"Clopidogrel": analogues, application, instruction, price

In what situations do doctors prescribe a drug called Clopidogrel? Instructions for use, analogs, form of release, composition, side effects and indications for the use of this medication will be detailed in this article. In addition, you will learn the cost of the drug and the opinion of patients about it.

Form of issue and composition

In what form can I buy Clopidogrel? The instruction informs that this medication is produced in the form of tablets, which are covered with a film membrane. One cell pack contains 14 pieces, 14 or 28 in a can, 1 or 2 plates in a carton. The main active substance is clopidogrel in the form of hydrogen sulfate. The auxiliaries contained in the drug include anhydrous lactose, magnesium stearate, pregelatinized starch, hydrogenated castor oil, polyethylene glycol 6000, and microcrystalline cellulose. The film coating, which is coated with tablets, consists of titanium dioxide, hypromellose, aluminum lacquer (based on Ponso 4 R colorant) and polyethylene glycol 400 and 6000. The drug "Clopidogrel" (the price will be indicated below) is realized through the network of pharmacies, but only if available Prescription.

Pharmacological characteristics

When the drug is treated with a decrease in platelet aggregation, caused by other agonists. The drug "Clopidogrel" (instructions for use, price, reviews and many other useful information are available on many medical portals and is presented in this article) is effective for two hours, the maximum effectiveness is on the 4th-7th day, subject to a constant intake of 50-100 Mg per day. The antiplatelet effect persists for 7 to 10 days during the entire life span of platelets.

Pharmacokinetics

After oral administration, the drug Clopidogrel (75 mg - the standard dose) is quickly absorbed from the digestive tract, while the concentration in the liquid part of the blood rises slightly, and after 2 hours reaches a level that can be determined (0.025 μg / l).

Intensively metabolized in the liver. The main metabolite is the inactive derivative of the carboxylic acid (approximately 85% of the circulating starting material in the plasma). The average maximum concentration after repeated application of Clopidogrel is 3 mg / l, it can be observed one hour after administration.

The active substance and metabolite are irreversibly bound to blood plasma proteins. Communication remains unsaturated.

After oral administration of 14C-labeled Clopidogrel, almost half of the dose is taken with urination, about 46% with feces for 120 hours. T1 / 2 of the main metabolite - 8 hours.

The satiety of the metabolite is many times greater in patients after reaching 75 years, while platelet aggregation and bleeding time do not change.

In blood plasma with severe kidney disease, the metabolite concentration is 5 to 15 ml / min, while in moderate to severe diseases it is 30-60. Despite the fact that the inhibitory effect in patients on adenosine diphosphate-induced platelet aggregation decreased, the time of bleeding increased in the same way as in healthy volunteers.

Indications

Are you aware, for what purposes do doctors prescribe to patients such a medication as Clopidogrel? Analogues and the medication itself are prescribed for the prevention of thrombotic complications in ischemic stroke, myocardial infarction and occlusion of peripheral arteries. Simultaneous reception of acetylsalicylic acid and "Clopidogrel" is indicated as a prophylaxis for thrombotic complications caused by acute coronary syndrome.

Contraindications

"Clopidogrel" (the price in the pharmacies of the Moscow region is about 510 rubles) is contraindicated when:

• Hypersensitivity;
• Acute bleeding;
• Hemorrhagic syndrome ;
• Severe hepatic impairment;
• Intracranial outpouring and pathology predisposing to the development of bleeding (lung tumor, peptic ulcer exacerbation, hyperfibrinolysis, tuberculosis);
• Deficiency of lactose (for medicinal forms containing milk sugar), hereditary intolerance to galactose, glucose-galactose malabsorption syndrome .

Clopidogrel: application and dosage

Tablets, according to the instructions, can be taken regardless of meals. For the prevention of thrombotic complications in patients with ischemic stroke or myocardial infarction, doctors appoint once a day "Clopidogrel" of 75 mg. In acute disease, which is due to the development of the focus of ischemic necrosis in the heart muscle, treatment should begin from the first days. The course of therapy with the use of "Clopidogrel" - no more than 35 days. Patients with ischemic stroke can take this medication for six months. When thrombotic complications occur in the background of ACS, without ST segment elevation, treatment starts with a single dose of loading dose (300 mg), and later take no more than one tablet per day. Maximum efficiency is observed after three months. Duration of therapy with Clopidogrel (analogs and generics are presented below) should not exceed 1 year. On the background of ACS with ST-segment elevation, 75 mg of the drug are usually prescribed daily with the initial one-time use of the loading dosage in combination with thrombolytic and acetylsalicylic acid. As soon as symptoms appear, you need to switch to combination therapy. Patients over 75 years of age are treated without a loading dose.

Overdose

The intake of the drug in doses exceeding the recommended levels is indicated by an increase in bleeding time with subsequent complications. In such situations, appropriate therapy will be needed. In the case where rapid correction of the increased bleeding time is necessary, transfusion of TM is necessary. There is no specific antidote.

Interaction with other drugs

Simultaneous reception of "Clopidogrel" with warfarin leads to an increase in the intensity of bleeding, which is why such a combination is highly undesirable. The likelihood of bleeding increases with treatment with a drug in combination with non-steroidal anti-inflammatory drugs, acetylsalicylic acid, glycoprotein inhibitors and heparin.

Side effects

Treatment with the drug Klopidogrel (instruction, price, method of application and dose described in detail in this material) can lead to undesirable consequences:

• Blood coagulation system: during the first month of therapy, bleeding often occurs, hematomas appear; Less often - conjunctive bleeding; Isolated cases - intracranial hemorrhages.
• Hemopoietic system: in rare cases - thrombocytopenic thrombohemolytic purpura, granulocytopenia, anemia, including pancytopenia and aplastic anemia.
• Nervous system: occasionally there are headaches, paresthesia, dizziness; Infrequently - vertigo; Single cases - confusion and hallucinations.
• Blood vessels and heart: haematomas are often formed; Sometimes there are heavy bleeding, vasculitis, lowering blood pressure.
• Respiratory organs: epistaxis, bronchospasm, pulmonary hemorrhage, interstitial pneumonitis, hemoptysis.
• Alimentary tract: diarrhea, dyspepsia, abdominal pain, gastrointestinal bleeding, gastritis and stomach ulcer, vomiting, flatulence, nausea, constipation, retroperitoneal bleeding, colitis, pancreatitis, stomatitis, acute hepatic insufficiency, hepatitis, increased activity of hepatic enzymes.
• Musculoskeletal system: arthralgia, myalgia, arthritis.
• Skin: Bullous rash (Stevens-Johnson and Lyell syndromes, erythema multiforme), eczema, erythematous rash and flat lichen.
• Urinary system: hematuria, hypercreatininaemia, glomerulonephritis.
• Allergic reactions: angioedema, serum sickness, hives, pseudoallergic reactions.

With therapy with this drug, an increase in body temperature is rarely seen enough, which is perceived not as a result of taking a medication, but as a symptom of a cold.

special instructions

The drug "Clopidogrel" with extreme caution is taken with a high probability of bleeding as a result of surgical interventions, a compromised system of hemostasis. If surgery is necessary, and antiplatelet effect is highly undesirable, it is necessary to refuse from taking the drug one week before the scheduled period of surgical intervention. Especially cautious medicine is prescribed for severe violations of the liver function, which can cause hemorrhagic diathesis. When there are signs of increased bleeding, a study of the hemostatic system will be required. In addition, it is necessary to constantly monitor the indicators of the functional activity of the liver. Caution "Clopidogrel" is used with heparin, NSAIDs, warfarin. In carrying out experimental studies, no carcinogenic and genotoxic effects of the drug have been identified, nor have the effect on the ability to manage transport been determined.

Clopidogrel: analogues and generics

Synonyms (analogues) of medicinal products are medicines having the same effect or having the same composition. What drugs can replace the drug "Clopidogrel"? Analogues of the drug on the active substance are the following: "Cardutol", "Detromb", "Agregal", "Trombeks", "Klopillet", "Troken", "Plavix", "Plagril", "Plogrel", "Targetek", "Egitromb" , "Clopidogrel-Teva".

Each medication has different characteristics, so the use is only permissible after consultation with the attending physician.

Opinions about the medicine

What do people say about such a drug as Clopidogrel? The feedback of patients who have suffered serious illnesses and surgical interventions are extremely positive. Patients note the high effective action of the medication, however, it is not calculated for admission for self-treatment. Analogues of medicines help patients to choose the optimal option for them in the ratio of price and quality, but the appointment and monitoring of effectiveness should be entrusted to an experienced specialist.