Plavix, a popular anti-clotting drug used in patients at risk for heart attacks and strokes, has recently been linked to a number of severe side effects including cerebral bleeding and hemorrhaging. Signs and symptoms of Plavix-induced cerebral bleeding include nausea, vomiting, decreased alertness, and loss of consciousness. Other Plavix side effects have been found to include internal and gastrointestinal bleeding, as well as a rare blood-clotting disease known as thrombotic thrombocytopenic purpura (TTP).
What’s the problem?
For years, it was considered common knowledge in the medical community that the Plavix-aspirin combination would cause less cerebral hemorrhaging than a similar anti-clotting agent known as Warfarin. But a recent study conducted by the Centers for Disease Control and Prevention (CDC) found the risk of bleeding among Plavix-aspirin users was significantly higher than originally thought. While the research did link Warfarin to a higher rate of hemorrhaging than the Plavix-aspirin regimen, the combo treatment did not do nearly as well in that area as expected. For both methods of treatment, the number of hospital admissions for internal bleeding was statistically similar. And bleeding-related emergency room visits were only about 50% lower for those on the Plavix-aspirin regimen.
Another recent study published in the New England Journal of Medicine (NEJM) found that individuals taking Plavix are nearly 12 times more likely to suffer cerebral and gastrointestinal bleeding than patients who took a combo regimen of aspirin and a heartburn medication. To reduce the risk of cerebral bleeding and hemorrhaging, heartburn drugs like Prilosec, Nexium, Prevacid, Aciphex and Protonix are often prescribed to patients taking Plavix. But now it appears that patients cannot even rely on these medications to reduce the risk of Plavix cerebral bleeding. In November 2009, the FDA issued a press release warning the public that Prilosec could interfere with the body’s production of the liver enzyme CYP2C19. This enzyme is required to convert Plavix into its active form.
Symptoms of Plavix Cerebral Bleeding & Hemorrhaging
Cerebral hemorrhaging is bleeding in the brain caused by the rupture of a blood vessel in the head. Internal bleeding can occur in any part of the brain. Blood may build up in the brain, or in the spaces between the brain and the membranes that cover it. The hemorrhaging may only occur in one hemisphere, or it may be found in other brain structures such as the thalamus, basal ganglia, pons, or cerebellum.
Signs and symptoms of Plavix-induced cerebral hemorrhaging may include:
- change in level of consciousness or alertness such as passing out or unresponsiveness
- difficulty swallowing
- difficulty with thinking, talking, comprehension, writing or reading
- loss of vision or changes in vision
- severe headaches
Cerebral bleeding can be life-threatening and should always be treated as a medical emergency. Seek immediate medical attention if you experience any of the following symptoms:
- change in consciousness or alertness
- change in mental status
- sudden behavior change
- garbled or slurred speech or inability to speak
- paralysis or inability to move a body part
- sudden change in vision, loss of vision, or eye pain
- trauma to the head
- worst headache of your life
Diagnosis & Treatment
Depending on the severity of the patient’s signs and symptoms, the doctor may suspect bleeding inside the skull and order a CT scan to be conducted on the brain. If the CT scan is unable to confirm the diagnosis, a lumbar puncture (spinal tap) may be used to identify or rule out cerebral hemorrhaging. MRI, MRA, or CT angiograms may also be needed to make a conclusive diagnosis and enable the doctors to decide on which course of treatment will be most effective.
Treatment for Plavix-induced cerebral hemorrhaging depends on the underlying condition that caused the bleeding. Surgical intervention may be required if the bleeding was caused by a torn artery or a ruptured cerebral aneurysm. Other popular methods of treatment may include:
- anti-anxiety drugs
- medication to control blood pressure
- anti-epileptic drugs for seizure control
- other medications necessary to control other symptoms, such as painkillers for severe headache and stool softeners to prevent constipation and straining during bowel movements
- nutrients and fluids