Plavix versus Effient

My cardiologist recently changed one of my medications. I was taken off of Plavix and put on Effient. The reason that he did this is because right after my heart attack, I was tested and found that my body was resistant to the Plavix. I then began a regimen of two Plavix a day, as recommended by my first cardiologist. I was also taking 9 mg of Coumadin as well as aspirin. My new cardiologist says that there is no way that my body could sustain all of these blood thinning meds for long term. It seems as though since I am on the Effient, I have slight angina or a tightening in my chest-not sure though.
Was wondering if anyone out there is taking Effient?

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hi cajin,

(Who dat fan? : ) "Was wondering if anyone out there is taking Effient?"

My new cardio is going to have me try that one too....supposed to be tolerable for women who can't tolerate Plavix. Wish I had something more helpful to share with you. You truly are on a boatload of blood thinners. whew! I can only imagine all the fun bruising you are sporting now.....!!! whew!

take care,
Jaynie

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Hi Jaynie,
Yes, I am a who dat fan-live right here in the heart of Cajun country in south central Louisiana and am a couple hours away from New Orleans.
My cardiologist feels strongly that the Effient is good for younger women. He says that he has seen excellent results and has explained to me the different chemistry make up behind the two meds-Plavix versus Effient. He says that Plavix's chemistry is such that one's body can have a genetic resistance, which apparently I do have. He says that the Effient, however is set up to work much differently with a totally differently chemistry set up. So far so good for me. Have a little bruising but really not so bad. I just got an ICD placed a week ago, so definitely have bruising from that. Thanks for the reply-I appreciate it.
Myra

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yes, i am. switched away from plavix onto effient after 2nd heart attack. no adverse symptoms (which is better, is anyone's guess).

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Hey there. Does Effient act to make the platelets "slippery" (this is how my surgeon described it)? I've been on Plavix for almost 7 years and he wants me on it forever. Also, does Effient bother your stomach like Plavix does?

(Congrats on the win! Best Super Bowl ever.)
Katherine

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Hi Katherine,
Thanks for the congrats regarding the superbowl win-it is like a dream come true for our entire state.
Yes, Effient serves the exact same purpose as the Plavix by making the platelets slippery and allowing the blood to pass seamlessly through the stents. I had a visit with my cardiologist yesterday and he did say that it is likely that I will remain on the Effient for the rest of my life as well. Unfortunately, Effient does bother my stomach the same way the Plavix did. I have noticed that, for the most part, when I eat the foods that I am supposed to(raw fruits and veggies, non-fat/low fat items, fiber rich foods, etc) I do not get indigestion. The moment I slip in something that is off limits(I was a junk food junkie), even a reasonable portion, I get indigestion. For me, I supposed, it is my bodies' way of keeping me in check-lol.
The only major difference between the Plavix and Effient, as I understand it, is the way that chemistry make up is set up to work with our bodies. I have learned that because I am a young heart disease patient, that my liver functions very well, thus causing me to require a higher dose of Coumadin(when I was taking it). I do not believe that was the case for the Plavix with me. I think that for whatever reason, my body was simply resistant to Plavix.

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One other thing-my cardiologist treats several young women with heart conditions. He feels strongly that Effient is a better drug for people such as myself, a young, fairly healthy woman. He even told me that he feels that overall, the Effient is far more superior to Plavix. Again, this is simply his opinion and it is not my goal to bash Plavix. For me, we are learning that the Effient may be the better route in my heart treatment.

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Thanks for the great explanation. That's too bad it bothers your stomach still, though.

I just got a new prescription for Plavix, but haven't filled it yet, so will double check with my guy about Effient. Is it as expensive as Plavix? I've been buying it from Canada to stretch my pharmacy benefit, but we just switched to a new high deductible plan, so it's sort of six one, half dozen the other.

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My doc seems to have all of the samples that I need-which is great. For me, so few of his patients take the Effient that the samples last. When I was on the Plavix, I was NEVER lucky enough to get samples and was told that the reps don't leave Plavix samples. I did have to purchase the first days does, which is referred to as a "loading" dose and consists of taking 6 Effient on that first day only. I had to purchase the first 6 only and the next day the Effient rep brought enough samples to last me for about 4 weeks. The six that I did have to purchase at full price cost me a total of 36 dollars, so it is roughly 6 dollars a pill. I think that is a little bit more than the Plavix runs, however, I was needing two Plavix a day so my month's supply of Plavix was running me 300 dollars a month! I am in no way trying to discourage you with the Canadian meds, but when I was looking for a solution to being able to afford my meds each month, I was so excited to discover that the Canadian meds may have been an option. However, when I mentioned this to my cardiologist, I immediately read the writing on the wall with the look on his face that he did not support this. I fully trust my cardiologist so for me, that was not an option at that point. He assured me that he would help me by having samples available for me. I too have a very high deductible, 5 thousand dollars to be exact. I have just received my ICD, so I have already met my deductible should I need meds. Like I said, my doc is wonderful enough to provide me with samples from the drug reps.

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I am so glad your guy is getting you samples! He sounds like a "keeper."

My doctors don't like that I do Canada either; but my RX benefit used to max out in April and it was just awful trying to ration, scrounge up samples of everything, and pay big $ for 9 months.

Our new deductible is 5400 too. It certainly goes quickly, doesn't it! I can kick my Canadian habit with this new plan.

Thanks for the help. Happy Friday!

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Hello Heart Sisters,

This 'Plavix vs. Effient' discussion has been going on for some time, but not where you'd expect to find it (doctor-patient conversation) but rather on the stock market pages.

For example:

" The Food and Drug Administration has approved Effient, a blood thinner made by Daiichi Sankyo and Eli Lilly, after an 18-month delay.

But Effient will carry stark "black box" warnings about the risk of deadly bleeding. Such warnings are not borne by Effient's main competitor, Plavix.

That could make it difficult for Effient to capture market share from Plavix, which generates $6 billion a year in sales for makers Sanofi-Aventis and Bristol-Myers Squibb and is the second-biggest selling drug in the world.

** Effient is ONLY APPROVED FOR PATIENTS WHO HAVE UNDERGONE ANGIOPLASTY TO OPEN A BLOCKED ARTERY. This is a fraction of the Plavix market. The U.S. patent on Plavix will expire in three years, potentially flooding the market with cheap generics.

The Effient warning says: "Effient can cause significant, sometimes fatal bleeding." It tells doctors NOT to prescribe the drug in patient with "pathological bleeding" or in those with a history of strokes or mini-strokes.

-- "It also says that Effient is NOT RECOMMENDED in patients older than 75 years of age unless they are especially at risk of heart disease, and states people weighing 130 lbs or less, and those on certain medicines* are at increased risk for serious bleeding. ( * NOTE to MYRA!!! this is likely why your new cardiologist warns "that there is no way that my body could sustain all of these blood thinning meds for long term".)

"We think being able to get this approved and available will be an important option for the patients who have acute coronary syndrome and are being treated with [angioplasty]," says Anthony Ware, the Lilly drug executive who directed Effient's development. He says the company has "never shied away" from the drug's bleeding risks.

"The difficulty of evaluating the drug (Effient) is that while it reduced the number of non-fatal heart attacks, compared with Plavix, it also increased the rate of dangerous bleeding," says Dr. Robert Temple, director of the FDA's office of drug evaluation.

Dr. Sanjay Kaul of Cedar-Sinai Medical Center says that Effient's black box warning is "sufficient" but that he would like to be clearer that Effient's benefits over Plavix are driven mainly by differences in heart attacks, not by differences in overall death or stroke.

FDA physicians claim that they expect interventional cardiologists who perform angioplasty procedures to use Effient often, but think it is unlikely that the drug will be used outside of this narrow indication. "

Read the rest of this Forbes article from July 09: http://www.forbes.com/2009/07/10/effient-eli-lilly-fda-business-healthcare- effient.html?partner=yahootix

The 'Wall Street Journal' has also reported extensively on the launch of Effient, particularly about the drug's manufacturere Eli Lilly's need to maximize early sales now, before its only competition Plavix loses patent protection in 2011: "So Lilly’s eager to get Effient approved now, so docs can start prescribing it while the main competition is still a high-price brand. Once Plavix goes off patent, Effient will be up against not only docs’ familiarity with Plavix, but also the much lower-prices of generic versions of the drug."

And that is why your cardiologists - educated by their Eli Lilly drug sales reps - are keen on prescribing Effient, and why they have lots of free samples to give patients now.

The reality for all of us on any prescription drug is that we must research, research, research until our eyes bleed. And that means not asking the drug's manufacturer or drug reps what they think of their own drugs.

XOXOX

http://www.myheartsisters.org

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Breaking news on Plavix ...

Please check out the links below for most recent news from the FDA and news media on Plavix.

The articles discuss the new Black Box Warning for Plavix due to the fact that not all patients can metabolize the drug properly, thus leaving them without any protection and posing a risk.

Effient can be properly metabolized by ALL patients.

As always, please discuss with your doctor.

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm204253.htm

http://www.webmd.com/heart-disease/news/20100312/new-plavix-warning-lack-of -effect-in-gene-carriers

http://latimesblogs.latimes.com/booster_shots/2010/03/the-fda-requires-a-ne w-blackbox-warning-on-plavix.html

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Wow...I learn lots of stuff on here...am so happy I joined. Okay...I never heard of Effient? I am on
plavix and do get a little bruising here and there
mostly on my legs and sometimes on my feet...but
nothing really that bad. A friend of mine had to
take Coumadin only for a short time because that
is some powerful stuff....somtimes makes you
scared about even getting a small cut and what's
going to happen next? I enjoy reading these messages so much....thanks ladies!!!

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Hi, wondering if anyone has had excessive menstrual bleeding on plavix? I had a stent placed in Nov. '09, and started plavix, aspirin regime. My first period lasted 3 weeks and was heavy enough that I ended up in hospital and received 3 units of blood. Hemoglobin was around 5 (normal range 12+). Cardiologist on call knew nothing of this side effect and Ob/Gyn knew nothing about plavix at all. Two weeks out of hospital I had mirena iud inserted to stop future periods. Any similar experiences? Thanks for sharing.

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Lucky for me, my menstrual periods are not bad at all. I went from being on birth control pills(at the time of my MI) to being on nothing at all for birth control right now, and so far, so good with my periods.
Hey wondering48, besides any visible cuts and the risk associated with that sort of bleeding, the other risk to be worried about with any type of blood thinner med is internal bleeding. I was advised that if I sustain any sort of fall, or blow to the head that I should contact my doc immediately and let him know. There could be internal(brain especially) bleeding and one would not immediately know about. Right now, I pretty much have no choice but to take the blood thinning meds such as Effient and aspirin and am just very careful with my daily activities. All and all, sometimes I feel that we can't win for losing, but then again, God is great and all of this has happened to me for a reason and I am surely trying to embrace every moment and experience.

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