Antiplatelet drugs effect may be affected by patient's medications, current medical conditions, food and supplements taken. Antiplatelet drugs effect may be increased or decreased. An increase in antiplatelet effect would increase the risk of bleeding and could cause prolonged or excessive bleeding. A decrease in antiplatelet effect would reduce the risk of bleeding, but increase the thromboembolic risk.
Medications Medications that may increase antiplatelet drug effect: • Cytotoxic drugs or drugs associated with bone marrow suppression (e.g.: leflunomide, hydroxychloroquine, adalimumab, infliximab, etanercept, sulfasalazine, penicillamine, gold, methotrexate, azathioprine, mycophenolate) • Drugs affecting the nervous system (e.g.:
Selective serotonin reuptake inhibitors (SSRIs)) • NSAIDS (e.g.: aspirin, ibuprofen, diclofenac, naproxen) • Other anticoagulants or antiplatelet drugs Medications that may decrease antiplatelet drug effect: • Carbamazepine • Erythromycin • Fluconazole • Omeprazole Use of NSAIDs as part of dental management of patients with vascular disease should be discouraged as NSAIDs have antiplatelet effect. Instead, simple analgesics such as paracetamol or co-codamol should be of first choice. If NSAIDs are required, the risk of bleeding increases with duration of dental treatment.
Medical conditions Medical conditions that may increase antiplatelet drugs' effect include: Chronic
kidney failure,
liver disease, haematological malignancy, recent or current
chemotherapy, advanced heart failure, mild forms of inherited bleeding disorders (e.g.
haemophilia,
Von Willebrand's disease) and
idiopathic thrombocytopenic purpura.
Food and supplements Food and supplements that may increase antiplatelet drugs' effect: St. John's wort, ginkgo biloba, garlic. == Oral antiplatelet drugs available in the UK ==