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A new boxed warning has been added to the anti-blood clotting drug Plavix by the Food and Drug Administration, who says the medication doesn't work well in people who have difficulty metabolizing the drug. Plavix is used by patients with heart disease to help decrease risk of heart attack, stroke and death. It works on platelets—special blood cells that help blood clot to stop bleeding—by preventing blood clots from forming. Plavix needs to be activated by the liver enzyme, CYP2C Patients that have reduced liver enzyme function can't activate the drug making it less effective for them.

They're called "poor metabolizers" and this puts them at greater risk of heart attack, stroke and death. The Agency says there are tests available to evaluate CYP2C19 and determine if you are a "poor metabolizer. Last November the FDA issued a warning about using Plavix in conjunction with over the counter stomach acid reducer Prilosec and Prilosec OTC when new data found that taking the two together reducedPlavix's anti-clotting effect by about half.

Plavix is available only by prescription. It's made by Bristol-Myer Squibb and Sanofi Aventis, who issued the following statement "The revisions to the prescribing information for Plavix reflect the companies' ongoing research in collaboration with the FDA, which better defines the patient population that may be affected by a genetic variation in CYP2C19 and alternate treatment strategies. Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted.

Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog.

We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation. I was so happy to get off of that drug. Taking it with aspirin on Dr's orders.

When you get cut, you bleed and bleed and bleed. I would also get nose bleeds, which I never have had not taking that medication. Hi, I'm just curious about what the possible symptom's or side effect's are with someone that is taking plavix and can not metabolize it proper.

The reason I'm asking is because my dad is on it and had been on it for almost 9 years now. I'm on Plavix and aspirin as well, but 15 years post MI and open heart surgery plus two agioplasties and two stents, I'm alive and kicking and in the best health of my life. Sure I bleed a lot I've ruined a lot of clothes from little scratchs and hangnails but that's a small price to pay.

I have blood work done once a year to check liver function and cholesterol levels, would this test detect weather or not my liver was processing the drug? My tests have all been fine for liver function. I think it is so scarry to beielve that moms and aunts and femal baby sitters are potentially dangerous that we do everything we can to shut out the information.

Women have most of the access to children, and we like to think that they are all safe. It makes us feel better to do so, it is comfortable. But obviously, all women are not safe. And that is frightening. My daughter was harmed by a woman therapist. My father abused by a woman teacher for two years. We need to toughen up and face facts, that abuse is a human problem, not a male one.

M y health seems to be the same, and my life activity hasnt suffered. I think the world of the Veterans Administration health care for keeping me alive. My Mother is 91 yrs old and has been on plavix for about four years. Her skin is very thin, the plavix makes her body looked bruised and very bad.

Would you advise me to talk to the doctor about the drug which Jason Twomley wrote in his comment. She also bleeds when gets cuts. Her skin is so thin the doctor told us to be careful not to grab her arms because the skin could tear. This new blackbox is not very useful clinically.

I just don't see it ever happening where it becomes std of practice to order cyp isozyme evals for all patients. Plavix is a fantastic drug I was recently told by a pharmacist that they would NOT put their spouse on Plavix even though the spouse had a heart attack several years ago. Pharmacists know drugs. Doctor's often just prescribe and send you home. Is this a ambiguous drug with too many negative effects? Are their better options? Pharmacist recommends Vitamin E at least IU.

I had a TIA and can't get a clear perspective on this drug. Currently, Plavix lawsuits out there. It is now the second most prescribed drug on the market. Costly — no generic — big revenues for maker.

Company did a little song and dance to renew patent on it. I would really like to know the truth about Plavix. I continue to ask doctors. Nothing but, "yes take it. I have read that the drug company that makes plavix knew about the problem. Dave T: If it works for you great. I don't like flags because they allow us to keep measgses in the inbox, after we've decided what work they require. This makes the inbox a place that holds a mix of processed and unprocessed measgses. It is much easier for a message to get lost under this pile and not be handled until it's too late.

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Most depressing book I ever read in my life. Any woman that thinks life as a man in contemporary America is just a joyride should read that book. Also, "No More Mr. Nice Guy" by Dr. Robert A. Glover, which I'm reading now. Also addresses how life as a man in western society can be an exercise in getting your head completely f'ed up. Just my 2 cents. You may now amble about the cabin. So what happens if you have two stints of the kind which when installed required plavix for the rest of your life, which after being installed without your permission after being told that one was having a heart attack, you can't take plavix?

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A new boxed warning has been added to the anti-blood clotting drug Plavix by the Food and Drug Administration, who says the medication doesn't work well in people who have difficulty metabolizing the drug. Plavix is used by patients with heart disease to help decrease risk of heart attack, stroke and death. It works on platelets—special blood cells that help blood clot to stop bleeding—by preventing blood clots from forming. Plavix needs to be activated by the liver enzyme, CYP2C

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