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    Suggest a substitute for Brilinta

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Posted on Fri, 14 Jul 2017 in Hypertension and Heart Disease
Question: My wife had a stent put in on XXXXXXX 4. Cardiologist prescribed 90 mg brilinta ever 12 hours and asprin. She was discharged on XXXXXXX 7. On XXXXXXX 9 experienced sever shortness of breath; went to ER and admitted. Between XXXXXXX 9 and XXXXXXX 15 (a) given 6 units of blood due to low Hemoglobin; (b) endoscopy performed with no evidence of bleeding; (c) had colonoscopy; found 6 AVNs which were cauterized; and (d) had a cat scan to determine location of bleeding. Results no yet known. Cardiologist says that taking brilinta unmasked pre-existing internal bleeding, but she must take brilinta to prevent clots at stent. QUESTION: Are their alternatives to brilinta that might not accelerate internal bleeding? Is there a drug that will stop internal bleeding? I think I can guess the answers to these questions, but hope XXXXXXX eternal.
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Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HealthcareMagic.

I passed carefully through your question and would explain that all antiplatelet agents carry the risk of bleeding.

It is in our guidelines that all the patients who undergo who have been put a stent should take dual anti-platelet therapy.

A substitute option to brilinta would be clopidogrel, but it carries the risk of bleeding too, although in a lower degree compared to brilinta. While brilinta in superior to clopidogrel in protecting the stent from occlusion.

As the bleeding has been stopped, I would recommend continue on PPI (omeprazone, pantoprazole) in order to protect her from gastro-intestinal bleeding.

I would not recommend stopping dual anti-platelet therapy for at least one month after the stent implantation, because it carries the risk for stent occlusion, which could be life-threatening.

If bleeding restarts, you may discuss again with her doctor on stopping aspirin. In such case a close monitoring with resting ECG and cardiac enzymes would be needed, in order to examine the blood flow to the stent and detect possible occlusion.

Hope to have been helpful!

I remain at your disposal for any other questions.

Wishing good health,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Kampana
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7428 Questions

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