Plavix Letter for Patients

To Our Patients Taking Plavix:

We have been discussing the safest use of blood thinners, such as Plavix, for patients needing to undergo colonoscopy, upper endoscopy or similar procedures.  With these procedures, there is a small chance of bleeding, especially with removal of polyps, cautery (burning tissue) or stretching narrowed areas (dilations).  This risk needs to be balanced against the problem of clotting while patients are off of blood thinning drugs, even if stopped only briefly.

Cardiologists have published new recommendations, and are concerned about the risk of heart stents clotting off and leading to heart attack or even death when these medications are discontinued.  In appreciation of this concern, we have revised our policy.

We recommend that patients continue on their usual Plavix dosing before and after a colonoscopy or upper endoscopy.  Because your own cardiologist, neurologist or primary doctor knows your circumstances best, they may recommend otherwise if they feel it is safe for you to stop your medicine 5 days before a study.

Advantage of Staying on Plavix

-          Minimizes risk of clotting which can cause stroke or heart attack.

Disadvantages of Staying on Plavix

-         Potential need to repeat a colonoscopy, IF a large polyp is found, due to concern about bleeding risk.  We think this would rarely happen, but repeating the colonoscopy would require another bowel prep.

-         Potential need to repeat an upper endoscopy, IF stretching of a narrowing in the esophagus is required.

-      Repeating either test could result in additional expense.

Thank you for taking the time to look over this information.  Please call the doctor who prescribes your Plavix, if you have questions regarding that medication. Please call Minnesota Gastroenterology at 612-871-1145 with questions regarding your upcoming procedure.

The Physicians of Minnesota Gastroenterology, PA

04/07/2008