Clopidogrel side effects

[FindingCaradoc]

I have been taking 75 mg of Clopidogrel - plus 30 mg of Lansoprazole (both once a day) for nearly 11 months now, since a heart attack (NSTEMI) followed by two stents, at the end of April 2022. I have been told I can stop taking both when 12 months is up, so around 5 weeks away.

As I believe is quite common, I have had various spells of chest discomfort since the NSTEMI, the first included a trip to A&E and I have since then spoken to my GP more than once (who is very sensible) as well as two Cardiologists, who don’t believe it is heart related, and have not suggested any further investigations.

I am now thinking that it may well be Gastro related. I have a history of abdominal discomfort, which has been checked out over the years and which by elimination has been put down to Irritable Bowel Syndrome (IBS).

I thought I was tolerating Clopidogrel and Lansoprazole fairly well, but I am now wondering if this is the case, particularly as I have had some significant stomach/abdominal pain (which has spread into my lower chest region – typically symmetrical and into the sides) over the last couple of days. Might it be the case that taking these medications for a prolonged period has now caught up with me? As it is so close to being able to stop both I am hoping that things will improve afterwards. Either way I am thinking of speaking to my GP again over the next few days (when I can get an appointment!).

I presently take both the Clopidogrel and Lansoprazole in the morning, at least 30 minutes before food. The Patient Information Leaflet for Clopidogrel suggests it can be taken with or without food, but a Pharmacist I spoke to recently suggested definitely with food.

Any thoughts and advice would be appreciated. Thanks.

[Hidden]

This is my experience which may be of help to you since we may share similar conditions. I have reflux disease and what I call a grumbling hiatus hernia. I struggled off and on with these conditions untreated for many years then, after a really bad spell of 'indigestion' about 15 years ago (for which I had the blue light treatment since the symptoms were similar to a heart attack), I followed up with an endoscopy which confirmed the damage to my oesophagus that years of back washing of highly acidic stomach acid had caused, and fortunately nothing too sinister was found. And so I was prescribed PPIs and have been taking them ever since. I now control both of these conditions by PPIs, diet and, particularly for the hernia, avoiding bending over and compressing my diaphragm wherever possible (I had to stop yoga because of this). I have identified some trigger foods which in the past have cased flare ups . Common trigger foods are onions, causing gas, coffee which relaxes the stomach inlet valve, and citrus (acid), there are others and a trigger food for one person may not be the same for the next person, one of mine is green peppers. So since you are already on a PPI, just like me, my suggestion to you is to keep a food diary to see what causes you problems so that you can then avoid them which may help you. In the meantime if you have a flare up I advise a diet of really bland food to allow your body to heal, say for a week or two, so curries and alcohol are definitely off the menu. You could also talk to you your GP for a referral to a gastro specialist with a view to an endoscopy. Anyway I also had an NSTEMI five years ago and having had chest discomfort last year was initially diagnosed with angina as the best fit (given my previous heart health record) but the diagnosis was never certain and in the end the cardiologist changed his diagnosis to one of a gastro related condition, especially since I had stopped taking the angina meds and had been symptom free for some time and apart from an occasional flare up that remains so. Finally I was also prescribed Clopidogrel for 12 months following my NSTEMI and don't recall any problems whilst taking it, and I now take enteric coated aspirin not the dispersible sort as my blood thinner. Hope you get sorted.

[FindingCaradoc in reply to Hidden]

Thanks for your reply - as I mentioned, I do have a history of abdominal discomfort prior to the NSTEMI in 2022, so I have been prone to flare ups, however before my health problems last year things had been pretty good for a while on the GI front! So I do think that Clopidogrel must have a hand in why things have got worse again, and quite unpleasant recently. I have tried identifying triggers in the past (in fact I went on an exclusion diet over 30 years ago that wasn't particularly helpful or conclusive!) without much success, but with the present situation I may give it another go. I am hoping that when I stop Clopidogrel in a few weeks that things will settle down again 🤞- in the meantime and as you suggest I will try a bland diet for a couple of weeks to see if that helps.

[AlfredV]

I had systemic problems from clopidogrel, including gastro-intestinal issues which didn't begin to resolve until I stopped taking them. Even then it took several weeks for a return to baseline. Good luck, and hopefully you see some improvement.

[FindingCaradoc in reply to AlfredV]

Thanks. Yes, as I have replied to LowerField above, my GI issues had been pretty stable until my health problems last year and ending up on Clopidogrel, so it does seem likely that this may be the culprit with this current/recent flare up. It just seems odd that it has taken nearly 11 months to become an issue, although in hindsight the fairly mild intermittent chest discomfort that I have had on and off for months is probably related as well.

[Captain_Birdseye]

I was given peptac (think it's like gaviscon) to take as well as omeprazole when I was on clopidogrel... I still had some tummy issues.

Cleared up shortly after stopping.

[FindingCaradoc in reply to Captain_Birdseye]

Thanks for this, another pointer against Clopidogrel. I also have Peptac, but as for you it doesn't help that much as far as I can tell. As my 12 months are almost up I am thinking of asking my GP if I could stop the Clopidogrel a bit earlier as presumably the risk to my stents is now pretty low.

[Stentrunner]

After my stenting, I was advised take Lansoprazole half an hour before breakfast, and Clopidogrel on a full stomach, ie after breakfast. I was still more comfortable when I could stop the Clopidogrel after 12 months!

[FindingCaradoc in reply to Stentrunner]

Thanks. Yes, I have only just started doing that (and I have noticed some improvement) because as I mentioned the Clopidogrel PIL says with or without food, so up until a few days ago I was taking both the Clopidogrel and the Lansoprazole (as well as other medication - BP tablets and Apixaban) half and hour before my breakfast. Only five more weeks and I will be stopping it, which I will be glad about as it will reduce my bleeding risk as well (although unfortunately because of AFib I will remain on Apixaban or similar indefinitely).

[Stentrunner in reply to FindingCaradoc]

Very similar here. The Clopidogrel isn’t kind to your insides, which is why you take Lansoprazole. I had Aspirin too, also not kind to the stomach. I was switched to Edoxaban after the 12 months (I have AF too) which has given me no problems.

[FindingCaradoc in reply to Stentrunner]

Yes, I just wish I had been told before now that it is best to take Clopidogrel with food, regardless of what the PIL says!! All the best.