A question I get fairly frequently nowadays is, "Should I take Plavix?"
For the few of you who've managed to miss the mass advertising campaign for this drug on TV, USA Today, etc., Plavix is a platelet-blocking drug, known chemically as clopidogrel, that "thins" the blood and helps prevent blood clot formation in coronary arteries and carotid arteries, thus potentially reducing heart attack and stroke risk.
What if you have a heart scan score of, say, 450--should you take Plavix?
In general, no. First of all, aspirin and Plavix (generally taken together, since the effect of Plavix is incremental to that of aspirin) only block blood clot formation. They have no effect whatsoever on the rate of plaque growth. Aspirin and Plavix will neither slow it or increase it.
What they do is when a plaque ruptures like a little volcano and exposes its internal contents (inflammatory cells, fat, etc.--like a raw wound), a blood clot forms on top of the ruptured surface. If the clot is big enough, it can occlude the vessel and causes heart attack. Or, if it's a carotid artery, debris from the clot can break off and find its way headward to the artery controlling your speech or memory center. Aspirin and Plavix simply help inhibit clot formation once a plaque ruptures. That's it.
Interestingly, if you view any of Sanofi Aventis' commercials for Plavix, you'd think they came up with a cure for heart disease. It ain't true.
When is Plavix helpful? It's clearly an advantage after someone receives a coronary stent, drug-coated or uncoated;, after coronary bypass, particularly if certain metal punch devices are used to create the grafts in the aorta; and during and after heart attack. These are all situations in which blood clot formation is a forceful process. Blocking it helps.
In general, in asymptomatic people with positive heart scan scores at any level, we do not recommend taking Plavix. The Plavix people are extremely aggressive pushing their drug (hang around any medical office and see!) and, I believe, have gone overboard in promoting its benefits. Rarely, in someone with a very high heart scan score, say 2000 or more, we'll use Plavix for a period of a few months until lipids/lipoproteins and other risk measures are addressed, just as an added safety measure. But, in general, the great majority of people with some heart scan score or another do not receive it and I don't believe that they should.
As always, look beyond the marketing. The purpose of marketing is to increase profits, not to educate.
I read this article with much interest. I was searching for information on Plavix. Over the holidays, my 73 year old Mother was in town to visit. She has had 2 stents, the last more than 4 years ago. Her doctor continues to have her take Plavix. I think it is actually killing her. Previously, I was on;y concerned with the horendous bruises all over both of her arms. But, after this visit, she has a blood vessel burst in her eye. She has also had a horrable RASH, all over her neck, back and face. I think she is allergic to Plavix. Her saw a dermatotlogist with the rash and they could not determine it's cause. After a steroid shot it got better. But now is it back again.
I take Plavix and 81 mg. aspirin daily, and I believe that I am a good candidate for it. I have advanced coronary and peripheral artery disease, have never had any bypasses, and have a medicated (drug-edluding) stent in one of my coronary arteries. I read reports that studies done not too long ago showed that drug-eluding stents require a constant blood-thinner like Plavix to avoid developing clots around the stent, presumably forever, unless a bypass is performed around the artery. If anyone has advice about this, please comment.
I have advanced coronary and peripheral artery disease. I have never had any bypasses. I have a drug-eluding (medicated) stent in one of my coronary arteries. I take 75 mg. of Plavix and 81 mg. aspirin daily. I think I am a good candidate for daily Plavix and aspirin therapy, since studies not too long ago warned about clot formation around drug eluding stents (not to mention my advanced case of atherosclerosis). If anyone has advice or comments about this, please post a reply. Thanks.
My husband had a stent placed and was placed on plavix. He was 43 years old no insurance. He was told to stay on Plavix for life. However, after about a year we struggled to pay for it. It was costing us $400 a month and the economy had gotten bad. I lost my job and we complained to Dr we couldn't afford the meds we were told he didn't need it anymore. Why? because we couldn't afford it and they couldn't help that or no he didn't need it? Well, he did because we have just brought him home with 2 more stent placements and his first stent had clogged up. So plavix is worth taking. I saw the difference in him over the years. Stay on your plavix. We have to get the price down so people can live, it shouldn't cost so much. He is now on disability ssi and medicare that pays $1.00 for a month supply of plavix. This took us 2 heart attacks later. This is unfair to have a stent and it needs med and you can't get the med for your stent to work properly and you could die anyway. What is the problem with our society? MONEY and that is the truth. If you are having bruising, and showing signs of bleeding under the skin or in urine then you need blood work done to monitor your blood clotting and let your dr know of anything like this. My husband now has a blocked carotid artery in his head that wasn't there before he quit his plavix. It is too close to brain we are told to operate. We need prayers and different opinions from other doctors. I love my husband and I have begged for years for help with his heart problems. And because we havent had money he wasn't treated with medical treatments that should have been done. He is 48 now and what we are still struggling for help and answers only to get more bad information. God is our only hope. He will guide us to the help we need. I have to trust that because he is still living. Although we have been so terrified for years, knowing something is wrong and getting told it was only a "tiny heartattack". You can work". I have a book to write about the care he received and I will write this book but right now I must continue to find a dr that will help with this carotid artery blockage that is causing double vision.
I was diagnosed with atrial flutter and my cardiologist said I have a small leak in one of my valves. I also have HBP and am on Avalide, Norvasc & Crestor. I have not had any heart surgery at all. I'm 58. I've had no issues with muscular aches here and there, fatigue until I was put on Crestor. I was once on coumadin and when I told my cardio I was not happy with it, because of the aches and fatigue, he changed it to plavix. What could be the reason why he's putting me on plavix on top of all the other meds I'm already taking? /Why can't I just take aspirin since I understand people on Plavix are those who's had stents. I want to make sure before I put the first tablet in my mouth.
There are recent studies that confirm the importance of clopidogrel/ASA at least 1 year after stent placement. Beyond that, the evidence gets merky for clopidogrel and one study suggests discontinuing the drug.
6 Comments
A question I get fairly frequently nowadays is, "Should I take Plavix?"
For the few of you who've managed to miss the mass advertising campaign for this drug on TV, USA Today, etc., Plavix is a platelet-blocking drug, known chemically as clopidogrel, that "thins" the blood and helps prevent blood clot formation in coronary arteries and carotid arteries, thus potentially reducing heart attack and stroke risk.
What if you have a heart scan score of, say, 450--should you take Plavix?
In general, no. First of all, aspirin and Plavix (generally taken together, since the effect of Plavix is incremental to that of aspirin) only block blood clot formation. They have no effect whatsoever on the rate of plaque growth. Aspirin and Plavix will neither slow it or increase it.
What they do is when a plaque ruptures like a little volcano and exposes its internal contents (inflammatory cells, fat, etc.--like a raw wound), a blood clot forms on top of the ruptured surface. If the clot is big enough, it can occlude the vessel and causes heart attack. Or, if it's a carotid artery, debris from the clot can break off and find its way headward to the artery controlling your speech or memory center. Aspirin and Plavix simply help inhibit clot formation once a plaque ruptures. That's it.
Interestingly, if you view any of Sanofi Aventis' commercials for Plavix, you'd think they came up with a cure for heart disease. It ain't true.
When is Plavix helpful? It's clearly an advantage after someone receives a coronary stent, drug-coated or uncoated;, after coronary bypass, particularly if certain metal punch devices are used to create the grafts in the aorta; and during and after heart attack. These are all situations in which blood clot formation is a forceful process. Blocking it helps.
In general, in asymptomatic people with positive heart scan scores at any level, we do not recommend taking Plavix. The Plavix people are extremely aggressive pushing their drug (hang around any medical office and see!) and, I believe, have gone overboard in promoting its benefits. Rarely, in someone with a very high heart scan score, say 2000 or more, we'll use Plavix for a period of a few months until lipids/lipoproteins and other risk measures are addressed, just as an added safety measure. But, in general, the great majority of people with some heart scan score or another do not receive it and I don't believe that they should.
As always, look beyond the marketing. The purpose of marketing is to increase profits, not to educate.