Stage 3 Cancer: Definition, Diagnosis, Treatment, Prognosis
Plavix Side Effects: What You Should Know
Plavix (clopidogrel) is a brand-name oral tablet prescribed to lower the risk of heart attack and stroke in certain people. As with other drugs, Plavix can cause side effects, such as bleeding, which can be mild or serious.
The Food and Drug Administration (FDA) has approved Plavix to decrease the risk of heart attack and stroke in people with:
* For this use, Plavix is given in combination with aspirin.
Plavix can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Plavix in clinical trials:
For more information about these side effects, see "Side effect specifics" below.
Mild side effects can occur with Plavix. This list doesn't include all possible mild side effects of the drug. For more information, you can refer to Plavix's prescribing information.
Mild side effects that have been reported with Plavix include:
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Plavix and want to tell the FDA about it, visit MedWatch.
* For more information about this side effect, see "Side effect specifics" below.
Plavix may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Plavix's prescribing information.
If you develop serious side effects while taking Plavix, call your doctor right away. If the side effects seem life threatening or you think you're having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported and their symptoms include:
* For more information about this side effect, see "Side effect specifics" below.† An allergic reaction is possible after taking Plavix. However, this side effect wasn't reported in clinical trials. To learn more, see the "Side effect specifics" section below.
Plavix may cause several side effects. Here are some frequently asked questions about the drug's side effects and their answers.
Does Plavix cause any different side effects in older adults?No, it's not likely. In clinical trials of Plavix, older adults (ages 65 years and over) reported the same side effects as other age groups. These side effects can include bruising and bleeding problems.
If you are an older adult and you have questions about side effects from Plavix, talk with your doctor or pharmacist.
If I stop taking Plavix 75 mg, will I experience withdrawal symptoms?No, withdrawal symptoms were not a reported side effect in Plavix's clinical trials. Withdrawal symptoms are effects that happen after you stop taking a drug that your body has become dependent on. With dependence, your body needs the drug to feel as it typically would.
However, stopping Plavix can increase your risk of heart attack and stroke.
Talk with your doctor before stopping Plavix. If you need to stop the drug for any reason, follow their instructions for doing so.
Can Plavix cause fatigue, hallucinations, or constipation?Fatigue, hallucinations, and constipation were not reported in clinical trials of Plavix.
However, after the drug was available on the market, some people reported having hallucinations while taking Plavix. It's not known whether this side effect was caused by Plavix or something else.
If you have fatigue, hallucinations, or constipation while taking Plavix, talk with your doctor. They can help determine what may be causing these symptoms.
Learn more about some of the side effects that Plavix may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Plavix.
BruisingIn clinical trials, bruising was a common side effect reported with Plavix.
Bruising happens when small blood vessels under the skin break and release blood. A bruise may appear discolored at first and then change in color and appearance as it heals. The bruised area may be painful or tender.
What you can doMost bruises are small and will heal quickly. If a bruise is painful, you can apply an ice pack for 20 minutes at a time.
However, bruising can sometimes be serious. Talk with your doctor if you have concerns about bruising, such as large bruises that don't seem to be healing or getting better.
NosebleedsIt's possible to have nosebleeds during treatment with Plavix. In clinical trials, this side effect was common. Symptoms can include tasting blood, needing to swallow frequently, and bleeding from either nostril.
What you can doTell your doctor about any nosebleeds that won't stop on their own or become severe.
To stop a nosebleed, you should:
Call your doctor or go to the nearest emergency room for a nosebleed that continues for more than 15 minutes or makes you feel lightheaded (as if you're going to pass out). You should also talk with your doctor if your nosebleed is very heavy, with blood rushing out your nostrils and down your throat.
Thrombotic thrombocytopenic purpuraThrombotic thrombocytopenic purpura (TPP) is a side effect that was reported after Plavix was released on the market.
TTP is a serious condition that can be life threatening. It happens when tiny blood clots form throughout your body. Symptoms can include:
If you have symptoms of TPP, call your doctor right away. If the symptoms seem life threatening or you think you are having a medical emergency, immediately call 911 or your local emergency number.
ItchingIn clinical trials of Plavix, itching was a common side effect. Itching may go away on its own or may be a sign of an allergic reaction.
What you can doTell your doctor about any itching you develop while taking Plavix. They may be able to recommend ways to manage this side effect, such as taking an over-the-counter antihistamine such as Benadryl (diphenhydramine).
If the itching occurs with any symptoms of an allergic reaction, call 911 or go to the nearest emergency room right away. See "Allergic reaction" below for more details.
Allergic reactionAs with most drugs, Plavix can cause an allergic reaction in some people. However, this side effect wasn't reported in clinical trials.
Symptoms can be mild or serious and can include:
For mild symptoms of an allergic reaction, call your doctor right away. They may be able to recommend ways to ease your symptoms and determine whether you should keep taking Plavix. However, if your symptoms are serious and you think you're having a medical emergency, immediately call 911 or your local emergency number.
Plavix comes with several precautions. Read on for more details.
Boxed warning: Drug metabolism problem in certain peopleThis drug has a boxed warning for a risk of drug metabolism problems in certain people. This is a serious warning from the Food and Drug Administration (FDA).
In your body, Plavix is metabolized (processed) by the liver to its active form. This happens through an enzyme (protein) called CYP2C19. However, if you're missing this enzyme, you may not be able to metabolize Plavix. Because of this, the drug may not work as it should.
Your doctor may check your CYP2C19 function before prescribing Plavix to check whether your body is able to metabolize the drug.
Other precautionsBe sure to talk with your doctor about your health history before you take Plavix. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are known as drug-condition or drug-factor interactions. The conditions and factors to consider include:
Risk of bleeding. Plavix increases your risk of bleeding. If you take other medications that affect your platelets, you may be at an increased risk of this side effect. Tell your doctor about all of the medications you take, including any over-the-counter medications such as Motrin (ibuprofen) or Aleve (naproxen).
If you're bleeding from an injury or recent surgery, talk with your doctor before taking Plavix. They'll likely recommend that you give your body time to heal before taking this drug. If you have any health conditions that increase your risk of bleeding, such as hemophilia, tell your doctor. They may decide Plavix is not the best treatment option for you.
Surgery. If you're planning on having surgery, your doctor may advise you to stop taking Plavix beforehand. However, stopping Plavix can increase your risk of a heart attack or stroke. Be sure to follow your doctor's recommendation about Plavix if you're having surgery.
Kidney problems. Let your doctor know if you have any problems with your kidneys. Plavix may not work as well for you if your kidneys aren't functioning effectively.
Allergic reaction. If you've had an allergic reaction to Plavix or any of its ingredients, your doctor will likely not prescribe Plavix. Ask your doctor what other medications may be better options for you.
Alcohol with PlavixThere are no known interactions between Plavix and alcohol. However, drinking alcohol can irritate your stomach and intestines. Over time, this irritation may lead to ulcers (sores) and bleeding. Taking Plavix may make these conditions worse.
If you'd like to drink alcohol while you're taking Plavix, talk with your doctor. They can advise you on how much alcohol, if any, may be safe for you.
Pregnancy and breastfeeding while taking PlavixPlavix has not been clinically trialed in pregnant humans. However, reports of people taking Plavix during pregnancy have not shown harm to the fetus.
Plavix has not caused fetal harm in animal studies. However, it's important to note that animal studies don't always predict what will happen in humans.
If you're pregnant and taking Plavix, your doctor will likely recommend that you stop the drug 5–7 days before you give birth. This is because Plavix increases the risk of serious bleeding during labor.
If you're pregnant or planning to become pregnant, talk with your doctor. They can discuss the risks and benefits of taking Plavix during pregnancy.
It's not known whether Plavix may pass into breast milk or what effects it may have on a child who is breastfed. However, animal studies have shown that the drug passes into animal milk.
If you're breastfeeding or considering it, talk with your doctor. They may recommend that you stop breastfeeding or that you try another treatment than Plavix.
Similar to other drugs, Plavix can cause side effects. Some of them are mild, and others, such as bleeding, are serious. If you'd like to learn more about Plavix, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.
Besides talking with your doctor, you can do some research on your own. These articles might help:
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
From Chemo To Surgery: How Cancer Treatments Are Becoming Kinder
Chemotherapy has been used to fight cancer since the 1940s, radiotherapy was pioneered almost a century ago, and surgeons have been removing tumours in order to save lives for much longer. While these familiar-sounding treatments are still widely used today, they now look vastly different, are more successful and cause fewer side effects. So while one measure of progress in cancer research is that more people survive the disease – since the early 1970s, mortality rates for all cancers combined have decreased by around a fifth in the UK – another is that treatments can be less gruelling. The even more encouraging news is that, with the help of gifts left in wills to Cancer Research UK, all this progress is part of a trajectory still heading full-throttle towards an even greater understanding of the disease and, one day, the possibility of beating it.
If you were diagnosed with breast cancer at the turn of the 20th century, doctors had to take drastic measures, cutting away the entire breast along with the underlying chest muscles and all the lymph nodes from the armpit. The recovery time from these radical mastectomies was long and some of the after-effects were for life, ranging from swollen arms and movement difficulties to poor body image, depression and anxiety. But through determined research and listening to patients more, by the 1960s there was enough evidence that a far less invasive lumpectomy had survival outcomes just as good as radical mastectomies for women with early stage breast cancer, while also minimising physical and psychological side effects.
Radiotherapy and chemotherapy are the other two main prongs in breast cancer treatment. As in many other types of cancer, radiotherapy is often used after surgery to kill any cancer cells that might remain in the area around where the tumour had been, but it comes with risks of causing permanent damage to healthy tissue, leaving scarring and hard areas of breast tissue. And it once meant 25 hospital visits over five weeks.
This was until two landmark studies, starting in the late 1990s and supported by Cancer Research UK, found that a smaller number of higher doses of radiotherapy were just as effective and minimised side effects, while reducing hospital visits for treatment from 25 to 15, spread over three weeks. In 2009, once the 10-year post-treatment outcome figures were in, the evidence changed the National Institute for Health and Care Excellence guidelines on radiotherapy for breast cancer. The efficacy of these developments along with others – more on which follows – is highlighted by the fact that the risk of breast cancer coming back within five years after treatment has dropped from around 10 in 100 people in the 1980s to between one and two in 100.
The next step is a study, still under way, called PRIMETIME, which aims to see if women who have only a small risk of their breast cancer returning need to have radiotherapy after surgery.
The age of bespoke medicineLike our faces and fingerprints, every case of cancer is unique – and researchers have discovered many ways of reducing the negative impacts of treatments by tailoring them according to individual need. When Oliver, 60, was diagnosed with tonsil cancer in 2009, he had a tonsillectomy followed by chemotherapy, and then radiotherapy. This brings with it a risk of side effects arising from damage to healthy tissue, which in Oliver's case would include a permanently dry mouth. But Oliver took the opportunity to take part in a key Cancer Research UK-funded clinical trial of a newer, more targeted form called intensity modulated radiotherapy (IMRT). In this treatment, the radiation beams vary in strength and intensity, allowing them to be shaped to target a precise area – either in the exact shape of a tumour if used to shrink it before operating or, as in Oliver's case, the immediate area around where the tumour had been. "I feel fortunate to have been offered the chance to help medical research," says Oliver, who recovered well.
The race to reduce complications when treating children with cancer reached a much needed milestone in 2022. The most common aggressive brain tumour affecting children is medulloblastoma, which grows in the cerebellum at the back of the brain. Every year in the UK, around 50 children face this diagnosis. Ongoing research has established four subtypes of medulloblastoma, which can help doctors develop better treatment plans. Around 70% of children survive medulloblastoma for five years or more, but recent findings by Cancer Research UK scientists, led by Prof Steve Clifford at Newcastle University, are paving the way for even more honed treatments.
"The sequencing tools available to us now allow us to see, in much greater detail, the driving forces behind the different types of medulloblastoma at the single-cell level," says Clifford. Among their discoveries is that tumours in the subtypes with the highest survival rates contain genetically identical cancer cells, whereas the harder to treat tumour types have three or four different types of cancer cells. This gives them a better chance of evading treatment. The team also discovered a way to identify subtypes more easily, which could avoid the need to take multiple biopsies.
"We are now at the stage where we can clearly see what changes cause medulloblastoma to emerge in the first place, and the paths it can go down that determine how aggressive it is likely to be," says Clifford. These crucial findings could lead to more effective treatments.
50 years of Cancer Research UK: how small successes over time are leading to better outcomes for people with cancer
Read more
"No child should have to suffer a disability as a result of their cancer treatment," says Prof Pam Kearns, previously director of the Cancer Research UK Clinical Trials Unit at the University of Birmingham, referring to the hearing loss experienced by more than 60% of young patients with hepatoblastoma – a type of childhood liver cancer. It's a side effect of the most effective chemotherapy for this disease, but phase three clinical trials showed that the risk can be almost halved by taking a new drug, sodium thiosulphate, alongside it. The drug has now been approved by the Food and Drug Administration and European Medicines Agency for use in reducing chemotherapy-associated risk of hearing loss.
Meanwhile, yet more recent research has further honed treatment for breast cancer – the world's most prevalent type of cancer. The drug Herceptin was developed in the 1980s after it was discovered that some breast cancers have large amounts of a protein called HER2, which makes the cancer cells grow and divide. Herceptin is a targeted cancer drug that works by attaching to HER2, stopping this process. A downside is that it can damage the heart. But in 2019, Cancer Research UK scientists published a paper showing that cutting the treatment time from a year to six months was still as effective at stopping cancer from returning, but it also reduced the risk of adverse effects of the drug.
A brighter futureWhile some treatments involve large innovations, others have benefited from small adjustments. Take the FOxTROT trial, which showed that starting chemotherapy six weeks before surgery for colon cancer, then continuing for 18 weeks after, cut the risk of the cancer returning within two years by 28%. Patients previously had surgery at the start of their treatment followed by 24 weeks of chemotherapy, however, the trial revealed that not only did chemo prior to surgery increase the chances of all cancer cells being killed, it also reduced the number of side effects from surgery, meaning patients were less likely to suffer infection or need further operations.
These results are particularly positive as, unlike many breakthroughs, this change is quick and costs little to implement, and can be rolled out worldwide. In many parts of the world cancer treatments can be prohibitively expensive, which is why the researchers behind the FOxTROT trial wanted to go in the opposite direction, testing a treatment that could be used on the widest possible group of patients. Doctors in countries around the world will be able to save many thousands of lives as a result of the trial, which was funded by Cancer Research UK.
Pancreatic cancer is a common cancer in the UK – and one of the more difficult to treat – but the Institute of Cancer Research in London is testing a new targeted way of using radiotherapy that will minimise damage to surrounding healthy organs.
The project is being led by Prof Uwe Oelfke, whose joint specialities in fundamental and medical physics mean he is well placed to drive the implementation of such medical treatment innovation. He and his team use a radiotherapy machine with a built-in MRI scanner that allows radiation oncologists to see inside the patients as they treat them, including the position of the tumour. Tumours will move during therapy due to breathing and can drift substantially during the days of a treatment course. As Oelfke says: "We don't want to have to treat patients based on an image someone took a few days ago – we want to be able to treat what we can actually see in front of us at the time."
While working towards setting up clinical trials for the machine, Oelfke is also busy establishing a research facility to investigate two potential new types of radiotherapy, called "micro-beam radiation therapy" and "Flash therapy". These novel techniques require special equipment to produce either much smaller rays or deliver doses in much shorter time scales. For both techniques, preclinical trials have shown that they could eradicate tumours while sparing healthy tissue. "Ultimately, if we get this right," says Oelfke of his work, "we'll see better quality treatment and greater efficiency." All part of the trajectory in cancer research that means ever better outcomes and improved quality of life for patients.
Funding the futureA pledge of a gift in your will could lead to investments in research that further change the outcomes for people affected by cancer, helping them live longer, better lives. These legacy gifts enable Cancer Research UK to commit to the large-scale, long-term research projects that yield the biggest breakthroughs.
Gifts in wills are vital to accelerating progress, and fund one-third of Cancer Research UK's work, enabling lifesaving breakthroughs. To find out how you can help fund the next 50 years of progress by pledging a gift, visit cruk.Org/giftsinwills
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