From the Research
You should not stop Plavix (clopidogrel) after a cerebrovascular accident (CVA) without consulting your healthcare provider, as the risk of another stroke outweighs the risk of bleeding in most cases. Typically, Plavix is prescribed for at least 3 months following a stroke, but many patients require it for longer periods—often 12 months or indefinitely—depending on their specific risk factors and medical history. Stopping Plavix prematurely significantly increases your risk of having another stroke, as the medication prevents blood platelets from sticking together and forming clots that could block blood vessels in the brain.
If you need to temporarily discontinue Plavix for a procedure, this should only be done under medical supervision, usually for the shortest time possible (typically 5-7 days before procedures with high bleeding risk) 1. Your doctor will weigh the risks of stopping the medication against the benefits and may recommend alternative antiplatelet therapy during this period. Never stop taking Plavix on your own, as the consequences could be life-threatening.
Some studies suggest that a minimum washout period of 5 days should be observed to minimize perioperative bleeding and bleeding-related complications, unless emergency indications exist 1. However, the decision to stop Plavix should be made on a case-by-case basis, considering the individual patient's risk factors and medical history.
It's also important to note that some patients may require a bridging therapy, such as eptifibatide, to minimize the risk of cardiovascular events during the perioperative period 2. Ultimately, the management of Plavix in patients with CVA requires careful consideration of the risks and benefits, and should only be done under the guidance of a healthcare provider.
Key points to consider:
- Plavix is typically prescribed for at least 3 months following a stroke, but may be required for longer periods
- Stopping Plavix prematurely increases the risk of another stroke
- Temporary discontinuation of Plavix for a procedure should only be done under medical supervision
- Alternative antiplatelet therapy may be recommended during the perioperative period
- Bridging therapy, such as eptifibatide, may be necessary for high-risk patients.