Spoke to the GP'S pharmacist Monday who said ok to come off Clopidogrel but said they wouldn't normally prescribe aspirin on its own but only along side Dipyridamole, only if I couldn't take Dipyridamole would they prescribe aspirin on its own. Didn't seem to make a lot of sense to me as if they could eventually prescribe aspirin alone, why can't they from the outset ? When I looked up the drug on patient access it says it has to be taken with meals which I presume means it is harsh on your stomach. That would mean I would be taking two drugs which can cause stomach trouble. Not sure that's a good idea. My assumption is that whatever drugs i am to take are only preventative as ,as yet, I have had no definitive diagnosis. When we asked the consultant whether I would have a scan to ascertain if I had actually had a TIA he said even if it showed no evidence his diagnosis would be the same !. I asked my chemist what he would recommend he said without seeing the blood results he wouldn't be able to give any advice, but the doctors want to begin a drug regime without seeing the results.
Hi William. It sounds to me as though you have been given a definitive diagnosis by your consultant based on the symptoms you presented to her/him and that further tests/scans won’t rule out that diagnosis. If you doubt you’ve had a TIA (although in previous posts you seem to accept that you’ve had one) why not seek out a second opinion? I can understand your reluctance to take unnecessary medication but, if you have had a TIA, there’s a strong chance you’ll have a stroke/heart attack or worse in the next 12 months. Only you can weigh up the risks with potential side effects. Perhaps a second opinion might help to persuade you one way or the other?
I have to accept what the consultant has said, and of course the GP referred me , so in a sense I've had two opinions. When I meant definitive I meant medically/clinically . At the moment nothing indicates WHY I have had a TIA. For example the consultant wanted to put me on statins , when I pointed out that my cholesterol level was only 4.5 , he said if I could get it below 4 he would be happy for me to not take statins. Of course if I fail to achieve it I will take statins. My blood pressure is normal, my BMI is under 24, my ECG was normal, my cartoid arteries were clear. I await the blood results and am to have a heart monitor for 48 hours. My point is, if aspirin is the only requirement while I awaited the hospital appointment, why can I not just take that ? Other doctors believe only aspirin is necessary.
I know people will think I am being difficult, but I know so many people who s lives are ruined by the drug regimes they are on, that I made my mind up many years ago that I wouldn't go down that road, unless it could be shown that it was necessary. Doctors are very busy and don't have the time to spend on each patients individual needs. One example is my niece who was put on methotrexate about 5 years ago, two months ago she was told she should never had been put on it ! As she's only a young woman it may be years before we find out what damage has been done.
To respond to your question about why Clopidogrel or Aspirin + Dipyridamole after your hospital visit I expect it was because they’re the recommended treatments once a diagnosis of TIA has been confirmed (which it wasn’t when it was a GP referral). For what it’s worth - I don’t think you’re being difficult.
Have you been prescribed a PPI (proton pump inhibitor) like Omeprazole to protect your stomach. This is fairly usual practice.
TIAs are tricky. They suspected my late mother had had one and sent her for a scan. The scan was clear but the consultant said that although a scan could prove someone had a TIA it could not prove they did not have one!
That s a fair point about the scan, which is pretty much what the consultant said, regarding omeprazole/lansoprazole I have two problems with them, 1, they give me stomach cramps, 2 , the manufacturers admit that long term use can cause osteoporosis, I had two friends ( one has died ) that shrank several inches due to long term use. Fortunately I can take ranitidine without any obvious side effects, but that has been withdrawn.
Just of note - your cholesterol number doesn’t give an indication of the stability of any plaques that are there. Statins help stabilise plaques as well as reduce cholesterol.
I’m unsure why you’re not keen to follow the clinical advice, but if you feel it is unnecessary then I wouldn’t be taking anything.
I would definitely push for at least an explanation of what they’re basing their diagnosis on if they haven’t scanned you. Clearly there was some event, possibly not even cardiovascular. I would be extremely uncomfortable having had something that was severe enough for TIA to be on the list of possibles, but leaving such a huge question mark.
My brother had a TIA at age 40 and was tested and scanned to there and back. He had intermediate stenosis of one of his carotid artery, which had briefly dissected.
Obviously it’s an individual decision but I know that these drugs are what stands between me and leaving my children (age 13 and 14) motherless. I think the media has a huge influence on perceptions of side effects, and quite often what the patient is feeling is nothing to do with the drugs, sometimes it’s clear from the patient information leaflet that they’re not even associated with that particular drug. Statins get hugely bad press, but when they’ve done double blind trials more people who were on the placebo reported side effects than those actually on the drug!
30 years ago the majority of us posting wouldn’t be here - I’m very grateful for the advances medicine has made, and honestly, if I don’t trust the team who saved my life I might as well give up now!
Hi Sillyfroggy, I'm impressed with everyones concern, and thank you for yours. As regards statins, the consultant was happy for me to not take them if my cholesterol level was lower than 4, To be honest he seemed surprised that my cholesterol was as low as it was and that my blood pressure was not high but at the lower end of normal 110/70 my ECG was fine , my carotid scan was also fine. My point is that taking unnecessary drugs is not good. I will take any drugs i need once the results have been seen. In the meantime I will take the aspirin that was prescribed when it was first suspected i had had a TIA.
Just as a side note one of my neighbours ( bumped into this morning )started on statins last month can hardly walk now.
Hi Fortepiano, the last thing I want to bring on myself is a stroke having witnessed someone have a stroke firsthand. But if you look at the methods for preventing a stroke /TIA first in line is lifestyle, my lifestyle at the moment is as close to the guidelines as possible, when I took the Clopidogrel, for the first time in ages I didn't go for my daily walk because of the pain in my hips and shoulders. Medication is only one of the methods, if that reduces one of the others, that would seem to me counter productive. But as I have made clear previously if when all the evidence is available i will consult with my GP and decide with them what is necessary. But thank you for your advice and concern.
Two years ago I had what they thought was a TIA, after all the tests the consultant decided it was a hemiplegic migraine. I had in the meanwhile been put on asprin then clopidogrel to be taken off both once they had decided it wasnt a TIA.
I have had hypertension for years and been taking the tablets and have never smoked. My mum had her first TIA and went onto have a number of strokes before the age of 55 though she did smoke like a chimney and had other health problems.
3 weeks ago I had numbness in my face and in a couple of fingers on my left side, I suffer from RA, Fibro and had shingles 3 times back in 2017 so spent some time thinking it was shingles back! Feeling was still there next day so was advised to go to A&E after tests no conclusive evidence of anything (CT, Bloods ECG) put on asprin again and went back for MRI a few days later, results from that showed I had a lanacula stroke, my BP was still high so now on double dose of BP meds and Clopidogrel that is making me feel awful,( no problems when I took it a couple of year ago) itchy skin, gastric problems and had a temperature for some reason the last two days. I have just read a temp on this stuff may be problems with the bone marrow!
I get what you are saying, start off on one drug end up on five! I wont do the statins I have seen too many with side effects, but since I have been on Clopidogrel (11 days) I have had antihystamines prescribed for my itching skin, been offered lanzaprole for gastric protection ( no one even thought to ask about my bone density as I already have osteopenia). Sometimes I think no matter what you do its genetics that get the better of us...............You may be interested in this guys take on statins, Aseem Malhotra
Cardiologist
WHAT SHOULD I AVOID WHILE TAKING DIPYRIDAMOLE (PERSANTINE)?
Do not take aspirin while you are taking dipyridamole. Many medicines available over the counter also contain aspirin or similar medicines called salicylates. Ask your doctor before taking any other medication for pain, arthritis, fever, or swelling. Check the label to see if a medicine contains aspirin.
My wife has just had to come off Clopidogrel due to a bad reaction (shortness of breath and hives - on top of the infamous Ramipril cough) and has been prescribed Dipyridamole. Did you go on the latter and if so have you had any side effects?
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