If you are one of the millions of Americans with acute coronary syndrome who recently experienced a heart attack or stroke, you have likely been prescribed a blood thinner. Blood thinners can help prevent potentially dangerous clotting within arteries or stents.
The most commonly used blood thinner is Plavix, but two newer medications to the market are Effient and Brilinta, and they serve similar purposes. There are some important differences between blood thinners, however, and it is critical to know what they are.
How Antiplatelet Medications Work
Antiplatelets are a type of medication that stops blood cells (platelets) from grouping together and creating a blood clot. While platelets create a blood clot to stop bleeding in your injury, sometimes platelets group together inside injured or swollen blood vessels. When platelets group in this way, they can cause blood clots to form inside blood vessels.
Sometimes, platelets can also cause blood clots to form around artificial heart valves and other heart assistance devices placed in a person’s body. Patients who prescribed antiplatelet medications often have either coronary artery disease, heart attacks, angina, strokes, or peripheral vascular diseases.
There are several types of antiplatelet medications and each type works differently. For example, aspirin is the most common type of antiplatelet medicine. Adenosine diphosphate receptor inhibitors like Plavix, Brilinta, and Efficient are another type of medication often given to patients who recently had heart attacks or stroke. Plavix, Effient, and Brilinta all bind to the P2Y12 receptor, which prevents blood clots from forming. While these medications serve similar purposes, only Plavix is metabolized by the liver.
Differences Between the Medications
Before discussing the differences between these drugs, it is important to note that each of these medications carries an increased bleeding risk.
The critical differences between Effient, Brilinta, and Plavix, include the following:
Each medication leads to adverse reactions with various types of medications. Plavix can interact adversely with various medications including aspirin, nonsteroidal anti-inflammatory drugs, armodafinil, modafinil, fluoxetine, fluvoxamine, gemfibrozil, isoniazid, cancer medications, and stomach acid reducers.
Brilinta can also adversely interact with dexamethasone, digoxin, nefazodone, antibiotics, cholesterol-lowering medication, and blood pressure medications. Effient also has interactions with blood thinners, heparin, non-steroidal anti-inflammatory medications, and other medication used to treat blood clots.
The generic version of Plavix is called Clopidogrel. There is not a generic version of Brilinta. There is also no generic version of Effient.
First approved in 1997, Plavix is the oldest of the three drugs. Effient is slightly older than Brilinta. Effient was first approved by the FDA on July 10, 2009, while Brilinta was approved by the FDA on July 20, 2011.
How the medication is taken
Plavix is prescribed in 75 to 300mg tablets. Effient is taken as an initial 60mg oral dose and then 10mg orally once a day. People who take Brilinta is also taken as an oral tablet that is available as either a 60mg or 90mg oral tablet. For all three of the medications, medical professionals recommend that patients also take aspirin daily. This is because aspirin taken in small daily doses is another safe way to combat clotting risks.
Both Plavix and Effient are classified as Category Type B pregnancy risks. Category B means that the Food and Drug Administration claims that controlled animal reproduction studies have failed to demonstrate a risk to the fetus. Brilinta is classified as a Pregnancy Category C. This means that risks of using the medicine have not been ruled, but that potential benefits might warrant using the drug despite those risks. Pregnant individuals should consult with their physician before taking any of these medications.
Brilinta is the most affordable of the three medications. The average price of Plavix is $237 for 30 tablets. The average price of Brilinta is $213.50 for 30 tablets. The average price of 30 Effient tablets is $488.70.
Plavix tends to be associated with fewer side effects than Effient or Brilinta. The commonly associated side effects of Plavix include nosebleeds, headaches, increased bleeding, headaches, itching, and bruising. Some of the common side effects of Effient include increased tendency to bleed, headaches, dizziness, back pain, minor chest pain, fatigue, nausea, coughing, extremely high or low blood pressure, shortness of breath, rashes, fever, swelling, and diarrhea.
Some of the common side effects of Brilinta include increased bleeding and bruising. Other side effects associated with Brilinta include dizziness, coughing, nausea, diarrhea, irregular heartbeats, extremely high or low blood pressure, back pain, chest pain, and fatigue.
Plavix must be processed and activated in a person’s liver, which means that the medication sometimes takes time to have an effect. This also means that some people do not respond to Plavix. Effient, however, tends to be more effective and works more quickly because it does not proceed through a person’s body the same way as Plavix.
There are also fewer cases of people not responding to Plavix. Brilinta has also been found to be more effective than Plavix because it is not processed by the liver. Brilinta, however, does not bind to platelets permanently like Plavix and Effient do. Instead, Brilinta interacts with CYP3A4 inhibitors and inducers while Plavix is mainly metabolized by the CYP2C19 enzyme.
All three medications have the potential to reduce the risk of heart attack or stroke in certain patients. While Plavix is the oldest, Brilinta and Effient are often more effective in treating blood clots. These two medications, however, can carry more adverse side effects than Plavix.
The best way to make sure you end up with a suitable healthcare plan is to have direct and honest discussions with your medical professional. By sharing details in this way, you can make informed medication, dosage, and surgery decisions. Selecting the most suitable blood thinner is not easy, but your medical team can help.