How to Discontinue Plavix Before Surgery
Plavix (or clopidogrel) is a prescription medication that works to prevent heart-related blood clots by preventing the platelets in your blood from clotting. It may be used if you have a condition with your blood vessels, coronary artery disease, or if you have had a recent heart attack or stroke. Because of Plavix's anti-clotting properties, patients taking the medication are at an increased risk of bleeding. Prior to surgery, your doctor will instruct you to stop taking Plavix, since it increases your risk of surgical complications and major blood loss during and after surgery.
Stopping Plavix
Talk to your doctor. Bristol-Myers Squibb/Sanofi Pharmaceuticals, the manufacturer of Plavix, recommends discontinuing Plavix use at least five days prior to having surgery. Depending on your health and the operation that you are going to undergo, your doctor may recommend that you stop using the medication two weeks in advance. Your doctor will give you the recommendation that he feels most comfortable with in order to minimize any risks to your health.
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Stop taking Plavix at the designated time (again, at least five days before surgery). According to an article by Ed Edelson, this reduces your risk of excessive bleeding, reduces the risk of requiring a second operation as a result of the bleeding, and reduces the length of time that you will need to spend in the hospital after your surgery.
Follow your doctor’s recommendations. Your doctor may recommend that you begin taking Plavix on the first day after your surgery, or she may recommend waiting for a longer period of time. It’s crucial to work with your doctor and follow her instructions to minimize any risks.
Tips
If you are considering an elective surgery, be sure to talk to your doctor about your Plavix use and schedule your surgery at least five days after discontinuing its use.
For patients undergoing emergency surgery, your doctor will weigh the risk of bleeding against the risk of not operating on you. According to the article by Ed Edelson, if the need for surgery is urgent, the increased risk of bleeding is usually considered to be an acceptable risk.
The November 18, 2008, edition of the Journal of the American College of Cardiology outlines a study performed by Dr. Richard C. Becker of Duke University and his colleagues, which clearly indicates an increased risk of bleeding when Plavix is used within five days of surgery. Dr. Becker indicates that every day that you can delay surgery lessens your risk of having a major bleed.
Warnings
This article does not take the place of receiving advice from your doctor. Consult your doctor for any and all instructions regarding your medication.
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References
- ABCNews.go.com; Ed Edelson; Study Upholds Stopping Plavix Use Before Surgery; November 10, 2009
- Bristol-Myers Squibb/Sanofi Pharmaceuticals Prescribing Information
- Journal of the American College of Cardiology; Impact of Clopidogrel in Patients With Acute Coronary Syndromes Requiring Coronary Artery Bypass Surgery; Jeffrey S. Berger, MD, MS, Carla B. Frye, PharmD, Qing Harshaw, MD, PhD, Fred H. Edwards, MD, Steven R. Steinhubl, MD and Richard C. Becker, MD, November 18, 2008
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