A year after stent - continue clopidogrel ?

[Neilb60]

Hi all - I believe I can now stop taking clopidogrel after having my stent a year ago. I will obviously talk to my GP/pharmacist but wonder if there is any benefit continuing. I have had a lot of heartburn from acid reflux so keen to reduce number of meds but wonder anyone with similar experience. Could you drop aspirin and stay on Clopidogrel ? TIA

[Lowerfield_no_more]

Assuming you are now discharged back to the GP, your hospital discharge notes to your GP which you should have or have access to will detail the plan for you. If you are on both clopidogrel and aspirin at present it is likely one will be dropped after 12 months, all detailed in the notes, and this may be done automatically by the GP practice. If you are having stomach issues likely caused by medication, a PPI is often prescribed by the GP. But in your case, assuming you do not take a PPI, if you drop clopidogrel and are to continue with aspirin, and you are taking the dispersible type, a change to gastro resistant alias coated might be the solution to your stomach issues, which you would find out by trial. That's what I take.

[Neilb60 in reply to Lowerfield_no_more]

Thanks - already on Pantoprazole and gastro resistant aspirin. On 5 or 6 meds and tinkered with variants, slightly better but gastro issues ongoing. Will refer back to GP

[BC4ever in reply to Neilb60]

I have had terrible stomach issues since my heart attack and 5 stents fitted eight months ago. I'm also on gastro resistant aspirin and clopidogrel. Also on pantoprazole and famotidine for my stomach. I have noticed that when I wake up I have no stomach pain whatsoever, (not had any medication or food for twelve hours), but a couple of hours after taking all my meds the stomach pains start. My doctor and cardiologist both think its the aspirin (it is renowned for causing stomach issues). I'm due to stop my clopidogrel in June (after twelve months), but my cardiologist has said I can stop the aspirin instead. Can't wait for the summer, as the side effects of some of these meds have been horrible. Talk to your doctor about stopping the aspirin instead of the clopidogrel. It's also about cost. Aspirin is extremely cheap to produce, clopidogrel more expensive. Don't let them fob you off. Good luck.

[Neilb60 in reply to BC4ever]

Thanks sounds similar 👍

[Lowerfield_no_more in reply to Neilb60]

You could ask your GP to change your PPI, of which there are several, or up the dose. I was on 20mg Nexium (esomeprazole) before my NSTEMI but this was changed to an equivalent dose of 30mg lansoprazole because of the interaction with Clopidogrel, which I had to take for the following 12 month, and have been on that ever since. Back in the days when I was finding out how to control my reflux I initially started on the max normal dose of 40mg Nexium which I took for several months, then I asked for this to be reduced to 20mg which still worked for me, but when I dropped it back to 10mg my symptoms returned so I went back up to 20mg.

[Hrty]

I ended up taking Clopidogrel for just over 2 years following my NSTEMI in November 2022. Initially the DAPT plan was to take it and aspiring for 12 months but after a second angiogram in the July 2023 it was extended for a further 12 months. My GP wouldn't just stop it until I'd seen my cardiologist again (I was waiting for a follow-up appointment), Unfortunately that got delayed because of waiting lists so eventually got to see him just after last Christmas when he confirmed I could stop it. I didn't get on with lansoprazole when it was prescribed, the irony of spending so long on the loo because of a drug designed to protect my stomach wasn't lost on me, so the practice pharmacist changed it to Famotidine. My cardiologist was happy with this and also happy for me to take gastro-resistant aspirin if I felt I needed that rather than the dispersible stuff.

[Breakfasttoday in reply to Hrty]

I too take Clopidogrel/aspirin combination and have some reflux issues. I’m reluctant to take Lansoprazole as I have an underlying bowel condition with terrible constipation problems. Could you please confirm if your excessive loo time was due to constipation or the opposite. How’s the Famotidine working for you. Sorry for the personal questions.

[Hrty in reply to Breakfasttoday]

Hi, It certainly wasn't constipation :-). Seriously, it was really unpleasant and I felt terrible until the pharmacist swapped me to famotidine. Been fine with it. The Diarrhoea stopped as soon as I stopped the lansoprazole.

[Breakfasttoday in reply to Hrty]

Thanks for your reply, very helpful. Strangely I will try it as it may help my problem.

[Golfer67]

I was the same as you in that I was always told clopiderol for just 12 months so that's what I did. I had to stop aspirin 1 month after, so I'm just on apixiban now for thinners, then ramapril and a statin

[Whiteghost]

I know this may sound dumb. Have you read the label the chemist puts on when dispensering your script. Mine said how to take and how long for. ie: month and year.🤗

[Chrissca71]

I was told to stop the aspirin after three months by my cardio doctor due to terrible heart burn but i still take the clopidogrel and will be taking long term but make sure your doctor agrees i had my 3 stents two years ago

[34leftbeat]

i took clopdogrel for 6 months after having 2 stents put in because of blocked arteries, 4 days after stopping it i had a massive heart attack, one of my stents became blocked i now have 3 stents and im now back on clopidogrel for life, see your doctor and your cardiologist, i take 9 different drugs daily. good luck

[theoldgolfer]

Hi Neil, I had my heart attack almost a year ago today. A consultant I saw mid summer said that I would probably stop the aspirin about now but nothing about the Clopidogral. I was referred to my pharmacist when I asked about stopping the aspirin and any other tablet and am still waiting for an answer.

[fishonabike]

A note on PPIs - I was prescribed omeprazole for silent reflux (no noticeable symptoms), within a week I developed stomach pain I describe as heartburn which gradually got worse, within 1 month I had heartburn 24 hrs a day, so I stopped the omeprazole and took a liquid alginate based antacid - it took at least a week for the heartburn to disappear

Stomach pain is listed as one of the most common side effects - i find that odd for a medication which is supposed to ease the symptoms of acid reflux!!

[Qualipop]

I asked my GP the same. I would have preferred to stay on clopidogrel with fewer stomach problems but he insisted I stay on aspirin because they know far more about the effects of aspiring and long term it's safer. I don't kwno what he meant by safer. I now take a coated aspirin that doesn't dissolve until after it's passed through your stomach.

[Richie34]

Hi Neilb60,

In most cases clopidogrel is for 12 months post date of procedure but as you said please confirm that with cardiology before stopping, the aspirin as I understand is for life, it can cause acid reflux (I was prescribed a PPI/lansoprazole to offset that) but I also have a sliding hiatus hernia too so it's primarily used as a preventative medication. Hope that helps. Incidentally how have you been since the stent was fitted?

[OK10]

No, i was told aspirin is for life.

[Jedi14]

Well initially, discuss with your GP. In my case, a year post stents, I developed other angina problems and ended up back to hospital etc. Resulting in both my Clopidogrel and Aspirin being replaced by Apixaban, apparrently a replacement blood thinner for life.