Antiplatelet Medications (“Platelet Antagonists”)

Clopidogrel (Plavix, Clopilet)
Ticlopidine (Ticlid)

What are antiplatelet medications, and why are they used in the treatment of lupus?

Clopidogrel (Plavix, Clopilet) and ticlopidine (Ticlid) are antiplatelet medicines (a.k.a., “platelet antagonists”) that help to prevent blood clots (thromboses). By preventing these clots, platelet antagonists help to prevent heart attack, stroke, and other complications. Lupus patients are at an increased risk for blood clots due to the prevalence of a condition known as antiphospholipid antibody syndrome (APS).  There are different kind of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibody, and an antibody called anti-beta2 glycoprotein I. APS is also sometimes called Hughes Syndrome after the British doctor who first described it in the 1980s. Virtually 50% of lupus patients have antiphospholipid antibodies, but only 10% experience complications associated with APS, including miscarriages, stroke, and deep vein thrombosis (DVT). People who do not have lupus can also have antiphospholipid syndrome, but lupus patients comprise about 50% of people who have the condition. Aspirin is usually used to prevent APS, but other antiplatelet medications may also be used.

How should I take my antiplatelet medication?

Antiplatelet medications come in tablet form. They should be taken with a full glass of water, with or without food. If you miss a dose, take that dose as soon as you remember. However, if it is closer to the time you will take your next scheduled dose, simply wait until that time and take your normal dose—do not take extra medicine to make up for the dose(s) you missed.

What are the side effects of antiplatelet medications?

Since antiplatelet medications work to prevent platelets from clumping together to cause a clot, they may cause easy bleeding, even with minor injuries. If you experience bleeding that will not stop, you should get medical attention immediately. In addition, let your doctor know of any surgeries—including dental surgeries—that you intend to have, since you will most likely need to stop this medication before the procedure to prevent excess bleeding. Antiplatelet medications can also cause bleeding in your stomach or intestines, so tell your doctor if you have black or bloody stools or vomit that looks like coffee grounds.

What should I remember while taking this medication?

Do not drink alcohol or smoke while taking this medication. In fact, people who have lupus should do neither of these things, because they will only aggravate your symptoms and cause further damage to your heart, lungs, liver, kidneys, and other organs. In addition, usually people who take antiplatelet medications should not take NSAIDs or aspirin. However, your doctor may prescribe aspirin along with a platelet antagonist to treat your risk or clotting because the benefits of taking the medications together may outweigh the risks. It is important that you stick to the medications prescribed by your doctor and take them only as directed.

You should not take antiplatelet medications if you have a stomach ulcer. Make sure you also discuss with your doctor any history of blood clots, stroke, liver disease, or kidney problems. Also talk to your doctor if you are pregnant, may become pregnant, or are breastfeeding. Platelet antagonists are not harmful to an unborn baby, but it is not known yet whether they can be passed into breastmilk.