The Journal of the American Medical Association, March 4, 2009 (Vol. 301, No 9 Pg. 937-944), contains an article entitled Risk of Adverse Outcomes Associated with Concomitant Use of Clopidogrel (PLAVIX) and Proton Pump Inhibitors (PPI) following Acute Coronary Syndrome (ACS).
Available proton pump inhibitors (PPI) include:
- omeprazole (Prilosec),
- lansoprazole (Prevacid),
- rabeprazole (Aciphex),
- pantoprazole (Protonix),
- esomeprazole (Nexium), and
- Zegarid, a rapid release form of omeprazole.
The common treatment for ACS is an inpatient placement of a stent or medical treatment. Upon discharge, the common medical treatment is the use of PLAVIX and daily aspirin is common to protect from thrombosis and ischemia. The PPIs are added to reduce risk of gastrointestinal bleeding.
Of 8205 patients treated with ACS in this manner, a significant number of patients had complications after discharge. Death or rehospitalization for ACS occurred in 29.8% taking PLAVIX plus PPI. The use of the PPI without PLAVIX was not associated with death or rehospitalization.
I have also observed an increase in older diabetic patients who require this re-hospitalization after inpatient treatment for ACS and follow-up treatment with PLAVIX. This leads me to believe that it is time to consider follow-up medical treatment with alternatives to PLAVIX.
8 comments:
What are the alternative treatments to Plavix? Thanks.
I use l-arginine 10 gm daily with a gm of l-citrulline. I have developed another product for other uses that works well for this situation called proArgi9 plus. 1: J Am Coll Cardiol. 1997 Mar 1;29(3):479-85.
I have recently had a pacemaker implanted due to a right bundle branch blockage. I have also been diagnosed with stenosis in both the mitral and aortic valves. The cause is most likely due to radiation therapy received 40 years ago for Hodgkins Disease. Is there hope with your l-arginine for my situation to reverse any of the stenosis in my valves. I do not want to have the replacement surgery.
I don’t know your whole situation so I can’t really advise you but I pursue health as a special principal when threatened by disease. All of us have legacies of ill health from our past so I say the process of ProArgi 9 plus in doses of 2 scoops a day and generous amounts of Vitamin D as we have in our 5,000 IU oral spray D3 do as much as can be done to enable your aging tissues to go back two decades and stay there to age 126. With this we don’t have any reason to believe that this won’t work and you situation can be monitored regularly by your doctor to monitor any flaws in this pursuit of health.
I am 59 years old and take an aspirin (81mg) a day. Will this interfere with the l-arginine production of NO?
There is no interference between aspirin and l-arginine.
Dr Joe!
I purchased L- Arginine 500 mg capsules, serving size is 2 capsules daily. Is this equivalent to the dosage you take? I could not find theL-Citrulline. Iam type 2 diabetic with CHF 66 Yrs young Female. My D-3 Blood level was initially 15 and is now 16 1/2. I take calcitriol & Otc D-3. 2000 mg 6 daily, am looking for 50,ooo mg of D-3. should i take more or less of the above?
Dr Joe;
I am type 2 diabetic with CHF. I purchased 500 mg of L- Arginine, serving size 2 capsules daily. I also had my D-3 Blood test and was severely deficient at 15, i have been on calcitriol since October and level was re-checked and is 16 1/2. i also take D-3 Otc 2000 mg 3 x daily. Should i take more or less of above ? I am 66 yrs young (female)
Bj
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