Bilgrel 75mg Bilim Ilac medicine for myocardial infarction, stroke, peripheral artery disease (2 blisters x 14 tablets)

Dosage form Box of 2 blisters x 14 tablets
Specifications Clopidogrel
Ingredient Atherosclerosis, stroke, psoriasis, peripheral artery disease, angina

Ingredient

Composition information	Content
Clopidogrel	75mg

Uses

indications

Bilgrel drugs are indicated in the following cases:

Preventive prevention of thrombosis disorders such as myocardial infarction, stroke and peripheral artery disease.

The secondary control and preventive prevent in patients with atherosclerosis have a new stroke, new myocardial infarction or peripheral artery disease identified.

Pharmacy

Clopidogrel is an initial substance and strongly inhibits platelet aggregation. Clopidogrel selectively inhibits the cohesion of adenosine diphosphate (ADP) on its platelet receptor and activates the ADP through the next intermediate of GPIIV/Illa, thus inhibiting platelet aggregation. Clopidogrel's biological shift is needed to create platelet aggregation inhibition.

Clopidogrel also inhibits platelet gathering caused by other owners than ADP by preventing platelet activation amplifiers launched by ADP. Clopidogrel does not limit the operation of phosphodiesterase. Clopidogrel's activity cannot restore the change of platelet ADP receptors. Therefore, platelets in contact with Clopidogrel will be affected by the rest of life expectancy and return to normal platelet function occurs at a speed in accordance with platelet cycle (about 7 days).

According to statistics, platelet assisting dose may be 2 hours after taking the single dose of clopidogrel. Repeated dose of 75 mg (clopidogrel bisulfate) every day significantly increases the inhibition of platelet aggregation. This inhibitor increases gradually and reaches a stable state between day 3 and 7. Stabilizing the average inhibition level observed with a dose of 75 mg daily is from 40% to 60%. Platelets and bleeding gradually return to the original value after stopping treatment, usually at about 7 days.

pharmacokinetic

absorption

Clopidogrel is quickly absorbed after taking the dose repeated 75 mg Clopidogrel (Base).

Distribution

Clopidogrel and conjunction with plasma proteins are reversible, the ratio corresponds to 98% and 94% (research in test tubes).

Metabolism

Clopidogrel is a medication. The main activity is of its metabolites, a derivative with clopidogrel oxidation into 2 - clopidogrel - Oxo and hydrolyzed later. Oxidation steps are mainly regulated with Cytocrom P450 enzymes 2B6, 3A4, 101, 1A2 and 2019. Thiol metabolites linked to quick, non -recovery and inhibiting platelet aggregation. This metabolism cannot be determined in plasma. The pharmacokinetics of metabolites are linear (plasma concentrations increased corresponding to the dosage of drugs) within the dose range from 50 to 150 mg of clopidogrel. Clopidogrel metabolizes in the liver, metabolites are carboxylic acid derivatives and it is no longer active on platelets.

Elimination

About 50% of the drug is excreted in the urine and about 46% excreted in the feces. Selling time of 8 hours.

Before taking Bilgrel 75mg Bilim Ilac medicine for myocardial infarction, stroke, peripheral artery disease (2 blisters x 14 tablets)

How to use

Bigrel medicine is taken orally.

Dosage

Adults

Should use a single dose of 75 mg once a day. There is no need to adjust the dose for older patients and patients with kidney disease.

Children

Safety and effectiveness have not been determined in patients less than 18 years old.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Treatment: Stop taking medication, gastric lavage within 4 hours. Treatment of symptoms, airway ventilation and gastrointestinal hemostasis.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using bigrel , you may experience unwanted effects (ADR).

As with all drugs that affect blood clotting, bleeding may appear due to the use of clopidogrel. Bleeding can occur in any part of the body. The risk depends on many factors, including the use of drugs and sensitivity of the patient.

Common, ADR> 1/100

Digestive: abdominal pain, indigestion, gastritis and constipation, diarrhea, nausea.

cardiovascular: chest pain, edema, hypertension.

Central nerve: headache, dizziness, depression, fatigue.

Reaction in the skin: rash, itching.

Endocrine: Hyper cholesterol.

genital: Urinary tract infection.

Hematology: Hemorrhage, nosebleeds.

Liver system: Liver dysfunction test.

Bone system: joint pain, back pain.

Respiratory: Difficulty breathing, rhinitis, bronchitis, cough, upper respiratory tract infection.

Other disorders: The syndrome is like the flu (8%).

Uncommon, 1/1000

Immunity: allergic reactions, angioedema, ..

Hematology: Anemia, leukopenia.

Respiratory: Bronchospasm, blood cough. Other disorders: fever, blood, hepatitis, necrosis due to ischemia, platelet hemorrhage, urticaria.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Bigrel medicine is contraindicated in the following cases:

Patients with hypersensitivity to any ingredients of the drug.

Patients with pathological bleeding such as peptic ulcer or intracranial bleeding.

Precautions when using

Do not overdose unless the doctor's prescribed.

Use cautious for people at risk of increased bleeding from trauma, surgery or other pathology. Should stop taking the drug before surgery 7 days.

Bilgrel extends the bleeding time. Therefore, it is necessary to be cautious when used simultaneously with drugs that can cause lesions similar to salicylic acid, nonsteroidal anti -inflammatory drugs.

Patients should notify the doctor and dentist that they are taking Bilgrel before any expected surgery and before using any new drug.

The ability to drive and operate machinery

The drug can cause headaches, drowsiness, dizziness, fatigue, affecting the ability to drive, operate machinery. Do not use drugs when operating machinery and train.

Pregnancy

There is no adequate evidence of the effect of the drug on pregnant women. Bilgrel should only be used during pregnancy when really necessary.

Breastfeeding period

People do not know whether the drug is excreted in breast milk. Therefore, when using the drug should stop breastfeeding.

Drug interaction

with acetylsalicylic acid

ASA does not change the ability to inhibit sub -sentence training due to the adp of clopidogrel, but clopidogrel increases asa's efficiency on platelet aggregation due to collagen. However, the combination of 500 mg of aspirin twice a day with 75 mg of clopidogrel once a day does not increase the meaning of prolonging the bleeding time due to clopidogrel. Pharmacological interaction between clopidogrel and Asa is possible, increasing the risk of bleeding. Therefore, be careful when used in combination.

with heparin

Concomitance of Bilgrel and Heparin has no effect in inhibiting platelet aggregation caused by bilgrel. However, the safety of this combination has not been determined. Therefore, be careful when using simultaneously.

with Warfarin

Safety of simultaneous use of Warfarin and Bilgrel has not been determined. Therefore, be careful when used.

With nonsteroidal anti -inflammatory drugs

Concomitance use of bilgrel and naproxen has increased gastrointestinal bleeding. Therefore, to avoid the risk of blood loss, NSAIDS and Bilgrel should be used carefully.

Concomplified use of other therapies

There is no interaction when using Bilgrel at the same time with Atenolol, Nifedipin or both Atenolol and Nifedipin

Bilgrel's pharmacological pharmacology is negligible when used with phenobarbital, cimetidin or estrogel.

pharmacokinetics of theophylin or digoxin are not affected when used simultaneously with bilgrel.

Antacids are not affected by the level of absorption by Bilgrel.

Studies on liver microsomes have shown that bilgrel inhibits the activity of one of the enzymes (CYP 2C9) of Cytochrome P450 (2C9) enzyme. This condition can lead to an increase in the concentration of the drug's blood, such as phenytoin and tolbutamide, metabolized by CYP 2C9.

There is no evidence of adverse clinical interactive significance due to simultaneous use of bilgrel with diuretics, choosing beta, calcium antagonists, reducing cholesterol, coronary reliability drugs, treatments for diabetes, anti -epileptic drugs and hormones.

Storage

Put in a dry place, avoid light, temperature below 30 ° C.

Other drugs

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