Clopistad 75mg Stella prevents arterial thrombosis (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Clopidogrel
Ingredient Atherosclerosis, stroke, myocardial infarction, psoriasis, peripheral artery disease, angina

Ingredient

Composition information	Content
Clopidogrel	75mg

Uses

indications

Clopistad drug indicated in the following cases:

Prevention of arterial thrombosis:

Older patients with myocardial infarction (from a few days to less than 35 days), stroke due to ischemia (from 7 days to less than 6 months) or the peripheral artery disease has been established.

Older patients with acute coronary syndrome

Acute coronary syndrome does not have a difference of ST segment (unstable angina or myocardial infarction without Q), including patients with coronary catheter (stent) during the skin of coronary artery intervention, used in combination with aspirin.

Acute myocardial infarction has a difference in combination with aspirin in patients with medical treatment and therapy with thrombolytic drugs.

Prevention of arterial thrombosis and blood vessels in the atrial fibrillation

In older patients with atrial fibrillation, there is at least one risk factor for blood vessel events, not suitable for vitamin K antagonistic medication (VKA) and those at risk of low bleeding, clopidogrel is indicated in combination with aspirin to prevent arterial thrombosis and blood vessels, including stroke.

Pharmacology

Clopidogrel is a selective inhibitor of adenosin diphosphate (ADP) to its receptor in platelets and leads to the activity through the ADP intermediaries of the Glycoprotein GPIIB/IIIA complex, so that the inhibition of platelet aggression.Clopidogrel's metabolism is needed for the inhibition of platelets, but the active metabolites of the drug have not been isolated.

Clopidogrel also inhibits the stopping of platelets by other agreements from ADP by blocking the platelet activation process from ADP release.

Clopidogrel does not inhibit the activity of phosphodiesterase.

Clopidogrel is impacted by non -recovery of ADP platelet recovery. As a result, platelets mounted clopidogrel will affect the later stage of platelet life.

The inhibition of platelets depends on the dose, can be seen after 2 hours of single dose. The repeated dose of Clopidogrel 75mg per day significantly inhibits platelet aggregation due to the ADP in the first day and this inhibitor reaches a stable level in the 3rd and 7th days.

After reaching a stability, the average inhibitor level at a dose of 75 mg/day is about 40-60%. Platelet's collection and bleeding time gradually return to the basic value, usually in about 5 days after treatment.

Pharmacokinetics

absorption: Clopidogrel is quickly absorbed but not completely after drinking, the absorption is at least 50%.

Distribution: Clopidogrel and derivative of carboxylic acid bond with plasma proteins.

Metabolism: Clopidogrel is a precursor and is metabolized in the liver, mainly into the derivative of carboxylic acid that is not active. The active metabolic substance is a derivative of Thiol but not detected in plasma.

Extraction: Clopidogrel and metabolites are eliminated through urine and feces, after oral, about 50% of the dose is eliminated through the urine, about 46% are eliminated in feces.

Before taking Clopistad 75mg Stella prevents arterial thrombosis (3 blisters x 10 tablets)

How to use

Clopistad is used by oral regardless of meals.

Dosage

Adults and the elderly:

Clopidogrel is recommended at a single dose of 75 mg/day.

In patients with acute coronary syndrome:

Acute coronary syndrome does not have a difference of ST segment (unstable angina or myocardial infarction without q):

should start clopidogrel treatment with 300 mg offensive doses only and then continue at a dose of 75 mg, 1 time/day (combined with Aspirin 75 - 325 mg/day). Clinical test data supports the use of up to 12 months and the maximum benefit is recorded from the 3rd month.

Should start clopidogrel treatment with an attack dose of 300 mg combined with aspirin and have or have no cause of fiber solubility, followed by a single dose of 75 mg/day. The combined therapy should be started as soon as possible after the beginning of symptoms and continue to maintain for at least 4 weeks.

Clopidogrel is recommended at a single dose of 75 mg/day. Should start and continue to coordinate with aspirin (75 - 100 mg/day).

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? If bleeding should apply appropriate therapies.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

There is no active antidote of clopidogrel. If it is necessary to quickly adjust the phenomenon of prolonged bleeding time, platelet transmission may cause the effect of clopidogrel.

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

Unwanted effects when using Clopistad that you may encounter.

Common, ADR> 1/100

Blood vessels: Hematoma.

digestive: gastrointestinal bleeding, diarrhea, abdominal pain, indigestion.

Skin and subcutaneous tissue: bruising. Other: nosebleeds.

Uncommon, 1/1000

Blood and lymph: platelet reduction, leukopenia, eosinophilia like eosin.

Neurology: Bleeding of the skull, headache, paresthesia, dizziness. Eye: Eye bleeding (conjunctiva, eyeball, retina). digestive: peptic ulcer, gastritis, nausea, vomiting, constipation, flatulence.

Skin and subcutaneous tissue: Rash rashes, skin bleeding (bleeding). kidney and urinary: urine.

Other: prolonging bleeding time, neutropenia, reducing the number of platelets.

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

Clopistad drugs contraindicated in the following cases:

Hypersensitivity to clopidogrel or any ingredient of the drug.

There is pathological bleeding such as digestive ulcers, intracranial hemorrhage. Severe liver failure.

Caution when using

Due to the risk of bleeding and unwanted effects on hematology, so during the treatment process, if there are symptoms of clinical hemorrhage suggesting, it must quickly perform the blood cell count and/or do appropriate tests.

Like other anti -platelets, cautiously use clopidogrel in patients at risk of bleeding such as injury, surgery or other pathological states.

Patients should be carefully monitored any signs of hemorrhage including hidden bleeding, especially in the first few weeks of treatment and/ or after performing invasive procedures in the heart or surgery.

It is not recommended to use Clopidogrel with anticoagulant drugs that can increase bleeding.

If the patient has a surgical plan and does not need platelet resistance effect, Clopidogrel should be discontinued 7 days before surgery.

Before surgery planning and before taking any new medicine, the patient must notify the pharmacist and the dentist that they are taking clopidogrel.

Clopidogrel extends the bleeding time and should be used carefully in patients with damage tend to bleed (especially gastrointestinal bleeding and intraocular eye).

Patients should know that hemostasis may last longer than usual when using clopidogrel (separate or combined with aspirin) and should notify the doctor when there is any abnormal bleeding.

Platelet hemorrhage has been recorded but very rare after using clopidogrel, sometimes only after a short time of medication. This phenomenon is manifested by a decrease in the number of platelets and small blood blood cell anemia accompanied by nervous manifestations, kidney dysfunction or fever. Platelet hemorrhage is a life -threatening situation that requires immediate treatment including plasma extraction methods.

Due to lack of data, Clopidogrel did not recommend in the first 7 days after acute anemia stroke.

Not much experience using clopidogrel in patients with renal failure. Therefore, be careful when using clopidogrel for these patients.

Not much experience using clopidogrel in patients with liver disease and people with multiple organs. Therefore, be careful when using clopidogrel for these patients.

Clopistad contains lactose excipients. This drug should not be used for patients with rare genetic problems galactose intolerance, total lactase enzyme deficiency or poorly absorbed glucose-galactose.

The ability to drive and operate machinery

Unwanted effects such as headache, dizziness and eye bleeding (less common frequency) and dizziness (rare frequency) have been reported when using clopidogrel. Patients experience these unwanted effects should not drive or operate machinery.

During pregnancy

There was no adequate and well -controlled research on pregnant women, Clopidogrel used only during pregnancy when really necessary.

The period of breastfeeding

whether the drug is excreted through human milk or not. Should stop breastfeeding or stopping the drug because the risk of reaction is serious for children.

Interactive drugs

should use clopidogrel cautious in patients who are taking other drugs that increase the risk of bleeding, including anticoagulant, other anticonstrokes and NSAIDs.

Clopidogrel can inhibit Cytochrom P450 ISOENZYM CYP2C9 and theoretically interact with this metabolic drug by this isoenzym; Clopidogrel can also inhibit CYP2B6.

Antivopeders: Ketoconazole reduces the plasma concentration of metabolites with the activity of clopidogrel; Platelet inhibitor also decreased.

bupropion: Clopidogrel reduces the conversion of bupropion into active metabolites, showing that Clopidogrel inhibits Cytochrom P450 ISOENZYM CYP2B6.

ciclosporin, statin:

There have been reports on progressive muscle and elimination in patients when using clopidogrel along with ciclosporin and statin (Atorvastatin, lovastatin or simvastatin). There is no incident and progression of muscle and elimination after 1-3 weeks start using clopidogrel. Despite the idea that the statin can reduce the platelet anti -platelog effect of clopidogrel, evidence for this interaction is still debated and unpretessed clinical associations.

Storage

In closed packaging, dry place. The temperature does not exceed 30 ° C.

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