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Jan 30, 2023

Heart Health


Antiplatelet Medications

If you're at risk of developing a blood clot, heart attack, and/or stroke, antiplatelet drugs may be a suitable agent for you.

What are platelets?

Your blood contains tiny cells called platelets, which your body uses to coagulate and obstruct bleeding. When there is a wound or injury to your body, platelets aggregate or adhere to one another and form a clot. Platelets naturally aid in the formation of these blood clots to stop excessive bleeding.

How platelets work

If your platelet count is low, your risk of bleeding is higher. If your platelet count is high or your platelets clump together too much, you risk developing clots that stop blood flow. Heart attacks or strokes may result from this clotting, which can occur inside your arteries/ bloodstream.

What are antiplatelets?

Antiplatelets are a drug class of medications that are essentially used to stop the platelets in your body from coagulating to form a clot.

Aspirin (acetylsalicylic acid)—Bayer, Bufferin, Ecotrin, Ascriptin, Durlaza): 3—325 mg daily

  • Aspirin works by irreversibly binding to an enzyme called COX-1 and COX-2, resulting in a reduction of prostaglandin (PG) and thromboxane A2 (TXA2) production, which are responsible for causing platelet aggregation and platelet production.
  • The first line of anti-platelet medication is often daily aspirin for the primary and secondary prevention of heart diease.
  • Aspirin has been shown to decrease incidences of myocardial infarction (heart attack), cardiovascular (CV) events, and death. This medication is also used for individuals with stable ischemic heart disease (SIHD) indefinitely.
  • This medication is available over-the-counter (OTC) and by prescription
  • Side effects:
    • Dyspepsia (indigestion)
    • Heartburn
    • Nausea
    • Tinnitus (ringing in the ears)
  • Warning:
    • If you've recently experienced stomach or intestinal bleeding, have a bleeding problem like hemophilia, are allergic to NSAIDs (non-steroidal anti- inflammatory drugs) such as Advil, Motrin, Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, or Feldene, you should not use aspirin.
    • Children and adolescents with a fever, flu-like symptoms, or chickenpox should not use this medication. Reye's syndrome, a dangerous and occasionally deadly illness in children, can be caused by salicylates.

Clopidogrel (Plavix): 75 mg daily

  • After experiencing a heart attack, severe chest pain (angina), or circulation issues, clopidogrel is used to reduce your risk of suffering from a stroke, blood clot, or serious cardiac/heart conditions
  • Clopidogrel is also used to treat stable ischemic heart disease (SIHD) and stroke in individuals that are unable to take aspirin.
  • Side effects:
    • Serious bleeding, such as gastrointestinal bleeding, intracranial bleeding (bleeding inside your skull), or nose bleeds
    • Signs of a blood clot (i.e. numbness or weakness, confusion, problems with vision or speech.
    • Jaundice (yellowing of your eyes or skin)
    • Increased heartbeats
    • Headache
    • Weakness
    • Shortness of breath
  • Warning: Your risk of bleeding, which can be serious or life-threatening, is increased by clopidogrel. If you have any active bleeding, such as a stomach ulcer or brain hemorrhage, you should not take clopidogrel.
  • Drug interactions: clopidogrel should be avoided in combination with omeprazole and esomeprazole.

Prasugrel (Effient): 10 mg daily (commonly taken with aspirin). 5 mg daily in individuals that weigh less than 60 kg (132 pounds).

  • After having a heart attack or experiencing significant chest pain, prasugrel is used to unblock clogged arteries in individuals who have had balloon angioplasty. Your chance of having another heart attack or stroke may be reduced with the use of prasugrel.
  • Side effects:
    • Bleeding (more than clopidogrel; not recommended for individuals older than 75 years due to excessive bleeding risk)
    • Feeling light-headed
    • Pink or brown urine
    • Signs of a blood clot (i.e. abrupt numbness or weakness, confusion, problems with vision or speech, pale skin, purple spots on your skin and/or mouth, jaundice (yellowing of your skin or eyes).
  • Warning: Your risk of bleeding, which can be serious or life-threatening, is increased by prasugrel. If you have any active bleeding, such as a stomach ulcer or brain hemorrhage, you should not take prasugrel.

Ticagrelor (Brillinta): 90 mg twice a day for 1 year, then 60 mg twice a day

  • Low-dose aspirin is typically used together with ticagrelor.
  • With ticagrelor, you can reduce your risk of having a heart attack, stroke, or dying from a blocked artery or a previous heart attack.
  • If you have coronary artery disease and have received stent treatment to open blocked arteries, ticagrelor is also used to reduce your risk of blood clots.
  • Side effects:
    • Bleeding
    • Slow heartbeats
    • Easy bruising
    • Red, pink, or brown urine
    • Cough up blood or vomit that looks like coffee grounds
    • Shortness of breath
  • Warning: Your risk of bleeding, which can be serious or life-threatening, is increased by ticagrelor. If you have any active bleeding, such as a stomach ulcer or brain hemorrhage, you should not take ticagrelor.

What are antiplatelet medications used to treat?

Anti-platelet medications play a major role in treating the following:

  • Ischemic strokes (strokes that are caused by a blood clot)
  • Angina
  • Stable ischemic heart disease (SIHD)
  • Acute coronary syndrome (ACS)
  • Myocardial infarction (heart attack) prevention
  • Atrial fibrillation
  • Prevent heart attack and stroke for those with peripheral arterial disease (PAD)
  • Stent thrombosis or angioplasty; prevent clots from developing inside stents that have been placed into your arteries to widen them.
  • Surgery following bypass graft surgery that uses a synthetic or prosthetic graft performed on arteries below your knee

What should I do if I miss a dose?

If you forget to take a dose, take it as soon as you remember unless it's almost time for your next dose. In this case, skip the forgotten dose and take the next one at the usual time. Do not take 2 doses together to make up for a missed dose.

Speak with your doctor

Antiplatelet medications protect against various conditions, such as heart attack, stroke, and cardiovascular death. Talk to your healthcare provider today and send your prescription to Marley Drug. Save up to 95% compared to your local pharmacy by using Marley Drug.

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