Does anyone know if there is an alter... - British Heart Fou...

British Heart Foundation

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Does anyone know if there is an alternative medication to Clopidogrel?

DizzyD profile image
22 Replies

Hi all I had a stent fitted 16 May 23. As is the norm I was prescribed Clopidogrel which I cannot tolerate due to dreadful gut and bowel issues which is a nightmare. Was prescribed Lansoprazole to counteract these issues only had some minor improvement. Literally, I am afraid to eat anymore. A morsel of food has not passed my lips today which helps keep some of gut symptoms away. Prior to taking Clopidogrel I have never had problems with my gut before. I also take Amiodarone and apixiban.

Please does anyone know if there is an alternative medication to Clopidagrel that does not play havoc with digestive tract and stomach?

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DizzyD profile image
DizzyD
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22 Replies

hi a pharmacist or your GP will be best placed to advice on an alternative that would be best in your particular circumstances. Have they advised any alternatives? Or GP could help purse why getting such symptoms?

👍

Maisie2014 profile image
Maisie2014 in reply to

I found Lansoprazole ineffective. I take esomeprazole. My anti platelet medication is Ticagrelor.

Avdi profile image
Avdi in reply toMaisie2014

Maisie

Avoid the combined use of clopidogrel with omeprazole or esomeprazole due to a significant interaction. Other PPIs (Lansoprazole) are considered safe with clopidogrel.

I was on duel Aspirin and Clopidogrel plus Lansoprazole after double bypass 12 months ago, I have just stopped the Clopidogrel as per my cardiologist. I was on Esomeprazole prior to being prescribed Clopidogrel but changed to Lansoprazole due to the interaction.

Take care x

Nathan53 profile image
Nathan53

Hi DizzyAs already mentioned discuss with your GP and don't be fobbed off. I experienced bad stomach problems with clopidogrel and lansoprazole didn't help. I changed to ticagrelor and the problems went.

DizzyD profile image
DizzyD in reply toNathan53

Will do Nathan asap getting to see GP is a nightmare. I will request ticagrelor when I manage to get an appointment. I have not taken the PPI or Clopidogrel today but did take 75mg of aspirin to play it safe but know I am taking it on a already malfunctioning gut and stomach which is not the best thing to do. Will phone the rehab nurse tomorrow and tell her what I have done. Sincere thanks

Heather1957 profile image
Heather1957 in reply toDizzyD

Ticagrelor can have its own side effects as I posted, it may well be a matter of trial and error. I also bruised badly when taking Ticagrelor.

Kevin1962 profile image
Kevin1962 in reply toDizzyD

Please be careful with the aspirin that eats your stomach wall. I have just finished my 1year on clop

RegularWalker profile image
RegularWalker in reply toKevin1962

A doctor once told me "Never take aspirin again" but I've taken 75mg dispersible aspirin every day since my HA in 2017 without harm. Take it with or after a meal as advised and it shouldn't affect your stomach. Re Dizzy D's original post, I took Clopidogrel for a year after having stents, together with aspirin, without any problem. By contrast, Ramipril made me cough so I got it changed to Losartan, and I was given Bisoprolol and should not have been because my pulse has always been below 60bpm at rest, and it took 3 years to get someone to say "Stop taking it". So I don't suffer in silence.

Heather1957 profile image
Heather1957

There are always alternatives but as already stated you need to speak to your GP or pharmacist first.

I was put on Clopidogrel way back in 2017 after a stroke that followed an angiogram. I remained on it following by bypass also in 2017.

In October 2021 I had 2 stents fitted and was taken off Clopidogrel and put on ticagrelor and aspirin. My prescription said this was for 12 months and then I would revert to Clopidogrel (which has never caused me any problems) I managed 6 months on ticagrelor and it was a nightmare, I found myself panting for breath and waking myself up at night. I consulted with my GP who said 6 months was fine so I went back to Clopidogrel.

Depending on the person and what other meds they are on thinners react differently so sometimes it is a matter of trial and error.

Qualipop profile image
Qualipop in reply toHeather1957

I had the same trouble with ticagrelor. I was breathing ok but it gave a feeling as if I had asthma. I changed to clopidogrel.

MrsSuzuki profile image
MrsSuzuki

It was the aspirin that caused my gut problems not clopidogrel. A few members said they took coated aspirin and it helped me enormously.

Lily

Ethel14 profile image
Ethel14 in reply toMrsSuzuki

I have dispersable aspirin

devonian186 profile image
devonian186

I take both the medico9nes mentioned which have little effect except some loose bowels occasionally. What time of day do you take them and is it before or after food?

Qualipop profile image
Qualipop

Yes ticagrelor. I started ont hat but had to change to clopidogrel buit ticagrelor is the hospital's first choice.

Goosebumps profile image
Goosebumps

I can echo some of your problems. I had immediate problems with Clopidogrel even before having the stent fitted and told the hospital but they insisted I took it. I pushed on and suffered for a couple of weeks after the stent and then had a nasty episode and a visit to A&E. That got me Lansoprazole prescribed but it didn’t help so I stopped it.

I went back through my cardiologist and told them I couldn’t stomach ( sorry for the pun) Clopidogrel and they consulted with the stent surgeon and agreed that as I was on Apixaban and Aspirin that would be sufficient protection. I can’t say it was all perfect after stopping the Clopidogrel but it was so so much better.

I spent 6 months on the Aspirin in accordance with instructions and then stopped. I can’t say that I noticed any side effects of the Aspirin on my stomach, maybe I was lucky.

My advice is to get on to your cardiologist or the surgeon that did your stent. In my case the fact that I was on Apixaban was the game changer for them and I was actually able to remove a drug from the regime which is a huge bonus for those of us that react so sensitively to various medications. Good luck.

Gibson01 profile image
Gibson01

an alternative to clopidogrel and ticagrelor that I have not seen mentioned in the relief is Prasugrel. Consultant put me on that as an alternative to Ticagrelor after an angiogram in 2021

momander profile image
momander

Hi,

We are all different in the way our bodies react to medication. IU have had no trouble at all with clopidogrel. I do know that you should not take clopidogrel with omeprazole!!! I actually found thios out on this forum 3 years ago!!! my GP had not told me of the interractions and so I asked if I could change to lansoprazole. I would suggest you talk to your GP about all of this. There are many alternatives out there and I am sure you will find one that suits you better than clopidogrel. Good luck

Cavalierrubie profile image
Cavalierrubie

You probably need stronger stomach medication. I take Omeprazole and Gaviscon liquid at bedtime. You shouldn’t be feeling this way and need more protection for your stomach or need other medication change, so see GP.

Handel profile image
Handel

Hi Dizzy D. After his bypass 4 and a half years ago, the doctor took hubby off clopidogrel and put him on a 75mg aspirin a day. He takes Omeprazole to counter the dodgy effects of aspirin on his stomach but he's also taking Gaviscon tablets as well now.

I think you need a trip to your GP. I'm sure my husband needs a medication review as he's been on the same drugs since he left hospital. Our GP surgery is like Fort Knox to get in.

Good luck and hoping you feel much better soon. Best wishes. Jan xxx

Chriswood79 profile image
Chriswood79

Agree with Gibson01 - prasugrel is an alternative

Paperlover profile image
Paperlover

I know everyone is different, but I would bet money on your issues being caused by Apixaban rather than Clopidogrel. Before my heart op, I was on Apixaban. I tolerated it for around 3 months, then started getting terrible abdominal pain after eating, more so with particular foods. Gasto problems resulting fro Apixaban are quite well documented in other countries, but less so here. I got so bad that I was sent to A&are at one point. I contacted my cardiologist and was transferred to Rivaroxaban, but as they are from the same family of drugs, was warned I may suffer the same problems. I was fine for a few months and then started feeling poorly again. I then decided I would take my tablet part way through my evening meal and had no further problems. since my operation I am no longer on either medication but do take Clopidogrel. I have had no problems with this. I can’t even take paracetamol without being sick! Might just be worth trying changing the timing of your dose of your Apixaban to see if it helps?

Ethel14 profile image
Ethel14

I have Ticagrelor

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