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Doctors Lounge - Cardiology Answers

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Back to Cardiology Answers List

Forum Name: Clots & Anticoagulants

Question: plavix vs aggrenox


 dinobub - Fri Jan 26, 2007 3:59 pm Bookmark and Share  

Dear Doctor -- I am a 66yo male ischemic stroke victim, which happened in Nov. 05. I have since been treated with Plavix once a day, and I have, on my own, also added aspirin, 325 mg once a day, which may be a bit risky.
I have since been told by 2 other neurologists that they would have started me on Aggrenox instead of Plavix. The best I can find out by internet research is that Plavix acts by coating platelets with a smooth surface so they won’t stick together, and the active ingredient in Aggrenox, ER-DP, acts as a vasodilator. Is there any information or study addressing the theory that a combination of these would add symbiotically ?
 John Kenyon, CNA - Thu Feb 15, 2007 11:47 am Bookmark and Share  

User avatar Hello dynodub - I apologize for being so late in replying to your question but it somehow got by me. Oh, by the way, I'm not an MD, but an allied health professional. Still, I think I can answer your question. Here goes:

Aggrenox is, as you accurately point, out a vasodilator, or at least contains something (dipyridamole) which has that property. It also, however, contains aspirin. While on paper Plavix and Aggrenox should provide increased protection, and Aggrenox has become very much favored by doctors for its protective capabilities regarding strokes, adding aspirin to a Plavix regimen increases one's bleeding potential to an undesireable (because potentially dangerous) degree. While aspirin has anti-coagulant properties, Plavix reduces the viscosity of blood. The combination could, in a worst-case scenario, lead to a very dangerous and difficult to stop bleed.

If you feel you might be better served by Aggrenox than Plavix (a controversial issue) I would strongly suggest you contact your doctor, asking if he would be willing to prescribe a trial of Aggrenox. If he doesn't feel it's appropriate he probaby has his reasons and since I don't have access to your chart (nor the authority of an MD), I wouldn't second-guess such a decision on the part of any MD.

In any event I would discontinue the aspirin unless specifically recommended by your doctor, for the reasons stated above. You've already noted that your self-medication with the aspirin might be risky, and you are correct. Since Plavix does not cause blood vessel dilation, any signifcant increase in blood pressure could result in a bleed on the brain that would be far more serious than an ischemic stroke.

Hope this helps answer your question.

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