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Clopidogrel 75 mg
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Clopidogrel (generic Plavix)
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Pharmacological Effects:
Clopidogrel - antiplatelet drugs. Effect of the drug is due to the ability of clopidogrel selectively inhibit the binding of adenosine receptors of platelets, thus inhibited the activation of a complex glycoprotein IIb / IIIa and decreases platelet aggregation. Clopidogrel increases the bleeding time. Antiplatelet action of clopidogrel is dose dependent, with use of the drug at the recommended therapeutic doses, the maximum therapeutic effect occurs within 3-7 days. Clopidogrel irreversibly blocks ADP receptors of platelets, so that they lose their ability to aggregate, the restoration of normal function was restored 7 days after drug withdrawal, as we update platelets.
After oral administration the drug is rapidly absorbed from the gastrointestinal tract. Bioavailability is about 50% and is independent of food intake. Clopidogrel - prodrug, is metabolized in the liver with the formation of the active substance - thiol metabolite of clopidogrel. The main metabolite is a carboxylic acid derivative, which determine the pharmacokinetic profile. Peak drug concentrations in plasma observed after 60 minutes after oral administration. Excreted in the urine and feces as metabolites. The half-life of about 8 hours.
Indications:
Clopidogrel is administered as a prophylactic agent in patients suffering from diseases of the cardiovascular system, in particular for the prevention of atherothrombotic events in patients with myocardial infarction, ischemic stroke and patients with peripheral artery disease.
Clopidogrel is also used in combination with acetylsalicylic acid for the treatment of acute coronary syndrome without ST segment elevation ST (in particular, patients with unstable angina or myocardial infarction without wave Q).
Clopidogrel is used in treatment of patients with acute myocardial infarction-segment elevation ST, when the patient shows thrombolytic therapy.
How to use:
Clopidogrel is taken orally. A tablet recommended to swallow whole, without chewing or crushing, drinking plenty of water. Clopidogrel does not depend on food intake. The duration of treatment and dose usually determines the physician for each patient individually.
Adult and elderly patients for the prevention of atherothrombotic events is usually prescribed for 75mg of the drug (1 tablet), 1 per day. Receiving the drug for prevention after myocardial infarction should be started a few days later, but no later than 35 days later, after suffering an ischemic stroke - after 1 week but no later than 6 months.
Patients with acute coronary syndrome without ST-segment elevation is usually prescribed 300mg once the drug (4 tablets) at the beginning of treatment, then transferred to taking 75mg of the drug 1 per day in combination with acetylsalicylic acid. Dose of acetylsalicylic acid determines the physician individually, usually it is 75-325mg per day, however, due to the increased risk of bleeding did not exceed the recommended daily dose of aspirin 100mg. Maximum therapeutic effect observed after 3 months of therapy.
In acute myocardial infarction is usually prescribed 300mg of the drug once at the beginning of treatment, then switching to the use of a drug 75mg once daily in combination with acetylsalicylic acid. When treating patients over the age of 75 years, the drug starts with 75mg of the drug 1 time per day, skipping the loading dose of the drug at the beginning of therapy. Duration of treatment for at least 4 weeks.
Data on the need for dose adjustment of the drug in patients with impaired liver function and / or kidney disease, are absent.
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Side effects:
Using the drug clopidogrel in patients noted the development of such adverse reactions:
From the blood system: thrombocytopenia, granulocytopenia, neutropenia, anemia (including aplastic anemia), in a few cases noted the development of thrombotic thrombocytopenic purpura syndrome (Moshkovitsa) and Henoch-Schonlein purpura. In addition, frequently noted the development of different localization of bleeding in patients receiving the drug clopidogrel, including gastrointestinal and nasal bleeding, as well as ocular and intracranial hemorrhage
From the gastrointestinal tract and liver: stomatitis, nausea, vomiting, indigestion, pain in the epigastric region, violations of the chair, gastritis and peptic ulcers of the stomach and duodenum. In addition, the possible elevation of liver enzymes and increased levels of bilirubin in the blood.
Allergic reactions: skin rash, itching, rash, maculopapular rash, bronchospasm, angioedema.
Other: cough, arrhythmia, pulmonary embolism, fatigue, confusion, headache, fever, myalgia, arthralgia, hematuria.
With the development of side effects should stop taking the drug and call your doctor.
In the case of bleeding, including hidden, you should contact your doctor, since the drug prolongs bleeding time and increases the risk of complications from bleeding. If the observed development of abnormal bleeding, including bleeding gums, it is necessary to conduct a study of the hemostatic system, in addition, when using the drug clopidogrel is recommended to regularly monitor liver function.
Patients taking the drug clopidogrel, should inform health care workers (including dentists) of the medication.
Contraindications:
Individual hypersensitivity to the drug.
Severe liver damage, jaundice, accompanied by cholestasis.
Due to the fact that the drug contains lactose, it is not prescribed to patients with glucose-galactose malabsorption and hereditary lactase deficiency.
Clopidogrel is not used for the treatment of patients with active bleeding, including bleeding from the peptide ulcer or intracranial hemorrhage.
Clopidogrel is contraindicated during pregnancy and breastfeeding.
In connection with unproven efficacy and safety of the drug in patients under 18 years of clopidogrel should not be used in pediatrics.
Clopidogrel should be prescribed with care to patients with an increased risk of bleeding due to trauma, surgical interventions, as well as violations of the blood system.
Clopidogrel should be used with caution in patients suffering from impaired renal function and / or liver.
Do not take the drug for 7 days before the scheduled surgery.
Pregnancy:
Clopidogrel is contraindicated in pregnancy due to the fact that the safety of the drug to the fetus is not proven.
If necessary, use during lactation should solve the issue of a possible interruption of breastfeeding.
Interaction with other drugs:
The combined use of medication with acetylsalicylic acid indicated a mutual enhancement of their effect on platelet aggregation. Safety of combined treatment with these drugs for more than 12 months is not proven.
Clopidogrel should be used with caution in conjunction with heparin, but the drug clopidogrel to patients receiving heparin therapy, does not require dosage adjustment of the latter.
In the appointment of the drug to patients receiving other thrombolytic drugs, caution should be exercised.
With the simultaneous application of clopidogrel with warfarin may increase the risk of bleeding. Should not be prescribed clopidogrel for patients receiving warfarin therapy.
Clopidogrel should be prescribed with care with medications that have a high degree of association with plasma proteins.
With the simultaneous appointment of a drug with non-steroidal anti-inflammatory drugs with caution.
With the simultaneous application of the drug with antacid drugs are not observed changes in pharmacokinetic parameters of clopidogrel.
Caution must be exercised in the appointment of the drug clopidogrel patients taking inhibitors of glycoprotein IIb / IIIa.
Overdose:
In the application of excessive doses of the drug in patients there is an increase in bleeding time.
No specific antidote. In case of overdose symptomatic treatment is shown. In the case require immediate correction of the state, shows platelet transfusion.
Product:
Film-coated tablets, 10 pieces per blister, 1 or 2 blisters per carton.
Storage Conditions:
Clopidogrel is recommended that you store in a dry place away from direct sunlight at a temperature above 25 degrees Celsius.
Shelf life - 3 years.
Synonyms:
Plavix, Zilt, Agregal, Listab.
Ingredients:
1 tablet, film coated contains:
Clopidogrel bisulfate (recalculated as clopidogrel) - 75mg;
Excipients, including lactose.
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