Plavix and Morphine Combo May Cause Problems Following Heart Attack

New research suggests that combining the powerful painkiller morphine with Plavix may decrease the effectiveness of the blood thinner, raising concerns about use of the medications following a heart attack. 

In a study published in the Journal of the American College of Cardiology on December 4, researchers warn that doctors may be making it harder to treat heart attacks when they give patients both Plavix and morphine, a common emergency room response for victims.

Plavix is typically given to heart attack patients to reduce and eliminate blood clots, taking pressure off the heart and addressing the heart attack itself. Those patients are also usually suffering from intense pain, which is where the morphine typically comes into play. According to the findings of this new research, combining Plavix and morphine may be counterproductive.

Researchers looked at 24 patients, some of whom were given Plavix together with morphine, while others were given Plavix and a placebo. They found that morphine use delayed the effects of Plavix for up to two hours. In addition, it dropped blood levels of Plavix by half, delaying the body’s ability to absorb the drug. It also seemed to reduce Plavix’s ability to break up blood clots.

As a result of the findings, researchers recommend that doctors not use the two drugs at the same time. It is unclear if other blood thinners, such as aspirin, are similarly affected.

Plavix Effectiveness Concerns

Plavix (clopidrogrel) is a blockbuster medication that has been used by millions of people in the United States and is commonly prescribed to prevent blood platelets from sticking together and forming clots. There are between 2.5 million and 3 million Plavix prescriptions handed out each month in the U.S.

In recent years, some concerns have emerged about the potential side effects of Plavix and whether many of these prescriptions may have been unnecessary due to genetic resistance to the medication. While Plavix has been promoted as being better at its job than aspirin, with a cost that is many times higher than aspirin, questions have been raised about the effectiveness of Plavix for many patients and whether it actually provides any benefit over aspirin.

In August 2009, researchers from the University of Maryland identified a gene variant found in about one-third of the population that may signal a reduced effectiveness of Plavix. People with the CYP2C19 variant have reduced functioning of a liver enzyme that is supposed to convert Plavix from its inactive form to its active form, potentially making Plavix ineffective at reducing the risk of blood clots.

Unnecessary use of Plavix may expose individuals to an increased risk of gastrointestinal bleeding, severe ulcers, a rare blood disorder known as thrombotic thrombocytopenic pupura (TTP) and other injuries.

Bristol-Myers Squibb and Sanofi-Aventis currently face hundreds of Plavix injury lawsuits filed in state and federal courts throughout the United States, alleging that the drug makers have placed their desire for profits before the safety of consumers by aggressively marketing the medication while failing to adequately warn consumers or the medical community about the health risks associated with the medication.

Earlier this year, the U.S. Judicial Panel on Multidistrict Litigation (JPML) centralized all Plavix cases filed in the federal court system before U.S. District Judge Freda L. Wolfson in the District of New Jersey for coordinated handling during pretrial proceedings.