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Suggest Treatment For Acute Weakness, Inability To Walk Unasssisted And Confusion
Question: My dad has been taking Plavix to prevent strokes from his AFIB for about 15 years. He is not stented. He displays some of the side-effects of Plavix, including acute weakness, inability to walk unassisted, confusion. I would like to know from a cardiologist with experience or knowledge of long-term Plavix use whether it might be advisable to transition him off of Plavix in favor of some newer antiplatelet / anticoagulant for AFIB. I don't want Coumadin because of the blood tests and other risks.
Isn't 10-15 years on Plavix excessive ? Might changing his regimen reverse his symptoms ?
Isn't 10-15 years on Plavix excessive ? Might changing his regimen reverse his symptoms ?
Brief Answer:
Neurological problems to rule out first....
Detailed Answer:
Hi there,
I have gone through the medical history of your father carefully and understood your concerns.
You are reporting that your father is having acute weakness, inability to walk unasssisted, confusion. If I was his caring doctor would exclude neurological problems before confirming these symptoms are due to Plavix use.
I suggest to run neurological examinations to exclude vascular neuropathies, silent stroke or other problems. If everything is ok, then, all these symptoms are confirmed to be related to Plavix use.
When no neurological problem, then, I suggest to substitute Plavix with Xarelto in order to reverse the symptoms. Otherwise, no need to change Plavix therapy.
Hope it answered to your queries! Let me know if I can assist you further!
Dr.Benard
Neurological problems to rule out first....
Detailed Answer:
Hi there,
I have gone through the medical history of your father carefully and understood your concerns.
You are reporting that your father is having acute weakness, inability to walk unasssisted, confusion. If I was his caring doctor would exclude neurological problems before confirming these symptoms are due to Plavix use.
I suggest to run neurological examinations to exclude vascular neuropathies, silent stroke or other problems. If everything is ok, then, all these symptoms are confirmed to be related to Plavix use.
When no neurological problem, then, I suggest to substitute Plavix with Xarelto in order to reverse the symptoms. Otherwise, no need to change Plavix therapy.
Hope it answered to your queries! Let me know if I can assist you further!
Dr.Benard
Above answer was peer-reviewed by :
Dr. Raju A.T
As he transitions to Xarelto (hypothetically), do we simply discontinue Plavix one day and start him on Xarelto, or is there a "tapering" of Plavix dosage down to zero with a corresponding increase in Xarelto dosage (in order to maintain a constant anti-coagulant effect ?
I think they may have diagnosed him with vascular neuropathy due to diabetes (2), but I question this diagnosis because if he had vascular neuropathy, he would have other obvious symptoms of neuropathy as well, such as numbness in the feet, etc, wouldn't he ? I tend to think that if vascular neuropathy had set in, there would be signs of extreme neuropathy throughout.
Is it possible that he might have both neuropathy and Plavix side-effects, and considfering this, wouldn't it still be advisable to switch drugs ?
Are there any special risks to Xarelto we might need to know about ?
I think they may have diagnosed him with vascular neuropathy due to diabetes (2), but I question this diagnosis because if he had vascular neuropathy, he would have other obvious symptoms of neuropathy as well, such as numbness in the feet, etc, wouldn't he ? I tend to think that if vascular neuropathy had set in, there would be signs of extreme neuropathy throughout.
Is it possible that he might have both neuropathy and Plavix side-effects, and considfering this, wouldn't it still be advisable to switch drugs ?
Are there any special risks to Xarelto we might need to know about ?
Brief Answer:
Following answers to your queries...
Detailed Answer:
Hi back,
If his doctor decide to start Xarelto and stop Plavix, there is no need for tapering. He can directly shift from Plavix to using Xarelto.
To my opinion, all he is facing is related to diabetic neuropathy more than from side effects of Plavix. Usually, diabetic neuropathy is gradually set with no know extreme symptoms.
I advise to get him off Plavix and start Xarelto for about 2 or 3 months. If the symptoms will subside, then, it is related to diabetic neuropathy.
The risks of using Xarelto are the same as for any other blood thinners. Studies have concluded lighter side effects.
All the best!
Dr.Benard
Following answers to your queries...
Detailed Answer:
Hi back,
If his doctor decide to start Xarelto and stop Plavix, there is no need for tapering. He can directly shift from Plavix to using Xarelto.
To my opinion, all he is facing is related to diabetic neuropathy more than from side effects of Plavix. Usually, diabetic neuropathy is gradually set with no know extreme symptoms.
I advise to get him off Plavix and start Xarelto for about 2 or 3 months. If the symptoms will subside, then, it is related to diabetic neuropathy.
The risks of using Xarelto are the same as for any other blood thinners. Studies have concluded lighter side effects.
All the best!
Dr.Benard
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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