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Plavix, Effient, Aspirin and Stents (2009 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 2009 on This Page (177):

• My father was on Plavix for a week and had a rash back in october. He was put on Ticlid and after one month he has now persistent diarrhea (duration of the diarrhea: 25 days now). Is there any other anticoagulant than Plavix or Ticlid ? He is also on Lipitor, Lopressor, Asaphen and Hytrin. Is there any interactions between these drugs that could cause a persistent diarrhea ? Thanks for your answers.
Fabi, Quebec, Canada, December 31, 2009

• For those having difficulty affording Plavix or other prescriptions, try googling and ordering through Canada pharmacies. My local pharmacy charged me about $150 for a 30 day supply of Plavix. I got a 90 day supply (90 tablets) of Plavix generic (clopidogrel) for less than $40 including shipping with a 2 week delivery time. Just look for reputable licensed pharmacies in Canada and compare prices between them. Ask for their delivery time. I was initially concerned but the drug is typically shipped directly from a worldwide pharmaceutical company overseas and not some hole in the wall. Also remember the licensed pharmacy in Canada is vouching for the product and source. Usually they have an 800# so you can talk to them about any concerns. There are so many Canada pharmacies advertising you can be very choosy and select the best one for you in terms of price and service.
Bay, California, USA, December 28, 2009

• Lori -- sounds like your mother has a complex situation with a number of clinical issues. We are very sorry to hear that she had a second heart attack because "the stents were the wrong size". One of our missions here at Angioplasty.Org is to help make the procedure better -- and there are various tools that exist to help with sizing stents correctly -- we hope these are adopted more widely (see our Intravascular Imaging Center). As for your mother's reactions, you might want to check out our Forum Topic on Allergic Reactions After Drug Eluting Stent (DES). Not saying this is the problem, but it's worth a read.
Angioplasty.Org Staff, Angioplasty.Org, December 22, 2009

• My mother had a heart attack in Feb. 2009, 2 stents were implanted. One week later she had a second heart attack because the stents were the wrong size. 2 more stents were implanted. She felt good except some back pain. In june 2009 she started having burning, itching, numbness from head to toe. She had been to the emergency room 9 times for these symptoms and has been to an internist,allergist, cardiologist, neurologist, psychiatrist, and primary care doctor. Every doctor says the same thing, that there is nothing wrong with her that they can find. She was taking Plavix which her doctor took her off of twice with no relief from the symptoms. She has had an MRI, several EKG's, ENG (nerve test, upper and lower), stress test, complete blood work, and heart cath procedure. Every test has come back normal. She was told her vitamin B-12 was a little low, other than that nothing is wrong. She is 61 years old, has diabetes, high cholesterol and high BP. Her symptoms are getting worse by the day. Her teeth and gums are numb, she feels like electrical shocks are going through her body, her legs and arms are numb, her private area is numb. Please help if you can. I will do anything for her.
Lori W., Grand Blanc, Michigan, USA, December 19, 2009

• John from Australia -- this site doesn't dispense "medical advice". However, anything people can do to reduce their cholesterol, etc. is a good thing. As for "natural blood thinners", we would not recommend replacing prescription meds like Plavix with them, but as an adjunct for a healthy diet, again, why not, as long as there are no negative effects. The guidelines in the U.S. for dual antiplatelet therapy (aspirin plus Plavix) after drug-eluting stent implantation are for 12 months or more. We always recommend discussing these issues with your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, December 18, 2009

• I had a medicated stent inserted in a coronary artery after a heart attack in June 2008. I was originally put on plavix, aspirin, somac, lipitor, bicor.Initially it was ok but after 6 months the side effects started to kick in. After trial and error I'm now on Plavix, aspirin and somac. I also take 3000mg Flax seed oil as a cholesterol control plus it is good for the digestive tract. I've stopped butter, cream, bacon etc. I also take Coenzyme Q10 (150g) which really increased my energy levels immediately. I'm considering dropping the plavix and aspirin and somac as it's been 18 months now. I'm interested in what this site has to say about natural blood thinners as the author obviously is very sensitive in this area.
John, Australia, December 17, 2009

• Tel (hi!) and L.H. -- the optimal duration of DAPT (dual antiplatelet therapy) after drug-eluting stenting is THE question these days in the cardiology community. Interestingly, there are several trials just beginning, two of which are exclusively testing whether the Endeavor stent may not require a year of these meds. We'll be reporting on these in the next couple of months.
Angioplasty.Org Staff, Angioplasty.Org, December 14, 2009

• to LH Like you I had an Endeavour stent, mine done in Jan2007, Was on Plavix until earlier this year, when I weaned myself off it by withdrawing over 2 months. Gradually reducing dosage until pointless. Have not had one now for 3 months. Don't seem to come out in bruises like I used to when on it, but I still take Warfarin, as I have Atrial Fibrillation. Still take 75mg Aspirin.
Tel, United Kingdom, December 12, 2009

• Greetings all. Just checking in. In Sept/04 had mild MI at the ripe old age of 42. I worked out every day in the gym and was taking all the proper vitamins and watched my diet. My cholesterol #'s weren't bad either. Since then (2004) I have been taking Plavix 75, Aspirin. 81, Toprol 25, Procardia 30, Cozaar 100 and Crestor 10. Sometimes I feel like I'm personally supporting the pharmaceutical industry, but I'm thankful to be alive. This Sept. it was FIVE years! Thank you Burt for all you do. Enjoy life folks while you have it, it makes all the hard work that all the people involved in treating CAD worth while!
Paul, New Hampshire, USA, December 5, 2009

• One stent in 2007 due to 99% blockage of left cor. artery. Placed on plavix 75 & asa 325 as well as bp meds.. I'm 65 now. always was hot natured. For past year and ,esp. since start of winter (ga.)USA I feel like i'm freezing in my face and happens inside even with my thermostat on like 74 today. It even hurts sometimes. For example this morning I was painting (artist), just moving around (u would think opposite) i started getting colder in my face and nose. After about 30 min.. I got so uncomfortable from coldness I had to stop. I sat down on my sofa, wrapped up and put a ski mask type thing over my head , nose, etc. I turned my therm. up, took my temp. 97.3 orally. (i'm a retired nurse) ha ha/!! It has been 30 min. my face is still cold ,esp. my nose, but more bearable. I going to my cardiologist ASAP....Have you heard anyone being this extremely cold? I stopped the asa about a yr. ago due to acute stomach pain. I've done good since my stent (unless something is hiding). I would love to stop the plavix. I hate this coldness. Summer when shopping in just cool store with ac the same thing happens. Any info will be greatly appreciated.
J.H., Georgia, USA, December 5, 2009

• Thank you for your prompt reply. It's very upsetting to be prescribed medication which has unpredictable results when trying to get off. Being a very healthy person prior to my tear (pulling together a trampoline the LAD dissected, not a bad diet) I'm now extremely anxious due to this unpredictability. Now Drs want me to take add'l meds to relieve these symptoms. Hopefully, a year from now I'm still around and nothing went wrong with ending the Plavix!
L. H., Long Island, New York, USA, December 3, 2009

• L. H. -- see the post below about the Medtronic Endeavor stent and duration of Plavix/aspirin. As for going off Plavix, there have been some observational studies that there is an increased incidence of problems in the period right after stopping, but these have not been tested in a clinical trial. Some doctors advise gradually lowering the dose or frequency for a couple weeks, just to play it safe -- again not proven. This is a very complex issue and there are many many factors involved in dosing, duration and cessation of Plavix.
Angioplasty.Org Staff, Angioplasty.Org, December 3, 2009

• In April 2009 my dad had an endoscopy. results= chronic gastritis and H. pylori bacteria. He has had H. pylori bacteria once before. For some reason his family doctor did not treat the chronic gastritis. However the H. pylori was treated with the 2 week antibiotic and the PPI.4 months ago my dad went into emerg for unstable angina. they did an angiogram and put in 4 stents. Because of my father's slightly anemic condition the interventional cardiologist gave him the regular stents and 2 months of plavix.HIs NEW family doctor put him on pantaloc, a PPI, because of his slight anemic condition and due to the report chronic gastritis from that endoscopy. I am very concerned. she said the only PPI that won't affect Plavix is Pantaloc. My father could only be on Plavix for 2 mths, according to the interv. cardiologist because he is slightly anemic.My concern is that the family physician should not have put him on Pantaloc for those two months he was on plavix. i am concerned that the plavix would not have had full effect. I am concerned that the chronic gastritis was from H. pylori and if that was treated in April..wouldn't it be gone? Did plavix have full effect?
Julia, Oakville, Ontario, Canada, December 2, 2009

• At 49 years old, had 2 bare metal stents in LAD 5/07, due to a tear (not heart attack). Due to scar tissue had DES stent/Endeavor (balloon) implanted 12/15/08. Put on Plavix/aspirin. Advised Plavix for one year. As the anniversary date is near, how do I get off the Plavix? Based upon what I've read I'm afraid to stop cold turkey. What methods are suggested? Will increase from 81 to 325 aspirin when done.
L. H., Long Island, New York, USA, December 1, 2009

• Joz -- could be any number of things. Did he start taking an ACE inhibitor after stenting. This class of blood pressure medications can sometimes cause coughing as a side effect -- there are alternative BP meds. Another possibility is that he has developed gastroesophageal reflux disease (GERD) which can be treated with other meds, such as Proton Pump Inhibitors. Discuss this issue with your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, December 1, 2009

• My husband who is 48 years old has a stent and is taking a lot of tablets. This happened in July 2009. After a month of taking this medication he has developed a cough which is most irritable because it happens mostly when he lies down. Can you tell me what might be causing this please? Thanks
Joz, Malta, November 29, 2009

• Leona and John -- how long to take Plavix is the big question in this field. Current recommendations for drug-eluting stents are for at least a year. It was originally 6 months but after the late stent thrombosis scare a few years ago, practice was changed. The truth, however, is that no one knows exactly. There are currently several clinical trials that may answer these questions (it's the subject of two upcoming interviews on Angioplasty.Org with Dr. Fausto Feres of Brazil and Dr. Eric Topol at Scripps in California). Some data show that different patients may do best with different durations. Also all stents are not the same. The Medtronic Endeavor stent seems to show complete healing at 6 months or less, but this is the subject of the above-mentioned trials. Bare metal stents heal sooner and so recommendations for them are 4-6 weeks of Plavix. Certain clinical situations also may suggest longer use -- bifurcation lesions (the two diagonal branchs) being one of them. Our suggestion is to discuss this issue with your interventional cardiologist specifically (not just the family physician) -- the interventionalist is best suited to judge the various factors in each individual patient's situation.
Angioplasty.Org Staff, Angioplasty.Org, November 29, 2009

• I had two Xience stents inserted into the LAD in Feb. 2009. My physician told me that I can be taken off Plavix after 12 months and take a 325 mg enteric coated aspirin. I feel a little jittery about this although I trust my physician. The reason for the stent placement was a break off of plaque which closed the LAD in two areas 95% and 70% and the stents are almost piggy-back. I also had two diagonal arteries angioplastied at the same time.If anyone has additional information for me please e-mail me. I have talked this over with my physician. As an aside I had two surgeries while on Plavix and had very little problems with each surgery, so surgery can be done if really necessary. I am a 70 yr. old caucasian female. Thank you.
Leona H., Missouri, USA, November 20, 2009

• I have been taking plavix for over one year. Can plavix cause nose ulcerations and ringing in the ears?
A. B., New York, USA, November 19, 2009

• 2008 I had minor chest pain followed by stress tests, doc decided I needed 4 stents. Had that done at age 69, now 70, still taking Plavix (75) and aspirin (325) daily. Health fine, weight 155, but here's the problem. On a long trip, have 12 pills left and 24 days left till I get back where my pills are waiting for me. Can I take half dosage for 24 days? Just cut pills in half? (After all, I have been taking for more than a year already anyhow). Thanks.
John Hulpke, retired professor, California and Hong Kong now in Ireland, November 14, 2009

• Margaret G. -- stents themselves don't have Plavix in or on them -- Plavix is a blood thinner which should be be taken by all stent patients after implantation to keep blood from forming a clot inside the stent. If your husband is allergic to Plavix, there are alternatives, such a Ticlid and now prasugrel, which was just approved by the FDA.
Angioplasty.Org Staff, Angioplasty.Org, November 14, 2009

• My husband's Dr recommended that my husband have stents because of lack of blood flow to his lower leg. I told him he could not take plavix because he is allergic. He told there would be no plavix used. He lied and gave him a plavix stent and told me to have him take plavix which I refused. My husband sets around like a zombie and is very weak, has a lung infection that we can't get rid of because of the plavix in his system. I think I have a law suit on my hands with all the stress of dealing with my husband's affliction. I now have to wait on him hand and foot. I hate Dr.s
Margaret G., Florida, USA, November 13, 2009

• I am Taking 150 mg Plavix-Ecosprin daily along with other advis 150mg plavix per day is Okconstiption & gui8diness occuring recently.before the operation i don't have any problems like guideness,constiption etc shall I continue 2X75mg plavix dailyiunderwent 2 angiplast in aug2009.
gssrajkumar, Elbitec innovations ltd., Chennai- India., October 28, 2009

• I take Plavix and 81mg Aspirin daily . I also take Prograf and Prednisone as anti-rejection medication, Lipitor, Novasc,Atenolol and Cozaar. I also take one pill, 40mg of Nexium.Is any interaction between them, or at least between Plavix and Nexium. I understand that my cardiologist wants me to continue Plavix, although I had angioplasty a year and four months ago.
Sergio, North York, Canada, September 6, 2009

• Jan -- sorry your cardiologist's office is not returning your calls. This reaction is certainly not unknown. We've heard of some people getting relief with prednisone -- perhaps an allergist or immunologist could be of help. There are other drugs available: ticlopidine (which has other side effects) and prasugrel -- recently approved, but more bleeding complications.

Speaking of which, Debbie from Texas -- discuss this with your cardiologist. Since you are 3 years out from the Taxus stent, and it's a good guess that you are having bleeding complications (black stool, rectal bleeding, bleeding ulcer, etc.) it might be a good idea to stop the Plavix -- but this is not medical advice -- talk to your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, September 4, 2009

• Had a heart attack 1-24-06 I was 48 years old, female. Am now 52. I have COPD, anxiety, depression, GERD, 2 Surgeries for vaginal cancer. Did have TAXUS Stent in 2006 after heart attack. I take Prevacid, Plavix, 81mg aspirin,Simvastatin, Metoprolol, Captopril, Premarin, Effexor XR,Xanax, Hydrochlorthiazide, Spiriva everyday since 2006. Ihave stomach pain, rectal bleeding, black stools, joint pain, dizziness, weakness, tiredness, depression, anxiety and have been told by family doctor that I have a bleeding ulcer. Am I in trouble from all the medications that I amon currently? What should I do? Am going for colonoscopy on 09-04-09. I am very scared and depressed. bleeding ulcerand Diverticulitis.
Debbie G., Texas, USA, September 3, 2009

• Question for those who have hives or skin rashes after stent, or as a result of taking Plavix: Does it go away after a while? I began having a skin rash about 25 days after stenting (last weekend), on my chest and around the neck, which itches a little, and is irritating when I wear a bra. I've tried to call cardiologist twice, but calls have not been returned. I know this is minimal compared to some side effects. I have used Benadryl caplets(made me too sleepy) and cream, and today started using aloe plant directly on area. Does anyone have other suggestions? Mainly, I want to know if this is something my body will adjust to and eventually go away? Thanks to anyone who can answer.
Jan Finley, Spartanburg, South Carolina, USA, September 3, 2009

• After heart attack i got a bare metal stent in LAD. I took Plavix and Aspirin. 17 months later the stent was blocked by my own tissue - heart attack again and DES stent again in LAD. No complains and 1 year after the last event and taking Plavix and Aspirin can I stop taking them? Every doctor here will say: continue the reception, for an accident insurance.
Peter N., Sofia, Bulgaria, September 1, 2009

• Stout in India -- Aspirin is used to treat coronary artery disease because it helps keep the platelets in the blood from clotting, very important especially after stenting. Both Plavix and aspirin do this. A side effect, as you can imagine, is a higher risk of bleeding. So these meds must be monitored and balanced by a medical doctor (along with any other meds you may be taking). One thing, from your original post, you say you had a stroke and had two stents implanted. Were these coronary stents? Stroke is sometimes described as "a heart attack of the brain", but the treatment for stroke does not involve stenting the coronaries, rather opening up the carotid artery in the neck, either through surgery or stenting.
Angioplasty.Org Staff, Angioplasty.Org, August 26, 2009

• Reference to my post dated Aug.25,'09, I found a relation between colon cancer and Aspirin dose. from internet, some say Aspirin is good for heart (prevents strokes) but not for digestive system causing gastric troubles and colon cancer. The colon cancer has symptoms on abnormal bowel movement and gas generation. Do you feel the medicines prescribed in heart disease have such side effects? Kindly analyze, as I am an engineer and not physician.
Stout, Kolkata, India, August 26, 2009

• Jim -- that's an excellent question and a situation we've not read a study on. Plavix does have beneficial properties other than preventing stent thrombosis. What does your cardiologist say?

And Stout in India -- not sure what your other meds are (they may be causing the constipation. We again recommend all patients to discuss these issues with their doctor. And make sure to report any over-the-counter or herbal remedies you are using. Somethings their effects are as strong as prescription meds. Any readers have some insight regarding Stout's complaint?
Angioplasty.Org Staff, Angioplasty.Org, August 25, 2009

• In April, I had two drug eluting stents put in the diagonal artery, but in August was re-cathed and they found that the two stents were totally occluded. However two collateral arteries have been created, and are providing some flow to this area of the heart. My question is since the stents are totally occluded, do I still need to take Plavix?
Jim, Massachusetts, USA, August 25, 2009

• I am 56 years old, had a stroke due to two 99% blockages and was treated by two non-medicated stents in March 2008. I am now otherwise well and use regular medicines such as 1 tablet Noklot 150 plus(150mg Aspirin + 75mg Clopidogrel),1 tablet for cholesterol and 1 tablet for BP control. These medicines are used at a stretch under physician's advice and periodic checkups. I never had any constipation before but now I have regular constipation problem with gastric trouble after I started these medicines. Let me advice how to get rid of this side effects.
Stout, Kolkata, India, August 25, 2009

• Paula -- read our article on PPI meds (Prevacid is one) and Plavix. On a completely different notes, is your mom taking any other OTC meds. One of the main complications of Plavix and aspirin is bleeding. Has your cardiologist discussed this? The very low blood pressure and passing out are not normal side-effects. What is her blood count?
Angioplasty.Org Staff, Angioplasty.Org, August 25, 2009

• I need help and not sure where to turn. Mom had heart attack 1 week prior. She had a stint [stent, ed.], was put on Plavix (75mg) and Aspirin (325mg) and then Pravastatin at night. She also takes Neurontin and Lorazepam due to previous nerve damage and several vitamins. She is passing out after taking the Plavix and Aspirin (BP 80/50) and the doctor said to drink more water. I think she's on too much aspirin. Her stomach also acts up so sometimes so she takes Previcid in the morning before anything else. A strange side effect is her ear and nose close up at odd times and now there is ringing in the ear after her morning pills. The doctor just said post nasal drip gets worse with the elderly. I think she's taking too much medication and she may end up with a GI bleed or fall from a blackout. Can anyone give some advice?
Paula Gabbert, Skokie, Illinois, USA, August 23, 2009

• Val -- Plavix is indicated for several clinical conditions -- in fact in a very technical sense, its use after stenting was NOT an original indication approved by the FDA drug panel. The DAPT and other studies are being done on patients who have received DES, so that would tend towards older patients. Sounds like your son's case is pretty specific and not the norm -- so study results may or may not be that applicable to his situation. We would ask these questions of your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, August 19, 2009

• Thank you for the information about Plavix that my now 19 year old son went on when his 2 drug eluding [eluting, ed.] stents were put in 3 (not 4 as I mistakenly said) years ago. As a healthy 19 year old who did not and does not have heart disease (his docs can't explain why his arteries collapsed during catheter ablation for SVT)and is not at risk for another heart attack for 30 or 40 years, the risk of another event is nil, right? As for the studies on long term use of Plavix, are they being done across all age groups, or just on older people that already had "clogged arteries"? What are some of the other concerns that his cardiologist may have for keeping him on plavix for life?
Val H., Minnesota, USA, August 18, 2009

• Val -- there are several studies being done right now, trying to determine the optimal duration of dual antiplatelet therapy (DAPT, Plavix and aspirin) after drug-eluting stent implantation. Recommended by most is one year -- with many docs saying "for life", as has your son's. Most cardiologists would say there's no problem with Plavix for life, unless there are bleeding complications, which your son is having. But this is a very tricky and very difficult situation, one that perplexes the top people in the field. No one wants to say, okay go off it -- only to have an event occur. Yes, the stents should be covered by now -- of course there may be other reasons for your cardio's recommendation.
Angioplasty.Org Staff, Angioplasty.Org, August 17, 2009

• My then 16 year old son had 2 drug-eluting stents put in his left main when his arteries collapsed for no apparent reason during a catheter ablation for SVT in 2005. He's been on Plavix and 81mg aspirin for 4 years. Aren't the stents grown over by now and he can come off the Plavix? Besides the high cost of the drug, we've had numerous trips to the ER and ENT to find a solution to his reoccurring nosebleeds. Why does his dr insist he stay on Plavix for life?
Val H., Minnesota, USA, August 17, 2009

• To: Nancy, Poughkeepsie, New York,On Plavix over 4 months; no vision issues. Discovered yesterday that I'd neglected to take Plavix for almost one week (don't ask; long story), Cardio Dr said to take 4 (300MG) to ramp back up immediately. Shortly after -- I noticed a couple pronounced eye 'floaters' in one eye (i.e., spots caused by disturbance to fluid in the eye). Also note occasional light flashes as I orbit my eyes around (almost like a detached retina). It's calmed a bit today, but 'floaters' are still there. Checked BP and it was/has been normal throughout. Not sure if there's a connection -- but seemed to occur right after heavy Plavix dosing.
R. Allen, Warren, New Jersey, USA, August 16, 2009

• I have been on Plavix for 14 months due to a TIA. For much of that time I have had severe muscle pain/cramps in my back at night, which goes with movement upon waking. In the last 2 months I have developed shoulder joint pains as well for seemingly no reason, and getting worse. My shoulders feel like some posts sound. I have also had very severe foot pain / tenderness upon hitting the floor (gently) in the morning, and which gets better over time with movement. As a nutritionist, I have tried 3 - 4 magnesium citrate lately to relax the muscles and it has helped my back and my sleeping is somewhat better and less restless. I know that many drugs create nutritional deficiencies that if addressed would reduce or eliminate their side effects. Does Plavix create Magnesium or any other nutrient deficiency?
Rien, Abbotsford, BC, Canada, August 15, 2009

• I received a second coronary stent October 22, 2008 and was put on Plavix and 160 milligrams of aspirin. I discontinued the aspirin in January 2009 due to severe heartburn and chest pressure, which subsided right away once I stopped taking the aspirin. I was also experiencing profuse rectal bleeding after bowel movement which required trips to the ER to stop it, so I stopped taking Plavix in March 2009 and have had no adverse effect from discontinuing the drug 7 months sooner than doctor recommended and have had no more recurrences of rectal bleeding.
Jan, North Carolina, USA, August 13, 2009

• I have been on Plavix and aspirin since Nov. 2006. My cardiologist wants me to stay on Plavix, my primary physician tells me to stop and just continue the 81 mg. aspirin. What shall I do??
Irv M., New York, USA, August 13, 2009

• in france they rec. taking off plavix after 20 months after taxus stents but increase cardio aspirin to 160 from 100 mg to compensate from dual to single therapy. BTW they use powdered soluble sachets as say better than tablet aspirin any agree/disagree and any risk in rebound? tks
Relax, Nice, France, August 10, 2009

Elizabeth R. in Georgetown, Ky. I had an Angioplasty and a drug eluding [eluting] stent put in 8 days ago. My Cardiologist had me start taking 75mg Plavix in addition to the 325mg Aspirin I was already taking daily. He warned me to never stop taking either drug, or there would be a very high possibility of having a heart attack. I grew up in Georgetown. My Dad pastored Georgetown Baptist Church for over 25 years. My three older siblings graduated from Georgetown College. I hope this helps you. I'll be praying for you and husband. Please email me if I can be of further assistance.
Buddy M., Texas, USA, August 7, 2009

• I read the abstract in Circulation (Oct 2008; 118: S_815) and am alarmed by your data. You claim that stent patients with no preceding CV events taking PPIs with clopidogrel showed a 32.5% incidence of a major CV event within one year vs. 21.2% of patients not taking PPIs (adjusted OR 1.79, CI 1.621.97). Is that really so - 21% incidence of major CV event after stenting in the first year even without PPI's? That sounds worse than no intervention at all!
TVR, Farmington, Connecticut, USA, August 4, 2009

• Thanks for the note. I am writing a paper for the Annals of Internal Medicine. Is there a citable version of your data?
TVR, Farmington, Connecticut, USA, August 4, 2009

• Elizabeth R. -- if the stent was a drug-eluting stent, current guidelines recommend at least one year of dual antiplatelet therapy of Plavix (clopidogrel) and aspirin. This is to prevent blood clotting inside the stent, also called "stent thrombosis". This is a very serious condition and could result in a heart attack. Not sure which other meds you refer to, but check out our Forum Topic on Financial Assistance for some help (we hope).
Angioplasty.Org Staff, Angioplasty.Org, August 3, 2009

• My husband had a stent put in 4 months ago due to a blocked artery. His medical insurance was cancelled 11 days prior to the heart attack. The company just could not afford their portion any longer (economy). Anyhow, these MEDS ARE EXPENSIVE, does anyone have any experiences with coming off of the meds? Should he stay on them regardless. If he comes off, what symptoms should we be alarmed with?
Elizabeth R., Georgetown, Kentucky, USA, August 3, 2009

• TVR -- the most recent data for the Medco Study was presented at the Annual SCAI Meeting, as per our article "Heartburn Drugs Increase Cardiac Events for Stent Patients by 50%" and the related stories in the article's sidebar. The earlier data from this study was published in Circulation last fall. The SCAI presentation has not yet been published in a peer-reviewed journal, but it probably will be soon.
Angioplasty.Org Staff, Angioplasty.Org, August 3, 2009

• Someone posted a note on the effect of PPIs on plavix bioconversion (the Medco study). Has this been published in a peer-reviewed journal? I tried to look it up on PubMed but could not find it. Thanks!
TVR, Farmington, Connecticut, USA, August 3, 2009

• I have been taking Plavix for one month. My eyes and vision are not the same as before. Has anyone had an problems like this?
Nancy, Poughkeepsie, New York, USA, August 2, 2009

• David -- check out our topic, "Financial Assistance for Plavix and Other Prescription Drugs". Several posts have links to help people who cannot afford medications. Also, contact your state or county -- they may have a prescription assistance plan. Hope this helps.
Angioplasty.Org Staff, Angioplasty.Org, July 29, 2009

• I need to find where I can get free plavix 75mg. tablets. I had a stent put in on April 1, 2005. Recently I was laid off and had other medical problems such as high blood pressure, high cholesterol and sickle cell anemia. Also my needs include toprol 100mg and norvasc 10 mg tablets. Any help that I can get would be greatly appreciated.
David C., Monroe, North Carolina, USA, July 29, 2009

• coating splitting on Clopidogrel tablets ,but presumed ok until one split completely into two halves .As had been feeling rough during the two weeks carried on taking them, saw chemist who checked tablets and replaced. I've been taking new ok tablets for four days, but I'm so tired and my mouth and throat are sore with a few ulcers, I also have a dull persistent pain to the right of my breast bone. Could this be connected? The chemist said the coating was giving way too soon but advised I didn't need to see the doc.
Wendy H., Durham UK, July 28, 2009

• I had a stent put in about 4 weeks ago. #weeks after the stent I started with Joint pain and also numbness in my finger. I wanted this stent to have that quality of life with my wife Paula again. This is not what I signed up for. I can not sleep right at night the pain is so high. I need something to control it. You are not crazy P Clancy from NY. This drug can change your life or turn it the other way. I went back to see the Doc. he did take a lot of blood test. I will let you know....
F J K, Florida, USA, July 28, 2009

• James J. -- Read our article, "Heartburn Drugs Increase Cardiac Events for Stent Patients by 50%" and the related stories in the right-hand sidebar -- and you'll see that you're not the only one confused about this issue. There have been conflicting results but, as your inhibition test showed, there is an interaction with PPIs that reduces the antiplatelet effect of clopidogrel (Plavix). You're also correct that a German study showed no inhibition with pantoprazole (Protonix) but the Medco study in our above article showed that Protonix in fact had the most inhibition! Your cardiologist's observation is correct that this seems to vary from person to person.
Angioplasty.Org Staff, Angioplasty.Org, July 27, 2009

• I am taking 40mg of Protonix 2 times per day and 75mg of Plavix 1 time per day. Approximately two months ago an inhibition blood test was performed in order to see if the Protonix was ruining the effect of the Plavix. The result was 37% inhibition. On the results, it states "Therapeutic levels of Plavix are associated with higher % inhibition demonstrating the expected antiplatelet effect of Plavix." The reference ranges are unclear on the results. My question is: Am I receiving a therapeutic level of Plavix when taking the Protonix? My concerns: I have read several articles claiming proton pump inhibitors, Protonix being one, can ruin the effect of Plavix. However, I did read one article that said Protonix was an exception to affecting Plavix. Then I overheard a cardiologist state it was a case by case matter, and only blood testing could determine if a proton pump inhibitor was reducing the effect of Plavix below a therapeutic level in a person's body.
James J., California, USA, July 27, 2009

• Hello everyone, I am one of those poor souls who acquired one of the so called " rare side effects " called TTP, I had stents placed in my legs due to poor circulation, my doctor prescribed Plavix, upon the first week of taking this medicine my body started to react , numbness in my fingers, dizziness, stomach pain, headache, joint pain uncontrollable hand and finger jerking, confusion and my speech was effect on the 13th day of taking this medication my head felt like it was twisting off my neck, I called an ambulance,upon arrival to the hospital I began to convulse and slipped into a coma " I WAS DYING " My platelet levels had dropped and I began to build antibodies in my blood.The doctors immediately diagnosed me with TTP, they began a plasma exchange on me, I woke up three days later in ICU and placed on steroids, this medicine almost killed me, be very careful when taking this or any medicine....god bless.
Larry, Jersey City, New Jersey, USA, July 26, 2009

P. Clancy, New York, USA.......I have been on Plavix for 3 months an have extreme pain in my shoulders, wrist and knees it moves around. Plus numbness in my hands am trying to find others that have this so I can show the doctor I am not alone.
CR, Lawrenceburg, Indiana, USA, July 25, 2009

• Extreme traveling joint pain from using Plavix. Has anyone else had this? Have only been on it 3 months first few weeks were fine. Now it's hard to walk or move my arms will see doctor in 3 weeks.
Connie, Ohio, USA, July 25, 2009

• to nurse "E" from Mobile -- thank you for your post. Your recommendations are right on and very important for all readers!
Angioplasty.Org Staff, Angioplasty.Org, July 25, 2009

• I have been a Cath Lab nurse for the past 25 years and have seen it all. The most important thing I learned was the major importance of Plavix and ASA therapy post stenting. Patients returning to the Cath Lab with recurring chest pain after stent placement about 85-95% had discontinued their plavix. So many returned that I made Plavix importance foremost in my pre and post procedure teaching. If money was the issue I made sure that the Physician ordered a social service consult in order to get Plavix assistance for them. The drug company will usually assist patient's with either free or reduced cost Plavix. In 2006 I had a heart attack, received a drug eluting stent and left on Plavix and ASA 325mg regime. I am such a Plavix advocate when my Cardiologist told me I could come off Plavix and reduce my ASA to 81mg I told him if it was alright with him I would leave both as they were. He agreed with me but said it would not be a problem unless I had problems. So, far with the annoyance of bruising I have been great. I would recommend to everyone to stay on your Cardiologist's recommendations even to the point that no one but your Cardiologist take you off of the meds. If you do need surgery or any other procedure have your doctor call your Cardiologist for permission. Remember, Social Service Consult if needed and only your Cardiologist should stop your Plavix or ASA. Questions or allergy call Cardiologist. Your doctor works for you.
E, Mobile, Alabama, USA, July 25, 2009

forum, no we haven't -- They are now giving us the run around on finding allergist (non seem to know how to check him). I have given the dr print outs of the and they are trying to get him into a cardio at a mayo clinic. I don't understand why this is taking so long draw blood send it to melisa.
Amanda, Patterson, Georgia, USA, July 22, 2009

• Standard recommendations for antiplatelet meds after placement of a drug-eluting stent (the Taxus is one) is at least one year of Plavix -- and aspirin for life. However, many cardiologists feel Plavix can be helpful if given longer, if there are no bleeding complications or other adverse reactions. (Plavix helps keep blood from clotting inside the stent, something which can cause a heart attack.) Modern medications have been shown to be very helpful in the treatment of coronary artery disease. Possibly the meds can be adjusted. But the decision to stop or alter any medication should definitely be done in consultation with your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, July 21, 2009

• My 82 yr old wife had two Taxus stents placed in June, 2008 because of sudden 100% blockage of her LAD. She is currently on 75mg Plavix, 40 mg Diovan, 40mg Simvastatin and 50 mg Carvedilol. She hates pills (she wasn't taking any prior to the heart attack) and would like to stop taking them if possible. Are there any guidelines or ongoing studies about how long you need to take Plavix or any of her drugs?
Dennis Meronek, retired, California, USA, July 21, 2009

P. Clancy, New York, USA, July 16, 2009

• Amanda -- have you determined whether or not your father is allergic to nickel or stainless steel (which contains nickel). ALL Stents, DES or bare metal, contain nickel and the official FDA-mandated Directions For Use (DFU) included with each stent specifically warns that stents should not be implanted in persons with a known hypersensitivity to any of the components.
Angioplasty.Org Staff, Angioplasty.Org, July 14, 2009

• Hello all I do feel for each of you I am a 33 yr old not a problem it is my father-in-law he has had problems since Oct 2006 he had DES placed put on plavix and aspirin by Dec 2006 they were doing bypass to remove the stent he was allergic. We found the problem not the DR. No Dr had ever heard of someone being allergic to a stent. He then developed some more problems blood pressure would suddenly drop causing him to pass out or faint some times 3 times a day. Dr. don't know again what it could be. He tried to wean off plavix chest hurt so bad he started them again. Dr's put a pacemaker in. no help he still pass out 3 times or more a day some days no probs. He just had cath done Dr told us he thought it was the med on stent he was allergic to and told us with no options he was putting in a bare metal stent. pro was done on fri sent home on sat and guess what he is in allergic reaction again looking at second bypass to cut stent out. still dr.'s haven't heard of this the same dr.'s I have been researching and some of u my want to check this site out most of ur problems could be the metal in the stents themselves and not med. GOOD LUCK!
Amanda, Georgia, USA, July 13, 2009

• Hi, folks, having had a heart attack in 1999..and had an angioplasty.....i take the following medication, ASPRIN.75MG....ATENOLOL.100MG...NICORANDL.30MG.[twice a day]RAMIPIL.10mg...MONOMAX XL 120mg...."CLOPIDOGREL.75mg.".....BEZAFIBRATE.400mg...SIMVASTATIN.40mg...LANSOPRAZOLE.15mg....I GET MOST OF THE SIDE EFFECTS...COLD,RASH,SWELLINGS...AND NOW I HAVE TROUBLE WITH MY KNEES [joints]....i have been on PLAVIX for about 6 years ???? my consultant now wants me to stop taking it???....WOULD APPRECIATE ANY ADVICE....[TIP] i take a finely chopped garlic clove....most a comfey leave in really helps,the building blocks of life....
Frank M. Pountney, Wallasey, United Kingdom, July 13, 2009

• Thank you for your responses, it's good to know there are people out there who understand what you're going through. Incredulous as it is, we haven't actually got to speak to my Dad's cardiologist, so I have no idea what kind/brand of stents they used on him. I don't even think that the hospital he is being treated at now have gotten to speak to his cardiologist - the stent procedure was performed at a different hospital. However I am going to the hospital within the next hour to insist that an aspirin alternative is found, as we know that plavix has no adverse side effects for him.

Mike - we're lucky that in the UK plavix is free / only costs approx 6 for a prescription. It's horrendous that your doctor doesn't care about the side effects. We put him on a high fibre intake for a few days coupled with eating fruit, drinking fruit juice and lots of water. It's good that you've been able to remedy that for yourself without needing drugs.
Miss H, Northern Ireland, United Kingdom, July 9, 2009

• Miss H - Age 62, similar problems after DES 1 year ago. Found that enteric coated aspirin (doesn't dissolve until after the stomach) eliminated the stomach pain and bleeding. Massive doses of fiber (:-) eliminates the constipation - Fiber One for breakfast and shredded wheat for supper. No need for other drugs. If I could afford the Plavix, I would be doing well. My doctor doesn't seem to care about side effects.
Mike, Missouri, USA, July 9, 2009

• Miss H -- what type of stents did your father get? Drug-eluting or bare metal and what brand, if you know. Bleeding complications are one of the biggest concerns with dual antiplatelet therapy (Plavix plus aspirin) -- perhaps your father's cardiologist might have some input here.
Angioplasty.Org Staff, Angioplasty.Org, July 9, 2009

• Hi all, so glad I found this site. My Dad is 60 and has been on plavix for 7 years (never caused him a problem)because he was diagnosed back then with angina. Last summer follow up tests were requested (slight delay there) and 7 weeks ago he had an angiogram and told he needed 3 stents in his artery. He gave up smoking immediately and has been on nicotine patches since. He ended up requiring 4 stents (was not told why the extra 1 was needed) and was also prescribed aspirin, lipitor and a beta blocker. At the time he told his consultant he'd had a stomach ulcer when he was younger and expressed his concern about taking aspirin. This concern wasn't listened to, and things have been going downhill since. For the last month he has had problems with bowel movements, culminating in severe constipation and stomach pain for the past few weeks. After several trips to the GP it was discovered that he had been on aspirin all that time without taking a stomach-protecting tablet. For the past 2 weeks he has also been passing blood when he tries to go to the toilet. Has been given movicol laxatives, take 13 sachets in total, has also been given 3 enemas - still NO real relief. After 3 trips to A&E has finally been admitted to hospital, still nothing is being done and am now very concerned re post by Mary, Virginia, USA, April 6, 2009 saying that her friend was in icu with damage caused by a gi bleed from taking both tablets together. Do I take this info with my to the hospital in the morning?
Miss H, Northern Ireland, United Kingdom, July 9, 2009

• With so many people taking Plavix how come the price stays so high we on Social Security can't afford it. I finally resorted to a Canadian Pharmacy where I got twice the amount of pills at half the price. I would rather deal with my local pharmacy but each time I go in they have raised the price again, four times in one year. Too bad they don't warn us before we ever start on Plavix.
Louisie Brett, Tillamook, Oregon, USA, July 6, 2009

• Elizabeth in Providence -- there aren't "terrible side effects" with Plavix and aspirin. Certainly some people experiences some allergic reactions, or more seriously, bleeding complications. But these are life-saving medications. And they have been shown to be very necessary post-stenting. We do not recommend going off these meds for "natural" substitutes. We don't know of any natural substitutes with the antiplatelet properties of Plavix and aspirin combined. We have heard of the book you mention -- without getting into any details (readers can Google the author themselves) about the author's medical credentials -- we would point out that in the past 30 years, mortality from heart attacks has radically decreased due to the invention of modern therapies and pharmaceuticals.
Angioplasty.Org Staff, Angioplasty.Org, July 5, 2009

• I guess I'm luckier than most. Oh, like many of you, I, too, had medicated stents inserted -- five of them on April 1, 2009. I, too, am on 75 mg of Plavix per day as well as a 325 mg Aspirin and 100 mg of Lopressor. So far, there have been no adverse reactions, but... I am very concerned about the use of these medications, especially knowing that there are terrible side effects associated with their use. After having read, "Is Your Cardiologist Killing You," and reading surfing the internet for information regarding more "natural" substitutes, I am ready to take back my life and my health by weaning myself off these poisons and beginning to use more natural alternatives.
Elizabeth, Providence, Rhode Island, USA, July 4, 2009

• Gary...John from Maryland recently posted a similar question. Anyone else out there having this reaction??
Angioplasty.Org Staff, Angioplasty.Org, July 4, 2009

• I have been taking plavix 75mg for a year now, over the past few months I have tinnitus which is annoying the hell out of me. I also noticed that within 60mins of taking plavix my tinnitus gets worse. Has anyone else had these symptoms?
Gary, Newcastle, United Kingdom, July 4, 2009

• My husband had a vascular bypass and two stents put in almost three months ago. About three weeks after starting plavix, his eyes swelled shut, his tongue thickened and he had blisters on his upper thighs. They treated it with Benadryl and prednisone. We thought everything was better. Then he got an infection and while being treated with IV antibiotics, he became very confused. They have done a CT scan to check for a stroke, but the Neurologist asked if he was over his allergy to Plavix. How do you know? Now I am wondering if it is the plavix. He gets hungry, but eats very little. He is up in the middle of the night cleaning. He throws away good stuff, misplaces things, and sometimes can't remember words. His sense of time is gone. However, he can reason many things. He made bacon and over-easy eggs successfully, but he prepared for 4 people instead of the 3 in our family. Can anyone comment on the possibility of the plavix causing this.
Darlene, Waseca, Minnesota, USA, July 2, 2009

• We suggest that posters communicate with each other via the Forum so that others may benefit from the information. We also do not post people's email addresses unless specifically requested to, in order to protect them from SpamBots that troll the Web.
Angioplasty.Org Staff, Angioplasty.Org, July 1, 2009

• I am just reading all this now. EASY from Massachusetts commented that he/she is looking for me. How can we communicate, Easy?
NanaBCornflake, Houston, Texas, USA, July 1, 2009

• My hand has swollen up and I am having terrible pain in my knees. Could this be caused by the Plavix?
Hop, Ohio, USA, June 28, 2009

• Jean from Canada -- read over some of the posts in "Not Feeling Well After Stenting". Similar complaints have been reported -- this usually subsides as the body adjusts, but if there is anything worrying you, call your cardiologist for no other reason than to set your mind at ease.
Angioplasty.Org Staff, Angioplasty.Org, June 27, 2009

• Stent put in on June 19, 2009 -- on plavix 75mg. Is it normal to have burning in chest area, not all the time, comes and goes?
Jean, Canada, June 26, 2009

• I had an Endeavor DES placed in LAD 1 year ago after 95+% blockage. Lucky to be alive, apparently. 62 years old, take 75mg Plavix, 325mg aspirin, beta blocker and 10mg Lipitor. Have cramps that I never had before in my feet, numbness in my hands, and some itching from one of these drugs (which one?). Muscle aches and some skin problems, both from the statin. My side effects are not anywhere near what some folk describe on this forum, thankfully. Because it is well tolerated, I expect to be taking Plavix for a long time. Am considering buying it online from Canada. Not the generic version made in a 3rd world country, but brand name Plavix. I can buy it for about 1/2 the price of US Plavix. Should I be concerned about the quality/safety of Canadian Plavix?
Mike, Missouri, USA, June 18, 2009

• Has anyone experienced increased ringing in their ears (tinnitus) as a result of taking Plavix or any other medication?
John, Maryland, USA, June 12, 2009

• John -- NSAIDs, such as ibuprofen (Motrin, Advil) counteract the antiplatelet (blood thinning) properties of aspirin, although there is a timing issue and a recent study showed that they could be taken by the same patient if the aspirin was taken first and the ibuprofen a few hours later. However, there is also the issue of gastric distress if all these are taken. Plavix and aspirin are required for a year or more after drug-eluting stents -- but you should discuss this issue with a cardiologist. He/she may also want to ease you off the Plavix, instead of stopping cold turkey (see our article about the possibility of a Plavix rebound effect)
Angioplasty.Org Staff, Angioplasty.Org, June 12, 2009

• Had heart attacks March of 2005 , VA Doc put in two Taxus DES`S in upper right coronary artery 98% blockage , went back in a month later and placed one Taxus DES in lower left coronary artery. Been on Plavix and 325 aspirin since .No noticeable side effects. One VA Doc in Orlando wanted me to go it cold turkey my other VA Doc in Wisconsin says stay on it . I have loads of degenerative bone and disc disease plus an enormous amount of Arthritis pains all over. I would like to treat the Arthritis pain with anti-inflammatories but no one will prescribe because of the Plavix Aspirin. Do I stay in pain or die. Thanks. John 61 years old.
John. St. Cloud, Florida, USA, June 12, 2009

• My internist prescribed plavix 75 mg (generic which I purchase in Canada) as my carotids were narrowing and had two episodes of dizziness and balance issues, although the narrowing has stopped with an aggressive program of crestor (40mg) and zetia (10mg) along with good diet and pro active fitness program. I seem to tolerate the plavix OK but now have minor digestion problems and rectal itching. I am a 69 year old male.
Lee B., Norwalk, Connecticut, USA, June 5, 2009

• Burt -- check out our topic on Exercise and see all the marathoners and bicyclists! Medtronic even holds a race every year for heart patients who have been fitted with pacemakers, stents, etc.
Angioplasty.Org Staff, Angioplasty.Org, June 5, 2009

• I had three drug coated stents fitted in January 2007. I took Plavix for 12 months while stopping the aspirin. Then I started on the aspirin again. I cycle up a steep hill every day, no chest pain or complications to date. I hope this lasts, my specialist advised me to continue with plavix and aspirin two years later. Does anyone think I'm taking a risk?
Burt G., South Africa, June 5, 2009

• 68 yrs old, had a medicated stent installed (100% blockage) two ballooned , 70 and 89% blockage, put on Plavix, however had an emergency bladder operation seven days later, took a chance , they said no choice, bleeding inside the bladder (tumor) then the same procedure on the Bladder aging 14th May,still on the plavix,and since I've had terrible shoulder pain..scale of 9 at least,continues daily, weak use of the shoulder etc, however after a long walk the pain goes away, strange, that evening during the middle of the night I am awaking again with severe pain,went to the Emergency room ,spent most of the Night (waste of time) given a couple tylenol sent home, x-rays shows nothing, had a cortisone shot etc.....pain continues, could this be for the use of Plavix?
Terry, Tacoma, Washington, USA, June 2, 2009

• Hi! I am Kathy in Illinois. I went in for a cardiac cath, they ended up putting in a medicated stent because I had 90-90% blockage in the main artery in the right side of my heart. I am on plavix. The doc told me I would be on it the rest of my life. About 3-4 days after the I came home, I started itching. Thinking nothing of it, thought it was dry skin, or mosquitoes, I went to looking and my back looked like I had hives. I suspect its the plavix, but unsure.
Kathy, Illinois, USA, June 1, 2009

• From Chuck to Barbara L , I had a heart attack March 12 2008 and had two stents put in on the 13th. was told that my carotid artery left side needed cleaned out 80% blocked was told to stop taking Plavix for a week before they would do the operation.
Chuck, Johnson City, Tennessee, USA, May 29, 2009

• I just had a coated stent put in 2 weeks ago and was put on Plavix 75 and zocor 40 and 325 mg aspirin. I had problems almost from the onset with the zocor, so I stopped it. But, I notice that after I take the Plavix, I freeze. My body gets very cold all over, especially my legs. Does anyone else have this issue from the Plavix. I have no idea how long I have to be on it, but I hate taking meds and do not want to take this the rest of my life. I was told a year and then was told forever. How can we find out the truth?
Janeen Weiss, Los Angeles, California, USA, May 29, 2009

• I'm having terrible side effects from Plavix and would like to try taking Plavix every other day and continue the aspirin every day. Cannot not stop Plavix per my heart doctor's orders. I feel so much better even one day without the Plavix, but I do want to know if it is safe to take this way? Please advise. When I first started Plavix, I was hospitalized with severe hives. Tried again, no hives just over all feeling awful. If anyone has done this safely, please let me know.
Norma, Pennsylvania, USA, May 28, 2009

• In 1991 I got 2 By-pass and in 2007 a stent . I am taking one Plavix 75 a day and 100 mg. aspirin .How long I have to continue with Plavix? Thanks
Eng. Salvador Koziolas, Montevideo, URUGUAY, May 28, 2009

• Don and Ann -- Plavix has helped many and isn't "a killer", but it does carry a well-known complication for bleeding in certain individuals, as does any blood-thinning medication.
Angioplasty.Org Staff, Angioplasty.Org, May 27, 2009

• 68yrold male put on Plavix. April 2008. after 3 TIA's.13 mo.later a new Dr.said he should only be on Plavix until he was stable after TIA's. Has developed bleeding ulcer, just felt so rotten. stopped Plavix 2 weeks ago and is like a new man! Help get the word out, Plavix is a killer!!! Dr.s and drug companies are in cohoots! We're not thru with his Dr.s yet!!!We live in Southern Illinois.
Don & Ann Schnitker, Hoyleton, Illinois, USA, May 26, 2009

• I had 3 medicated stents 5/08 now getting ready to go off. I have had itchy red bumps on my private area since taking plavix. Could this be the problem? Guess I will soon know.
Ted, Tennessee, USA, May 25, 2009

• hi all Had second stent (DES) fitted in Jan 2007. Stayed on normal dose of Plavix until earlier this year when I started a planned reduction. Now taking half tab per day. At the same time as all this I also have Atrial Fibrillation (10 years) and so am on the normal Warfarin. Again as is normal after I had the first stent I was also put on 75mg Aspirin daily. Being on Warfarin, do we know if it is necessary to be on Aspirin as well, as I do seem to have lots of digestion issues which have not yet been addressed. I am seeing a general Surgery doc shortly and want to talk to him about this whole issue of tablets.
Tel, United Kingdom, May 18, 2009

• I had a heart attack in November 2007 and was placed on plavix and aspirin. I have had trouble with intermittent chest pains and tremors in my chest and shoulders. In February 2009 I had to discontinue the plavix and aspirin for 5 days in order to get a colonoscopy. During the 5 days , the tremors and chest pain stopped. When I started back on the plavix, the tremors started up again. My cardiologist insisted that I stay on the plavix for 2 years after the heart attack.
James C., Tuscumbia, Alabama, USA, May 15, 2009

• Hey gang I had a heart attack on of days Friday the 13th of March. Two stents put in and a lot of side effects from the medication. I have been on a quest for information ever since. I am currently reviewing Dr.Ignarro's book on Nitric oxide called NO. It is well worth the time to read it and will really educate you as to how to get your heart healthy and functioning at peak performance. I checked the Nobel Peace prize site and this guy is legit. Get back to me with your information and critiques of his findings.
Jim McMaster, Salt Lake, Utah, USA, May 5, 2009

• Am trying to communicate with NanaBanaCornflake, Houston, Texas,USA, posting on April 16, 2009. In 12/2009 had two failed attempts to place a stent in my RCA to remedy the narrowing of a "Taxus Express2" stent placed 3/2005. Would like to compare notes on narrowing "Taxus" stents to anticipate potential future symptoms.
Easy, Massachusetts, USA, May 2, 2009

• This is for Mike who lost his taste. I have never been on plavix or heart meds, but I have been on other type meds...none related to heart or blood pressure. BUT I lost my sense of smell AND taste. I went to the ENT , had MRI'S etc...all the tests to see if something could be causing it. After a year and a half I went back again to the ENT to see if maybe THEN he could find something to figure out why I lost my smeller and taster. He found nothing and he told me he had never seen anyone who had lost their smell and taste for so long ever regain it. I was so bummed. Its terrible not to smell and taste. No one can really relate to it cause it seems so rare. Well one day after two years of no smell and taste i went for a walk and I smelled fresh cut grass. I almost cried... I was so happy. after that, little by little I began to smell and taste again. Coffee is about the only thing that still smells a bit weird. So hang in there...i bet it will eventually come back.. One day you will smell something and it will be awesome.
Melinda B, Birmingham, Alabama, USA, April 17, 2009

• I am now 67 years YOUNG and have 5 DES stents. 4 Cypher and One Taxus. The TAXUS DES closed on me last year and I had a Balloon angioplasty inserted. The Cardio Interventionalist said Plavix would not of helped keep this open nor aspirin as this TAXUS stent was notorious for doing this. (BUMMER) The other DES stents are wide open. I have been on Plavix now for 5 years and take TWO 81mg of aspirin daily. I am ready to wean myself off this stuff. I will continue the baby aspirins but I believe all the wheezing I do and especially at night may well be the result of the Plavix. Plus coughing my fool head off. Plavix people were of no help to me. In fact I did not like her attitude. I needed to talk to them. I have suffered for 4 years with torn ligaments in both knees and walk like a 90 year old. No one will do surgery unless I am off Plavix for 8 days. Interventionalist said NO! Well, I have no life as it is. I will have to take my chances on re-bound. Now, this is my decision. No one is telling me to do this BUT ME!.....My Son in Law had one Bare Metal stent in 2000. He took Plavix for one year and said No more. It has now been 8 years now and no incidents. he is doing great! My sister had 2 bare metal stents in 2001. She was on Plavix 17 months. She suffered Steven Johnson syndrome and Low Blood count so her husband weaned her off that med. This was 7 years ago and she is much better but CBCount is still a tad low from this. Then me with 5 DES. Not a happy camper. I also feel Plavix is responsible for my ongoing GERD/REFLUX. I have to take Nexium daily. I may e-mail the Cardio to see how much he will tell me this time. Maybe he has some updated info.
NanaBananaCornflake, Houston, Texas, USA, April 16, 2009

• Bob -- all studies have shown that with drug-eluting stents, stopping Plavix/aspirin therapy too soon increases the risk of stent thrombosis. We strongly recommend discussing this issue with your cardiologist. Maybe he/she can adjust your meds. After all, the reason to get stents is to improve the patient's quality of life, not the opposite.
Angioplasty.Org Staff, Angioplasty.Org, April 16, 2009

• I had 2 stents five months ago and also have irregular heart, which occurred after I started taking blood pressure pills. They have me taking Diovan for blood pressure, 325 mg aspirin, plavix 75 mg, Simvastatin 20 mg, and warfarin 2.5 mg 3days and 5 mg 4 days weekly. My INR is between 2-3, but having difficulty taking all these meds. Think I'm getting more meds than I need, because of reactions such as weight gain, upset stomach, shortness of breath and lack of energy. Thinking of dropping most of these meds and just taking 1800 - 2000 mg of fish oil. Any suggestions?
Bob, Denver, Colorado, USA, April 15, 2009

• I'm interested in finding out if EDTA (oral chelation) will interfere with plavix, Can any one answer that, if so how? I been on Plavix for a couple years and had a stent put in for pain in my legs. I also have high blood pressure low dose (zestoretic 10/25) I only take that as needed. I keep close tabs on my pressure.
Emily, New Caney, Texas, USA, April 13, 2009

• Mary -- the current guidelines recommend Plavix and aspirin (a.k.a. DAPT or Dual AntiPlatelet Therapy) for 6-12 months or longer, post DES, assuming there are no complications. Bleeding is definitely one of these complications, and something for all to be aware of. We would only stress to you and our readers that the issue of continuing with Plavix and aspirin is a very important one, because stopping Plavix too soon increases the risk of stent thrombosis. We strongly recommend discussing this issue with your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, April 9, 2009

• Hello,I had two D.E.S. put in one year ago. Like most people, I am on 75 of Plavix and 81mg. of asprin. As I write my friend is in the i.c.u. fighting for his life from a g.i. bleed caused by the combo of Plavix and aspirin. I have read everything that comes out on Plavix and I have decided that I am taking myself off it but I will do a taper over several months. I have worked cardiac med surg. for a number of years so I am well aware of all sides to the questions and fears. I am not telling anyone to taper nor am I saying that anyone should stop period. I am making my own choice for my own body. Besides the two stents I am otherwise extremely healthy and walk daily as well as following a good diet. Out of four siblings, the doctors were shocked at the blockages because of my overall health.
Mary, Virginia, USA, April 6, 2009

• My 83 yr old father recently had a small MI, with stent placement in heart then several weeks later leg -peripheral stent. developed VT after that,which resolved on lidocaine gtt and mexilitine po. was started on plavix and asa after stents. went into afib, started back on coumadin. cardioverted out of afib, but next day experienced increased shortness of breath. Now on ventilator in ICU. bronchoscopy showed lung hemorrhage from plavix,coumadin and asa. Hopefully he will wean off respirator soon. Drugs can be good, but not in his case. They said it is a rare occurrence. His INR was in therapeutic range. wonder why they don't check bleeding times, or platelet counts in people on combo rx. Just wonder how may people hemorrhage in the lungs from plavix, and the long term outcomes. No real antidote for treatment in critical situations.
Sandra, Massachusetts, USA, April 5, 2009

• Lesly and others -- you need to find out what type of stent was placed. Guidelines are that DAPT (dual antiplatelet therapy, which is Plavix and aspirin) should be continued for 4-6 weeks for bare metal stents and 6-12 months or longer for drug-eluting stents. Premature cessation of antiplatelet therapy is associated with increased risk of thrombosis (clotting). There are possible alternatives to Plavix, such as Ticlid. But every patient's situation is different, which is why nothing you read on this or any other site should be a substitute for a medical professional's opinion. Talk to your cardiologist -- if you are not getting the right information, go for a second opinion.
Angioplasty.Org Staff, Angioplasty.Org, April 5, 2009

• I have a unique case. I had a stent placed in my celiac artery (no heart disease) due to compression of the artery by a ligament. The ligament was cut, the stent placed and I was put on plavix for 90 days. Cut to 2 years later, the artery restenosed (75%) I had an angiogram and a second stent placed. I am trying to find out if it was bare metal or des. All my research shows that plavix does not prevent restenosis, just clotting. The artery involved in my case does not go to my heart, but to my intestines. This time around I am having terrible side effects from the plavix-severe stomach and back pain. I am planning on stopping the plavix (my dr. is an idiot as far as I am concerned and insists I stay on the plavix, possibly indefinitely although I can not get any real reason from her) but I can't seem to get any information on my particular type of situation. Anyone out there have a similar situation or insight? Thanks.
Lesly M., California, USA, April 5, 2009

• I had a medicated stent 10/08 with 60% blockage, 01/09 after returning to cardiologist several time another angiogram performs there it was determined I was 80 to 95% blocked,I had quadruple bypass 01/29/09 prior to that I was on Plavix for 3 months, I have diabetes which was under control with an A1C of 6.4 and now my blood glucose levels uncontrollable A1C is 8.0, GP has put me on insulin and the insulin is not working. Could the plavix cause the insulin to not get into the cell. I will be going to an Endocrinologist very soon. Any responses will be greatly appreciated.
Kelly M, Naytahwaush, Minnesota, USA, April 5, 2009

• I am getting ready to stop Plavix after having a bare metal stent placed a little over a year ago. In addition to tapering off of Plavix I have been tested to be sure my aspirin dose is actually working. I heard a cardiologist recently say that it is important to have your aspirin response tested before you stop Plavix. One of the reasons people have heart attacks, strokes or die is because aspirin doesn't work in them or they are taking the wrong dose. It is probably between 10% to 20% of the population. My doctor used a test called AspirinWorks to test me.
Gordon E, Wichita, Kansas, USA, March 26, 2009

• I had a stent put in 2 years ago. How long can I go without taking plavix?
Fred Rupeter, Biloxi, Mississippi, USA, March 24, 2009

• Is it safe to go off Plavix after having a drug coated stent 18 months ago?
Peggy, Phoenix, Arizona, USA, March 13, 2009

• I am a 49 year old female who had two medicated stents placed in my RCA. I was put on plavix 325mg aspirin lowered to 81 because of severe bruising. I also was on ranexa which caused bloody urine and am on metoprolol 12.5 twice a day. I have had steady declining mental functions, feeling like i am in a fog, inability to concentrate, identify items at times and memory loss.The Doctor tried an antidepressant Lexapro and I could barely move and yet it felt like i was racing. I had told him I wasn't capable of being depressed because I could not hold a thought long enough to even think I was depressed. Now after reading this and starting to think I had some kind of brain tumor I can attribute my mental problems to plavix I am sure of it. Why don't the doctors listen to us? This decreased thought function and severe lack of energy leaves me in a suspended state each and every day. I am alone and I barely can function. There has to be another way. Don't they know we know ourselves more than anyone?
Sandi P., Connecticut, USA, March 12, 2009

• Apr. 07 4 stents implanted, 3 DES. On Plavix for 18 months, then decided to take same every second day 4 months ago. Today's Dr. Visit said, "stop Plavix". I will so, and do hope that someone, eventually will help all others in a dilemma re: Plavix!!
Fred Bircham, Winnipeg, Manitoba, Canada, March 12, 2009

• Mike--Stent-Dec.5-08-Circumflex-90%-I am 44yrs.I have had trouble with dizziness and *LOSS OF TASTE.* Could be worse,but it really sucks to lose your taste. Anyone else had this problem. I guess I have to take this med. for at least a year or I could keel over and die..From what I have been reading it is scary to try to get off of this med.WOW! miracle drug ha!Guess I'm lucky?Not so sure..If anyone knows how to regain taste please send an e-mail. I really do feel for everybody with these awful side effects.
Mike, Oklahoma, USA, March 12, 2009

• My husband just had 2 DES placed in RCA 2 weeks ago Put him on Plavix, baby aspirin, etc. all the usual drugs. After 1 week developed rash/hives type symptoms, Dr said he's probably reacting to Plavix so he had him start taking Ticlid plus Plavix for 5 days and then stop taking Plavix all together. Put him on a steroid regimen too. After 2 days rash was all but gone but now developed large bumps/itching again. Can you develop allergies to foods you were never allergic to before taking these drugs?? Seems it happens when he eats bananas. Any ideas???
Jacki, Derby, Kansas, USA, March 11, 2009

• I had stenting done about 2 years back for one artery... and was on Plavix for around 4 months. Can I take any medicine apart from Aspirin
Arun, Pune, India, March 10, 2009

• Update to my Feb 2007 report on my 2 des (stents) fitted to r/h coronary artery (100 % blocked) , I was placed on plavix, 40mg simvastatin, 75mg aspirin, - 3 months later the statin was stopped, 8 months later the plavix was stopped, - I currently take - 75 mg aspirin and 10 mg statin, that is all - no problems other than itchy skin on legs - cholesterol is 4.2 - sugars are ok.
Dave W., England, March 6, 2009

• I have been on plavix for 6 years. been off 10 days for surgery . Last week I had 2 more stents and was put on plavix with aspirin I have a bad allergic reaction to aspirin and have been warned by my old deceased physician. Now I found that they gave me aspirin the day of the stents and when I got home I now have some bad reactions I stopped the aspirin. Has anyone had a problem with plavix and aspirin.
Sue R., Missouri, USA, March 4, 2009

• This is Donna who husband has 16 stents, no he has never taken Avandia, just Plavix. He takes three different cholesterol pills, plus others. He takes 1 isosorbide dinitrate three times a day. Which is a form of nitroglycerin, he use to wear a large patch everyday, but they started giving him this kind. He don't get the headaches that often now.
Donna Sherron, Smithfield, North Carolina, USA, March 4, 2009

• I am a 50 year old female who had a heart attack at home last Thurs. Feb 26 on Fri 27. I had an angioplasty for a clot on a blocked artery and a stent inserted. Home on Sunday taking aspirin, 75mg Plavix, 20mg Lipitor and 1 Blood Pressure tablet. I am so nervous and have a dullness still in my left arm. Can anybody reassure me I am terrified.
Bernie, Ireland, March 4, 2009

• I am 37 years old and have had three blood clots so far -- 2 while on Coumadin. My doctor then prescribed 75 mg of Plavix and 81 mg of aspirin daily. I have been taking the Plavix-aspirin regimen for about 1 year. My doctor told me that he believes I need to be on this regimen for life. I'm super concerned now that I have read about long-term effects, re-bound effects and other complications. Can anyone point me to literature that might help me make an informed decision about perhaps taking half the dose.
Michael , Costa Rica, March 4, 2009

• My husband had both metal and coated which was they way they did all of his stents. Dr's told us he would be on Plavix rest of his life. He needs a knee operation, but Dr's won't do it because he can not come off the Plavix.
Donna Sherron, Smithfield, North Carolina, USA, March 3, 2009

• I'm trying to Reach Donna, the woman who's Husband has had 16 stents! Does your husband take Avandia!? I've had 4 stents, I blocked up every 6 months like clock work! I did everything I was supposed to do during this time too! Please, if he's taking Avandia, it's the Avandia. I stopped taking it one month after my last stent surgery, and it's been 1.8 years without anymore blockage! Anyone that started taking Avandia, and was healthy before, then started having heart attacks or blockage 3 to 9 months later, please stop the Avandia, and go to glucotrol! Please ask your MD don't take my word for this! My MD thank god had suspected that it was the Avandia! This saved my life!
Waylen, Medford, Oregon, USA, March 3, 2009

• Withdrawing from Plavix......possible side effects Being part way through my withdrawal programme I have noticed a strange symptom, which I am not sure could be attributed to slowly coming off plavix. I find that after a walk, in normal conditions, my feet both start to `hurt`, and feel as if they are cold, but on stopping and unshoeing, my toes particularly, feel uncomfortable as if they are cold, but are actually warm, but tender. This stays for about 2 hours. Anyone else had anything similar after stopping Plavix??
Tel, United Kingdom, March 1, 2009

• After stopping Plavix, my four coronaries became severely blocked, just 60 days after. Two were 100% and the other two 95%. I had to have open heart surgery with four bypasses. After 3 months, I suspected that it was Plavix that caused it. Now, after a year, I took a CTA Cardiac scan to have a look at my heart. Guess what? My native arteries are fully open and the bypasses dead. I was told that I was probably misdiagnosed; that the blockages could probably have been flushed out. I am still after BMS for not warning physicians or patients about being careful stopping Plavix, but slowly weaning off. How many other are out there with the same dilemma as me?
Miya, Los Angeles, California, USA, February 27, 2009

• Chris H. -- read the blog entry titled, "Plavix, Prilosec, Prevacid, Protonix -- Do I Hear a Nexium?" about the current statements on PPIs and Plavix. Also the "Plavix Safety Update" which links to the latest document from the professional societies. As for Ticlid (ticlopidine) it fell out of use when Plavix came around, because it tended to have more adverse reactions. However, several cardiologists we have spoken to have switched patients to Ticlid when they were having difficulty with Plavix -- and they did fine. In Japan, Plavix is not reimbursed, so everyone there is on Ticlid. These are definitely issues to discuss specifically with your cardiologist and in no should you take anything you read here (or elsewhere on the Net) as a substitute for his/her advice.
Angioplasty.Org Staff, Angioplasty.Org, February 28, 2009

• I'm a 49 year old male that had an MI Jan 2009, had a single DES placed in my LAD (don't recall being given an option) and have been on 75 mg Plavix + 81 mg Aspirin for only 6 miserable weeks now. Actually, at first I was also taking lopressor & zocor, but Cardiologist stopped them (separately, a couple weeks apart) because I was complaining about how miserable I am. I was very active before the MI, but since, I am always tired & weak, always sick to my stomach, many times I have chest pressure and back pain & burning in my stomach. When I tried to get my Prilosec refilled, my regular MD would not refill it based on a Nov '08 report about PPIs interfering with Plavix. My Cardiologist had actually given me a bunch of Nexium samples on my first visit after the Stent...guess he doesn't believe that report or care. Anyway, for about two weeks now I'm only on 81 mg Aspirin and 75 mg Plavix and I still feel really lifeless and sick to my stomach all the time. I've never had an issue with aspirin, so I'm about 100% sure the Plavix is to blame for my misery. I'm supposed to take Plavix for no less than 1 year...I'm going to die from malnourishment, lack of physical activity and depression first. My bad days far outnumber the good & I haven't had a single day that was all good. Cardio says he'll only take me off Plavix IF the GI Doc tells him to. I'm seeing the GI Doc this week, but don't expect him to make that call, PLUS, after everything I've read, I'm scared to death to stop Plavix unless I'm given an alternative drug, but Ticlid seems like the only alternative and sounds even worse. I don't want to die, but can't keep living like this.
Chris H., Palm Bay, Florida, USA, February 22, 2009

• I dissected the LAD 2 years ago and had 2 bare metal stents emplaced. I was put on coreg cr and aspirin. In Dec 08, the Dr told me one of the stents had scar tissue and emplaced a DES/Balloon and put me on plavix, aspirin, coreg, nexium. I now have extreme dry mouth. I can barely eat anything as it feels like it's stuck. The Dr thinks it's from anxiety and prescribed xanax .25, which makes me calmer, but doesn't take away the dry mouth. Can it be the drugs and if so, what can be done? I'm not doing well. Need help asap.
LF, New York, USA, February 19, 2009

• Ian -- check out our reply on Feb 10th re: Plavix rebound effect. Hope others will respond, but if you are having bleeding symptom, definitely check with your cardiologist. You should check with him/her anyway re: stopping Plavix -- stopping any med, but especially Plavix, is not something patients should do on their own -- even though the Endeavor has a good safety record re: late stent thrombosis.
Angioplasty.Org Staff, Angioplasty.Org, February 19, 2009

• Hello, has anybody had any experience of kidney pain, head aches, nausea, loss of concentration and extreme lethargy whilst taking Plavix ? I had three drug eluding [eluting] stents fitted four years ago and two Endeavour stents in March of 08. Medication is 75 mg Plavix, 75 mg aspirin, 2.5 mg Bisoporol, 10 mg statin. I have had muscle cramps from the statins, hence the low dose and also cannot tolerate ace inhibitors. Other side effects that appear to be the result of Plavix are nose bleeds, bruising and blood in semen. Was about to stop the Plavix until reading about the rebound effect, may now cut the dose in half. What is the forums opinion on this ? Thanks for your feed back.
Ian, United Kingdom, February 19, 2009

• Barbara -- check out the related topic on "Plavix and Surgery" as well. You'll see that recommendations from all major medical societies is to discuss issue this with your cardiologist and possibly to have your cardiologist and surgeon talk to each other as well.
Angioplasty.Org Staff, Angioplasty.Org, February 18, 2009

• Has anyone stopped taking their Plavix and aspirin for a short period of time? I need to have some surgery and want to know how dangerous it would be to be off these medications for about 10 days. I have 3 stents and have been on Plavix and aspirin for 2 years.
Barbara L., Los Angeles, California, USA, February 18, 2009

• To Byron hi, I had last DES fitted in Dec 2006. Have taken Plavix and 75mg Enteric coated aspirin since. Cardio has suggested I stop Plavix, so I have started a slow withdrawal regime of my own. First month 1 tab one day, half the next.(done) Second month I have gone to I tab one day then 2 days on half. (doing) Next month I will go to half tab per day. Fourth month I will go to half tab every other day. Fifth month I trust i will have courage to stop altogether. As everyone says this is not coming from the Cardio, but she knows I belong to this forum and am savvy about the possibles problem and is happy that I take this route, but it was not her idea.
tel, United Kingdom, February 18, 2009

• Byron N. -- check out the related topic on "Financial Assistance for Plavix" as well.
Angioplasty.Org Staff, Angioplasty.Org, February 17, 2009

• Has anyone stopped Plavix and taken just aspirin? If Plavix was stopped, what dosage of aspirin was used? I take both Plavix and 325 Aspirin, and have had 9 stents placed 3 years ago, and find Plavix much too expensive.
Byron N., San Diego, California, USA, February 17, 2009

• Recently had surgery, carotid artery left side. I was healthy 67 yr old. I was given Plavix (75mg) and (80mg) baby aspirin, 1 wk after being at home I broke out in hives lip and tongue swollen, and at one point throat was closing. Since, I have been to an allergy doctor, on antihistamines and prednisone. Have had break out since, can't eat tomato products, citrus, or nuts. could before, help what’s wrong?
Julie, Mississippi, USA, February 16, 2009

• Donna -- when did your husband get his latest stents and what type were they -- current guidelines recommend 6-12 months for Plavix after drug-eluting stents, significantly less for bare metal.
Angioplasty.Org Staff, Angioplasty.Org, February 16, 2009

• Hello, my husband has 16 stents in his heart now, on Dec. 4 1997 he had 8 in his RCA, he also now has 1 in the Left (LAD), 1 in Circumflex (Circ) and then had 2 placed on the end of the 8 and then 4 place inside the eight. Dr's said he was not a candidate for open heart. He has been on Plavix from the beginning and 325 mg aspirin along with other meds. He was a working roofer and now has torn his meniscus cup and Drs will not operate because he can not come off of Plavix. Since this now, can he get disability on social security? We are lost as of what to do. Do you know anyone else that has had this many stents?
Donna S., North Carolina, USA, February 15, 2009

• Wayne and Christine -- current antiplatelet protocols for stent patients are 75mg of Plavix plus aspirin (sometimes baby aspirin of 81mg or standard 325mg -- both are considered "low-dose). As for the Plavix "rebound" effect, it is only observational and has not been "proven" and there is no scientific evidence that tapering off would prevent it. (We don't know of any aspirin rebound effect.) That being said, the observational data of the Plavix reb ound effect definitely are cause for concern -- the reason there is no clinical proof is that the effect was first described only a year ago, and it takes time (and money) to run these trials to get "proof". Another issue is the whole area of resistance in some patients to Plavix and/or aspirin. There are recent studies involving genetic markers for this resistance and also to see if increasing dosage can overcome resistance. There are no real clear answers yet, and the future of medicine is that these therapies are going to be need to be tailored more to the individual patient. We don't/can't medical advice and for these answers you need to consult your cardiologist. But one question we would ask would be, if you are not having adverse effects from the current dosages (bleeding, etc.) and you have been doing well, what would be the reason to change the dose?
Angioplasty.Org Staff, Angioplasty.Org, February 10, 2009

• I have a question regarding the dose of aspirin. In March of 2007, almost 2 yrs ago, my 85 year old dad had a drug coated Taxus Express2 stent placed in his LAD to treat an 80% blockage. This was not due to an MI. He had a cath performed to investigate chest pain that he was having and when they found the blockage, in went the stent. Prior to the procedure he was on a number of drugs to control BP, cholesterol, and a baby aspirin. In the hospital they upped his aspirin to 325 and of course added Plavix 75. Now almost 2 years later when accompanying him to his PCP for a checkup, the doctor said that he could really be taking just a baby aspirin. In my paranoia from all I am reading about late stent thrombosis and going off the drugs for any reason as well as the rebound effect of going off Plavix, I made my dad wait to see his local cardiologist to ask the aspirin question. That Dr also said that he could be on a baby aspirin. I am wondering is there a danger of reducing aspirin if you have been taking a higher dose for years??? Is there also a "rebound effect" with aspirin? And what really are the guidelines as to the aspirin dosage?? I would love to reduce his risk of bleeding, but I am afraid to increase his risk of a clot!! Any information would be very appreciated.
Christine, Pittsfield, Massachusetts, USA, February 10, 2009

• The reason I am taking plavix is because my Doctor put me on it during a procedure to check the blood flow in my leg which has 3 stints [stents] in it, it was to prevent a clot, then a month later I had a mild TIA, then an MRI and I'm scheduled to have another MRI in April to compare with the first, I also am wondering if the procedure mentioned above had anything to do with my TIA?
Wayne, Cedartown, Georgia, USA, February 10, 2009

• Wayne -- why were you prescribed Plavix? Did you get a stent? Both aspirin and Plavix (clopidogrel) are antiplatelet meds, but they act differently to keep blood from clotting so, for stent patients, they are alway prescribed together.
Angioplasty.Org Staff, Angioplasty.Org, February 9, 2009

• I am simply wanting to know if there is a problem with taking Plavix and a 325 aspirin at the same time, and is there any extra benefit to taking Plavix over Aspirin ? I have been taking 325 Aspirin for 12 years, no problem, and now am taking Plavix 75mg. I had a mild TIA a month ago?
Wayne Kines, Cedartown, Georgia, USA, February 8, 2009

NEXIUM, ETC. ALERT (repeated from January 28) -- a number of postings mention being on Nexium or a similar drug (called a Proton Pump Inhibitor, or PPI) to stop stomach upsets, etc. If you are taking this type of drug, check out the Editor's blog discussions of this past week about new findings and the FDA alert (here and here) about Plavix and PPI drugs, such as Nexium, Prevacid, etc.
Angioplasty.Org Staff, Angioplasty.Org, February 7, 2009

• m.b. My mother had a stint (her 4th) in Dec. In Jan. she had two strokes (TIA's) with her right side affected. Yesterday her right leg was severely swollen and had turned a deep purple with blisters. She is also on Nexium as well as Plavix. We took her to the dr. and are waiting for the blood tests. Is this a side effect?
HMB, Tennessee, USA, February 6, 2009

• HI all, I have now been on Plavix coming up for 3 years. Is there yet any advice on stopping or reducing the dose. Luckily in the UK my Plavix is free but that is no reason to keep taking it if I don't need to. I do know that I am increasingly experiencing strange side effects, dry lips, dry skin, a strange allergy to aftershave (it causes a hives effect). Any ideas anyone?...My Doctor ..GP..says it is just a side effect of age!!! I am also taking Bisoprolol, baby aspirin, Simvastatin, hytrin and valsartan. Yep, I rattle when I walk!!
John, Daventry, United Kingdom, February 6, 2009

• Hello. I had two stents put in August 08 and was put on plavix (75mg) and aspirin (325) daily. Within the first few weeks I started to have problems with confusion and short term memory loss. The memory loss for example forgetting peoples names, loss of thought during a conversation, etc. Anyone having any memory problems or is this my imagination. Dr. just ignores problem.
Mark, Texas, USA, February 3, 2009

• I had a kidney transplant 13 years ago and had DES a month ago. Now taking the following meds: prednisone, plavix, aspirin, nexium, neoral, lopressor and lipitor. Are these combinations good for my health. Lately also I am experiencing mild angina, is this normal for a new DES patient?
JY, Saudi Arabia, February 1, 2009

• I had a stroke four years ago, and consequently started taking Plavix. I never had a good day on them, not one...four years later and I have decided/ given the go ahead to take Aspirin instead, been on this for a week now but been feeling very sick at night, keeps me awake, but I am fine during the day now which is a miracle!! Is this a normal reaction to taking a new drug after being on another one for so long? Just a little worried, any insight would be appreciated.
Angela, France, January 29, 2009

ALERT!!! -- ALL patients on Plavix -- check out the Editor's blog discussions (here and here) about Plavix and PPI drugs, such as Nexium, Prevacid, etc.
Angioplasty.Org Staff, Angioplasty.Org, January 28, 2009

• A.D. -- read through the Forum Topic on Plavix and Surgery -- the best advice is that your two physicians should be talking to each other about the relative risks and making a joint decision. That's not our opinion. That's the recommendation from the major medical professional organizations (ACC, College of Surgeons, etc.) --

Mar from Kentucky -- we don't know of any research showing these drugs raise cholesterol. Imdur can cause some cholesterol tests to read falsely low.

Sue from Wisconsin -- is your husband on any other heart meds? Beta blockers are known to cause cold extremeties -- it's not a listed side-effect of clopidogrel, but we have heard from patients who have similar complaints. If this is of concern, call your cardiologist -- maybe check blood count, if there's a concern.
Angioplasty.Org Staff, Angioplasty.Org, January 27, 2009

• Possible TIA. Over the weekend I `blacked out` for a split second, and was left feeling dizzy and disorientated. History of 2 stents (1 DES in Jan 2007) had been on Plavix ever since. Cardio finally convinced me to wean myself off it which I had started to do about 2 weeks ago, going down to half a pill/whole pill every other day. Not yest sure if this had anything to do with what my Doc thinks could have been a TIA, but hopefully CT scan due tomorrow will find out what happened.
Tel, United Kingdom, January 26, 2009

• I had a Drug eluding [eluting] stent placed into my coronary artery in June of 2008. I am in need of a Hip replacement. My cardiologist says that it is ok to go off Plavix six months after stent insertion . My orthopedic surgeon says I should wait another six months. Who should i listen to.
A.D., California, USA, January 25, 2009

• Can Plavix or Imdur cause the rise in cholesterol?
Mar, Kentucky, USA, January 24, 2009

• My husband had a stent placed about a month ago and is now taking Plavix. He notices that his hands and feet get cold very easily. Is this a side effect of Plavix?
Sue M., Wisconsin, USA, January 23, 2009

• Sally L. (and Tim from California)-- all guidelines strongly state that Plavix (clopidogrel) and aspirin are to be taken for at least a month (for bare metal stents) and 6 months to a year or longer (for drug-eluting stents). The proper length of time is one of the major discussions among the interventional cardiology profession.
Angioplasty.Org Staff, Angioplasty.Org, January 23, 2009

• My husband had a heart attack on Jan. 2nd, 2009. He had three stents placed and was out of the hospital three days later. Two days after discharge he returned to the hospital with a major heart attack. He was on life support for three days (ventilator and balloon pump). Now he is diagnosed with congestive heart failure. The first time he was discharged the doctors/pharmacy forgot to give us the Plavix. Is this negligence? What are current treatments for congestive heart failure besides a low salt diet with lasix?
Sally L., Washington, USA, January 22, 2009

• Hello, I had a stent placed in LDA [LAD] in 1995, Norvasc, lipitor, 325 aspirin a day. Thirteen years later Jan 13, another stent in LDA a little south of the first. Dr. added Plavix for one year and continue all meds. I know it's only been a few days, everything seems ok. Plavix being new to me should I have anything to worry about? I did fine for thirteen years with out it. Also, when tapering off of any med. I would think it be best to do it slowly, couldn't hurt, but cold turkey might.
Tim, California, USA, January 17, 2009

• Hi, I really need help. My father just had one stent placed in Oct 2008. He had a 85% blockage. He did well and was discharged from the hospital. He was put on the normal plavix and 81mg aspirin. He since has not gotten any better, he has had chest pain on and off, lost his appetite and has chest pain when he eats. He went to cardiologist twice since and they said his cardiac enzymes, EKG are all good. All they did was discontinue his zocor- saying that may have some side effects. He is also very frustrated cause his arm/ hands/ feet are going numb and having odd temp problems. He also can't tolerate any nicotine at all (which I know he was told to stop chewing tobacco but he tried to put a tiny bit and he had to call 911 cause he was having a stroke! Any ideas??? I'm afraid he is having some rare problem that they are overlooking and something is going to happen to him.
Barbie, Somerset, Pennsylvania, USA, January 16, 2009

• Kerstin -- when did you stop taking Plavix and when did this incident happen? The "rebound" effect, if it is in fact real, has been observed within the first 90 days after cessation of Plavix, and mostly in the first 30.
Angioplasty.Org Staff, Angioplasty.Org, January 14, 2009

• I had a bare metal stent placed in me in August 07. One blockage, otherwise very healthy. Doctor told me to take Plavix for 30 days. I never used medicine before, as I had never been sick. I felt fine after the stent and returned to swimming (54 yrs old). On November 28, I felt something painful in my heart. My husband took me to ER. They could not detect anything so I was released in the morning. Pain consisted and after a few tests, the doctor decided to re-stent me. That's when they saw that all four coronary arteries were totally blocked (2 were 100% blocked, the others were 95% blocked). Rushed into open heart surgery with 4 bypasses. No doctor could understand this. They said it was a miracle that I have lived through this, without having a fatal heart attack. It took me 6 months of research to find out about the "rebound effect" after stopping taking Plavix. I have since then "educated" many doctors who didn't had a clue about this, including my own cardiologist . My life is forever changed. Had there been a warning on the prescription, I would surely not have stopped taking Plavix, but slowly tapering off.
Kerstin M., Cypress, California, USA, January 13, 2009

• Since 1996 I have been taking a 325 mg aspirin per day and 1 folic acid per day, all because of poor circulation in my legs. 1 year ago I had three stints [stents] put in my left leg and 2 months ago My Doctor did a dye test and opened up one of those stints while he was doing the test, he put me on plavix 5 days before this and am currently still doing the 75 plavix and the 325 aspirin, A few days ago my right arm went totally limp ? like a wet noodle, what should I do?
Wayne K., Georgia, January 12, 2009

Clay - I am interested in any responses you may get. My mother has been on Plavix for about a month and just lost her sense of taste. She is very depressed and is very thin as it is.
Chris, Birmingham, Alabama, USA, January 11, 2009

• David -- check out our related topic, "Financial Assistance for Plavix and Other Prescription Drugs" -- and if you have gotten a drug-eluting stent in the past year, don't stop taking it -- in fact don't change any meds without consulting your cardiologist first.
Angioplasty.Org Staff, Angioplasty.Org, January 9, 2009

DAVID, Minnesota, USA, January 7, 2009

• Jona -- You asked a complicated question -- here's a complicated answer: (1) the tests for Plavix resistance are not absolutely accurate; (2) two years out is farther than the guidelines, but your cardiologist has a lot of company, since no one really know how long to take Plavix; (3) there is some observational data suggesting the possibility of a Plavix rebound effect in the 90 days after stopping -- tapering off has been suggested, but there is no data to show it works; (4) there is a new technology called OCT which DOES show if stent struts are covered or not -- it's not yet approved by FDA for clinical use in the U.S. -- and it is invasive (done in a cath lab, during an angiogram).
Angioplasty.Org Staff, Angioplasty.Org, January 7, 2009

• Pardon another complicated "do I stop Plavix" story. I'm 50yo physician. Had 1 Taxus stent placed 2yrs ago for isolated lesion (prox LAD) complicated by immediate (in recovery room) stent thrombosis. Taken right back to cath lab for clot removal & restenting. Now doing very well heart-wise on aspirin & Plavix (exercise nut-no angina) but have had 2 serious nose bleeds over past 2 yrs each requiring hospitalization & embolization (like cath for placing material to clog the bleeding nose vessels- but with risk of stroke). Odd thing is the vascular lab ran testing which found I am partially RESISTANT to Plavix. ENT wants Plavix stopped, but cardiologist reluctant due to earlier stent thrombosis. Am staying on Plavix for now, but what to do longer term?? How close are we to a scan which might show if my stent is re-epithelialized (fully healed to platelets would not stick to it).
Jona, Indianapolis, Indiana, USA, January 4, 2009

• P. -- we are so sorry for your loss. It's impossible to say from a distance -- stroke can be caused by many things. Plavix and aspirin are blood-thinners and have a side-effect of increased bleeding. But Plavix is also known to prevent certain type of stroke.
Angioplasty.Org Staff, Angioplasty.Org, January 4, 2009

• My husband had two stents (one medicated and one not) plus a defibrillator put in in 11/08 due to two blockages and a heart attack in lower left part of heart. His heart beat was irregular thus the defibrillator. Put on lots of medication including 75mg plavix and 325mg ecotrin. Everything was fine until last week he suffered hemorrhage stroke and died. Was the combo too much? Should he have been on lower dose of ecotrin or taken off plavix? He was given good reports and he felt good. He was only 63 yrs. old.
P., Florida, USA, January 3, 2009

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