Dasarab 75mg Davi Pharm treats acute coronary syndrome (2 blisters x 14 tablets)

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

Ingredient

Composition information	Content
Clopidogrel	75mg

Uses

Indications

Dasarab is indicated in the following cases:

Secondary prophylaxis reduces the risk of cardiovascular disease after myocardial infarction, stroke and peripheral artery disease. As an alternative to aspirin in preventing cardiovascular and brain vessels in patients who need to prevent platelet anti -platelet drugs.

Treatment of acute coronary syndrome (unstable angina, myocardial infarction with no disc difference and myocardial infarction with st differentiation). Patients with coronary artery disease with high risk leading to cardiovascular events should combine aspirin with clopidogrel.

Pharmacy

Clopidogrel is precursor, one of its metabolites is platelet aggregation inhibitors. Clopidogrel is metabolized by CYP450 into metabolites that inhibit platelets. This activity selectively inhibits the cohesion of adenosin diphosphate (ADP) with platelet P2Y12 receptor and the next ADP intermediate activation of the Glycoprotein GPIIB/IIIA complex, thus inhibiting platelet aggregation. The inhibition of platelet gathering by other ADP agents is also inhibited by the prevention of platelet activation due to ADP release. Because the active metabolites are created by the CYP450 enzyme, some types of enzyme shapes are inhibited by other drugs, so not all patients have appropriate platelet aggregation inhibitors. Use the repeated dose of 75 mg/day for the effect of inhibiting the ADP sensor collection starting from the first day, it increases continuously and reaches the status of the status between the 3rd and Saturdays.

pharmacokinetic

absorption

Clopidogrel is quickly absorbed after drinking. The average peak concentration in plasma is achieved after about 45 minutes.

Distribution

Clopidogrel and the main circulating metabolites (without active) associated with plasma proteins (equivalent to 98% and 94%) in vitro.

Metabolism

Clopidogrel is metabolized mainly by the liver.

Elimination

The sale time of the drug is about 6 hours. Elimination mainly through urine.

Before taking Dasarab 75mg Davi Pharm treats acute coronary syndrome (2 blisters x 14 tablets)

How to use

oral drugs. Take medicine with or not at the same meal.

Dosage

adults:

Daily oral dose in adults is 75 mg/day.

After myocardial infarction, stroke, peripheral artery disease:

75 mg x 1 time/day.

Acute coronary syndrome:

Unstable angina, myocardial infarction has no ST difference: If the patient is chosen to intervene with coronary artery intervention, the initial loading dose is 300 mg before intervention at least 2 hours, then 75 mg/day (combined 75 - 325 mg Aspirin/day). If the patient cannot use aspirin, the first dose of Clopidogrel 300 - 600 mg before intervention for at least 24 hours, then 75 mg/day, lasts at least 12 months.

Myocardial infarction has a difference: If the patient is conservative, drink Clopidogrel 75 mg/day (combination of Aspirin 75 mg - 162 mg/day). Treatment period

children:

There is no information on the optimal dose for children, the information about children's doses is very limited, it is necessary to have appropriate studies. For children> 2 years old, no optimal dose is recommended, but not higher doses of adults, the initial dose can be used 1 mg/kg, then adjust the dose depending on the response.

Patients with kidney failure, elderly:

No dose adjustments for patients with renal impairment, elderly.

Patients with liver failure:

Modified treatment experience in patients with medium liver failure, these patients may bleed.

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?
What to do when forgetting 1 dose?

If you forget to use 1 dose:
Within 12 hours after the usual medication: Take the forgotten dose immediately, then take the next dose as usual.

If over the usual medication time is over 12 hours: skip the forgotten dose, take the next dose as usual, do not take twice as much as the dose to compensate for the forgotten dose.

Side Effects

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

Very common, 3/100

Digestive: abdominal pain, vomiting, anorexia, gastritis, constipation.

cardiovascular: chest pain, angioedema, hypertension.

Central nervous system: headache, dizziness, fatigue, human pain. skin: itching, erythema.

Endocrine and metabolism: Hyper cholesterol.

Urinary tract infections.

Hematology: Bleeding, erythema, nosebleeds.

Liver: Liver function abnormalities.

muscle and bone: joint pain, back pain.

Respiratory: Difficulty breathing, rhinitis, bronchitis, upper respiratory infections.

Fake influenza syndrome.

Common, 1/100

Cardiovascular: Atrial fibrillation, heart failure, tachycardia, fainting.

Neurology: fever, insomnia, dizziness, anxiety. skin: indigo.

Endocrine and metabolism: increased blood uric, gout.

digestive: constipation, gastrointestinal bleeding, vomiting. urinary: Cystic inflammation.

Hematology: Anemia, bleeding.

Neurosurgery: cramps, nerve pain, muscle weakness.

eyes: cataract, conjunctivitis.

Uncommon, 1/1000

Acute liver failure, loss of granulocytes, allergies, anaphylaxis, rash, angioedema, anemia, hyperlirubin blood, bronchospasm, pink rash, pneumothorax, hepatitis, interstitial pneumonia, intracellular bleeding, ischemic necrosis, label bleeding, pancreatitis, Stevens - Johnson syndrome, platelet reduction, hemorrhagic hemorrhage, severe hemorrhagic skin, severe hemorrhagic hypernage

Instructions on how to handle ADR

Periodically monitor parameters of signs of anemia, hemoglobin, hematocrit during clopidogrel treatment. Replace emergency plasma in case of thrombocytopenia. The drug can cause other unwanted effects. It is necessary to closely monitor and recommend the patient to notify the doctor with unwanted effects when using the drug.

Warnings

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

Contraindicated

Dasarab drugs contraindicated in the following cases:

Patients with clopidogrel hypersensitivity or any ingredient of the drug.

There is pathological bleeding such as peptic bleeding, retinal hemorrhage or intracranial hemorrhage.

severe liver failure.

Precautions when using

Be careful when used for patients with increased risk of bleeding due to trauma, surgery or pathological bleeding such as peptic ulcer, intraocular bleeding, intracranial bleeding. If the patient needs surgery, it is necessary to stop the drug 5 days in advance. (Clopidogrel and Aspirin) After the stent release slowly, there are some evidence that the ratio of late thrombosis in the stent increases after stopping clopidogrel, even in patients who have been treated for a long time.

Patients with liver failure or renal failure also need to be used carefully.

Hardly clotting blood: Hematoma has been reported after using clopidogrel.

Cytocrom P450 2C19 (CYP2C19): In patients who are poor CYP2C19 metabolic, clopidogrel at the recommended dose is given less metabolized and effective on platelet function. Precautions in patients treated and clopidogrel with drugs are CYP2C8 substrate.

Cross -reaction between Thienopyridin: There has been a cross -sectional response between thienopyridin.

The ability to drive and operate machinery

Clopidogrel does not affect or affect the ability to drive and operate machinery.

Pregnancy

No research has been conducted in pregnant women. Therefore, only use clopidogrel for pregnant women when really necessary.

Breastfeeding period

Need to consider stopping breastfeeding during use of clopidogrel or stop clopidogrel.

Medicinal interaction

pharmacokinetic interaction

Clopidogrel increases the concentration of the following drugs: Phenytoin, Tamoxifen, Tolbutamid, Warfarin, Torsemid, Fluvastatin, nonsteroidal anti -inflammatory drugs. Felbamat, fluoxetin, fluoxamine) can reduce the concentration of active metabolites in the plasma of clopidogrel.

Increase effect/toxicity

Clopidogrel may increase the effects/ toxicity of the following drugs: anticoagulants, anti -platelets, blood clots, Drotrecogin Alfa, Ibritumomab, Salicylate, Tositumomab, Warfarin.

Oral anticoagulant: simultaneously using clopidogrel with oral anticoagulants, including warfarin, can increase the risk of bleeding.

Acetylsalicylic acid (ASA): Be careful when using clopidogrel and ASA. However, Clopidogrel and ASA have been used simultaneously for a year.

heparin: There may be pharmacokinetic interactions between heparin and clopidogrel, increasing the risk of bleeding.

Blood therapy: Clopidogrel is used with a specialized thrombolyte fibrin or non -fibrin and safe heparin in acute myocardial infarction patients.

The effect of clopidogrel increases when used with the following drugs: dasatinib, nonsteroidal anti -inflammatory drugs, ethyl ester of omega - 3 acid, pentosan sodium polysulfate, prostacylin, rifamycin derivatives.

Reducing effects

The effect of clopidogrel may be reduced when used with the following drugs: Calcium channel blockers, Macrolid antibiotics, nonsteroidal anti -inflammatory drugs, Proton pump inhibitors, CYP2C19 inhibitors inhibitors. Kumquat, pineapple tree, basil lemon, cardamom oil, garlic, turmeric, ginger, ginseng, ginkgo, grape seeds, ...

Storage

In a dry place, avoid light, the temperature does not exceed 30 ° C.

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