Aspirin clopidogrel warfarin
Common Questions and Answers about Aspirin clopidogrel warfarin
plavix
After six years post MI and ef varying between 25-35%, my cardiologist now feels that I should shift from aspirin(150)+clopidogrel (75) to warfarin. Two years back he did tell me that he is double minded on whether to put me on warfarin. But this time he appears to be very sure and has insisted me to go for warfarin.
His justification is "that is what literature says".
I have no AF or valve problem.
Based on the level of risk, most patients are either started on aspirin or Warfarin (Coumadin). Clopidogrel (Plavix) is an anti-platelet agent and acts via a different mechanism than coumadin does (coagulation pathway). Adding Clopidogrel to aspirin is a guideline that holds a Class 2b (see below) recommendation, and usually considered in those in which Warfarin is unsuitable due to patient preference or physician's assessment on a patient's ability to safely sustain anticoagulation.
To date there have been no reports of an important interaction in humans between warfarin and clopidogrel. Nonetheless, because warfarin increases the risk of bleeding, blood tests to measure the degree to which the blood is anti-coagulated or thinned (prothrombin time; INR) may be ordered to assess the degree of blood-thinning when warfarin and clopidogrel are used together.
s like if I want some Clopidogrel (another form of anti platelet med) I could ask for either Clopidogrel or Plavix, Plavix is the brand name the drug company trades the medication under.
And because it can thin the blood, avoid taking aspirin with anti-clotting medications, such as Coumadin (warfarin) or Plavix (clopidogrel), unless advised to do so by your doctor. The bottom line here is that if you’re healthy you shouldn’t take aspirin without a cardiovascular risk assessment by your doctor. If you’re not sure about your risk of heart disease, get tested.
Warfarin (coumadin): Because of the increased risk of bleeding, the concomitant administration of Warfarin with Plavix should be undertaken with caution. (See PRECAUTIONS - General.)
At high concentrations in vitro, clopidogrel inhibits P450 (C).
It is becoming more acceptable now that clopidogrel is a benefit for life. While aspirin works on one side of the clotting process, clopidogrel works from another. You say your heart attack was caused by cholesterol but this isn't strictly true. Cholesterol is one of the later processes which makes the heart attack happen but isn't the initial cause. The initial cause is damage to your artery linings which can be through blood pressure or bad diet.
If you are bruising that easily with warfarin, clopidogrel(plavix) and aspirin, then I think your cardiologist is probably suggesting a wise change in your medication. Warfarin is a powerful anticoagulant and I think your stents should be fine with withdrawal of the plavix. The main concern here is obviously an internal bleed which can be life threatening. My opinion is that the balance for your safety has to be right, and the cardiologist has done that.
I've lost count how many procedures I've had, but each has required the 600mg of clopidogrel. I too had problems with aspirin, so just stick with clopidogrel each day. I take 30mg of Lansoprazole each morning too. No stomach issues anymore. Clopidogrel has quite a short half life, so it will soon reduce back down in your body. I believe the half life is around 8 hours. So after 24 hours you will basically be back down to your usual level of 75mg.
Are we giving enough clopidogrel and aspirin to prevent stent thrombosis? And as we know, there are different levels of IPAs (inhibition of platelet aggregation). that has been measured with patients who are taking clopidogrel, and..."
There are studies about aspirin resistance and plavix resistance and there are studies that say it's 20-40% of the population. Other studies, at least with aspirin, it's about less than 1% if you use the arachidonic acid based (testing).
In the CAPRIE trial, clopidogrel (plavix) was equivalent to aspirin for patients with a recent (but not acute) MI. Some subgroups of patients with cardiovascular disease in this trial seemed to benefit more from clopidogrel than from aspirin: those with a history of bypass surgery, a prior stroke or MI, arterial disease in two or more areas, diabetes, or high cholesterol. Clopidogrel may be a reasonable choice for these patients.
And because it can thin the blood, avoid taking aspirin with anti-clotting medications, such as Coumadin (warfarin) or Plavix (clopidogrel), unless advised to do so by your doctor. The bottom line here is that if you’re healthy you shouldn’t take aspirin without a cardiovascular risk assessment by your doctor. If you’re not sure about your risk of heart disease, get tested.
To make this work as a routine he now has to continue with the blood thinner CLOPIDOGREL along with his usual Aspirin daily. Also a daily walking for one hour. I am so grateful to the Doctor who made it possible for my husband to get relief from his Angina. My question to the people who are on the same boat.....
Do you get an awful bruising easily? Some bruising is common I heard but my worries are regarding cerebral haemorrhage.
It should not be used if you are taking anticoagulant medications, including warfarin, aspirin, aspirin-containing products, NSAIDs, or antiplatelet agents (eg, ticlopidine, clopidogrel, dipyridamole). I am not sure of what other potential drug interactions.
I would discuss the use of this drug with your urologist and you should mention it whenever a healthcare professional inquires about the medications you are taking.
I am a 71y male, active , working medical professional, with Hx of Htn & carbamatic mechanical aortic valve in 2000 for AI. Non Eluding Stent in Nov. 2009. Although published INR range is b/w 2-3 for patients on triple anti-thrombotic therapy of 75mg clopidogrel, 80mg asprin & warfarin,I've also heard that INR of 1.5 - 2 is also acceptable. Kindly verify, confirm, advise, forward relevant studies/trials PDFs.Thank you for your timely response and effort.
If you’ve already had a heart attack or stroke or are resistant to the beneficial effects of aspirin, your doctor may suggest supplementary aspirin therapy with another clot-preventing drug, such as clopidogrel (Plavix). Clopidogrel may even be suggested as an alternative drug therapy, particularly if you’re allergic to aspirin or can’t tolerate its side effects."
Maybe someone will be able to add a thought or 2. Take care and keep us posted.
However, when I visited the Cardiologist for the first time last Wednesday he informed me that neither he nor any of the other Cardiologists wanted me to continue taking Warfarin, and that they wanted me to switch over to one 81 mg baby aspirin a day. Does this make any sense, and if so, what is their reasoning?
This discussion is related to <a href="/posts/Heart-Rhythm/How-long-to-stay-on-Tykosin-/show/514573">How long to stay on Tykosin </a>.
I would definitely ask your liver specialist about taking a baby aspirin BEFORE taking it. Are you seeing a vascular specialist too?
ve had arthralgia ,oseaophigitis,rashes and chest pain .
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