Many of us are taking blood thinners post procedure especially if stents were used. You likely have a product sheet from your doctor or pharmacist, but a reminder is good. There is so much to remember for people with MS/CCSVI. This is not complete by any means, so contact your doctor if you have any questions or need more information.
Coumadin (Warfarin), is a medication originally extracted from coumarin, a chemical found in some plants. It suppresses the body's ability to form blood clots, by blocking the function of Vitamin K.
This is why you should monitor your intake of foods that are rich in vitamin K. Consuming too much of these foods can prevent Coumadin from working properly and may leave you temporarily at a high risk of stroke. Some foods with high vitamin K content include spinach, lettuce, alfalfa sprouts, asparagus, broccoli, cauliflower, and cabbage. Doctors recommend that you eat the same amounts of these food items every day in order to maintain a steady level of vitamin K in your body. This will both ensure that Coumadin works properly, and that you will have a low risk of dangerous bleeding while you take Coumadin.
The most common side effect of Coumadin is abnormal and sometimes profuse bleeding. Often the abnormal bleeding can occur inside the eye, and in the intestines. Because of this, people who take Coumadin must monitor stool color and seek medical attention if stools become black or tarry-appearing. Of course, bleeding and easy bruising can occur anywhere in the body.
Precautions:
Take only medicines prescribed by your doctor (coumadin interacts with multiple medications).
Take your coumadin at the same time every day.
Eat the same amount of vitamin K containing food every day (e.g., fish, broccoli, spinach, cabbage, kale, cauliflower).
Avoid excessive alcohol.
Avoid activities which might cause you to fall.
Never take double doses of coumadin, unless specifically asked by your doctor to do so.
Call your doctor if your stool changes in color.
Lovenox ( enoxaparin) is a form of heparin called fractionated heparin. Lovenox does not require monitoring of its blood levels and it can be injected intramuscularly. People with kidney disease should not use because poor kidney function makes Lovenox accumulate in the blood. The side effects of Lovenox include skin irritation at the site of injection and nausea.
Precautions: Rarely people develop an allergic reaction to Lovenox and develop a rash. If severe, the reaction can cause swelling on the hands and lips, and difficulty breathing. If you develop any of these symptoms go to an emergency room. Other symptoms are the about the same as heparin.
Plavix (clopidogrel) keeps the platelets in your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions.
Plavix keeps your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions. Because of this drug action, Plavix can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.
You may also have bleeding on the inside of your body, such as in your stomach or intestines. Call your doctor at once if you have black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds. These could be signs of bleeding in your digestive tract.
Avoid drinking alcohol. It may increase your risk of bleeding in your stomach or intestines.
While you are taking Plavix, do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) without your doctor's advice. NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.
Do not use Plavix if you are allergic to clopidogrel, or if you have any active bleeding such as a stomach ulcer or bleeding in the brain (such as from a head injury).
Common side effects of Plavix include stomach pain, muscle aches, dizziness, and headache. Easy bruising and nose bleeds can also occur. People who have stomach ulcers might develop intestinal bleeding, which can be life threatening.
The risk of bleeding ulcers is 12 times higher with Plavix compared to aspirin and a heart burn pill. Plavix was previously promoted and sold as a safer alternative to aspirin for individuals with Peptic Ulcer Disease or a history of gastrointestinal bleeding. However, a February 2005 study in the New England Journal of Medicine indicated that Plavix actually impairs the healing of ulcers and increases the risk of recurrent bleeding.
Plavix has also been shown to increase the risk of internal bleeding or gastrointestinal hemorrhaging for users. The manufacturers failed to adequately warn of this potential complication which could be potentially fatal. The signs and symptoms of internal bleeding including vomiting blood, black stools, passing blood, increased pulse rate, low blood pressure, confusion, disorientation or sleepiness. Treatment of GI bleeds may involve hospitalization.
In a desire to increase profits, the manufacturers pushed uses for Plavix which were not FDA approved. These Plavix off-label uses significantly increased the risk of heart attacks and strokes, even though the medication was prescribed to reduce the risk of such events.
For individuals with high cholesterol or high blood pressure, Plavix nearly doubles the risk of heart attacks, strokes and bleeding. In many cases Plavix is prescribed by doctors for atherosclerosis, following angioplasty and after use of drug-coated stents to reduce the risk of clotting. The stents obviously exist, folks. A study issued in March 2006 found that Plavix offered no significant benefit over aspirin, and actually increases the risk of heart attacks, strokes and bleeding for these users.
Pradaxa: [dabigatran] is a direct thrombin inhibitor that some doctors prefer over other blood thinners since it does not require frequent blood tests for (INR).
It is not recommended for people who have an indwelling catheter in their spine for pain relief after the surgery
Precaution:
The capsules should be swallowed whole with water once daily. People with active severe or dangerous bleeding, or problems with blood clotting.
It is not recommended for people who have an indwelling catheter in their spine for pain relief after the surgery
Common side effects:
Diarrhea; heartburn; indigestion; mild stomach pain or upset; nausea.
More serious side effects are:
Gastroesophogeal reflux disease (GERD)
Ulcers of the digestive tract
Bleeding in the gut
Bleeding from the rectum
Bleeding from piles
Nose bleeds
Abnormal liver function test results
Bleeding underneath the skin
Bleeding from a catheter site
Decrease in the number of platelets in the blood
Low Blood Pressure
Get medical help right away if any of these rare but very serious signs of bleeding occur: vision changes, confusion, slurred speech, weakness on one side of the body.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; wheezing); black, tarry, or bloody stools; chest pain; confusion; coughing up blood; dizziness, weakness, or unusual headaches; fainting; joint pain, swelling, or discomfort; one-sided weakness; pink, brown, or dark urine; severe or persistent sore throat or stomach pain; slurred speech; unusual bruising or bleeding (eg, excessive bleeding from cuts, unusually heavy menstrual or vaginal bleeding, repeated nosebleeds, unusual bleeding from gums); vision problems; vomit that looks like blood or coffee grounds.
ref:Barker Fiebach, and Zieve, Principles of Ambulatory Medicine, Seventh Edition, Baltimore, Williams and Wilkins