Leaflet Details
| Title | Antiplatelet Medication Advice in Vascular Patients |
| Department | Vascular Surgery |
| Author(s) | Dr Md Mahfooz Buksh |
| Review Date | January 2020 |
| Next Review | January 2022 |
| Download | A5 Booklet PDF |
| Accessibility Options | Click on the Recite Me button to show our accessibility resources |
Patient Information
Introduction
This leaflet explains the importance of antiplatelet medications (blood thinning medicines) such as Aspirin or Clopidogrel (Plavix) prescribed as you have undergone a vascular procedure such as angioplasty, stenting, or bypass operations. If you have further questions please speak to your GP or Nurse caring for you.
Why am I prescribed this Antiplatelet medicine?
Normally, if there is damage to blood vessel, a blood clot forms to protect and repair the damage to aid the healing process in blood vessels. One of the blood cells called platelets helps in the formation of clots. When platelets come close to damaged areas of a blood vessel, they start attracting other platelets causing them to stick together to form a blood clot.
Antiplatelets such as Aspirin or Clopidogrel reduce the ability of the platelets to stick together and reduce the risk of clots forming. Clots formed inside the blood vessels hamper the blood flow causing body organs to receive less blood. Depending on the organ affected such as: the heart, it can cause a heart attack; in brain, it can cause a stroke; in legs, it can cause leg pain on walking. However, it can even cause the organ to reach a critical level where supply to legs is critically stopped for example.
The added benefit of having an antiplatelet is it prevents a clot formation in the arteries in your heart and preventing a heart attack, prevents formation of clots in your brain hence reduces the chance of a stroke.
How should I take the medication?
Swallow the number of tablets or capsules prescribed with a glass of water. If you are taking Aspirin you should take one, once daily after food to help protect your stomach. If you have been prescribed CLOPIDOGREL you should avoid drinking grapefruit juice. If you find it difficult to swallow your medication, speak to your doctor or pharmacist.
How can I help my recovery?
Vascular treatment will usually improve the blood flow through the treated area but will not cure the underlying arterial disease. Arteries often become narrow again so it is important to follow the advice that you will have already been given about how you can help yourself to avoid more problems with hardening and blockage of the arteries. You can improve your general health by adhering to the following.
- Avoid tobacco and passive smoke but most importantly do not smoke yourself.
- Eat a healthy, low fat diet and lose weight if necessary.
- Take regular exercise, aiming for a decent walk at least five days a week; look after your feet.
- Make sure that underlying diabetes, high blood pressure, or high cholesterol are properly treated and controlled. These are usually managed with the help of your GP.
- Take the medicines which protect you from arterial disease, including antiplatelet drugs (Aspirin or Clopidogrel) and Cholesterol-lowering drugs (Statins, Fibrates, or Ezetimibe).
How long will I have to take the Antiplatelets for?
If you have been prescribed Aspirin only - as long as you do not experience any side effects - you will need to take aspirin lifelong.
If you have a STENT inserted inside your arteries during a procedure, you must continue to take a tablet called Clopidogrel (where indicated) alongside Aspirin to prevent you from blocking your arteries in your legs. When Aspirin and Clopidogrel are taken together, this combination is called Dual antiplatelet therapy (DAPT). This is prescribed until the artery wall covers the stent with a smooth lining of cells (Endothelium) to help prevent the formation of clots from forming in the newly inserted stents, and has to be continued for 3-12 months as advised by your doctor.
The duration of dual antiplatelet varies from patient to patient and after that you will need to continue either one Aspirin or Clopidogrel lifelong.
It is very important that you continue taking this drug as prescribed to prevent small clots forming around your stent/bypass operation and leading to failure of the procedure. You should not stop these medications without speaking to your doctor.
Are there any side effects?
The most common side effects of low dose ASPIRIN are stomach upset and indigestion. The most common side effects of CLOPIDOGREL are stomach upset and bleeding more easily than normal.
You may have nosebleeds, heavier periods, bleeding gums or bruising. Being on antiplatelet medication increases the chances of formation of bruises, but you should speak to your GP if you notice unexpected bruises or bleeding from any part of your body.
Precautions
You should inform your doctor if you have any of the following conditions.
- Medical condition that puts you at risk of internal bleeding (like a stomach ulcer).
- A blood disorder such as haemophilia.
- A recent serious injury.
- Any recent surgery.
- Liver or kidney problems.
- Any planned surgery
Medications which alter effectiveness of blood thinning medicines
- Avoid taking NSAID painkillers like Ibuprofen and Diclofenac; they will increase the chances of bleeding. You can take Paracetamol with Aspirin and/or Clopidogrel safely.
- Indigestion medicines such as Omeprazole and Esomeprazole may reduce the effect of Clopidogrel. Ask your GP or Consultant to prescribe other alternatives.
I have a planned surgery in future, what should I do?
Inform your Consultant beforehand as Clopidogrel needs to be stopped 7 days before procedure.
What to do if I miss a dose?
If you miss a dose within 12 hours of your regular time, please take that dose immediately.
If you miss a dose for more than 12 hours from your normal time, take the next dose at your regular time.
DO NOT DOUBLE THE DOSE.
