Harvard Heart Letter

6 steps to safer use of triple therapy

Take care when combining aspirin, Plavix, and warfarin.

Between a rock and a hard place. That's where many people with cardiovascular disease are finding themselves when it comes to taking the combination of three important and widely prescribed drugs.

Most heart attack survivors and folks who have received an artery-opening stent need to take aspirin plus clopidogrel (Plavix). People with atrial fibrillation or a mechanical heart valve or those who have had a deep-vein blood clot need to take warfarin (Coumadin, Jantoven, generic). As the tidal wave of baby boomers swells the ranks of older Americans, the number with coronary artery disease plus atrial fibrillation, a damaged heart valve, or deep-vein thrombosis keeps climbing. That means more and more people need this so-called triple therapy.

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