Atorvastatin and Clopidogrel

[Baldrick]

Ive just been reading that there may be adverse effect of taking these two medications together? I currently have a bout an 8 hour difference between taking the 2 medications but obviously I am wondering if I need to take advice (GP) about an alternative statin or even coming off statin if current levels permit. Anyone any thoughts or experience.

[ScubaJane]

Hi, can you point me to the direction of that article as my hubby takes both together and has been since his stroke last December!

Thanks

[Baldrick]

Hi Scuba Jane,

Sure here it is…..

Do Statins Interfere With Clopidogrel During Platelet Therapy? | Pharmacy Times

However, I did not want to alarm or concern anyOne about this just ask if anyone had been advised. I certainly would not change anything on the basis of one article- any changes must be only under a doctor’s direction. In any case Your current regime is obviously working for your husband, which to my mind is the overriding factor. I will not be changing anything but will run it by my GP when I see him on Tuesday (hopefully!).

Sorry to Labour the point - Im sure you wouldn’t change anything without proper consultation anyway. Very best wishes to you both…..

[Baldrick]

Further to the above, theres a lot on AI which suggests may be taken safely together in most cases ….. it’s all a but confusing with some say it’s fine others take caution . Interested in any advice anyone may have been given.

[harimanjaro]

I’ve been on both for the past nine months, so was interested to read that. It took a bit of effort to cut through the dense medical terminology, but my layman’s reading of it doesn’t give me much cause for alarm. The authors say that there is a theoretical interaction between clopidogrel and atorvastatin, but “Results of most studies showed no clinical significance”. They then point to just one study where there was a 2-fold increase of risk of an adverse event, but that was only in the first 30 days. I see that as a blip, not a trend.

There are plenty of studies on PubMed and elsewhere that can give us all sorts of worries if we take them in isolation. Thankfully we have an army of researchers around the world assembling a much bigger picture which informs the guidance published by NICE and used by our doctors. That doesn’t mean that we shouldn’t ever question that advice, though, and I really would advise anyone who’s worried to talk to their doctor. I’ll be really interested to hear what your doctor says about it, @Baldrick.

[ScubaJane]

Thanks. Be assured I’llread the article and run it by my hubby’s doctor and see what she thinks. Cheers

[Baldrick]

Thanks Harimanjaro & everyone,

I do agree with everything you have said which is a very balanced and rational viewpoint. My investigation started because I forgot to take my statin last night🙄 and so I initially looked for what to do. And if I could combine taking the 2 at once. I think you have got the answer to that correct but I’ll ask the GP and report back.

Im not a chemist or a doctor but it may be of interest - The other thing to come out of this is what time is best to take the medication and there seems to be an optimum for Clopidogrel. Atorvastatin unlike most statins is a slow release and can be taken anytime apparently. I have been very lucky and had a very healthy life until my stroke so taking medication is a new thing for me so I really value all advice and viewpoints.

thanks again friend .

[EmeraldEyes]

The best time to take statins is at bedtime for optimum effect. And that’s because you are not taking in food, because the liver produces the most cholesterol at night.

I take my clopidogrel in the morning with my breakfast and atorvastatin at bedtime. Even though its a long lasting statin, which means it doesn’t matter about time of day, I still prefer to keep it separate from other meds.

Lorraine

[EmeraldEyes]

@Baldrick

I forgot to take my statin last night🙄 and so I initially looked for what to do. And if I could combine taking the 2 at once.

The thing you need to remember is you won’t drop dead if you miss just one on occasion. That’s bound to happen with anyone. I’ve certainly missed mine on occasion and I’m still here to admit to it. If you remember an hour or two after a missed med then just take it as soon as you remember. Otherwise just wait ‘til the next dose is due, but never double up on a medication ever, without first discussing it with your gp, or with your chemist for a much quicker answer😉

Lorraine

[harimanjaro]

I take mine together in the morning, probably not optimal but it helps to ensure that I don’t forget to take them. I don’t think forgetting to take the odd statin is a disaster, @Baldrick, that’s looking after management of LDL and stabilisation of arterial plaque which is a medium to long term thing as I understand it. So soon after a second stroke you probably want to be quite diligent about the clopidogrel, though.

[Baldrick]

Thanks Emeraldeyes,

Yep thats what I am doing and it’s reassuring to hear your perspective. I realised it was bound to happen at some stage I am after all, like is all, human. It is though distressing anyway after a lifetime of no pills I suppose i have to say ive had a good run!!

Thanks again for your wisdom…..

[Baldrick]

Sorry missed this one first. Yep ive been taking atorvastatin at night and will continue like this. And Clopidogrel midday.. interesting.

Thanks again …..

[Baldrick]

Thanks Harimanjaro

Very wise and yes the Clopidogrel i take midday and carry with me in case im out. My fault forgetting the statin I’ll be taking it before I go to bed now (iso while im reading my book🙄).

Thanks again Harimanjaro and everyone- it’s probably basic stuff to you all - every post is much appreciated thanks for the wisdom.

[EmeraldEyes]

Hey, it’s only because the doctors put the fear of god in you about not forgetting to take your medications I remember the first time I missed a medication, being new to these things, I nearly had a heart attack in the process​:sweat_smile:

You just don’t want to make a habit of it because these meds are reducing much greater risks😬 keeping you alive and kicking😉

Lorraine

[ManjiB]

Hello @Baldrick - I thought I’d chip in with my tuppence worth on this.

Firstly, I start with a statement:

I don’t believe I am a contrarian, nor a conspiracy theorist, but sometimes my views might be construed as such - they are not intended as such. What I share is based on personal experiences either directly with me or with members of my family. I am not a healthcare professional and have not been medically trained, but I like to think I use a lot of common sense. Anyone reading my posts should decide whether it is something they would wish to consider or ignore.

1. When it comes to medicine and especially that which has been prescribed by GP or hospital consultant the first rule is always read the manufactures leaflet that comes with the medicine. To my knowledge almost all medicines come with such a leaflet and if there isn’t one, I would look it up on the NHS website. At the beginning of the year, we discussed this on this forum and the below link may be of interest.

Taking Medication - Read Manufacturer's Leaflet

This is not related specifically to Stroke, but it is general advice on what to look out for when taking medication. Let’s start with a survey. When taking medication, do you read the manufacturer’s leaflet: poll I have seen some posts on this forum asking questions or seeking advice about medication. I thought I would share with you what I like to do with regards to taking medication. For me, it is important to know as much as I can about the medication so that I use it as re…

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2. There is a website where you can look up information on medications and where you can also check how drugs interact e.g. with other medication, foodstuffs and lifestyle etc.
   Below are screen prints of results for your drugs of interest (Atorvastatin and Clopidogrel).
   It is my belief that Drugs.com is considered a reliable and reputable source for objective, professional medical and drug information

3. Taking advice
   This is interesting for me and hence my opening statement. Right now I find it difficult to know whose advise I can trust. Recent bad experiences with GP and hospital consultants to the cost of my Mum’s health leave me very sceptical about the professionals and their advice. Maybe we have been unlucky as I am aware many members on this forum have enjoyed excellent advice and service from their GPs and healthcare professionals.

So on that note, I/we feel the best advice we can get is from ourselves. Listen to your body is one of my mantras. Your body will tell you all you need to know. By listening to her body Mum has managed to avoid many serious complications arising from the drugs that have been prescribed for her following her stroke six years ago.

In closing, I have already posted on this subject, but we are in the process of taking Mum of her current medication, a PPI called omeprazole. Once we have done this, Mum will have been taken off all of the drugs she has been prescribed since she had her stroke and she will be on no drugs as she continues to deal with being a stroke survivor.

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I note that you have had much response to your post and note you are seeing your GP next Tuesday. I wish you all the best.

[Rups]

I switched from atorvastatin to rosuvastatin due to reacting adversely to it and then reading a fair amount of negative comments about the former, not on the stroke forum but on the Heart Foundation forum. I am now on 5mg rosuvastatin with the aim to go off. Just had my annual stroke review and cholesterol levels are fine (level 4) and the GP agrees there is little need for me to be taking it. From the article you posted it seems clopidogrel and rosuvastatin work on different enzymes so isn’t an interaction, if I’ve read that right. So if concerned maybe switch to rosuvastatin.

I used to take my meds in the morning but read some journals that pointed to clopidogrel being better taken at night to work more effectively in the morning when cardiovascular activity is high and there is more risk of stroke or heart attacks. I now, after almost five years take my meds at night. The other reason is also because of the SRRI I take, it is better that I sleep through any side effects than endure them during the day.

Many times, I have gone for days, sometimes up to four days without taking meds due to either the surgery or pharmacy delaying my prescription and the more it happened the less it worried me. Also, medication has a half -life, so even if you forget a dose, it is still working in your system for however long it’s half-life is, so I wouldn’t overly stress about it. The stress is worse than the forgetfulness. The only medication I suffer from if having a prolonged absence is the SRRI because after about three days, the awful withdrawals begin, fortunately, I have a friend who takes the same, so there have been times when she’s lent me a few tablets to buffer the symptoms.

[Baldrick]

Thanks Rups

Very good gen as always. I seem to get on ok with artorvastatin though i have no experience of others. Interestingly, the night I forgot my statin i didnt sleep that well whereas other nights I do and back to normal last night. Who knows but maybe the statin helps sleep🤷‍♂️…… So I’ll probably stick with atorvastatin but i will have a read up on the options in slow time.

I too have read that Clopidogrel is better taken in the evening. My understanding is Atorvastatin has a long half life (14 hours i think?) so my thinking is to switch the 2 around and take the statin midday or shortly after. I’ll talk to my Dr about this and how to do it though it doesn’t seem like rocket science to me probably i am overthinking it?

I guess we are all different and have to find what works best for each of us individually and probably it’s more refinements than essentials. Again im new to it all.

Thanks again Rups I found yr post both reassuring and helpful.

Cheers mate.

[wolfie]

Does it matter what time you take your medicines?

From the BHF.

[Baldrick]

Thanks wolfie

Heck of a lot of detail there but an interesting read. Interesting it says Clopidogrel Anytime (but at same time daily) which is different to the advice I found on line which was evening best. I get the impression it’s one study versus another at times (?) BUT I have to say that heart foundation page you forwarded seems the most authoritative yet. I will keep reading……

Thanks again Wolfie it all adds to the volume of knowledge for everyone i don’t suppose im the only one questioning.

Have a great weekend.

[Gnasher]

Hi all. I was on Atorvastatin and due to it giving me aches in my left arm I was taken off. After my stroke I was put on Rosuvastatin 10 mg and Clopidogrel 75 mg. And told to take the Clopidogrel in the morning at 8 am. And the Rosuvastatin at 8 pm again. This meaning a 12 hours difference. I have also set a reminder on my phone. So far not missed any. But was also told not to take them together or take 2 of the same in a one day. Start afresh the next day if you forget to take one.