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- Coumadin vs. Plavix quick comparison of differences
- What is Coumadin? What is Plavix?
- What are the uses for Coumadin vs. Plavix?
- What are the side effects of Coumadin vs. Plavix?
- What is the dosage of Coumadin vs. Plavix?
- What are the drug interactions for Coumadin vs. Plavix?
- Are Coumadin or Plavix safe to take if I am pregnant or breastfeeding?
Coumadin vs. Plavix quick comparison of differences
- Coumadin (warfarin) and Plavix (clopidogrel bisulfate) are anticoagulant medications used to prevent blood clots, which can cause heart attacks and strokes. Coumadin and Plavix also may be prescribed for people with atrial fibrillation (AFib) because AFib increases the chance of blood clots that can cause a stroke.
- Side effects of Coumadin and Plavix that are similar and include:
- Side effects of Coumadin that are different from Plavix include:
- Side effects of Plavix that are different from Coumadin include:
What is Coumadin? What is Plavix?
Coumadin (warfarin) is an oral anticoagulant (a drug that inhibits the clotting of blood). Coumadin helps prevent the formation of blood clots and the extension of clots already formed, and minimizes the risk of embolization of blood clots to other vital organs such as the lungs and brain. Blood clots can occur in the veins of the lower extremities (deep venous thrombosis, DVT), and can break off and become lodged in blood vessels of the lung (pulmonary embolism), causing shortness of breath, chest pain, and even life-threatening shock. Blood clots also can occur in the atria of the heart during atrial fibrillation and around artificial heart valves. These clots also can break off and obstruct blood vessels in the brain, causing an embolic stroke with paralysis. The generic name for Coumadin is warfarin.
Plavix (clopidogrel bisulfate) is an antiplatelet drug used to prevent blood clots. Plavix is used to reduce the risk of heart attacks and strokes, particularly in people with a recent history of stroke or heart attack, and those with peripheral vascular disease (peripheral artery disease, PAD). Plavix works by irreversibly binding to the P2Y12 receptor on platelets, preventing adenosine diphosphate (ADP) from activating platelets. Plavix belongs to a class of drugs called P2Y12 inhibitors. Other P2Y12 inhibitors include ticagrelor (Brilinta) and prasugrel (Effient). Clopidogrel is similar to ticlopidine (Ticlid) in chemical structure and in the how it works. The generic name for Plavix is clopidogrel bisulfate.
What are the uses for Coumadin vs. Plavix?
- Coumadin (warfarin) is used in treating people with deep vein thrombosis (DVT) to prevent extension of the clot, and to reduce the risk of pulmonary embolism.
- People with pulmonary embolism are treated with warfarin to prevent further emboli.
- Warfarin also is used in people with atrial fibrillation or artificial heart valves to reduce the risk of strokes, and after a heart attack.
- It also is helpful in preventing blood clots from forming in certain orthopedic surgeries such as knee or hip replacements.
- Warfarin is used in preventing closure of coronary artery stents due to clotting.
- Plavix (clopidogrel) is used for preventing strokes, heart attacks, and death in individuals who have had a previous stroke, unstable angina, heart attack or have peripheral arterial disease (PAD). The combination of clopidogrel and aspirin is better than aspirin or clopidogrel alone in preventing another heart attack but the risk of bleeding is higher.
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What are the side effects of Coumadin vs. Plavix?
Coumadin side effects
The two most serious side effects of warfarin include:
- Necrosis (gangrene) of the skin
Bleeding can occur in any organ or tissue. Bleeding around the brain can cause severe headache and paralysis. Bleeding in the joints can cause joint pain and swelling. Bleeding in the stomach or intestines can cause weakness, fainting spells, black tarry stools, vomiting of blood, or coffee ground material. Bleeding in the kidneys can cause back pain and blood in urine.
Other side effects include:
Plavix side effects
The tolerability of clopidogrel is similar to that of aspirin. The more common side effects of clopidogrel include:
- Abdominal pain
- chest pain,
- muscle aches,
- severe bleeding,
- allergic reactions,
- pancreatitis, and
- liver failure.
Ticlopidine (Ticlid) is an antiplatelet medication quite similar to clopidogrel. It has been associated with a severe reduction in white blood cell count in between 0.8% and 1% of persons. The risk of this dangerous side effect with clopidogrel is about 0.04%, much less than with ticlopidine but twice that of aspirin.
Clopidogrel rarely causes a condition called thrombotic thrombocytopenic purpura (TTP) in one out of every 250,000 people. TTP is a serious condition in which blood clots form throughout the body. Blood platelets, which participate in clotting, are consumed, and the result can be bleeding because enough platelets are no longer left to allow blood to clot normally. For comparison, the related drug, ticlodipine (Ticlid), causes TTP 17-50 times more frequently than clopidogrel.
What is the dosage of Coumadin vs. Plavix?
- Warfarin may be taken with or without food.
- Treatment usually is started at 2 to 5 mg once daily and the dose is adjusted based in INR tests.
- Patients typically require 2 to 10 mg of warfarin daily.
Frequent blood tests (INR test) are performed to measure the effect of warfarin and to adjust dosing. There are published INR ranges for the various uses of warfarin.
Since warfarin is metabolized (inactivated) by the liver and then excreted by the kidneys, dosages need to be lowered in patients with liver and kidney dysfunction.
- Clopidogrel bisulfate usually is taken once daily. It can be taken with or without food.
- The recommended dose for treating unstable angina or heart attack is 300 mg initially followed by 75 mg daily in combination with 75-325 mg of aspirin.
- Peripheral arterial disease or recent stroke is treated with 75 mg daily.
Clopidogrel is activated by enzymes in the liver to its active form. Individuals who have reduced activity of liver enzymes that activate clopidogrel due to liver disease may not adequately respond to clopidogrel. Alternative treatments should be used for these patients.
What are the drug interactions for Coumadin vs. Plavix?
Coumadin drug interactions
Many drugs, both prescription and nonprescription (OTC), can affect the anticoagulant action of warfarin or increase the risk of bleeding. Patients on warfarin should regularly consult their doctor before instituting any medications on their own. It also is advisable for patients on warfarin to carry identification such as bracelets to alert other health professionals to the presence of anticoagulation.
Drugs that increase the effect of warfarin by reducing the breakdown of warfarin include:
- amiodarone (Cordarone)
- trimethoprim/sulfamethoxazole (Bactrim)
- fluconazole (Diflucan)
- itraconazole (Sporanox)
- voriconazole (Vfend)
- zafirlukast (Accolate)
- ciprofloxacin (Cipro)
- atorvastatin (Lipitor)
- clarithromycin (Biaxin)
- fluoxetine (Prozac)
- indinavir (Crixivan)
- ritonavir (Norvir)
Drugs and herbal products that may reduce the effect of warfarin by increasing its breakdown include:
- St. John's wort
- carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol)
- bosentan (Tracleer)
Bleeding is increased by antiplatelet drugs such as aspirin and other nonsteroidal anti-inflammatory drugs (for example, ibuprofen [Motrin], naproxen [Alleve]), clopidogrel (Plavix), and prasugrel (Effient); serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and paroxetine (Paxil).
Foods with high vitamin K content (for example, green leafy vegetables) reduce the effect of warfarin. Maintenance of a consistent intake of vitamin K containing foods is important to avoid fluctuations in the effect of warfarin.
Plavix drug interactions
The combination of clopidogrel with nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of bleeding. Examples of NSAIDs include:
- Ibuprofen (Motrin, Advil, Nuprin)
- naproxen (Naprosyn, Aleve)
- diclofenac (Voltaren)
- etodolac (Lodine)
- nabumetone (Relafen)
- fenoprofen (Nalfon)
- flurbiprofen (Ansaid)
- indomethacin (Indocin)
- detoprofen (Orudis, Oruvail),
- oxaprozin (Daypro)
- piroxicam (Feldene)
- sulindac (Clinoril)
- tolmetin (Tolectin)
- mefenamic acid (Ponstel)
Combining Plavix with warfarin (Coumadin) or other drugs that cause bleeding increases the risk of bleeding.
Clopidogrel is converted to its active form by enzymes in the liver. Drugs that reduce the activity of these enzymes, for example, omeprazole (Prilosec, Zegerid) or esomeprazole (Nexium) may reduce the activity of clopidogrel and should not be used with clopidogrel.
Other drugs that also may react with clopidogrel in a similar way include:
Are Coumadin or Plavix safe to take if I am pregnant or breastfeeding?
- Warfarin should be avoided by pregnant women or women who may become pregnant. Birth defects and fetal bleeding have been reported.
- Available evidence suggests that warfarin is not secreted in breast milk.
- There are no adequate studies of clopidogrel in pregnant women.
- Studies in rats have shown that clopidogrel appears in breast milk; however, it is not known whether it also appears in human breast milk. Because of a potential for side effects in the nursing infant, the physician must weigh the potential benefits and possible risks before prescribing clopidogrel to nursing mothers.
Coumadin, brand name warfarin, and Plavix (clopidogrel), are drugs that break up blood clots and prevent blood clot formation. Coumadin is an anticoagulant and Plavix is an antiplatelet drug. Both Coumadin and Plavix are prescribed to treat deep vein thrombosis (DVT), blood clots in the lung (pulmonary embolism), peripheral artery or vascular disease, and to prevent heart attacks and strokes in individuals who have had either condition previously. Coumadin also to prevent strokes and further heart attacks in people with atrial fibrillation (Afib).
Coumadin and Plavix have similar side effects like rash, jaundice, and bleeding, possibly severe. Coumadin side effects that are different from Plavix include hair loss, bloating, diarrhea, and gangrene of the skin. Plavix side effects that are different from Coumadin include headache, itching, dizziness, abdominal pain, diarrhea, chest pain, pancreatitis, and muscle aches. Coumadin and Plavix should not be taken together.
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Deep Vein Thrombosis (DVT, Blood Clot in the Legs)
Deep vein thrombosis (DVT) is a blood clot in the deep veins, and can be caused by broken bones, trauma to a limb, immobility, medications, smoking, cancer, genetic predisposition, and cancer. Symptoms of a deep vein thrombosis in a leg are swelling, tenderness, redness, warmth, and pain. Treatments for DVT include medications and surgery.
How the Heart Works: Sides, Chambers, and Function
The heart is a very important organ in the body. It is responsible for continuously pumping oxygen and nutrient-rich blood throughout your body to sustain life. It is a fist-sized muscle that beats (expands and contracts) 100,000 times per day, pumping a total of five or six quarts of blood each minute, or about 2,000 gallons per day.
Heart Attack Symptoms and Early Warning Signs
Recognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men.
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include: weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Stroke vs. Mini-Stroke (TIA) Differences
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Pulmonary Embolism (Blood Clot in the Lung)
A pulmonary embolism (PE) occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks the artery and damages the lung. The most common symptoms of a pulmonary embolism are shortness of breath, chest pain, and a rapid heart rate. Causes of pulmonary embolism include prolonged immobilization, certain medications, smoking, cancer, pregnancy, and surgery. Pulmonary embolism can cause death if not treated promptly.
Early Warning Signs and Symptoms of Stroke (FAST)
Stroke is a serious medical condition. If you think you or someone you know is having a stroke call 911 immediately. There are two main types of strokes, hemorrhagic and ischemic (the most common type). A hemorrhagic stroke occurs due to a blood vessel rupture in the brain. An ischemic stroke occurs when a blood clot becomes lodged in a blood vessel in the brain, which causes a loss of blood supply to the brain, possibly causing brain tissue death. FAST is an acronym that helps people identify stroke signs and symptoms so they can act fast and call 911. Face drooping, Arm weakness, and Speech difficulty are indicators that a person may be having a stroke and it is Time to seek emergency medical treatment. Additional signs and symptoms of stroke may include weakness, difficulty walking, blurred vision, dizziness, headache, confusion, difficulty speaking, and loss of sensation. Stroke is a major cause of death and disability in the U.S. Early identification and treatment of stroke helps reduce the risk of morbidity and mortality.
Blood Clots (in the Leg)
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Peripheral Vascular Disease
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Atrial Fibrillation (AFib) Treatment Drugs
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Atrial Fibrillation Symptoms (AFib Warning Signs)
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Heart Attack Treatment
A heart attack involves damage or death of part of the heart muscle due to a blood clot. The aim of heart attack treatment is to prevent or stop this damage to the heart muscle. Heart attack treatments included medications, procedures, and surgeries to protect the heart muscle against injury.
Heart Disease in Women
Heart disease in women has somewhat different symptoms, risk factors, and treatment compared to heart disease in men. Many women and health professionals are not aware of the risk factors for heart disease in women and may delay diagnosis and treatment. Lifestyle factors such as diet, exercise, tobacco use, overweight/obesity, stress, alcohol consumption, and depression influence heart disease risk in women. High blood pressure, high cholesterol, and diabetes also increase women's risk of heart disease. Electrocardiogram (EKG or ECG), stress-ECG, endothelial testing, ankle-brachial index (ABI), echocardiogram, nuclear imaging, electron beam CT, and lab tests to assess blood lipids and biomarkers of inflammation are used to diagnose heart disease. Early diagnosis and treatment of heart disease in women saves lives. Heart disease can be prevented and reversed with lifestyle changes.
Heart Attack Pathology: Photo Essay
A heart attack is a layperson's term for a sudden blockage of a coronary artery. This photo essay includes graphics, pictures, and illustrations of diseased heart tissue and the mechanisms that lead to coronary artery disease, and possible heart attack. A coronary artery occlusion may be fatal, but most patients survive it. Death can occur when the occlusion leads to an abnormal heartbeat (severe arrhythmia) or death of heart muscle (extensive myocardial infarction).
Stroke vs Aneurysm (Differences and Similarities)
A stroke or "brain attack" is caused because blood flow to an area of the brain has been cut off by a blood clot or by a weakened or damaged blood vessel (for example, head trauma). The damaged area of the brain dies, which results in loss of function like speech capabilities, muscle movement, or muscles of an extremity like an arm or leg is reduced or lost completely. An aneurysm is a weakness in an artery wall. This weakness in the wall causes the artery to widen or balloon out, and then they rupture or break open. A person with an brain aneurysm generally won't have any symptoms until it becomes a problem. The symptoms and signs are similar to a stroke.Symptoms and signs of a stroke include: Vision problems Severe headache with no known cause Loss of memory Trouble getting words out Trouble typing, texting, or other coordination problems Both the American Heart Association and the American Stroke Association recommend using the FAST system to recognize and treat strokes. If you think someone may be having a stroke, remember FAST! F - Facial drooping A - Arm weakness S - Speech difficulty T - time - DO NOT DELAY. Call 911.If you think someone is having a stroke or aneurysm call 911 immediately. Both conditions require medical treatment. The prognosis for both diseases depend on the extent of the damage to the brain and any other affected areas of the body.
Heart Attacks in Women
Heart disease, particularly coronary artery disease is the leading cause of heart attacks. Women are more likely to die from a heart attack than men. High cholesterol, high blood pressure, obesity, and high triglycerides are contributors to heart disease. Some of the common symptoms of a heart attack in women include chest pain, shortness of breath, nausea, feeling faint or woozy, and more. Heart disease can be prevented by lifestyle changes and controlling high blood pressure, cholesterol, weight, and diseases such as diabetes.
Heart Attack Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience: Extreme fatigue Pain in the upper abdomen Dizziness Fainting Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
Heart Disease Treatment in Women
Heart disease treatment in women should take into account female-specific guidelines that were developed by the American Heart Association. Risk factors and symptoms of heart disease in women differ from those in men. Treatment may include lifestyle modification (diet, exercise, weight management, smoking cessation, stress reduction), medications, percutaneous intervention procedure (PCI), and coronary artery bypass grafting (CABG). Heart disease is reversible with treatment.
Stroke is the third leading killer in the United States. Some of the warning signs of stroke include sudden confusion, trouble seeing with one or both eyes, dizziness, loss of balance, and more. Stroke prevention and reatable risk factors for stroke include lowering high blood pressure, quit smoking, heart disease, diabetes control and prevention.
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