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Antiplatelet drugs - P2Y12 inhibitors

Blood thinners - clopidogrel; Antiplatelet therapy - clopidogrel; Thienopyridines

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Plaque buildup in arteries

Description

Platelets are small cells in your blood that your body uses to form clots and stop bleeding. If you have too many platelets or your platelets stick together too much, you are more likely to form clots. This clotting can take place on the inside of your arteries and lead to heart attack or stroke.

Antiplatelet drugs work to make your platelets less sticky and thereby help prevent blood clots from forming in your arteries.

Who Should Take Antiplatelet Drugs

Antiplatelet drugs may be used to:

Your health care provider will choose which one of these drugs are best for your problem. At times, you may be asked to take low dose aspirin along with one of these drugs.

Side Effects

Side effects of this medicine may include:

Before you start taking these medicines, tell your provider if:

There are a number of other possible side effects, depending on which drug you are prescribed. For example:

Taking P2Y12 Inhibitors

This medicine is taken as a pill. Your provider may change your dose from time to time.

Take this medicine with food and plenty of water to reduce side effects. You may need to stop taking clopidogrel before you have surgery or dental work. Do not just stop taking your medicine without first talking with your provider.

Talk with your provider before taking any of these drugs:

Do not take other drugs that may have aspirin or ibuprofen in them before talking with your provider. Read the labels on cold and flu medicines. Ask what other medicines are safe for you to take for aches and pains, colds, or the flu.

If you have any type of procedure scheduled, you may need to stop these drugs 5 to 7 days before hand. However, always check with your provider first about whether it is safe to stop.

Tell your provider if you are pregnant or planning to become pregnant, or breastfeeding or planning to breastfeed. Women in the later stages of pregnancy should not take clopidogrel. Clopidogrel can be passed to infants through breast milk.

Talk with your provider if you have liver or kidney disease.

If you miss a dose:

Store these drugs and all other medicines in a cool, dry place. Keep them where children cannot get to them.

When to Call the Doctor

Contact your provider if you have any of these side effects and they do not go away:

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References

Abraham NS, Hlatky MA, Antman EM, et al. ACCF/ACG/AHA 2010 expert consensus document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation. 2010;122(24):2619-2633. PMID: 21060077 pubmed.ncbi.nlm.nih.gov/21060077/.

Alberts MJ. Prevention and management of ischemic stroke. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 45.

Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;64(18):1929-1949. PMID: 25077860 pubmed.ncbi.nlm.nih.gov/25077860/.

January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74(4):599. PMID: 30703431 pubmed.ncbi.nlm.nih.gov/30703431/.

Kumbhani DJ, Bhatt DL. Percutaneous coronary intervention. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 41.

Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

Morrow DA, de Lemos JA. Stable ischemic heart disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 40.

Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019;50(12):e344-e418. PMID: 31662037 pubmed.ncbi.nlm.nih.gov/31662037/.

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Review Date: 8/23/2022  

Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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