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Side Effects of
Antiplatelets

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What are the Side Effects of Antiplatelet Medications?

Description: Antiplatelet drugs decrease platelet aggregation, which is a component in the blood responsible for clotting. There are a number of different classes of these medications. These include:

  • Irreversible cyclooxygenase (COX) inhibitors (e.g. Aspirin)
  • Adenosine diphosphate (ADP) receptor inhibitors (e.g. Clopidogrel)
  • Phosphodiesterase inhibitors (e.g. Cilostazol)
  • Protease activated 1 (PAR-1) antagonists (e.g. Vorapaxar)
  • Glycoprotein IIB and IIIA inhibitors (e.g. Abciximab)
  • Adenosine reuptake inhibitors (e.g. Dipyridamole)

(Drug Class Review: Newer Antiplatelet Agents, June 2011; Physicians’ Desk Reference. 70th ed., 2016)

Warnings and Severe Adverse Reactions to Antiplatelet Medications

The majority of users will react positively to the medications, however, individuals can suffer severe adverse reactions, including:

  • Cardiac failure
  • Anaphylaxis
  • Stroke
  • Heart attack
  • Anaphylaxis
  • Dyspnea (difficulty breathing)

(Nature Reviews: Cardiology “Managing adverse effects and drug-drug interactions of antiplatelet agents,” Sep 2011).

Summary of Common Side Effects by Class

COX inhibitors, such as Aspirin, are associated with the following side effects:

  • Gastrointestinal bleeding
  • Abdominal pain
  • Nausea
  • Vomiting
  • Mucosal lesions
  • Peptic ulcers
  • Hypoprothrombinemia (deficiency of prothrombin)
  • Bronchospasm
  • Rhinitis (runny nose)
  • Conjunctivitis (eye inflammation)
  • Urticaria (rash)
  • Angina
  • Tinnitus
  • Hemorrhage

ADP inhibitors are associated with a number of adverse reactions. These can include:

  • Bleeding
  • Dyspnea
  • Epistaxis (nosebleed)
  • Cough
  • Bradycardia (slowed heart rate)
  • Peripheral edema (swelling)
  • Hypertension (high blood pressure)
  • Serum creatinine elevations (increased renal filtration)
  • Back pain
  • Dizziness
  • Loss of consciousness
  • Abdominal pain
  • Dyspepsia (indigestion)
  • Gastrointestinal hemorrhage (bleeding)
  • Nausea
  • Diarrhea
  • Constipation
  • Vomiting
  • Urinary tract bleeding
  • Rash
  • Pruritus (itching)
  • Subcutaneous or dermal bleeding
  • Bruising
  • Vertigo
  • Fatigue
  • Pyrexia (fever)

Phosphodiesterase inhibitors are associated with the following side effects:

  • Headache
  • Dizziness
  • Vertigo
  • Paresthesia (pins and needles)
  • Palpitations
  • Tachycardia (increased heart rate)
  • Peripheral edema (swelling of ankles and hands)
  • Diarrhea
  • Nausea
  • Dyspepsia (indigestion)
  • Abdominal pain
  • Flatulence
  • Vomiting
  • Back pain
  • Myalgia
  • Leg cramps
  • Arthritis
  • Pharyngitis (sore throat)
  • Dyspnea (difficulty breathing)
  • Rash
  • Jaundice (yellowing of the skin)

Protease activated 1 (PAR-1) antagonists are associated with the following side effects:

  • Bleeding
  • Anemia (low red blood cell count)
  • Rashes
  • Gastrointestinal bleeding
  • Intracranial bleeding
  • Retinal disorder
  • Diplopia (double vision)

Glycoprotein IIB and IIIA inhibitors are associated with the following side effects:

  • Major bleeding
  • Hypersensitivity reactions
  • Chest pain
  • Palpitations
  • Nausea
  • Vomiting
  • Dyspepsia (indigestion)
  • Diarrhea
  • Abnormal vision
  • Dizziness
  • Anxiety
  • Abnormal thinking
  • Agitation
  • Confusion
  • Muscle contractions
  • Coma
  • Hypertonia (increased muscle tone)
  • Diplopia (double vision)
  • Myalgia (muscle pain)

Adenosine reuptake inhibitors are associated with the following side effects:

  • Myocardial infarction
  • Chest pain
  • Headache
  • Paresthesia (pins and needles)
  • Dizziness
  • Dyspnea (difficulty breathing)
  • Bronchospasm
  • Bleeding complications

(Drug Class Review: Newer Antiplatelet Agents
, June 2011); Journal of Thrombosis and Haemostasis “Antiplatelet therapy: new pharmacological agents and
changing paradigms,” Nov 2013)

Understand Your Risks with the Rxight® Genetic Test

Pharmacogenetics aims to alleviate this problem by giving doctors knowledge about how a patient will react to a medication before it is prescribed.
MD Labs provides genetic testing through Rxight®, which is based on the sequencing of 18 genes to establish how patients will react to hundreds of medications across dozens of pharmacological classes (including many antiplatelet medications).

How Does Pharmacogenetic Testing Work?

The requirements are simple and involve a non-invasive cheek swab by a participating pharmacist, which is reviewed with you in detail after it is analyzed at our labs. With the information from the Rxight® Genetic Test, your prescriber can determine the dosing that is safe for you based on how well you metabolize the drug. This will guide your prescriber in tailoring your medication treatment by lowering the dose, or in some cases finding an alternative medication that is safer or more effective for you – preferably before you begin treatment.

Contributors to this Article: Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

Antiplatelets Tested Include:

Read more about Rxight® Pharmacogenetic Testing