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Ask the doctor: Adding Plavix to Coumadin

Thomas Lee, M.D. and Richard Lee, M.D.

Q. I’ve been taking Coumadin for some time and have begun taking Plavix after having had several stents put in to open blocked arteries. My doctor said Plavix would prevent clots. Isn’t that what Coumadin does?

A. Warfarin (Coumadin) works to slow blood clotting in a different way from the antiplatelet agents such as clopidogrel (Plavix) that people are asked to take after angioplasty and stent placement. Warfarin is usually taken by people who have had, or are at risk for, clots in their veins, within the heart itself, or in larger arteries. One of the most common reasons warfarin is prescribed is for atrial fibrillation, because it helps prevent blood clot formation within the upper chambers of the heart.

The antiplatelet agents, like Plavix, are excellent for preventing clots inside stents. Many people who have atrial fibrillation also have stents, and thus need both warfarin and one or two antiplatelet agents. Their risk of bleeding is higher than with any one drug alone, but they do seem to benefit from taking both types of drugs.

— Thomas Lee, M.D. and Richard Lee, M.D.
Co-Editors in Chief, Harvard Heart Letter

Posted by: Dr.Health

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