hello,
I am 12 months post HA and stent fitted, Barts confirmed I can stop taking the antiplatlett (ticagrelor) which I used to take 2x daily.
I still take bisoprolol, aspirin, losartan, 25mg), Lipitor (80 mg) and pantoprazole (20mg) daily. My BP and heart rate remain good (actually on low side).
I am wondering if others who went through a similar experience have been able to reduce other meds?
You are still taking aspirin which for some can give gastro upsets, particularly if it is of the dispersible type. I suggest you discuss trialling dropping the PPI with your GP to see how you get on, perhaps in conjunction with coated aspirin, and if successful you will then be able to continue without it.
I was on Ticagrelor for 4years after stents. 90mg first two years, 60mg 2 years after that. At the end of the course I just stopped. Best thing no more bruising. I've found my meds can be changed after my yearly blood tests and yearly review. Just the norm I think.🤗
Hi 30min - after a HA & triple bypass three years ago, I was prescribed what seems to be the standard package of medications immediately afterwards. 1.25mg Bisoprolol, Furosemide (diuretic - taken for two weeks post op only), Ezetimibe 10mg (cholesterol lowering drug), 75mg Aspirin, Clopidogrel (anti-platelet) and Lansoprazole (to protect the stomach from Clopidogrel side effects). Six items in total. After one year the Clopidogrel and Lansoprazole were removed - I think this is the standard practice.
My daily medications now are 5mg Bisoprolol (dosage needed tweaking to lower heart rate which was still a bit high), Ezetimibe 10mg and an enteric coated Aspirin 75mg daily. I still have Lansoprazole on my prescription, but use it only as a pill-in-the-pocket when needed as discussed with my GP surgery's pharmacist.
If your GP has a pharmacist, it might be a good idea to have a word with them, I found ours to be extremely helpful and very knowledgeable.
Good luck with your prescription - I know it always gave me immense pleasure when they removed 'no-longer-necessary' items from my prescription and I didn't have to take a carrier bag to the chemist to collect them! ☺️
PPIs like pantoprazole are routinely given to help protect the stomach from the side effects of Aspirin, not clopidogrel.
If stomach upset is an issue , Some doctors will remove aspirin and continue with clopidogrel instead. This also should allow for the discontinuation of pantoprazole.
Really? It was the surgeon who performed my triple by-pass who told me that Lansoprazole was prescribed to me to protect my stomach from the side effects of clopidogrel and also told the same thing by the pharmacist in my GP's surgery. Perhaps it's because the aspirin I'm prescribed is enteric-coated that helps to afford some protection from irritation in itself. My sister was also prescribed a PPI for stomach protection when she had chemo last year for breast cancer - it seems they help a lot for various medication side-effects.
PPIs reduce the effectiveness of Clopidogrel, sps.nhs.uk/articles/using-c...
That's not quite correct as the linked article indicates. It is reported that some PPIs reduce the effectiveness of clopidogrel, namely omeprazole and esomeprazole, whereas for other PPIs 'clinically significant interactions have not been observed'. That is why I was moved from esomeprazole (which I was taking for my reflux disease) to lansoprazole after I had my NSTEMI and I had subsequently been put on clopidogrel for a year and aspirin for life, as no doubt others similarly placed will find. Nonetheless there are some contradictions on this subject in the article you linked, but in my view if you are high risk as I am, and/or likely to struggle due to medication causing stomach upsets, I would quite readily trade a slight reduction in the effectiveness of clopidogrel caused by taking a PPI, compared to the significant quality of life reduction having to endure gastro upsets or worse through not taking a PPI.
Thank you, Lowerfield - my sister was also switched from omeprazole to lansoprazole during chemo treatment and your explanation makes perfect sense. I'll be able to update her, she couldn't understand why it was changed at all but thankfully found lansoprazole to be both gentle and effective. I now realise I was prescribed lansoprazole rather than the other PPI's by the surgeon and the GP's pharmacist due to the NHS guidelines stating:
"Taking clopidogrel with indigestion medicines
Indigestion remedies called proton pump inhibitors (PPIs), such as omeprazole and esomeprazole, may reduce the effect of clopidogrel.
If you have indigestion and need a medicine to protect your stomach, your doctor can prescribe you a different PPI, such as lansoprazole."
I completely agree with you too with regard to trading a slight reduction in effectiveness given how horribly Clopidogrel upset my stomach while I was taking it for that one year - I think I'd have been prepared to take anything to help with it! I have severe diverticular disease and Clopidogrel really exacerbated the problems I sometimes experience with a flare up. But wouldn't it be great if we didn't need to take any medications at all!☺️
after reading the info i realised the picture was more complex than i initially realised, that's why i included the link - it explains much better than i could
Hi, I was told that I could stop taking clopidogrel after a year and at the same time I could also stop taking Lansoprazole as well. I will probably still use Lansoprazole as and when I need as I suffer from acid reflux.
I don't like taking clopidogrel at all as it might cause bleeding.
I am slo told that aspirin is for life.
Hi OK10 - yes, that's what I was told as well, it's also on my discharge from hospital notes that both clopidogrel & lansoprazole could be stopped one year after the bypass. I had a telephone appointment with the pharmacist from our GP's surgery to amend my prescription after the year was up and she suggested that I might like to leave the lansoprazole on my prescription and use it as a pill-in-the-pocket when needed, so that's what I've done. Thankfully, the indigestion/reflux I suffered while taking clopidogrel, all but disappeared a few weeks after stopping it and I very rarely need to use lansoprazole these days. My aspirin is also for life - I take a coated aspirin and usually have it with a meal or some plain yoghurt, that seems to help with the associated indigestion as well.
thanks - I will speak to our GP pharmacist as I can get that appointment quicker and I think she is good.
I really want to reduce what I take, where it may not be necessary because of the potential long term damage but obviously not at the risk of another HA.
Thank you.
As Lowerfield_no_more says, pantoprazole is meant to protect your stomach from side effects of aspirin, but not everybody needs this, also taking enteric coated aspirin and always taking it with a meal can also help prevent these side effects - so it might help to discuss this with your GP
Bisoprolol is to control your BP, so I guess it depends how much on the 'low side' your current readings are as to whether reducing the dose would be a sensible option. Suffice to say you're meant to have an annual medication review so I'd discuss it, initially with your GP, but ultimately with your cardiologist/cardiology team.
I would talk with your Cardiologist, GP or Pharmacist to review your prescriptions. You need to find out which are 'life long' drugs and how they all affect each other.
I was on Clopidogrel and Lanzaprazole as well as aspirin after my stents. Clopidogrel was stopped after 12 months but no mention of stopping Lanzaprazole. I found enteric coated aspirin in my local Home Bargains for under £1 so stopped the dispersible aspirin and Lanzaprazole too.
I have been taking many pills for my HF including a daily baby aspirin for the last 10 years with no gastro upsets, I think due to me spacing my meds out and ALWAYS eating a little something with them. My Dr. has never prescribed a PPI for me and it is one medication that is not for long term usage if possible. Great advice from Lowerfield_no_more.
Hi,
Hope you are well
Bisoprolol for me have been good regarding keeping my arrhythmia in check as well as taking flecanide.
I know I’m moaning about weight gain while taking bisoprolol whether it’s the medication or not exercising enough, stopping smoking?
Are you suffering with side effects?
I don’t think I have any side effects, but keen to reduce meds where possible because of long term effects.
Interesting, I hate exercise and do need to loose weight and wondered if you are alluding that bisopropol may be causing weight gain.
12 months on and more worries.
Can I reduce my Bisoprolol further?
5 and a half months after HA 
12 months post heart attack.
Magnesium Glycinate & Selenium - ok to take with post HA meds?
