Use of Plavix and Stomach Drugs Ups Risk of Death and Hospitalization

Although Plavix is prescribed to reduce the risk of heart attacks, new research suggests that when the anti-clotting drug is taken together with Nexium, Prilosec or other similar stomach medications to prevent gastrointestinal bleeding, users face an increased risk of death or being readmitted to the hospital with heart problems.

Plavix (clopidogrel), which is manufactured by Bristol-Myers Squibb Co. and Sanofi-Aventis SA, is used by millions of Americans and generated sales of $7.3 billion last year.

In many cases heartburn drugs known as proton pump inhibitors, which include Nexium and Prilosec, are prescribed together with Plavix to reduce the risk of potentially life-threatening stomach bleeds. However, a new study published on March 3, 2009, in the Journal of the American Medical Association, found that patients were 25% more likely to be readmitted to hospital or die if they were also taking a proton pump inhibitors with Plavix.

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Researchers followed 8205 VA patients who had suffered a heart attack or chest pain known as unstable angina. The patients were followed for 18 months after their discharge from 127 Veteran Affairs hospitals.

Nearly two-thirds of the patients in the study (about 5200 people) were given Plavix and Nexium, Prilosec or another stomach medication in the same class. The remaining patients were given Plavix alone.

For those who were taking both drugs, about 30% died or were readmitted to the hospital due to heart problems, compared with only 21% of those who were taking Plavix without a heartburn drug.

Researchers have suggested that doctors should only prescribe PPI drugs along with Plavix if there is already a history of gastrointestinal bleeding which may be life-threatening.

Prior studies have suggested that drugs like Prilosec and Nexium inhibit the operation of Plavix.

In January 2009, the FDA issued an Early Communication to notify healthcare providers that they are reviewing these Plavix problems to determine if any regulatory actions are necessary. In the statement, the FDA indicated that doctors should re-evaluate the need for patients to use Plavix with Prilosec OTC and other PPI drugs.

Stomach side effects of Plavix can increase the risk of potentially life-threatening gastrointestinal bleeding, which is why doctors often prescribe the heartburn drugs. However, other medications that can be used to reduce stomach acid, such as H2 blockers like Zantac, Pepcid, Tagamet and Axid, or antacids, can reduce stomach acid and the FDA has suggested that they do not appear to interfere with the antiplatelet activity of Plavix.

1 Comments

  • CharlesMay 12, 2010 at 12:44 am

    On March 1,2004 I had 2 stents in my heart. 3 weeks later I had two more put in. Found my 2 main arteries were 90+% plus blocked. Then June 22, 2004 I was flown out and had 3 more stents. Four days later I had 1 more. They had to wait because my platelets dropped to 30,000 to 40,000. All of the stents were done at St. Joseph's Medical Center in Towson, Md. Then on Nov. 14,2006 I was rushed again [Show More]On March 1,2004 I had 2 stents in my heart. 3 weeks later I had two more put in. Found my 2 main arteries were 90+% plus blocked. Then June 22, 2004 I was flown out and had 3 more stents. Four days later I had 1 more. They had to wait because my platelets dropped to 30,000 to 40,000. All of the stents were done at St. Joseph's Medical Center in Towson, Md. Then on Nov. 14,2006 I was rushed again to St. Joseph's where it was found I had more blockages. Then on Nov. 20 I under went surgery for 5 very extensive bypases. That night I was rushed back in to surgery because I started to hemorrhage and reopened. I was given 3 units of blood and 3 units of plasma. I was discharged Nov. 24, 2006. Did fine except being very sore. During this time I had been on Plavix, also took some Priosec. But as time went on, I started to have severe chest pains, nausea, blood pressure as high as 160/110-120, and pulse 110 -120. Also times not knowing anything, or unresponsive. Never knowing when it would hit me, for unknown reason. I've been in and out of hospitals, flown out, stress tests, heart caths, and no one could figure out what was going on. EMT's and Paramedics all know me because they have had me so many times. They have told me that I've scared them when they had me. One told me that the word was out that if you get Ron get going. No one knows what I've gone through. My sister who was a nurse was told that they thought I was having anxiety attacks. She and I are very, very close. One day she called me and asked how I was doing. Then asking all for the different questions, like what was I worried about, or upset about. I was furious when she told me what she was told. I hung up on her, and did not call her for a few days, which really hurt me. And both being Christians made it worse. Then the 2nd week of Feb. 2009 I had 4 emergency ambulance calls in one week. Admitted to the hospital, a stress test, and sent to St joseph's again for another heart cath. But nothing showed up. On March 3, 2009 I had an endoscopy. The night before my sister and brother-in-law were listening to the news. And that is when they heard about the reaction with the combination of Plavix and priosec. They both said that is {Butch) that is what they call me. The next day she told the surgeon about what they heard. He said to get off Prilosec immediately. I"ve had some problems with chest pains, and etc. But nothing what I had when I was on Priosec. I"ve lost a lot of work when I was working. I still will not go to far from my home.It stil scares me that I might get one of those spells, and I would be far from home and my close family. It is so frustration to think it took so long for someone to fing out what was going on. I"m a widower, but very close to my family. And to put them through so much. I"ve been told by emergency personell that they thought for sure I was having a heart attack. But thank the good Lord I never had one. But through it all all the doctores, EMT's, and Paramedics were and have been tremendious. But why did it take so long for this information to get our???? I still talk to people who do not know about this problem.

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