clopidogrel

I’m taking clopidogrel and aspirin following a Watchman implant. I feel fatigued all day, foggy—just as I did on metoprolol and did even more so on amiodarone.

I also bruise more easily and bleed more flowingly on clopidogrel than on apixaban, which I stopped when I started a three-month course of clopidogrel.

Is anyone else having similar side effects from clopidogrel?

It could be that I’m not quite two weeks out of stopping amiodarone, which stays in your body 2-6 months and caused me dreadful fatigue, among other distressing things.

Do I attribute the fatigue and fogginess to amiodarone or to the new drug, clopidogrel? Or to my HR still in the high 40’s/low 50’s following the course of amiodarone?

Probably all of those things.

But I’d like to know if others experience side effects from clopidogrel. Thanks.

[BobD Volunteer]

I can't comment on your fatigue issue but the bleeding is obvious. Clopidogrel. like aspirin is an antiplatelet and the only times I have ever had nose bleeds or similar has been when in hospital they made me take clopidogrel.

I assume that this is a temporary situation whilst the watchman settles in but maybe best speak to your medical team . Mine stopped the drug the morning after they had to change my red bed.

[Hidden in reply to BobD]

Thanks, Bob. It took me a lot of research and lobbying to get me off amiodarone before my EP had intended. I may have to do the same with clopidogrel. The thought of taking it for another almost 3 months is distressing—if indeed it is at the root of my feeling so crummy.

You reinforced my observation that it’s at the root of my bleeding so easily and profusely. If it’s doing that outside where I can see it, what is it doing inside my body where I can’t keep tabs on it—until obvious signs of internal bleeding show up and indicate a possibly serious bleed?

I’m just trying to figure when and if to start lobbying my EP Team by learning more about clopidogrel. It’s protocol for a Watchman implant. I had an implant and ablation at the same time, reverted to afib within a day, 3 attempts at DCCV didn’t work, hence the amiodarone. Is it the amiodarone, which takes forever to leave one’s body, that still makes me feel crummy, or should I look to the clopidogrel? I don’t know.

I’d really rather just take aspirin and cross my fingers. I’ve been taking aspirin my entire adult life. I know what I need to eat with it. I have no complicating medical conditions, a CHAD score of 3 just for being a woman and 82.

Hopefully all this will be OVER by this summer. I remain optimistic…and vigilant. I hope I don’t need to bleed in a hospital to get off this antiplatlet!

Hmm. why the switch from apixaban to copidogrel? That’s a question I should have asked. Will.

[BobD Volunteer in reply to Hidden]

Antiplatelets important when you have devices inside to prevent platelets clumping together on the device and causing a clot. Anybody with stents or artifical valves will take them. You have watchman .

[Hidden in reply to BobD]

Right. I’ll just stick with protocol. Still would be interested in others’ experiences with clopidogrel.

[Cookie24 in reply to Hidden]

I am considering a Watchman because during my last ablation the left atrial appendage was isolated. I am told this increases stroke risk. So, I am interested in your experience. I take have taken Eliquis for 7 years with no problemBest wishes.

[Hidden in reply to Cookie24]

The Watchman gives me comfort as strokes run in my family. I’ve taken care of my grandmother, mother, and sister with strokes. That was hard. They all died from their strokes. I was motivated to find the best way I could for stroke prevention, choosing the electricians (ablations) over the chemists (drugs). I hoped to get at the physical source of the problem (ablation and Watchman) and then be done with drugs. That is still my hope. I should mention that I’ve had three serious falls, all resulting in broken bones. They occurred before I started DOAC’s. I’m doing my darnedest not to fall again, including seeing a PT who specializes in balance issues, but given the propensity of old people to fall and my active lifestyle, I’m more comfortable not taking a blood thinner. I also look forward to not having a new bruise every time I turn around and always making sure I have my stop-bleeding powder and a bandaid with me. I look forward to a freer lifestyle and a freedom from worry with the Watchman.

That’s my story and decision-making process. Good luck to you!

[mary70]

Can I take aspirin instead of clopidogrel?

Regarding monotherapy, if the patient was on clopidogrel, then they should switch to aspirin which has a relatively lower risk of bleed. If the patient was on aspirin then to restart the same agent [19], one must consider various factors to reduce the risk of bleeding in the future [30-32] (Table ​6).20 Apr 2023

ncbi.nlm.nih.gov › pmc

Aspirin vs Clopidogrel: Antiplatelet Agent of Choice for Those ... - NCBI

[Hidden in reply to mary70]

Hi mary70,

Yes, I read the same study. Studies don’t all agree on the details, unfortunately. I’ll think the best thing for me to do is keep my EP informed and follow his protocol as we await the complete embolization of the Watchman. Dealing with afib, I have learned, is an exercise in patience (combined with a lot of finger crossing). Best to you.

[christos1]

I was on Asprin and Clopidogrel both antiplatelet meds for a year after a stent no brain fog might be worth discussing this symptom with your cardiologist.

As for bleeding and bruiseing this is a side effect of the antiplatelet meds

[Hidden in reply to christos1]

Appreciate your response!

[pip_pip]

I have fatigue from Beta blockers but I never had an issue with Amioderone over a 6 year period. It helped me no end.

Phil

[Hidden in reply to pip_pip]

Isn’t it odd how different we all are! Amiodarone knocked me for a loop. I was thrilled when my EP (after, I will admit, my strong lobbying to get off it) said I could stop taking it. I’m glad it helps you and causes you no side effects. I wish it had been that way for me. Thanks for your reply.

[pip_pip in reply to Hidden]

I stopped Amioderone many years ago. It was good for the period

[Qualipop]

I had no problems at all with clopidogrel apart from the obvious bruising. I was originally on tigarelor but it made me feel as if I couldn't breathe properly s o it was changed to clopi. Such a relief.

[Hidden in reply to Qualipop]

I feel better about clopidogrel from reading your reply. My best guess is that the fatigue and fogginess is left over from the amiodarone. Since I stopped that last week, the symptoms are improving. I just didn’t know if clopidogrel was implicated in those symptoms. Apparently for you they weren’t, so that’s good news!

[Qualipop in reply to Hidden]

Yes , just remember that's just me. Others may be different. IT really had no effect on me at all.

[Buffafly]

Has your thyroid been checked? Amiodarone can affect it.

[Hidden in reply to Buffafly]

I’ve been thinking of having my PCP look into that. Thanks for the suggestion.

[pd63]

If you have afib I thought clopidogrel was not suitable one of the NOACs, provided there's no valve disease, was needed

[Hidden in reply to pd63]

The clopidogrel is protocol after a Watchman implant, which I had at the same time as my 2nd ablation: the ablation was for atrial flutter, not afib, which the first ablation dealt with, and the Watchman for stroke prevention without the need for anticoagulants in the future. I’m not looking forward to three months (two months, three weeks now) on clopidogrel if it’s responsible for my fatigue and fogginess. It’s starting to appear it is not and that, in all probability, I’m still dealing with the side effects of amiodarone, which is only very slowly leaving my body. It’ll all work out, one way or another. (-: I was switched to clopidogrel from apixaban when a TEE showed that the embolization of the Watchman was on track and no clots were detected. It appears clots can collect around the Watchman until the body covers it over with tissue(embolization). Isn’t the body amazing?? The clopidogrel is used as a clot preventative until the embolization process provides protection against clots. So I’ll stick with it. I’ve not heard from anyone saying it had much in the way of adverse side effects. That’s good.

[willywombat44]

I was put on Apixaban in 2014 following diagnosis of PAF then on Clopidogrel also in 2019 following the insertion of 2 stents. I had no brain fog issues but worried about having an accident.In 2022 I had Watchman device fitted (as part of a study), stopped Apixaban immediately, stopped Clopidogrel after one month and replaced with Aspirin.

I experienced brain fog when meds were changed and I was put on the Beta blocker Bisoprolol and Amlodipine - I went back to my original Diltiazem and feel great.

[Hidden]

Wow. I’d love that post-Watchman protocol, off the DOAC immediately then only one month on clopidogrel, then aspirin. I’ve read elsewhere that one month on clopidogrel is the usual protocol. I’ll be sure to bring it up with my EP. The bleeding and bruising on clopidogrel + baby aspirin (I’m taking both, following directions) are, at minimum, unpleasant.

You don’t say, but I take it all goes well with the Watchman. That’s great! All seems to going well with mine so far.

I take it you’re not a beta blocker fan either. I hope I never have to take a beta blocker again in my whole life. Lots of side effects, like feeling draggy all the time. I do not have and never have had high blood pressure. Metoprolol and Diltazem both lowered my blood pressure (unnecessarily) and lowered my heart rate into the 40’s and 50’s. Amiodarone kept me in the 40’s bpm for weeks. Talk about draggy! And foggy.

I’m doing everything I can to get off all heart meds. I’ve not had a happy experience with any of them, though I am grateful that they helped me when I needed help…even though that help often didn’t last and had lots of adverse side effects. The amiodarone, the drug I dislike the most, got me back in sinus rhythm in two days after a cardioversion failed post-ablation. I’m grateful for that…but hope I never have to take it again.

I’ll keep in mind you were taken off clopidogrel in one month. That’s the protocol at Penn State Medical Center, where they’ve been doing Watchman implants even before FDA approval as part of a trial. Lots of experience. Boston Scientific, the makers of the Watchman, say three months of clopidogrel—but that could be self-protective commercially rather than in the best interests of a wide variety of patients. I have no comorbidities, am a healthy 82-year-old with normal blood pressure who eats nutritiously, doesn’t drink, and exercises regularly. I think that should be taken into consideration. I really don’t like drugs. Aspirin I don’t mind. I know it’s a drug, but it’s never caused me the slightest problem.

Thanks for your information. It’s helpful.