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Adding the blood thinner Plavix to aspirin can reduce the risk of stroke in patients with atrial fibrillation. This irregular heart rhythm increases the risk of a blood clot landing in the brain and causing a stroke. A new study shows that the risk of stroke went from more than 3 percent per year for those on aspirin alone to just over 2 percent per year for those on the combination. The downside was an increased risk of serious bleeding episodes.
[New England Journal of Medicine, May 14, 2009]
http://content.nejm.org/cgi/content/short/360/20/2066
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Perhaps, as stated, that combination reduced the rate of a "blood clot landing in the brain", however the stated increased risk of "serious bleeding episodes" includes, or is specifically referring to, the considerable increased risk of cerebral hemorrhage when taking daily aspirin alone. Adding Plavix to the mix sounds like a deadly combination to me. Too risky. The combination might keep the clots from lodging, but if the drugs give you a massive cerebral hemorrhage what is the difference? You are still dead.
PEOPLE'S PHARMACY RESPONSE: THE DISTINGUISHED DOCTORS WHO DID THIS RESEARCH BELIEVE THAT THE BENEFITS OUTWEIGH THE RISKS. CLEARLY, THOUGH, THIS IS NOT A DO-IT-YOURSELF PROJECT!
I have been taking Plavix 75 mg. once per day since 2005 when I had a TIA. I am allergic to aspirin so that was not an option. However, I question the value of the Plavix, since I have had two strokes, one in July of 2007, and a smaller one in January of 2008. My cholesterol is very good, also blood pressure good. I am type 2 diabetic and the blood sugar is under control, even rather low with glucotrol.
I would think the Plavix would have prevented the strokes, but the doctors just say it is a good drug and I should keep taking it. I wonder about it.
And were these "distinguished doctors" involved in any way (Say, financially) with the makers of Plavix? A 1% change is not very much, and it sounds like an attempt to sell more Plavix to me!!
PEOPLE'S PHARMACY RESPONSE: EXCELLENT QUESTION, KM, AND A DISCOURAGING ANSWER. PLAVIX IS MARKETED BY SANOFI-AVENTIS AND BRISTOL-MYERS-SQUIBB. THE STUDY WAS SUPPORTED BY GRANTS FROM THOSE TWO COMPANIES. SEVERAL OF THE DOCTORS WHO WROTE THE REPORT RECEIVE CONSULTING AND/OR LECTURE FEES FROM SANOFI-AVENTIS AND/OR BRISTOL-MYERS-SQUIBB.