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Problems with Clopidogrel(Plavix) Anyone?

Well, I've made it through the Watchman and off the coumadin, Now just began 4 months of clopidogrel 75mg/day and am having some not so pleasant early morning abd pain daily. Not bad enough to go the doctor but not fun to wake up to every morning, I have tried to figure out what (few) meds I take may also be a culprit and have pretty much decided it is the clopidogrel. Years ago,when first diagnosed with AF, was started on Pradaxa and had the same problem. If I have to continue it until July I'll do it but has anyone else been given another solution as part of their post Watchman regimen. I'm wondering what docs in other countries (beside the US) have as their protocol re what anticoagulants are necessary. I know that the US, IMO, overmedicates for many things, oftern to cover themselves legally and I don't want to to suffer through a med just for this reason when I don't have to. I did read my TEE/TOE report from 2 weeks ago and it was very good with no more blood flow between my atrium and LAA. I guess I'm looking for alternative suggestions to bring to my next appt. It doesn't look like a pleasant 4 months med-wise right now. Thanks for your input. irina1975 PS Still happy I had the Watchman. Just hate the drugs.

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Hi Irina, I still haven't heard back from the hospital re taking the Clopidogrel so I'm assuming that the prescribed 75mg aspirin daily is the correct meds for me. I will try them again today but have read reports that some people after watchman/amulet procedure are ok with antiplatelets only afterwards. Not much help to you but maybe worth asking the question next time. Hope you start to feel better soon.

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Hi Angie, Thanks for responding. Please let me know what they say. I would be interested to know about other protocols. My TEE/TOE done on March 9th showed my device was completely covered over by my own tissue so I don't really understand why 2 drugs are necessary as there is no part of the device exposed for blood to stick to.

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Did you have problems with the Coumadin? If you have CAD I assume you are taking Aspirin as well. If you are taking the anticoagulant for AFib other than the hassle of blood tests Coumadin should work just as well as pradaxa or other NOACs.

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Yes, I did frequent self-testing and self-managing with coumadin for several years and was able to keep a tight rein on my INR numbers. (weekly testing). But I began to have problems and wanted off all anticoagulants. Some of the new ones appear to be easier to tolerate but, to my mind, haven't been around long enough to really evaluate long term effects. Have never been on aspirin until now- as part of the weaning off process from anticoagulants post-op. Much of this is mainly me and my view re taking drugs. Many are necessary and helpful for whatever reason but I prefer to find other ways to treat illness when possible before committing to taking medication for the rest of my life. Just my opinion (and maybe eccentricity!)

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Hi Irina, i have been on 75mg of Clopidogrel (no aspirin) and 6mg of Warfarin for a few years now and never had any problems that i can remember.

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Hi Graeme, I'm happy you have a combo that works well for you. This is just a theory but I have always had more problems with side effects to meds that other people tolerate well. Maybe I was born with an extra 'side effect' gene (LOL). I have family members who are able to take most any med without probs. Don't know why this is.

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Try taking it with food or just after eating. I have to do this with Wafarin & Clopidogrel. Pam

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Really couldn’t comment Irina as it seems to be a very rare procedure in UK. Personally I wouldn’t take asprin or Clopidogrel daily - period. If you have pain then I would be straight to the doctor asking for an investigation for GI bleed, for peace of mind if nothing else.

Pradaxa was different - it needed an acid stomach for the gel capsule to be absorped and many people were taking it with carbohydrates which actually caused the acid reflux. Not only were they causing their own pain, the drug wasn’t absorbed properly - far too little information about drug absorption given! That one was easily remedied for most people by eating appropriate food and taking with full glass of water.

Hope you feel better soon.

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Thanks, CD, I will. The aspirin and clopidogrel are for the next 4 months. Over here it is the last part of the Watchman protocol but, you're right. Taking two of the same type drug is scary-esp these two. Maybe they act slightly differently. I don't know. Since it was the weekend and I couldn't call my doc til this morning, I skipped the aspirin Sat and Sun. One of my 'executive decisions'. But I thought better safe than sorry over the weekend. P.S. I take the coated aspirin for more stomach protection but I don't know how much difference that really makes.

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Hi Irina, they've advised me to take dispersible aspirin as the coated one isn't absorbed so well. The hospital has called me back this morning and they're not going to give me anticoagulants just the aspirin as could have bleeding problems with my cavernomas. I've read reports that you can do just as well with antiplatelets only but each individual has different needs I suppose, here's hoping my 6wk TOE will be as good as yours!

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Interesting. Thanks Angie. BTW I was so nervous about my 6 wk TEE/TOE I had such an anxiety attack I called my doc. He saw me in the office and very compassionately talked and listened to me and rescheduled 5-6 days later. I felt much better after having my fears and questions answered by him directly and not by subordinates.. This isn't like me as I usually can do what I have to medically. I think it had to do with being aware of instruments in my esophagus. Anyway, the procedure went so smoothly and quickly. They did sedate me but I was awake enough to keep my eyes open (I hate to miss anythingLOL) and hear the doctor softly talking to others in the room about what he was seeing. I think he knew I was listening and every so often he would say something reassuring like 'things look good,etc. A kind thing to do. If I ever need another one my anxiety level will be near zero. Try not to worry about it-easy to say. Here's hoping yours is as smooth. And he didn't make me wait for the outcome. Told me right then it had healed well and I could stop coumadin, so-more anxiety relieved on the spot. I saw him several days later in the office where he gave me more in-depth info. I appreciate that he cut down my 'worry-time'. Happy you are also on the other side of the mountain. Take care. irina

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Thanks Irina, unfortunately on the NHS you rarely get to see a consultant on demand and can wait weeks for an appointment. Also get more stressed about the journey to the hospital which involves 2.5hrs travel on 3 trains and two taxis through London which is scary enough, and will have to find someone to accompany me as well and the journey puts people off. I have a local hospital only 7miles away but apparently I have to return to the same doc that operated. Hopefully 6wks will be long enough to sort something less worrying. Thanks again for your reassurance it helps a lot.

Angie

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I'm sorry it will be so difficult to get there. More anxiety time built into the whole experience. But soon you'll be done. Keep your eye on the light at the end of the tunnel.

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I have to take lanzoprazol for acid reflux and perhaps that protects me from having stomach pain from my anticoagulants ? Perhaps you could ask your GP if they might help you ?

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PPI's are contra indicated with clopidogrel as they evidently reduce its effect.

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I was only on clopidogrel for 4 months before they found I had AF so now I am on Apixaban instead but I have been on PPI's for 3 years now 😕

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Only for VERY short term use as the long term side effects are NOT good.

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I agree. 4 months is not that long but seems so to me right now. Everything is relative, I guess.

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I just had to take clopidogrel for four weeks after my Amplatzer was fitted and aspirin for six months. However every report I've read seems to advocate different policies.

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From the various responses it seems Dr's preferences and comfort level play a large part in the post device meds we are prescribed. Armed with this info it gives me room for maneuver. Thanks everyone. I want to take the minimum meds that I can but safely. Thanks everyone for input re clopidogrel question. irina

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Maclan search for Dr. Sarah. Myhill from Wales and GERD. (acid reflux) She tells you the solution and it is not the drugs you are taking. In fact they just make your condition worse. You have acid reflux because you don't have enough acid in your stomach not because you have too much. This maybe why Irina is having issues with Clopidogrel.

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Thanks. Will look her up. From what I-ve read PPI's are not as innocuous as drs would have us believe. JMO. I think they must also be a 'big Pharma money-maker.' At the hospital I use here in Atlanta they are a routine order(like tylenol or laxatives) if any drugs you are on have N & V as a possible side effect. I know this because when meds were brought to me once I asked why the PPI was one of them. (I always ask that my meds be broght still in the labelled peelpak so I can double check they are right. )And the nurse said it was because (whatever drug) could cause nausea. So I refused it. IMO too many meds are given for prevention that may not be needed.

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When I left hospital after my aortic valve was replaced I think I had 14 drugs to take. I can't find the list at the moment.

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I believe it and do you wonder how many were really necessary? How can we even figure out where side effects might be coming from.

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When in there my blood glucose was going high and low. I'm T2 controlled by diet but I was prescribed two medications by a consultant I didn't see. Before I went in I told them that I had a prostate infection but they said that was OK. However in the theatre they could not get a catheter in so had a use a suprapubic one. I was then prescribed two prostate meds by a uroloigist who did not see me. I told them I had stopped them within days previously as they had given me bad side effects including a heart rate of 136 and drop in BP. Then there were two pain killers that I did not need plus the flouroquinolone antibiotic that gave me tendonitis while still in bed that plus later prescriptions for it over the years has given me neuropathy in my lower legs. I nearly forgot the statin atorvastatin that recent reports say causes heart disease,

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Unfortunately, scenarios like yours are all too common. Drs don't read charts before seeing new pts- especially re hospital consults. Your experience reinforces my belief we all need to advocate for ourselves in the hospital or if we can't (it's hard when we're sick and don't feel well) have someone advocate for us. Having a brief medical history written when you're feeling well is a good thing to bring to the hospital and a rule I never break is I don't take any pills without seeing the label and asking and receiving a plausible reason why they're necessary. I even check small IV bags of medicine. "Your doctor ordered it..." from the nurse is NOT a plausible explanation. These are your rights. If the nurse brings a pill in a cup with no package for ID, and you don't recognize it ask for another one. If she says I don't have one or I'll have to call the pharmacy then that's what needs to happen. Don't mean to be bossy but unfortunately in today's healthcare world we need to be on our toes. Nobody is as invested in our care like we are and it's your right as a patient. I'm sorry you went through all this. I wasn't there but from your description I can't help but feel some things might have been preventable. I hope you have recovered from all this 'care' and are doing well now. Take care. irina

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No the neuropathy affected my gait and has given me a back problem when standing and walking. Nothing really showed on CT or MRI scans for the neurosurgeon. I want a standing MRI in an open scanner when there is weight/pressure on my spine. That is a problem as they are few and far between and I need my MRI compatible pacemaker reset to have it done. The pacemaker manufacturer will send someone to reset it but we need a doctor or a physiologist present and we can't arrange that due to their insurance requirements. My cardiologist said he would use his contacts but it might take a couple of months..... that however was four months ago. If I want to go out unaided I have to use a wheelchair.

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Hi Engmac. Just finished checking out dr myhill's website drmyhill.co.uk and was very impressed. Thank you for turning me onto her. She thinks outside the box, marches to her own drummer, and IMO has had past problems with the medical powers that be because they don't like her ideas about medicine, illnesses, and effective treatments. Very interesting lady. One thing she said in her video is that she talks more about the importance of diet more than all other subjects combined. Her video and website are worth a look even if philosophies differ. Just ordered her new cookbook from amazon.com. Again, thanks for new info that I believe will be helpful for me. Take care. irina1975 (in US).

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