I had my annual combined Diabetes/Heart review with the nurse practitioner this week, and the first question she asked me was 'why are you taking both Clopidogrel & Aspirin as they both do the same thing, but Clopidogre does it better'. My answer was 'because my cardiac consultant prescribed them to me. So the question is this:- Is it correct that they do the same thing? (nurse practitioner vs cardiac consultant) Hmmmm.
Thanks in advance
Terry
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GoldfishPond
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Both these medications are usually prescribed after having a stent fitted, it is called dual anti-platelet therapy. At some point one is often discontinued, normally after a year but it can vary from person to person.
While both anti-platelet drugs, they work in different ways so have a combined effect more powerful than either drug alone. The reason for two after a stent is fitted is to minimise the chance of a clot forming in the stent while it is still bedding into the artery.
It would be worth checking with your cardiologist if you still need to be on both.
As above. If you were prescribed aspirin and clopidogrel, after a heart 'event' which meant you were seen in hospital, your discharge notes should indicate what the plan is for these meds. I took both for 12 months after my NSTEMI then dropped the clopidogrel, but still take low dose aspirin and will continue to do so, since it is now 'for life'.
Like Lowerfield_no_more I was on a dual anti-platelet therapy but in my case it was low dose aspirin and Ticagrelor for 12 months post OHS. I'm now on aspirin only (75mg) as an anti-platelet therapy, it's for life. My surgeon was adamant about stopping the Ticagrelor after 12 months.
I have come across a number of folk who remain on the dual course for some time (longest I've seen so far is 5 years).
My surgeon gave the time schedule for the Ticagrelor at discharge from hospital and re-inforced it at my review at 7 weeks post op. My GP and local cardiac unit both confirmed that decision as well.
Any doubts about continuing should be referred back to your cardiac team. I'm still able to contact my local cardiac team if I need to, they want to see me for an echo next year at two years post surgery but I have had AVR, CABG and two stents.
I suggest you don't make assumptions about your ongoing medication plan you should actually check what it is. If you have been discharged back to the GP by your cardiologist there will be reference to a plan in your discharge notes as I said above. Look through that. It you are supposed to be taking both meds indefinitely that's fine, if not then you should be stopping one at some point in time which should be defined. And if there is no reference to a plan, check with your GP who is now responsible for your care. I certainly would not want to be taking any more medication that I didn't need to. At least by flagging it up, your GP will actually have to think about your situation. There have certainly been cases on here where people have continued to take the two meds only to find they didn't need to and stopping one had been overlooked.
Following my heart attack in 2014, I was prescribed Aspirin 75mg for life and Tricagrelor for 12 months and that’s when the Tricagrelor disappeared from my monthly repeats list. The original plan was generated by the hospital Cardiologist and actioned by my GP. You will need to speak with your GP who can contact your Cardiologist if necessary.
Dual anti-platelet therapy is a standard of treatment and very well-evidenced..The fact that nurses - seemingly often question this, simply displays their astonishing ignorance.
...not true! As others have said, the two meds are not always required, and it is very often overlooked by busy practitioners. We need to be responsible for our own health with the state of our Nhs these days, and question what drugs we are taking that may or may not be necessary.
Excellent information given above. Just one note - when I stopped taking Clopidogrel one year after my bypass op, my GP practice queried why I was not taking up the prescription. They would not take my word that this is what had been instructed when I was discharged from hospital. It took six months to get it taken off my prescription list and in the end I had to write to my GP to set out what instructions I had received,. I was surprised my GP practice was not up to speed on what is standard practice.
hi when I had my stent fitted I couldn’t tolerate aspirin so I was put on presagrul for 2 years now I’m only taking clopidogrel my cardiologist said 75mg is fine and is better than aspirin and usually does not irritate the digestive system but it’s something I would ask your doctor or cardiologist for the reason why u are on both
After having a couple of stents fitted I was prescribed clopidogrel for 2 yrs and aspirin for life. After 2.5 years the pharmacist at my.gp rang and said they were stopping clopidogrel as it was only prescribed for 2 years. I just asked if it was safe to suddenly stop taking it and did I need to see cardiologist again. I was reasuured all was ok and and didnt need to see cardiologist and that now aspirin alone would be ok.
Hi I am also on dual anti coagulation therapy, rivaroxaban and Clopidogrel. I had a STEMI , total blockage with numerous blood clots and have Coronary Artery Ectasia ( a heart condition which means I am prone to clots ) It is not unusual to be on dual therapy, they compliment each other and despite the fact that this is often questioned by GP surgery staff and pharmacists, I trust my cardiologist who has pointed out the research that has been done on the merits of dual therapy. I would speak with your cardiologist if you have any concerns.
Before I had my bypass my cardiologist said the one medication I must be able to tolerate was aspirin. Considering I couldn’t tolerate any of the post op drugs I thought I was a gonna. However I found I could tolerate aspirin even though come summer I develop blue patches especially when I knock myself against anything . Therefore I think aspirin is enough for me personally.
I was on both for 12 months, then only to aspirin but was switched to only clopidogrel because the aspirin was too hard on my stomach. I suspect you'll be on one or the other.
Hi. Please may I ask you what your medical history is? Have you had a heart attack and stents fitted? My MI was in May and I had two stents fitted. I'm also on Clopidogrel and Asprin, but I'm getting terrible stomach pains all day long. Had them for the last four months. My Doctor examined my stomach (for anything sinister) which was clear. He says it's the Asprin, but I have to stay on it. I'm waiting to speak to my Cardiologist next month about it.
Long-term dual anti-platelet therapy is recommended for many people, and often necessary for some due to other health conditions. It is actually not for any of us to contradict any medical direction that has been given to others as we have no idea of their medical history.We can, obviously, give personal experience or recommendations, but must not make them dogmatically as many seem to do on these sites, and which can be dangerous rather than helpful.
12 months on from my Heart Attack that turned out not to be a Heart Attack my Cardio has just taken me of Clopidogrel but kept me on Aspirin. Sadly, I've come to the conclusion, after a year of botched diagnosis and conflicting advice, that they don't know their backside from their elbow.
I took clopidogrel after my third surgery, to place a prosthesis. Shortly after the first dose, I had a hemorrhage in my urinary tract and the medication was stopped. After more than a year, I continue with just aspirin. As our colleagues said, you should really check with your doctor to see if the two medications are still necessary in your case.
Hi there, Both are right. However combined therapy have a more ant-platelet effect. My hunch is clopidogrel is kinder to stomach and less likely to cause gastric bleed as opposed to aspirin which is not given to patients with gastric ulcer. There are newer anti clotting drug like Apixaban which has lesser side effect like Clopidogrel.
When I worked in pharmacy I was told that one thins the blood and one stops the blood being so sticky. Therefore I guess some people could stay on both for life depending on their health conditions. Check with your GP or speak to your cardiologists secretary and ask them to check with the cardiologist.
I now have the answer. The surgery phoned to say that my consultant has put me on both Aspirin and Clopidogrel for life and as a bonus has increased my Isosorbide mononitrate 60mg. So thank you everyone for your thoughts and input, it did help me with my thinking and conversation with the GP
Clopidogrel open up your arteries and Aspirin thins your blood, are very effective together, but higher risk of bleeding, in the gut , I take Clopidogrel in morning, then aspirin when go to bed , dissolved in water , but it’s up to the individual. I’ve been on aspirin for 5yrs and 3yrs on Clopidogrel and all ok
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