Dogrel Savi medicine reduces the risk of cardiovascular complications (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Clopidogrel

Ingredient

Composition information	Content
Clopidogrel	75mg

Uses

Indications

Dogrel Savi medicine is indicated in the following cases:

Secondary prophylactic treatment reduces the risk of post -myocardial cardiovascular disease myocardial infarction , stroke and peripheral dynamic disease.

Treatment of acute coronary syndrome (unstable angina, myocardial infarction without ST difference and myocardial infarction with st differentia).

Treatment of chronic stable angina syndrome: Clopidogrel is used instead of aspirin in patients with angina chronic stable stable intake of aspirin. Patients with symptoms with high risk leading to cardiovascular events should combine aspirin with clopidogrel. Other Clopidogrel atherosclerosis and myocardial ischemic are recommended to be used as an alternative anti -platelet aggregation drug or in combination with aspirin in the thrombotic prevention in people after coronary circuit surgery using transplanted veins. Coordinate with aspirin to prevent reinforcement after vascular intervention through skin and stent. Clopidogrel may be selected in platelet resistance therapy in people with artificial valve replacement without thus using aspirin or taking aspirin but have thrombosis.

Pharmacokological

Clopidogrel is a platelet collection inhibitor. The drug in the form of precursor is metabolized in the liver into an activity.

Clopidogrel's action mechanism is to inhibit the adenosin diphosphate receptor (ADP Receptor). Impact on the P2Y12 position of the ADP receptor on the platelet surface, inhibiting platelets.

pharmacokinetic

absorption

Clopidogrel is quickly absorbed by oral and incomplete.

Distribution

Clopidogrel and main metabolites are associated with plasma proteins with high ratios (98% and 94%).

Metabolism

Clopidogrel is metabolized mainly in the liver, oxidation is regulated by CYP 2C19 and other isoenzymes such as 2B6, 3A4, 1A1, 1A2.

Elimination

Clopidogrel and metabolites are eliminated through urine and feces. About 50% of oral doses are eliminated through urine and 46% excreted in feces. The sale time of carboxylic acid derivatives is about 8 hours.

Before taking Dogrel Savi medicine reduces the risk of cardiovascular complications (3 blisters x 10 tablets)

How to use

use it. Can take medicine during or outside meals.

Dosage

Adults

After myocardial infarction, rules and peripheral artery pathology:

75 mg/day, drink 1 time.

Acute coronary syndrome:

Unstable chest pain, myocardial infarction without ST difference: If the patient is selected to intervene through the skin, the initial dose is 300 mg before intervention for at least 2 hours, then 75 mg/day (in combination with 75 - 325 mg Aspirin/day). If the patient cannot use aspirin, the first dose Clopidogrel 300 - 600 mg before intervention for at least 24 hours, then 75 mg/day, lasting for at least 12 months.

Myocardial infarction has a difference:

Maintenance dose of 75 mg/day (combined with 75 - 162 mg of aspirin/day), treatment time

Put coronary artery stent in patients who are not at high risk of bleeding or clopidogrel tolerance:

The ideal treatment time is 12 months after ordering slow -release drugs, daily dose. The minimum treatment period of 1 month if the ceiling stent is placed, 3 months with a stent release syrolimus and 6 months if the stent releases Paclitaxel. If the early treatment is stopped, it can lead to thrombosis in the stent and myocardial infarction (causing myocardial blood and/or death). Adjusting the dose in people with kidney failure, the elderly is not necessary.

Children

There is no optimal dose for children, the information about the dose in children is very limited, and it is necessary to have continued studies. Research shows that children 2 years old, no optimal dose is recommended, but not higher dose of adults, the initial dose may be used 1 mg/kg, then adjust to the response.

kidney failure

Experience treatment with clopidogrel in patients with renal failure is limited. So be cautious when using Clopidrogrel in these patients.

liver failure

Not much experience using clopidogrel in people with liver disease is both those who may have bleeding organs. Be cautious when using clopidogrel for these patients.

What to do when overdose? If there is a request to quickly edit the prolonged bleeding time, platelet transmission can reverse the effect of clopidogrel.

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

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 Dogrel Savi , you may experience unwanted effects (ADR).

Very common, 3/100

Digestive: digestive disorders , 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: Urinary infection.

Hematology: Bleeding (large bleeding 4%, small bleeding 5%), erythema, nosebleeds.

liver: abnormal liver function.

muscle and bone: joint pain, back pain.

Respiratory: Difficulty breathing, rhinitis, bronchitis, upper respiratory infection . Fake influenza syndrome.

Common, ADR> 1/100

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

nerve: fever, insomnia, dizziness, anxiety.

Skin: eczema.

Endocrine and metabolism: increased blood uric, gout .

digestive: constipation, gastrointestinal bleeding, vomiting.

urinary tract: cystitis .

Hematology: Anemia, bleeding.

Neurosurgery: cramps, nerve pain, muscle weakness.

eyes: cataract, conjunctivitis.

Uncommon, 1/1000

These ADRs are rare but serious, can be life-threatening: Acute liver failure, loss of granulocytes, allergies, anaphylaxis, rash, angioedema, anemia, hyperlirubin blood, bronchial spasms, pneumothorax, pneumothorax, hepatitis, interstitial pneumonia, intracellular bleeding, local anemia, pancreatic bleeding, pancreatitis, reduction of pancreatitis, reduction of minor, reducing minor, reduction Poisoned skin necrosis, vasculitis, decreased - serious neutropenia.

Instructions on how to handle ADR

Periodically monitor the parameters signs of anemia , hemoglobin, hematocrit during clopidogrel treatment. Replace rescue plasma in case of thrombocytopenia.

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

Dogrel Savi contraindicated in the following cases:

Hypersensitivity to the drug or with any ingredients of the drug.

severe liver failure.

There is pathological bleeding such as digestive ulcers, intracranial bleeding.

Precautions when using

Caution used in the following cases:

In patients with acute myocardial infarction, do not start cure with clopidogrel in the first few days after heart attack.

Like other anti -platelets, Clopidogrel should be used with caution with patients who increase the risk of bleeding due to trauma, surgery or other pathological conditions. If a patient is prepared to be narrated without wanting to have a urinary -resistant effect, he should stop using Dogrel Savi (Clopidogrel) 7 days before surgery.

Dogrel Savi (Clopidogrel) extends the bleeding time and should be used carefully with patients who are likely to bleed (especially the stomach and intraocularity).

Information patients need to know: If using Clopidogrel (Dogrel Savi) is longer than usual, when bleeding appears, it is necessary to stop taking the drug and notify abnormal bleeding for the treating doctor. Patients should notify the doctor and dentist to know that Clopidogrel is using Clopidogrel (Dogrel Savi) before the appointment of surgery or before taking any new drug.

Inexperienced use of Clopidogrel (Dogrel Savi) in patients with renal failure. Therefore, be careful when using Dogrel Savi (Clopidogrel) for these patients.

Not much experience using Clopidogrel (Dogrel Savi) in patients with liver disease and people who may have bleeding organs. Be careful when using Dogrel Savi (Clopidogrel) for these patients.

Do not use Dogrel Savi combination with oral anticoagulant (warfarin), injection (heparin), acetylsalicylic acid (aspirin), nonsteroidal anti -inflammatory drugs because it can increase bleeding level.

The drugs that can cause stomach injuries (such as nonsteroidal anti -inflammatory drugs) should be used carefully for patients using Dogrel Savi (Clopidogrel).

Should be cautious when using Clopidogrel with RT - PA (Acfivaserecombinant Tissue Plasminogen Activator) and heparin due to increased risk of bleeding.

Should be cautious when used in combination with clopidogrel with Cy P2C19 breast medicines including omeprazole and esomeprazole, fluoxetine, Sluvoxamine, Moclobemide, Voriconazole, Fluconazole, Ticlopidine, Ciprofloxacin, Cimetidine, Carbamize,,,, Carbamize, Carbamize Oxcarbazepine and chloramphenicol.

Should avoid coordination of clopidogrel with proton pump inhibitors unless really needed.

The ability to drive and operate machinery

Clopidogrel does not have or have unnecessary effects on the ability to drive and operate machinery.

Pregnancy

Because there is no data, Clopidogrel is not recommended during pregnancy.

Breastfeeding period

No information that clopidogrel has excreted through human milk or not. Therefore, it is necessary to consider stopping breastfeeding during the use of clopidogrel or stop clopidogrel depending on the degree of need to take the drug in the mother who is breastfeeding.

Drug interaction

Acetylsalicylic acid (ASA, Aspirin)

Interactive force between clopidogrel and Asa can occur, increasing the risk of bleeding.

warfarin

Hematology interaction between clopidogrel and warfarin is possible, increasing the risk of bleeding ..

heparin

Hematology interaction between clopidogrel and heparin is possible, increasing the risk of bleeding.

Glycoprotein ib/Illa inhibitors

Clopidogrel should be used carefully in patients who may be at risk of bleeding after surgery, trauma or other pathological condition when used simultaneously with Glyco - Protein IIB/IIIA inhibitors (such as Abciximab , viewilofiban, orbofiban and sibrafiban ...).

Anti -sub -sentence gathering agents (such as Eptifibatide, Ticlopidine, Tirofiban ...) The effect of clopidogrel and other platelet aggregation inhibitors may increase the effect, leading to an increase in the risk of bleeding.

The drug is metabolized by Cytochrome P450 Isoemzyme 2C9: Clopidogrel intervenes in the metabolism of Phenytoin, Tamoxifen, Tolbutamide, Warfarin, Fluvastatin and many nonsteroidal anti -inflammatory agents (NSAIDs), but there is no data to predict the degree of interactions. Must be cautious when using these drugs with clopidogrel.

CYP2C19 inhibitors include omeprazole and esomeprazole, fluoxetine, fluvoxamine, moclobemide, voriconazole, fluconazole, ticlopidine, ciprofloxacin, cimetidine, carbamazepine, oxcarbazepine and chloramphenicolicolicolicolicolicolicolicolenicol. When used in combination, it reduces the effect of clopidogrel. Therefore, simultaneous use of clopidogrel with proton bomb inhibitors should be avoided, unless necessary.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

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