Q: Can you tell me if aspirin is just as safe and effective a blood thinner as Plavix? Is there any benefit to the more expensive Plavix if you do not have ulcers? If you have occasional acid reflux, does aspirin aggravate this?
My husband had a light stroke two years ago and was put on Plavix. It would be much cheaper to take aspirin if it is just as effective.
A: Anticoagulants and antiplatelet drugs are medications used to reduce a person’s risk for developing blood clots. Clots form when platelets stick together and proteins in the blood bind together. When clots form in a person’s blood vessels, they can block circulation and cause serious health issues. When they form in the arteries or heart, they obstruct the flow of blood and can cause a heart attack. When a clot forms in the blood vessels of the brain, a stroke can result. Anticoagulants and antiplatelet drugs stop platelets from sticking and stops proteins from binding together.
Many individuals with heart issues are placed on anti-coagulants to slow blood clotting and prevent complications. Anticoagulants stop blood from forming clots. Warfarin (Coumadin) and heparin are the old standbys but there are newer medications on the market that are gaining in popularity. Antiplatelet medications prevent platelets from sticking together to form a clot and they also have other subtle but helpful properties. Aspirin is the old standby antiplatelet drug but yet again, newer medications that include Plavix and Ticlid are now available options. Some cardiac patients use both aspirin and medications such as Plavix to prevent heart attacks. Stroke prevention is commonly controlled with aspirin; however, there are circumstances where Plavix has more benefit. So, it all depends on why your husband requires the medication. This will necessitate you speaking with his primary care physician or cardiologist for the answer you are seeking.
As as point of information, warfarin requires regular monitoring through lab testing, even when taken at the specific dosage prescribed and it also increases a person’s risk of serious bleeding issues. An INR (international normalized ratio) testing will determine how quickly blood clots. Dosing may be modified periodically in an attempt to maintain a level appropriate for a specific condition. Many over-the-counter and prescription drugs (particularly antibiotics, NSAIDS (non-steroidal anti-inflammatory drugs, and those for acid reflux) can interact with warfarin and change the INR level, causing complications. Therefore, a primary care physician or cardiologist must know every medication an individual is on which will help with dosing maintenance.
Plavix does not require monitoring; however, it affects platelet function and bleeding times for up to 10 days. Individuals who plan on having dental work or elective surgery performed may have to curtail the medication or aspirin usage because of the risk of a bleed. This medication was prescribed for your husband to keep his blood from clotting following his stroke. Side effects that can occur include bruising, itching, pain, swelling, and red/purple spots on the skin.
Again, I cannot tell you whether aspirin therapy would be sufficient for your husband. I don’t know his full medical history. This is a decision best left to the doctor who has his full medical history and can safely make that decision. I can appreciate that money is a factor and you would like to save the cost of the prescription; however, his health is certainly more important than saving money if the Plavix is endorsed. Make that appointment for your husband and join him on his next regular medical visit. Explain what you have indicated to me. If the doctor is willing to go along with aspirin therapy, you will realize an appreciable savings. If not, stick with the Plavix.
