Alternatives to Clopidogrel

[Taviterry]

In July 2023 I had a TAVI (new tissue heart valve) that was initially very successful, but after six weeks I started to feel very tired. My first thought was that this was due to my taking Clopidogrel, fatigue being a recognised side effect. My surgeon dismissed this idea and sent me on a long journey via a gastroenterologist, haematologist, A & E, and GP, all of whom have been unable to explain the extent of my fatigue. I'm now due to see a cardiologist later this month. Six ECGs have all shown nothing of concern.

Clopidogrel does seem to be the favoured anti-platelet medication, but I gather there are alternatives, such as Ticagelor/Brilinta and Dipyridamole.

I gather that both need to be taken more than once a day and that the former poses more of a risk of bleeding.

Obviously I'll be seeking the advice of the cardiologist.

I've posted about my fatigue (too?) many times, so please do not suggest other causes and remedies, just make any comments on your own experiences of the two alternatives (or others) and the reasons you were prescribed them rather than Clopidogrel.

[HolTed]

Hi,

I am also on clopidogrel. And I also am extremely tired. My doc took my off bisoprolol because he thought that may be causing the extra fatigue. I have come across a study that links clopidogrel to excessive fatigue is some patients - pubmed.ncbi.nlm.nih.gov/345...

Have you seen that study?

[Taviterry in reply to HolTed]

Interesting, and thanks for posting. I note that the report notes that the findings are subject to symptoms not being attributed to any other medical explanation. There are two other reasons for my fatigue, one borne out by blood tests, but I'm looking for any changes to treatment and medication that might reduce it, if only by a little.

[shopman]

I took Ticagrelor for a week earler this year after having another 2 stents. A week later woke up gasping for breath and whisked off again. Took me off the Ticagrelor and put on Clopidigrel, everything now OK. Different people react differently to different medicines.

[Babz7019 in reply to shopman]

I'm on Clopidogrel n don't feel tired only thing that has happened is my pm was changed last week from gp surgery as esomeprazole stops Clopidogrel working properly ! Now on Lansoprazole

Funny as I've been on both for a number of years

[shopman in reply to Babz7019]

I have to agree with you here as I also was changed similarly for the same reason despite having omeprazole for more years than pussy was a kitten. Noticed have more "wind" with the lansoprazole.

[Babz7019 in reply to shopman]

I,m getting more acid reflux than I was on Esomeprazole ! Will give it another week n get in touch with GP if it continues .

As having Achalasia acid reflux is a big problem .

[PadThaiNoodles in reply to Babz7019]

You could also ask about a H2 blocker (such as famotidine), though I think PPIs are generally more effective.

[Babz7019 in reply to PadThaiNoodles]

Yes have tried Famotodine didn't work on me .

[Loobycare in reply to shopman]

More years than pussy was a kitten - love it 😀

[Qualipop]

I had ticagrelor not for AF but after a heart attack . Had to take stomach protection but it also gave me a really scary feeling that I couldn't take a deep breath. My sats were perfect, it was just a feeling but it happened so often and was so distressing I had to beg to change it. It is a listed side effect but doesn't affect evryone.

[SandraLlew]

Hi there, I had a TAVI 12 weeks ago and was a bit tired afterwards, but then had to have cancer treatment so no fatigue has kicked in. have you checked on NICE and the BNF about what should be prescribed and the effects each drug has on each other?

[Taviterry]

I've spent a great deal of time checking, double-checking and cross-checking, especially as my health changes. (For the first part of this year I was seeking lots of iron and Vit C, now I need to avoid them.)

Curiously my surgeon prescribed only Clopidogrel and Ramipril (for blood pressure), my GP urged me to take Omiprazole as an antacid (though the combination is contraindicated), then issued a prescription for Lansoprazole. The surgeon confirmed I didn't need to take either, but after two months of bloating and violent wind I started the Lansoprazole, with the symptoms all but disappearing within 48 hours.

[Haresear55]

I was on Tricagrelor for a year after heart attack and stent. It made me very tired. However, switched to Clopidogrel and feeling much better. For reflux, using pantoprazole as it does not interfere with Clopidogrel. Try different antiplatelet medications to see what works for you. Best wishes!