from 2.2% to 3.9%) -- a surprise to the researchers. So the results of the study are not to prescribe aspirin plus Plavix to asymptomatic patients, just aspirin alone -- and that for patients with symptoms, while there was a slight benefit to the combination, it was not great enough to justify the expense and possible side-effects of the Plavix. But for stent and angioplasty patients and those with more advanced disease, the combination of Plavix and aspirin has been shown to be very beneficial and essential. Read our Editor's Blog for more.
Angioplasty.Org Staff, Angioplasty.Org, March 13, 2006

• Alana:I recently heard that plavix and aspirin can cause strokes on the news 3/13/06. I have been taking these medications since 9/10/05,I had a 100 percent blockage of the coronary artery and my cholesterol level was 176 at the time. I had 2 eluting stents put in 3.5x24mm and 3.5 8mm rca's i also am taking 80 miligrams of lipitor and 25 miligrams of toprol. Since I have been taking all these meds I have been gaining so much weight has the medicines have anything to do with this also. Thank You
Alana Mc Namara, Brooklyn New York, March 13, 2006

• My father has a very extensive heart history including triple bypass, about 10 or more angioplastys and 8 stent placements, well controlled type II diabetes and one very mild TIA. He had a pacemaker installed a couple years ago and is on many medications including plavix and baby asa. He is 72 yrs old and struggles daily with palpatations that cause weakness. No one seems to be able to help. They insist his pacemaker is working fine but at this point it is hard to believe anyone. My father tells them how bad he feels and they tell him he is doing fine. It really seems like many doctors don't listen, just doctoring their numbers, not the person. At this time they are increasing his Coreg to attempt to stop the palpatations. It has really affected his quality of life and his emotional state. He has always been a "get up and go" type of person despite a chronic back disability. We don't know what to do. Now, on top of it, my parents heard of a new study over the news saying that taking plavix and aspririn together actually increased your chances of heart attack or stroke by some 50-70%. Has anyone heard of this study? We are at the end of our rope...
Jody, Washington, USA, March 12, 2006

• My GI physician won't prescribe Plavix. Said its side effects are too bad. I reach the question about not removing a blockage less than 70%. What about the consequences of leaving it there? Try kinking a hose and watch the bulge build up. Isn't leaving it there only contributing to high blood pressure and aneurysms? I suppose the reason for not removing them is that you'll need more drugs until it is removed. And, you might be able to avoid all those checks every few months to "be sure" the blockage hasn't increased. I supposed to have test every year which cost about $7,000.00. If the blockage is removed, the hospital would lose that money.
C.M.W., March 05, 2006

• Had angioplasty 1/5/06, found 90% blockage in RCA, put in 2 stents (Cypher Sirolimus-eluting coronary stent). Left hospital with instructions to take 75mg Plavix, 325mg apsirin, and 10mg lipitor daily. Felt great for about 3 weeks, and then began noticing the easy bruising, then joints started bothering me, and also came a feeling of weakness. Was told to stop the lipitor to see if that helped. Did eliminate a bit of the joint pain. Am only on the plavix/aspirin now but continue to feel body weakness, always feel slightly dizzy, and have aches and pains all the time, especially in my legs and just generally feel lousy every day. Doesn't seem to be a solution since I was told that I have to stay on the plavix/aspirin for 9 months to a year.
Jane, Lemont, Illinois, February 27, 2006

• I had three Taxus-Express stents and was put on the aspirin-plavix regimen but in a few days had a very severe allergic reaction to the plavix. Substitution of Ticlid did not help. I was then put on a regimen of pletal, dipyrimadole and aspirin and have been on this for a year. Should another stent have to be used should I have the drug-coated one with the current pletal, aspirin, dipyrimadole regimen or would a bare stent be better?
Morris B., Ohio, USA, February 21, 2006

• my husband had a stent put in 3 mth ago he feels that he is losing muscle mass while also taking weight off , he is on plavix
diane wawiernia, eagle mi, united states, February 17, 2006

• I had a heart attack on January 9, 2006. I had angioplasty done and a Taxus stent put in. I am taking 20mg zocor, 325mg aspirin, 75mg plavix (twice a day). I left the hospital on January 13 and was feeling fine the first two weeks after leaving, but these last two weeks I have had a lot of joint pain in my hands, wrist, and knees. I have missed work because I can't walk and can barely type this letter. My internal medicine doctor said the plavix was what was making my joints ache, the cardiologist said it was the zocor. So he took me off the zocor and told me to continue the plavix. I still go very sore and am home again from work. All this medication is interrupting my life and my well-being. What can us heart attack sufferers do to stay healthy without all the terrible side affects from medications. To me the side affects surely outweigh the benefits, this pain is HELL!!!
Evelyn Hyland, St. Paul, MN USA, February 17, 2006

• What would happen if someone took Plavix and didn't need it?
C. V., February 12, 2006

• I had a drug eluting stent put in march 2005 for a blockage in my circumflex and was prescribed aspirin 75mg, plavix 75mg and bisoprolol 5mg. About 6 months after taking them i started to get pain in my left shoulder, mild chest pains (mt GTN spray don't seam to work) also i get burning in my hands so hot they would be sweaty and wet and am sick most days and burping a lot, the bruises i seem to get i can put up with them it the rest that i am bothered about. my doctor and the hospital have told me it's not my heart so what is causing all these problems? could it be the medication, any answers please as i feel worse now than i did before i had my stent.
amanda, United Kingdon, February 11, 2006

• Aspirin 75mg plavix 75mg 1 drug eluting stent. age 68. Feeling OK, but having trouble walking -- extreme pain in right thigh after walking 200 yards.
James I., United Kingdom, February 6, 2006

• Nick -- check our Forum Topic on "why won't my cardiologist open a 50-60% blockage". Most guidelines recommend not opening blockages that are less than 70%. These are, of course, medical questions and the solutions vary from patient to patient -- depends on whether you have symptoms, other clinical conditions, etc. That is why we do not and cannot offer "medical advice" on our Forum -- we can only steer you to resources and once again stress that this is a decision patients and their physicians need to reach together. Another resource is our Angioplasty 101 article. Good luck and let us know what happens.
Angioplasty.Org Staff, Angioplasty.Org, February 8, 2006

• Dear Forum Editor: Thanks for your response. My cardiologist who is also an interventional cardiologist surgeon who will do the procedure tells me that once he goes in, he will know how much is the blockage and if he does not have to do stenting or angioplasty he will not do it. Can you please provide any data and comments from your experience as to how many times they go in and not do anything and put the patient on a medical mamagement without stenting or angioplasty? I wamt to be only on medical mangement without stenting or angiopasty if I can help it and I am willing to go for an severe life style change. Is it foolish to think that nothing will be done when they do the procedure based on my previous CTA results and that they will put me only on a heavy dose of statins and blood pressure medication? Only 2 days are left for the procedure and I am nervous. They tell me that if I do not go through the procedure I may live for a longe time without it or can have heart attack any time. People go on without stenting and angiopasty with blocked arteries. I guess once you know you have some issues with your arteries you must fix it? I have only limited chest pain and a lot of shoulder muscle pain. Thanks.
Nick R, New Jersey, February 8, 2006

• Nick, if you get drug eluting stents placed, you will need to be on antiplatelet therapy for 3-6 months, perhaps a year. This is usually aspirin plus Plavix (clopidogrel) or Ticlid (ticlopidine). These are very important medicines. If you have had an allergic reaction to Plavix (and it's not clear from your post if you did, because you had a number of other factors involved) you need to make sure the cardiologists know this. Ticlid is sometimes used instead when Plavix causes adverse reactions. Bare metal stents don't need antiplatelet therapy for as long, but they do have a higher rate of restenosis and greater numbers of repeat procedures. These are issues you should discuss with your cardiologist, in advance of any procedure. But it is not advised to stop antiplatelet therapy after stenting, because of the risk of stent thrombosis (blood clotting) -- this is what Plavix and aspirin help prevent. Let us know how you fared.
Angioplasty.Org Staff, Angioplasty.Org, February 7, 2006

• Help: Recently in December 2005 during X-mas during driving I lost some coordination and felt some momentarily numbness in my arm. I had to stop the car and was not able to drive stead so I called my wife who picked me up and we went to ER. they took chest X-ray, didi MRA, MRI of head and determined that I may have had a TIA or could be neurological because MRA, MRI and vhest X-ray were not remarkable. I was taking 25 mg Atenolol and my BP was 155/99 at the time of ER visit. My cholesterol was 230. I had been on Cholsterol med Lipitor, 10 mg and that had brought it down to 171 but I had to stop because of the bad stomach problems due to sever irritable bowel syndrom for may years. At the time of supposedly TIA event the cardilogist put me on 100 mg Cozaar, 25 mg Atenolo, 10 mg Zetia, 80 mg Lescol and one 75 mg PLAVIX. After being on Plavix for two weeks with all other drugs I had bad chest pain and muscular pain in shoulders, arms and chest area. I reported to the cardiologist and we stopped Plavix, Lescol, Zetia and stayed on Cozzar 100 mg, Atenolo and 81 mg Apirin. The pain reduced. However we decided to do stress test and it had abnormal EKG read. The cardilogist asked me to do an angiogram but I decided to go for an 64 slice cardiac CT scan. It showed that I had three diffrent stenosis, one high grade stenosis versus segemental occlusion of the proximal right coronary artery, the other a high grade stenosis of the LAD just proximal to the first Diagonal branch and third high grade stenosis of the second diagonal branch origin. They asked me to do cardioangiogram and check how much is the damage and fix it. I will start to Plavix on 2/8/06 and the procedure is planned on 2/10/06.. I guess I will have to take the Plavix and depending on what they do I may have to continue taking it. Considering what could have happened during my earlier Plavix experience, should I wait for a week and be on Plavix for a week and not for two days before the procedure? I have a lot of shoulder and arm aches and occasional chest pain. Shuold I wait? I also have inflamed groined skin but no infection and the dermatologist tell me that it is okay to puncture it there for angiogram. What more questions I should ask about this planned surgery regarding post operation Plavix use and other post operation drug management and use care with my irritable bowel syndrom condition? I am in my mid 50's.
Nick R., New Jersey, February 7, 2006

• I had surgery for blocked veins in my legs about 3 months ago and the doctor prescribed 75MG Plavix. Since I have been taking Plavix I have bruises on my arms and one hand. What can I do to eliminate the bruises? Is there some kind of salve or ointment I can use to relieve the problem
Ray S, Fort Wayne/Indiana, USA, February 04, 2006

• I had a RCA 100% blockage in 2002 with resulting angioplasty and stent. A previous nuclear imaging stress test was negative, no sign of coronary artery blockages anywhere and larger than normal arteries. I was placed on Plavix and 325 mg aspirin following the stent and at the end of one year, it was decided that studies were showing no serious problems in remaining on Plavix, so I am still taking Plavix and aspirin with no side effects. I have not had any other coronary events with the exception of occasional irregular beats during periods of stress or intake of excess caffeine. Atenolol has taken care of the irregular beats. I have regular blood tests every 3 months because I am also on Provochol (to stabilize artery walls....not for cholesteral problems. 160 day of heart attack). Follow up cardiolyte stress tests show almost no heart damage from the heart attack and the minimal amount there is, occurred in a section of the heart that will probably not cause any issues in the future. I also take a low dose of Avapro for blood pressure which keeps my BP in the normal/low normal range. I exercise 4-5 times per week, am losing weight, but am severely obese and have type II diabetes for which I use Lantis and Humalog (none of the pills for Diabetes)which keeps my A1C at 7 or below. I was recently told I also had osteoporosis (T score of -2.73) and that I should take a medication (Fosomax) for this. I am very concerned with adding another medication to my growing list, especially with taking aspirin and Plavix already with Fosomax which is well known to cause gastro-intestinal problems (esophageal issues as well as stomach ulcers. I am 53...almost 54. I have not started the Fosomax yet, but have increased my exercise to include weight strengthening training and more weight bearing types of exercise as well as increased calcium and Vit D and calcium from diet. I am very hesitant to discontinue the aspirin/Plavix therapy because of the history of the blood clot that caused my heart attack. The actual cause of the clot to form was not found. BTW...I FEEL GREAT!!! Any thoughts?
Julie Tupker, self, Marion, Iowa USA, February 03, 2006

• Oneway -- recommended antiplatelet therapy with Plavix (clopidogrel) or Ticlid (ticlopidine) after drug-eluting stents is currently 3 months for the Cypher stent and 6 months for the Taxus -- we assume you that you had a drug-eluting stent implanted. Based on recent studies, some cardiologists extend this period to a year; sometimes more. This depends on several things, the patient's clinical situation, tolerance of the drug, etc. These antiplatelet drugs are taken in combination with aspirin, which is usually prescribed for life. Sounds like you've been tolerating the meds well and we're glad to hear you're feeling well (that is, after all, the idea). We certainly would recommend discussing your concern about extending antiplatelet therapy with your cardiologist. Plavix and Ticlid are indicated for several conditions, as a prophylactic against future cardiac events, etc.. See what he/she recommends for you -- and let us know as well so other patients can benefit.
Angioplasty.Org Staff, Angioplasty.Org, January 25, 2006

• Question: I had a stent put in six months ago and they have me taking a Ticlid twice a day to prevent clogging of the stent. The doctor mentioned that they would be taking me off the Ticlid this wise??? I am a bit concerned about a change in meds as I am feeling good right now. I also take a 325 aspirin and fish oil too, might this be enough to thin my blood slightly? Thanks for any comments about this...
onewaypockets, california, January 24, 2006

• i had 3 stents implanted on nov.2005. I'm on plavix 75mg, lipitor 20mg, coreg 25mg, cozaar 50mg and aspirin 81mg. After approx 5 weeks post nov 1st 2005 i began to feel great. i still do except that i've had a very stiff neck for the last 2 weeks. is this a side effect of the drugs? would welcome an answer.
james donnelly, sewell, new jersey usa, January 23, 2006

• I am a 57 year old male in excellent physical condition and had very few of the risks factors associated with coronary artery disease, other than high cholestrol and job related stress. My cholestrol has been under control using cholestrol lowering drugs since about 1990. I had three stents implanted on 11/18/05. One "Vision" Colbolt Chromium in the RCA and two "Cordis" drug-eluting in the LCA. I had already been taking 20 mg of Lipitor and a 81 mg aspirin daily for many years due to my high cholesterol. After the stent procedure, my cardiovascular surgeon also placed me on a 75 mg Plavix daily. After experiencing some muscle pain and weakness in my legs and arms, he switched from 20 mg of Lipitor to 10/20 mg of Vytorin. However, I have also been experiencing considerable side effects from the Plavix medication. Sore throat, cough, leg weakness, stomach upset, chills, tenderness in the groin area where the catheter was inserted, and a low grade fever (97.7). It is like having the flu, but without nasal congestion or a fever. The chills and stomach upset will come and go intermittently. These side effects are all listed as possible side effects for the Plavix medication. In my case they can last for several days to a week and then go away. I plan to discuss them with my doctor and find out how long I need to remain on the Plavix medication and whether there is an alternative blood thinning medication I can take in place of Plavix. My doctor never told me about these potential Plavix side effects. I thought my case was unusual, but after reading these patients internet postings, I see that I have a lot of company when it comes to Plavix side effects. Any comments or advise would be greatly appreciated...
Ed Lipinski, Retired, Woodbridge, Virginia, January 22, 2006

• Does Aspirin have the same mechanism or pharmacolgic action as Plavix in regards to anti-platlet effect? Can Plavix induce G.I. bleeding like aspirin?
J.F.L, Boone, Mo., January 18, 2006

• JFL -- Good question. Here's the answer from the AHA/ACC Guidelines revisions issued in November 2005: "In patients who have undergone PCI, clopidogrel 75 mg daily should be given for at least 1 month after bare-metal stent implantation (unless the patient is at increased risk for bleeding; then it should be given for a minimum of 2 weeks), 3 months after sirolimus stent implantation, and 6 months after paclitaxel stent implantation, and ideally up to 12 months in patients who are not at high risk of bleeding." So for a Cypher stent, 3 months minimum; Taxus is 6 but many physicians think a year or more is better.
Angioplasty.Org Staff, Angioplasty.Org, January 12, 2006

• What is the current recommendation by the American College of Cardiology and the Am.Heart Assoc. in regards to the length of time to take Plavix 75 per day after routine insertion of stents (Cypher)??
J.F.L., Boone, Mo., January 9, 2006

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