Antiplatelets

Antiplatelets help prevent dangerous blood clots from forming. They may be used to reduced the risk of clot-induced heart attack or stroke, which is called preventive or prophylactic treatment. One of the most common antiplatelets is ASA (acetylsalicylic acid or Aspirin).

What are the main types?
ASA (acetylsalicylic acid or Aspirin) is a common over-the-counter pain reliever that also has anti-platelet properties. ASA can irritate your stomach and in some cases can cause bleeding. ASA should never be given to children because it has been linked to Reyes Syndrome a rare brain and liver disorder in children.

Ticlopidine may be prescribed to stroke survivors or those who are at high risk of stroke, particularly if they are not able to take ASA.

Clopidogrel (clopidogrel bisulfate, Plavix) is an antiplatelet drug that is effective in preventing strokes and heart attacks and is often prescribed in patients who receive a coronary stent.

Dipyridmalole is usually given with other antiplatelet or anticoagulant medications, such as ASA. It can also be given by injection during tests on the heart.

How does it work?
Antiplatelets help prevent tiny cells in the blood (platelets) from clumping together and forming blood clots. Antiplatelets, such as Aspirin, act on platelets in your blood, making it less sticky so that the platelets are less likely to produce clots that block arteries and may cause heart attacks or strokes.

How should I take it?
Do not take over-the-counter antiplatelets such as Aspirin to prevent a heart attack unless your doctor has advised you to do so. Aspirin can prevent blood clots, but it can also increase the chances of serious bleeding in some people. If your doctor has advised you to take Aspirin, take it with or without food and swallow it whole with water do not cut, crush or chew the tablet as there is often a special coating to reduce stomach upset. Always talk to your doctor or pharmacist about how and when to take your medication.

What should I avoid while taking this medicine?
Avoid smoking and limit your use of alcohol. Also, try to avoid cutting yourself. Use an electric shaver and soft-bristled toothbrush. Youll also want to floss gently and wear gloves while gardening. If you need surgery (even a simple surgical procedure) or dental extraction, inform your surgeon or dentist that you are taking an antiplatelet. Talk to your dentist or doctor about whether you should consider delaying non-essential dental work until your treatment is finished.

What if I am taking other medicines?
Antiplatelet medications can enhance the effects of other blood thinning medications such as Warfarin. Some common side effects associated with Aspirin include upset stomach (taking your medication with food can help) and heartburn. Because antiplatelets interact with many other common drugs, always talk to your doctor or pharmacist before taking any other medication including prescription, non-prescription, over-the-counter or natural health products (vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as traditional Chinese medicines, probiotics and other products like amino acids and essential fatty acids).

What else should I tell my doctor?
If you require surgery (even a simple surgical procedure) or dental extraction, inform your surgeon or dentist that you are taking an antiplatelet. The blood thinning effects of these medications can last for up to 10 days after you stop taking them.

What are some common side effects?
Because antiplatelets interfere with the clotting action of the blood, they can increase the risk of uncontrolled bleeding so they should not be taken by individuals who have an ulcer or history of bleeding problems. This may also show up as abnormal bruising. Antiplatelet medications can irritate the stomach, promote the development of ulcers, and increase water and salt retention.

Lifestyle changes
Eating a healthy diet that is lower in fat, especially saturated and trans fats, being smoke free, limiting alcohol use, being physically active and reducing stress are also important in lowering the risk of heart disease. Talk to your health-care practitioner about how you can achieve these lifestyle changes.

Where can I get more information?
For warnings, recalls and other clinical drug information:

1. Health Canada Drugs and Health Products http://www.hc-sc.gc.ca/dhp-mps/prodpharma/index_e.html
2. Drugs and Health Products: Advisories, Warnings and Recalls http://www.hc-sc.gc.ca/dhp-mps/medeff/advisories-avis/index_e.html

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