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Had stents put in and was given Brilanta and aspirin. Bleeding started, prescribed Plavix and Nexium. Suggest?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Question
is it unwise to mix nexium with Plavix ? I had stents put in two and one half months ago and was given Brilanta and aspirin. XXXXXXX bleeding then began. now being prescribed Plavix no aspirin and 40 mg of Nexium twice a day. will the nixium hamper my Plavix ? I have a history of XXXXXXX bleeding from uses of effient and brilanta both with aspirin.
Posted Wed, 2 Oct 2013 in Blood Disorders
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer:
Yes, Nexium may reduce the efficacy of Plavix

Detailed Answer:
Hi,
Thank you for posting your query.

Nexium (esomeprazole) is a competitive inhibitor of enzyme CYP2C19. This enzyme is required to convert plavix (clopidogrel) to its active form. Therefore, reduction of CYP2C19 enzyme may reduce the active form of plavix, thereby reducing the efficacy of plavix.
I hope it helps.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by
 
Follow-up: Had stents put in and was given Brilanta and aspirin. Bleeding started, prescribed Plavix and Nexium. Suggest? 13 hours later
Thank you. If I am just coming off XXXXXXX bleeding using Brilanta and aspirin, and put on Plavix for recent heart stents, what should I be doing to mange the danger of my XXXXXXX bleeding. After 7 days in hospital, my stool is no longer black and seems to have returned to normal. However, am still anemic.
 
 
Answered by Dr. Sudhir Kumar 6 hours later
Brief Answer:
Continue nexium

Detailed Answer:
Thank you for getting back.

Please continue nexium (esomeprazole). Avoid taking aspirin in future too. Plavix has much lesser risk of causing XXXXXXX bleeding as compared to aspirin.

Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
Follow-up: Had stents put in and was given Brilanta and aspirin. Bleeding started, prescribed Plavix and Nexium. Suggest? 13 hours later
Thank you very much. I wish you well.
XXXXXXX Huddleston
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer:
Thank you

Detailed Answer:
Thank you and best wishes.
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by
 
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