Archive for the ‘coumadin’ Category

Plavix, Coumadin, and Aspirin: The Anticoagulant Network

Friday, January 11th, 2008

Anticoagulants (“blood thinners”) are widely used and overused in medicine. The combined use of these drugs, particularly aspirin with coumadin or Plavix© has received a great deal of attention recently, and increasing apprehension. The supine acceptance by the medical profession of the blood thinner, Plavix, is a frightening example of the results of a pharmaceutical media blitz. Thanks to manipulative marketing, sales of the drug, made by Sanofi-Aventis, distributed here by Bristol-Myers Squibb, are up 60% in the past two years to over $6 billion worldwide, making Plavix second only to Lipitor© as the best selling drug in the world!

But is it possible that Plavix is safe, and at the same time a therapeutic triumph that saves lives? The drug interferes with blood coagulation by a mechanism different from aspirin and is routinely used to prevent clots developing before and after the placement of cardiac stents. However, its safety and superiority over aspirin and heparin in pre-treatment before stent placement has been widely questioned.

Plavix alone or combined with aspirin, is also used for hundreds of thousands, if not millions of patients, who are assumed to be at increased risk for heart attacks and strokes. However, a study of 15,000 patients published last year found that adding Plavix ($1.50-$3.00 a day) to low dose aspirin (2-3 pennies a day) was no more effective than aspirin alone for preventing heart attacks, strokes, and cardiovascular deaths. In fact, Plavix plus aspirin, a risky combination, nearly doubled the heart disease death rate, and caused many patients severe bleeding problems, especially in elderly patients with minor head trauma.

The New England Journal of Medicine (NEJM) published a study three years ago showing that patients taking Plavix, experience more than 12 times as many ulcers as patients who take aspirin plus a heartburn pill. Up to half of those now taking Plavix do so because their doctors assume that Plavix is safer on the stomach than aspirin, said the study’s lead author. Another article in the NEJM (Oct. 3, 2007) pointed out the dangers of dual anticoagulant therapy (Plavix or Coumadin with aspirin) “…Increased risks not always offset by benefit…”, meaning serious or life-threatening bleeding.

The practice of prescribing drugs for a purpose outside the scope of the drug’s approved label, (off-label use) represents another Plavix problem, with an increasing number of physicians using the drug where it is not indicated. John LeCroy, a drug analyst stated “It’s a massive drug right now. It already gets massive use, a lot of it off-label.” The same article reported that the FDA granted fast-track review process for Plavix, that is being considered for an additional use: the treatment of a certain type of heart attack.

The anticoagulant conspiracy represents a new multibillion pharmaceutical dollar growth industry backed by investors inspired by authorization of coverage by Medicare and private insurers. For further revelations and detailed documentation of these and numerous other conflicts of interest and widespread corruption in industry, medical centers, and the medical profession see this site , Dr. Paul Rosch’s, The American Institute of Stress and its Newsletter, especially, the June 2006 issue.

A word of advice: If your doctor has you on aspirin plus coumadin or aspirin plus Plavix, (or Plavix alone for heart or stroke prevention), ask him to tell you the indications, the benefits, and the risks.