rich01
Well-known member
A friend is taking Plavix and his arms are black from bruising. Any suggestions on alternatives he should discuss with his cardiologist? All I know is he has a couple of stents and had a heart ablation.
Alternative to Plavix
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pellicle
Professional Dingbat, Guru and Merkintologist
As an anticoagulant or as an antiplatelet? Well of course there's warfarin ;-) but that's not set and forget.
As someone who doesn't need that (can't use it) I don't have much on this; however this seems like its on the right path:
https://www.singlecare.com/blog/clopidogrel-alternatives/
Plavix inhibits platelets, the blood cells which form clots. As a member of the thienopyridine class, it does so by irreversibly binding to adenosine diphosphate (ADP) at the P2Y12 receptor. Brilinta and Effient are fellow class members and P2Y12 receptor antagonists as well. In the setting of both major types of heart attack, ST-elevation and non-ST-elevation myocardial infarctions (differentiated by presence or lack of ST-segment elevation on electrocardiogram), this drug category can be given as a loading dose to kick start the antiplatelet effect. Each P2Y12 inhibitor has nuances that may be appealing to you.
Platelet inhibition can be achieved by other mechanisms. Aspirin does so by inhibiting cyclooxygenase, dipyridamole by blocking adenosine uptake, and cilostazol by inhibiting phosphodiesterase 3. The end result of all of these is to reduce platelets from sticking together to form a clot. Alternatively, the anticoagulant Xarelto can be used at a low dose as a blood thinner for some of the same medical conditions. Whatever the category or mechanism of action, the important differences for you to consider involve factors like convenience, cost, effectiveness, drug interactions, and side effects.
Top 5 clopidogrel alternatives
As someone who doesn't need that (can't use it) I don't have much on this; however this seems like its on the right path:
https://www.singlecare.com/blog/clopidogrel-alternatives/
Plavix inhibits platelets, the blood cells which form clots. As a member of the thienopyridine class, it does so by irreversibly binding to adenosine diphosphate (ADP) at the P2Y12 receptor. Brilinta and Effient are fellow class members and P2Y12 receptor antagonists as well. In the setting of both major types of heart attack, ST-elevation and non-ST-elevation myocardial infarctions (differentiated by presence or lack of ST-segment elevation on electrocardiogram), this drug category can be given as a loading dose to kick start the antiplatelet effect. Each P2Y12 inhibitor has nuances that may be appealing to you.
Platelet inhibition can be achieved by other mechanisms. Aspirin does so by inhibiting cyclooxygenase, dipyridamole by blocking adenosine uptake, and cilostazol by inhibiting phosphodiesterase 3. The end result of all of these is to reduce platelets from sticking together to form a clot. Alternatively, the anticoagulant Xarelto can be used at a low dose as a blood thinner for some of the same medical conditions. Whatever the category or mechanism of action, the important differences for you to consider involve factors like convenience, cost, effectiveness, drug interactions, and side effects.
Top 5 clopidogrel alternatives
- Brilinta
- Effient
- Aspirin/dipyridamole
- Cilostazol
- Xarelto
slipkid
Well-known member
From what I understand without knowing the reasons behind it people that get stents get put on plavix for a period of time (usually a year) as a matter of one size fits all medical guidelines.
When I had two stents put in about 5 years ago, DESPITE already being on warfarin AND 81mg of aspirin daily I was put on Plavix for a year as well.
pellicle
Professional Dingbat, Guru and Merkintologist
Have to ask
WTF
slipkid
Well-known member
That's what I thought. I tried to ask the cardiologist at the time but he refused to answer any of my questions (starting with my simply asking "how long do I need to be on Plavix?"). He told me "I'm not going to answer any of your questions, go ask Dr. google".
At that point my primary physician told me to get a different cardiologist but honestly the next one (and his "train-station-turnstile-see-100-patients-a-minute office so you have no idea who they are or why they are seeing you) was much worse in how they approached EVERYTHING (read my echo wrong, entered my echo wrong in my chart as stress echo instead of regular resting one, showed total lack of any comprehension of what was going on in your office visit and on and on and on, etc).
Long stories behind all this but it illustrates perfectly my detest of Drs, most of whom that I've encountered do not want patients to ask them intelligent questions, but instead want the patient to do exactly as they say and never ever ever dare to correct them when they make a mistake or give out wrong information (again long story - or stories - there as well).
Anyways, back to plavix, from talking to other people I know who got stents every single one was put on plavix for at least a year, so I assume that is the standard procedure if a patient gets stents (I did read something that depending on the type of material in the stent sometimes it is less than a year), but I have no idea if that is supposed to be a general rule with no exceptions made if patient is also on warfarin or any other "blood thinning" type of protocol (as opposed to a Dr being lazy or making a mistake).
Wow! Very sad, very scary. The cardiologists I have dealt with in Iowa and Minnesota are all very willing to answer my questions. They've done this both during a visit, and via the medical system's secure message system.
I hope you can find a better cardiologist!
slipkid
Well-known member
pellicle
Professional Dingbat, Guru and Merkintologist
as long as you're getting basic readings done by the GP, perhaps that's all you need?
its sure what everyone got before I was born ...
¯\_(ツ)_/¯
Best Wishes
slipkid
Well-known member
My current GP is actually the worst "DR" ever. Not a DR btw, a Nurse Practitioner. Lazy as hell. Doesn't follow through on anything like he should (long stories). I'm pretty fedup with Drs/medicine in general. I need to find a new GP and Cardio but am so disgusted with things that have gone on in last 2 years or so my attitude is "eff it, I can't take struggling with these morons anymore".
