DuoPlavin medicine 75mg/100mg Sanofi reduces the risk of blood clotting, reduces thrombosis (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Clopidogrel, acetylsalicylic acid
Ingredient Sanofi

Ingredient

Composition information	Content
Clopidogrel	75mg
Acetylsalicylic acid	100mg

Uses

indications

Duoplavin® 75mg/100mg drug is indicated in the following cases:

Duoplavin® contains clopidogrel and acetylsalicylic acid (ASA) and belongs to platelet anti -platelet drug group. Platelets are very small structures in the blood that can gather together during blood clotting. By preventing this convergence in arteries, platelet anti -platelets reduce the risk of blood clotting, reducing thrombosis.

Duoplavin® is used to prevent blood clots in sclerosis arteries that can lead to stroke (such as stroke, myocardial infarction or death).

duoplavin® to replace two separate drugs, clopidogrel and ASA, help prevent blood clots that cause unstable angina or myocardial infarction. To treat this disease, the doctor can place a stent in the artery or narrowed to recover the useful blood flow.

Pharmacology

Pharmacological - Therapy Group: Platelet inhibitors in addition to Heparin.

Clopidogrel is a precursor, it must be metabolized by CYP450 enzymes to form metabolites that inhibit platelet aggregation. Metabolic substances to have the activity of clopidogrel selectively inhibit the conclusion of Adenosin Diphosphate (ADP) with its P2Y12 receptor on platelets and thereby inhibit the activity of Glycoprotein GP IIB/IIIA complex through ADP intermediaries, thus inhibiting platelet aggregation.

Because the cohesion cannot be reversed, these platelets are affected for the rest of their lives (about 7-10 days) and the normal platelet function recovery occurs at a speed that is suitable for platelet movement.

Platelet collection caused by non -ADP -owned subjects is also inhibited by the blocking effect of the ADP platelet activity that is released.

Because the metabolites are active formed by CYP450 enzymes, some of which are polymorphic or objects that are inhibited by other drugs not all patients have satisfactory platelet inhibition.

Clopidogrel doses of 75mg/day repeated many times causing a clear inhibition for platelet aggregation caused by ADP from the first day, this effect increased gradually and achieved stability in the range 3 to 7.

In a stable state, the average inhibitor is noticeable at a dose of 75 mg/day at about 40% to 60%. Platelet's collection and bleeding time gradually returning to the initial value within 5 days after treatment.

Acetylsalicylic acid inhibits platelet aggregation by incheing inhibitors of prostaglandin cyclooxygenase and thus inhibition of the production of thromboxan A2, a substance that causes platelet and vasoconstriction. This effect lasts throughout the life of platelets.

Clopidogrel with Asa reduces the relative risk of death for all causes of 7% (P = 0.029), and the relative risk of death due to re -infarction, stroke or death decreases by 9% (P = 0.002), corresponding to absolute risk reduction, in order of 0.5% and 0.9%.

pharmacokinetics

absorption:

After the single doses and repeat 75 mg/day, Clopidogrel is quickly absorbed. The average peak concentration in the plasma of Clopidogrel does not change (about 2.2 - 2.5 ng/ml after taking a single dose of 75 mg) occurs about 45 minutes after drinking. The absorption rate is at least 50%, based on the excretion of metabolites of Clopidgrel in urine.

After absorbing, Asa in Duoplavin® is awarded into salicylic acid and reaches the peak concentration in plasma within 1 hour after drinking, the ASA concentration in plasma is basically no longer detected after drinking 1.5 - 3 hours.

Distribution:

Clopidogrel and the main metabolite in the blood (inactive) in vitro cohesion can be reversed with human plasma proteins (in order of 98% and 94%).

Asa is less attached to plasma proteins and has low apparent distribution (10L). Its metabolic substance - Salicylic acid has a high ratio of plasma proteins, but the binding is dependent on concentration (non -linear).

In low concentrations ( Metabolism:

Clopidogrel is widely metabolized in the liver.

In Vivo, Clopidogrel are metabolized in two main lines: one through the intermediary of the esterase and leads to the hydrophobia into the carboxylic acid that is not active (85% of the metabolic substance in the blood), and an intermediary multi -cytochrome P450. Clopidogrel is first converted into 2-oxo-clopidogrel metabolites.

The next metabolism of this metabolite leads to the formation of active metabolites, a thiol derivative of clopidogrel. In vitro, this transformation line is through intermediaries CYP3A4, CYP2C19, CYP1A2 and CYP2B6. The thiol metabolites are active, have been isolated in vivo, quickly unable to reverse with the platelet platelet receptors, thereby inhibiting platelets.

Asa in Duoplavin® is quickly solved in plasma into salicylic acid. Salicylic acid is mainly reacted with the liver to form salicyluric acid, a glucuronide phenol, a salicylic glucuronide acid, and some secondary metabolites. Saturated salicylate metabolism and body clearance decreases at higher serum concentrations due to the liver's limited ability to produce salicylic acid and phenol glucuronide.

Era:

On humans, after 120 hours after taking a dose of clopidogrel, about 50% is excreted in the urine and about 46% is excreted in the feces. After taking a single dose of 75 mg, Clopidogrel has a half -life of about 6 hours. The sale time of the main metabolites in the blood (not active) is 8 hours after the single dose is repeated.

Semi -canceled time is from 0.3 to 9.4 hours for ASA doses from 75 to 100 mg.

Salicylic acid in Duoplavin® has a half -life in plasma about 2 to 6 hours.

After taking the toxic dose (10 - 20 g), the half -life of plasma can increase over 20 hours. At high ASA dose, the rate of deduction of salicylic acid is determined compared to plasma concentrations, with the semi -cancellation time of 6 hours or higher.

The excretion of the kidneys of the active substance does not change depending on the urine pH. When the urine pH increases above 6.5, the free Salicylate clearance in the kidneys increases from 80%.

After the treatment doses, about 10% is excreted in the urine in the form of salicylic acid, 75% in the form of salicyluric acid, 10% is phenol glucuronide and 5% is acyl glucuronide of salicylic acid.

Before taking DuoPlavin medicine 75mg/100mg Sanofi reduces the risk of blood clotting, reduces thrombosis (3 blisters x 10 tablets)

How to use

take medicine with a glass of water, may be accompanied by food or not.

daily should take medicine at a certain hour.

Depending on your condition, the doctor will determine how long the time you need to use Duoplavin®. If you have had myocardial infarction, the drug must be taken at least 4 weeks. In all cases, you should continue to take as prescribed by your doctor.

Always drink Duoplavin® as the doctor told me. If not sure, you should ask the doctor or pharmacist.

Dosage

The usual dose is a Duoplavin® daily.

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 you forget a dose?

If you forget to take the medicine for more than 12 hours, just take the next dose at the usual time. Do not double the dose to compensate for the forgotten dose.

With the blisters 14, 28 and 84 tablets, you can check the day you take the last Duoplavin® tablet by comparing the calendar printed on the blister.

Side Effects

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

Common, ADR> 1/100

Digestive: diarrhea, abdominal pain, indigestion or heartburn.

Body: bleeding.

Uncommon, 1/1000

Digestive: stomach ulcers, vomiting, nausea, constipation, flatulence in the stomach or in the intestine.

Skin: Floating, itching.

Systemic: headache, dizziness, numbness or cow ants.

Rare, 1/10000

Body: Dizziness.

Very rare, 1/10000

Digestive: severe abdominal pain, mouth swelling, stomatitis, change of taste.

Systemic body: allergic reactions, reducing blood pressure, drowsiness, hallucinations, joint pain, muscle pain, small blood vessel.

Skin: jaundice, bullous skin, skin allergies.

Respiratory: shortness of breath sometimes combined with cough.

Not determined frequency

Hearing: Tinnitus, hearing loss.

Systemic body: Sudden allergic reactions that threaten life, hypoglycemia, gout (dominant), food allergies are bad.

urinary: kidney disease.

Instructions on how to handle ADR

If any side effect becomes serious or has any side effects not listed in this tutorial, please notify your doctor or pharmacist.

Warnings

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

contraindicated

Duoplavin® drug contraindicated in the following cases:

allergies (hypersensitivity) with clopidogrel, acetylsalicylic acid (ASA) or any other component of duoplavin®; severe;

Severe kidney disease;

Be cautious when using

If there is any of the following conditions, should tell the doctor before using Duoplavin®:

If you have a risk of bleeding such as: a disease that makes you at risk of internal bleeding (eg stomach ulcer), a blood disorder that makes you prone to internal bleeding (bleeding inside the tissues, organs or joints in the body), a recent severe serious injury, recently surgery (including tooth extraction), about to have surgery (including tooth extraction) in the next 7 days.

If you have a blood clot in the cerebral artery (cerebral) occurred within 7 days ago.

If you have liver or kidney disease.

If you have a history of asthma or allergic reactions.

If you have gout (gout).

While using DuoPlavin®:

You should notify your doctor if you plan to have surgery (including tooth extraction), if you have stomach pain or abdominal pain or bleeding in the stomach or in the intestine (redness or black stool).

You should also immediately notify the doctor if you have a disease (called the thrombocytopenic hemorrhage or TTP) including fever and bruising under the skin in the form of small red dots such as needle tip, with or without a very tired situation with unknown reasons, drowsiness, jaundice or yellow eyes.

If you have bleeding wounds, blood will flow longer than usual. This is due to the impact of the drug because it prevents the ability to form blood clots. For slight cuts or wounds, for example, cuts, shaving often is often not worrying. However, if you are concerned about bleeding, see the doctor immediately.

Use in children:

Duoplavin® is not for children or teenagers under 18 years old.

There may be interaction between acetylsalicylic acid (ASA) and Reye syndrome when using products containing ASA for children and teenagers infected with virus. Reye syndrome is a very rare but can cause death.

The ability to drive and operate machinery

Duoplavin® does not affect the ability to drive or use machinery.

Pregnancy

must not use Duoplavin® in the first 3 months of pregnancy.

Preventive, nor should this medication in the first 6 months of pregnancy. If you are pregnant or suspected of being pregnant, you should notify your doctor or pharmacist before using Duoplavin®. If you are pregnant during the time you are using DuoPlavin®, let your doctor immediately because Duoplavin® is not recommended during pregnancy.

The period of breastfeeding

During this medication, do not breastfeed. If you are breastfeeding or planning to breastfeed, consult your doctor before taking this medication.

Consult your doctor or pharmacist before taking any medicine.

Interactive drug

Please inform the doctor or pharmacist if you are taking or recently used any drug, including the drug without prescription.

Some drugs may affect the use of Duoplavin® or vice versa.

Especially, should tell the doctor if you use:

Oral anticoagulant. Treatment of severe arthritis (rheumatoid arthritis) or skin disease (psoriasis). Kinh).

Storage

To be out of reach and eyes of children.

Do not use DuoPlavin® is expired on the box and blister.

Store at temperatures below 250C. Do not use duoplavin® if you see any signs of metamorphosis.

Do not destroy drugs through wastewater or household waste. Should consult pharmacist about how to destroy drugs no longer need. These measures help protect the environment.

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