Google Answers Logo
View Question
 
Q: Too much meds? ( Answered,   2 Comments )
Question  
Subject: Too much meds?
Category: Health
Asked by: sylk126-ga
List Price: $25.00
Posted: 01 Mar 2006 18:32 PST
Expires: 31 Mar 2006 18:32 PST
Question ID: 702704
I am taking Plavix 75mg and aspirin 81mg once a day should I be taking both?
Answer  
Subject: Re: Too much meds?
Answered By: sublime1-ga on 01 Mar 2006 21:00 PST
 
sylk...

The use of the combination of Plavix and aspirin, in those
specific doses, is common for certain conditions, and is 
only contraindicated for those with greater sensitivity 
toward stomach irritation, such as those patients with
ulcers or a tendency toward gastrointestinal bleeding.

The conditions for which this combination of medications
is prescribed include risk of cardiovascular death, stroke,
myocardial infarction (heart attack), or refractory ischemia.

At the bottom of this page from RXlist.com are the results
of a study called CURE, in which the combination of aspirin
and Plavix was tested against the combination of aspirin and
a placebo. The results indicated a significant risk reduction
for the conditions noted above, particularly for myocardial
infarction. See Figure 2 and 3:
http://www.rxlist.com/cgi/generic/clopidog_cp.htm#CS

Table 3, on the following page, shows the increased risk
of stomach bleeding when aspirin and Plavix are used in
combination, in contrast to aspirin alone:
http://www.rxlist.com/cgi/generic/clopidog_ad.htm#AR

The findings are summarized at the beginning of this page
from the same site:

"In patients with recent TIA or stroke who are at high risk
 for recurrent ischemic events, the combination of aspirin
 and Plavix has not been shown to be more effective than
 Plavix alone, but the combination has been shown to
 increase major bleeding.

 GI Bleeding: In CAPRIE, Plavix was associated with a rate
 of gastrointestinal bleeding of 2.0%, vs. 2.7% on aspirin.
 In CURE, the incidence of major gastrointestinal bleeding
 was 1.3% vs. 0.7% (Plavix + aspirin vs. placebo + aspirin,
 respectively). Plavix should be used with caution in
 patients who have lesions with a propensity to bleed (such
 as ulcers). Drugs that might induce such lesions should be
 used with caution in patients taking Plavix.

 Use in Hepatically Impaired Patients: Experience is limited
 in patients with severe hepatic disease, who may have
 bleeding diatheses. Plavix should be used with caution in
 this population.

"Use in Renally-impaired Patients: Experience is limited in
 patients with severe renal impairment. Plavix should be used
 with caution in this population."
http://www.rxlist.com/cgi/generic/clopidog_wcp.htm

The following PDF file from the East Lancashire Medicines
Management Board in the United Kingdom gives information
about conditions for which Plavix is recommended in 
combination with aspirin, at the bottom of page 1, which
include the risk of myocardial infarction and non-ST
segment elevation acute coronary syndrome (NSTEMI ACS):
http://www.elmmb.nhs.uk/Clopidogrel%20policy%20v82.pdf


In summary, 75mg is the standard dosage for ongoing use
of Plavix, and 81mg is the lowest dosage of aspirin used
in combination with Plavix. There's no reason to consider
these dosages to be too high unless you are experiencing
unpleasant side effects - particularly gastrointestinal
bleeding or discomfort. There are also some conditions
which recommend the discontinuation of Plavix after 12
months, such as the non-ST segment elevation acute 
coronary syndrome (NSTEMI ACS) noted above, while for 
other conditions, the continuation of both is acceptable.
Only your physician can make that determination, depending
on the nature of your condition(s).

If you are *feeling* that the combination currently amounts
to too much medication, then you should feel perfectly 
entitled to request a review of your prescription by your
primary care physician or a specialist of his recommendation.


Please do not rate this answer until you are satisfied that  
the answer cannot be improved upon by way of a dialog  
established through the "Request for Clarification" process. 
 
A user's guide on this topic is on skermit-ga's site, here: 
http://www.christopherwu.net/google_answers/answer_guide.html#how_clarify 
 
sublime1-ga


Additional information may be found from an exploration of
the links resulting from the Google searches outlined below.

Searches done, via Google:

Plavix 75mg contraindications aspirin
://www.google.com/search?q=Plavix+75mg+contraindications+aspirin
Comments  
Subject: Re: Too much meds?
From: joe916-ga on 01 Mar 2006 22:12 PST
 
The info below was obtained from the site
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203403.html


Other medicines?Although certain medicines should not be used together
at all, in other cases two different medicines may be used together
even if an interaction might occur. In these cases, your doctor may
want to change the dose, or other precautions may be necessary. When
you are taking clopidogrel, it is especially important that your
health care professional know if you are taking any of the following:

Inflammation or pain medicine, except narcotics?The chance of serious
bleeding may be increased


I would double-check with you MD just to be safe. 
You mite need to be careful with cuts etc...
Subject: Re: Too much meds?
From: markvmd-ga on 02 Mar 2006 09:49 PST
 
It also depends on why you have been prescribed these meds. Plavix and
aspirin are strongly recommended for drug-eluting stent patients, for
instance, with the aspirin therapy suggested for one year.

Usually the aspirin should be coated so as to disolve in the intestine
rather than the stomach.

Important Disclaimer: Answers and comments provided on Google Answers are general information, and are not intended to substitute for informed professional medical, psychiatric, psychological, tax, legal, investment, accounting, or other professional advice. Google does not endorse, and expressly disclaims liability for any product, manufacturer, distributor, service or service provider mentioned or any opinion expressed in answers or comments. Please read carefully the Google Answers Terms of Service.

If you feel that you have found inappropriate content, please let us know by emailing us at answers-support@google.com with the question ID listed above. Thank you.
Search Google Answers for
Google Answers  


Google Home - Answers FAQ - Terms of Service - Privacy Policy