Aspirin and clopidogrel, the inhibition of platelets is irreversible, can I take it every other day?

Someone asked Huazi, among the antiplatelet drugs, the inhibitory effect of aspirin and clopidogrel on platelets is irreversible, so if these two drugs are taken every other day, can they reduce the dosage risk?

Hua Zi said that anti-platelet therapy is an important part of the prevention of cardiovascular and cerebrovascular diseases, especially those who have experienced cerebral infarction or myocardial infarction, the probability of disease recurrence is very high, and it is necessary to take medicine For secondary prevention, although there are risks, the benefits are greater. In order to reduce the risk of medication, taking medication every other day will increase the risk of disease, which is not worth the gain.

I. Who needs antiplatelet therapy

High blood pressure, high blood lipids, high blood sugar and other “three highs”, as well as smoking, obesity, aging, genetics and other factors, can cause atherosclerosis, the growth of hardened plaque in the arterial wall , itself is not a stable structure, and the fiber cap covered on the surface is prone to collapse.

Human blood can flow normally in smooth blood vessels, but if it encounters a ruptured plaque surface, it will activate platelet aggregation, which in turn activates fibrin to coagulate into a network. Thrombosis forms, blocking blood vessels. This is the pathological mechanism of most cerebral infarction and myocardial infarction.

People with atherosclerosis who are at high risk for cardiovascular and cerebrovascular disease require antiplatelet therapy. However, antiplatelet drugs have adverse reactions such as increased bleeding risk and digestive tract damage. Therefore, antiplatelet drugs are not recommended for healthy people without disease to prevent diseases.

Evaluate the benefits and risks of medication before taking medication, and recommend medication only if the benefit is far greater than the risk. Generally speaking, antiplatelet drugs are usually only used for the prevention of disease recurrence in people who have had cerebral infarction, myocardial infarction and other diseases, and those with high risk such as coronary heart disease and carotid artery stenosis of more than 50% are used for prevention Disease occurs.

Second, why it is not recommended to take medicine every other day

Among the antiplatelet drugs, aspirin and clopidogrel are the most commonly used. Aspirin works by inhibiting cyclooxygenase (COX) on platelets, and clopidogrel works by inhibiting adenosine diphosphate (ADP) receptors on platelets.

The two have different pharmacological mechanisms and can be used in combination, and the inhibition of platelets is irreversible, and the inhibition of platelets can reach 7-10 days. Many people asked Hua Zi, can he take medicine every other day?

Hua Zi said that although the inhibition of platelets by drugs is irreversible, human platelets will regenerate 7% to 15% every day. Platelets still activate aggregation and form thrombi.

If the drug is stopped for more than 48 hours, the newly formed platelets in the human body may form thrombus. Only taking medicine every day to inhibit the newly formed platelets can ensure the possibility of thrombosis. Sex is minimal.

Three, reduce the dose in special circumstances but not reduce the frequency of taking the medicine

The purpose of taking the medicine every other day is to reduce the adverse reactions of the medicine. However, each drug has its own minimum effective dose, and if the dose is too low, it will be difficult to inhibit all the new platelets that are produced every day, increasing the risk of disease.

The usual dose of aspirin is 100mg per day, the minimum dose is 75mg per day; the usual dose of clopidogrel is 75mg per day, the minimum effective dose 50mg per day, doses lower than the minimum effective dose are not recommended.

There are special patients with low platelet count. After evaluation by the doctor, a lower dosage can also be taken, but a daily low dosage should be taken, and it is not recommended 2 times the dose is given every other day, which not only reduces the risk of medication, but also ensures the effectiveness of the medication.

To sum up, in antiplatelet therapy, although the inhibition of platelets by aspirin and clopidogrel is irreversible, the human body generates new platelets every day, and the newly generated platelets are not affected by drugs. When the drug is stopped for more than 48 hours, it may induce thrombosis, so antiplatelet drugs should not be taken every other day. Special patients can reduce the dose, but still maintain daily medication, which will not increase the risk of disease while reducing the risk of medication.

The medicine should be used under the guidance of a doctor. If you have any doubts about the medicine, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.