DEAR DR. GOTT: I’ve seen three different cardiologists and have gotten three different answers to whether it is safe to go off Plavix for a short time before and after having surgery. (I take it because I had a heart attack.) Some say yes and some say no. I’m hoping to have surgery to correct a hearing problem.
What do you think?
DEAR READER: Plavix is prescribed to prevent blood clots. It is commonly taken following a heart attack or stroke and by some individuals with certain heart or blood vessel disorders. Therefore, while on the medication, blood flows more easily, making excessive loss even with a relatively minor injury or dental procedure, a possibility.
With your pending procedure, your surgeon should be advised you are on the medication. As you have discovered and while controversy abounds, The FDA information sheet which includes molecular composition, side effects, dosage, identification and more, states that if undergoing surgery where an antiplatelet effect isn’t desired, discontinuation of the Plavix five days before is necessary. Following surgery, you can then restart the drug under the physician’s direction. In my opinion, the choice should be made between the operating surgeon and you; however, I cannot give you a firm answer.
To aid in the decision-making, your PT (prothrombin time) and other lab test results should be made available to the otolaryngologist or other specialist performing the procedure on your ear. Once you get his or her direction, I recommend you advise your cardiologist and primary care physician of that decision. Both may go along with the choice or should give you adequate reasons for opposing it. At least then everyone will be on the right page. Remember, the final decision is ultimately yours. Only you have the right to decide whether the risks outweigh the benefits, but you need to be well informed beforehand.
Readers who would like related information can order my Health Reports “Ear Infections and Disorders and “Coronary Artery Disease” by sending $2 US for each report and a self-addressed, stamped number 10 envelope to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039-0433. Be sure to mention the title when writing or print out an order form from my website, www.AskDrGottMD.com.
