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Dec 2011
5:00pm, 28 Dec 2011
2,928 posts
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Kittenheels Kath
Not sure I believe the name of that second drug, but here goes for my question: my Dad is 83, and had a heart attack at the end of October, and has had a stent fitted, and is now on 75mg of Clopidogrel per day. The doctor wants him to go onto Warfarin, but he's resisting because he used to drink quite heavily, and understands that he can't drink and take Warfarin. Thing is, he doesn't drink hardly anything at all now, probably less than a unit a day, and hasn't for quite some time. My sister and I want to be able to advise him with a little bit of knowledge behind us, which is where you come in: what's the difference between Warfarin and Clopidogrel, and what would you advise?
Sadly, my sister and I both have very little faith in the doctor.
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Dec 2011
5:09pm, 28 Dec 2011
10,549 posts
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HellsBells
as long as alcohol intake is steady and not excessive, there's no problem with warfarin - it's sudden binges that mess it up. Most of my stent patients are sent home on a combination of aspirin and clopidogrel. I'm not a cardiologist and would always be guided by the local heart docs.
Is it the cardiologist suggesting warfarin or the GP?
Is the warfarin being suggested purely because of the stent or is there some other reason such as AF?
I'm in surgery and can't access some documents - you could try googling the NICE guidance on stents
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Dec 2011
5:16pm, 28 Dec 2011
2,929 posts
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Kittenheels Kath
Thanks HB, he has AF, and has been told he's at risk of a stroke, which would be awful as he's Mum's principal carer. The cardiologist sent him home with instruction to move onto Warfarin, but has left it to the GP as to when this should happen, so that's where we are at the moment.
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Dec 2011
5:39pm, 28 Dec 2011
10,550 posts
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HellsBells
with a combination of AF and a stent then warfarin is easily the safest way to go
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Dec 2011
6:38pm, 28 Dec 2011
2,930 posts
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Kittenheels Kath
You are very, very lovely. Many thanks for the advice. That's very reassuring and gives us a position of some knowledge to get through to Dad with.
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Dec 2011
6:40pm, 28 Dec 2011
10,552 posts
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HellsBells
usual disclaimer applies - anything I say will always be generic, listen to the docs who have his full history to hand 
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Dec 2011
6:41pm, 28 Dec 2011
4,502 posts
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LouLou
There is also dabigatran now - not sure what the NICE guidelines are for it south of the border but it doesn't require blood monitoring and can be used in elderly patients for home warf is less suitable - may not be a clinical option but may be worth asking about newer anticoagulants if there are concerns about warfarin.
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Dec 2011
6:42pm, 28 Dec 2011
4,503 posts
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LouLou
(AND again my disclaimer or not knowing patient, clinical scenario etc. etc. )
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Dec 2011
6:47pm, 28 Dec 2011
4,807 posts
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Boingy
I've just come off 6 months of Warfarin and had a little drinky every now and again. My INR was a bit screwy when I got tested a couple of days after an evening where I had a few more than I should have, but otherwise was under control, so as HellsBells (who knows a lot more about this than I ever will) says it's probably best to keep it to moderation. One other interesting thing I was told was to avoid cranberries! Best of luck to your dad KK.
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Dec 2011
6:54pm, 28 Dec 2011
2,866 posts
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CC2 Speedy Goth
Why avoid cranberries? My dad (89) is on Warfarin and drinks Cranberry juice most days as he has issues with repeated water infections.
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