coumadin vs plavix

[flw]

I am currently on plavix due to having several stents placed after two heart attacks.

I am suffering severe joint and back pain that I believe is cause by the plavix.  Does coumadin do the same thing as plavix, and if so, can I switch to coumadin to avoind the back and joint pain?  If not, what can I do.

Thanks

[Encephalomalcia]

Severe joint and back pain usually is not a side effect of Plavix.  Coumadin is more powerful than Plavix.  The Plavix is important to take especially if you have coated stents.  You may want to be checked for arthritis that may be flaring up.  Coumadin is not to be used in persons with high cholesterol.  

[kenkeith]

Coumadin and Plavix are both anti-platelet agents as well as aspirin. The most widely studied and prescribed antiplatelet agent for the prevention of stroke and other serious vascular events among high vascular risk patients is aspirin. I take aspirin daily prior to CHF..

Plavix and aspirin for preventing stroke and other serious vascular events in high vascular risk patients. Up to one year after a stent implant, plavix and aspirin are the recommended protocol as statistics have shown a high risk for clot.

The anticoagulant, coumadin, and the antiplatelet agent, aspirin, have been shown to have similar benefits after myocardial infarction. As these agents have different mechanisms of action, the beneficial effects of coumadin  and aspirin may be additive after myocardial infarction.

For a statistic, Coumadin and aspirin increased annual rates of major bleeding.  For your consideration, several risk factors, such as older age, diabetes, heart failure, and decreased kidney function, had the highest risks for heart attacks and strokes. Older patients who previously had a stroke, gastrointestinal bleeding episode, kidney disease, or atrial fibrillation were at higher risk for bleeding. Numbers of deaths did not differ between treatments. In patients with low or average risk for bleeding, the numbers of heart and stroke events prevented with combination therapy exceeded the numbers of major bleeding episodes that it caused.  

Coumadin and aspirin may be as effective or better than plavix depending on the variables for contraindiaction.

[NTB]

> Coumadin and Plavix are both anti-platelet agents as well as aspirin

that might just be a typo, but I'll go ahead anyway and point out that Coumadin is not antiplatelet, it's an anticoagulant. It works as a vitamin K antagonist, and vit K is necessary for the synthesis of prothrombin and Factor VII.

Generally, anticoagulants are for the venous side, antiplatelets are for the artery side, and both are being given for within the heart, as in afib -  which is like a cross between the two sides. Though researchers are trying anticoagulants for all kinds of problems clotting.

To flw: maybe you can go with ticlopidine instead of your clopidigrel. Ticlopidine was the predecessor.

[kenkeith]

NTB, you are absolutely correct. I had read the difference in anti-platelet and anticoangulant between the agents as you stated, but I flet it unnecessary to get that technical with the chemistry.  The point I wanted to make was there are different mechanisms of action and to evaluate what is appropriate (the doctor should know!).

QUOTE: "Generally, anticoagulants are for the venous side, antiplatelets are for the artery side, and both are being given for within the heart, as in afib -  which is like a cross between the two sides. Though researchers are trying anticoagulants for all kinds of problems clotting."  That is interesting information and I did not know the medications distinquished the application  between artery and veins.  Thanks. With that information an anticoangulant may not have favorable beneficial/risk application for venous clotting.

[NTB]

right, and so you won't see clopidogrel or GP IIb/IIIa inhibitors used to prevent DVT, eg.

Let's see if I can run through the types of anticoagulants, to refresh myself:
1) the coumarins, which inhibit vit K and have been around since at least 50 years
2) heparin, which is derived mainly from pig intestines
2a) Low Molecular Weight Heparins, like Lovenox/enoxaparin - which are separated out from heparin by size and don't have the extra parts which make heparin erratic
2b) synthetic pentasaccharides, which have only the 5 sugar-chain that is the active part of heparin - like fondaparinux
3) direct Factor Xa inhibitors, like rivaroxaban and apixaban which might be on the market soon. IIRC rivaroxaban is already approved for post orthopedic surgery only. Just think of the sawing and hammering that goes on in bone surgery, and that tells why clot formation is a big danger.
4) direct thrombin inhibitors like dabigatran, which are inspired by leech saliva