Noklot 75mg Cadilot tablets prevent atherosclerosis (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Clopidogrel

Ingredient

Composition information	Content
Clopidogrel	75mg

Uses

Indications

Noklot pills are indicated in the following cases:

Prevention of atherosclerosis due to atherosclerosis ( myocardial infarction , stroke, stroke) in patients with atherosclerosis new stroke, new heart attack or peripheral artery disease have been defined.

Pharmacokology

Clopidogrel is a pharmaceutical, one of the metabolites of Clopidogrel to inhibit platelets. Clopidogrel is converted by CYP450 enzyme into metabolic substances that inhibit platelets. Clopidogrel's active metabolites selectively inhibit adenosin diphosphate (ADP) to its receptor in platelets and then activated through the ADP intermediaries of Glycoprotein GPIIB/IIIA complex, thus inhibiting platelet's collection.

The metabolism of clopidogrel is necessary for the inhibition of platelet training, but the active metabolites of the drug have not been isolated. Clopidogrel also inhibits platelet training caused by different host mechanisms than ADP by preventing the amplification of platelet activation from ADP release. Clopidogrel does not inhibit the operation of phosphodiesterase.

The effect of clopidogrel is due to non -recovery ADP recovery in platelets. As a result, platelets attached clopidogrel will affect the later stage of platelet life. The inhibition of platelets depends on the dose, which can be observed after 2 hours of single -dose clopidogrel. The repeated dose of 75mg Clopidogrel every day has the effect of inhibiting the platelet aggregation due to the ADP from the first day, and the inhibitor reaches a stable level in the 3rd and Saturday day.

In a stable state, the average inhibitor level at a dose of 75mg daily is about 40% and 60%. Platelet's stoppers and bleeding time gradually returning to the limit value after stopping treatment, usually in about 5 days

pharmacokinetic

absorption

Clopidogrel is quickly absorbed after oral orally repeated 75mg/day (basic), with peak plasma concentrations (about 3mg/l) of the main metabolic substance that occurs about 1 hour after taking the drug.

Distribution

On Vitro, Clopidogrel and main metabolites associated with human serum protein (98% with clopidogrel and 94% with metabolites). On In vitro, this cohesion is not saturated in a wide range of concentrations.

Metabolism

Clopidogrel is strongly metabolized in the liver. The main metabolites are carboxylic acid derivatives, both the original compound and carboxylic acid derivatives have no anti -platelet aggregation effect.

Elimination

After taking a dose of Clopidogrel with 14C marked in humans, about 50% of the drug is eliminated in the urine, about 46% excreted through the part for 5 days after taking the drug. The sale time of metabolites is 8 hours after single dose and repeated dose. Using Clopidogrel with food does not significantly change the bioavailability of clopidogrel when conducting evaluation through pharmacokinetics of the main metabolites.

Before taking Noklot 75mg Cadilot tablets prevent atherosclerosis (3 blisters x 10 tablets)

How to use

Take oral use, can be used during or outside meals.

Dosage

Noklot's recommended dose is 75mg, 1 time a day. No need to adjust the dose for the elderly or patients with kidney disease.

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? A 34 -year -old woman used Clopidogrel with a single dose of 1050mg Clopidogrel (equivalent to 14 75mg tablets). No observation found any unwanted effect. The patient was not treated with special treatment and recovered from sequelae. However, based on biological basis, platelet transmission may be suitable to reverse the pharmacological effect of clopidogrel if necessary.

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 noklot pills , you may experience unwanted effects (ADR).

Unwanted effects occur in clinical trials or reported during the use of the drug. In each organ classification, the unwanted effects are arranged in the order of severity.

Common: 1/100 ≤ ADR

Vascular disorders: Hematoma.

Respiratory, chest and mediastinum disorders: nosebleeds .

Gastrointestinal disorders: gastrointestinal bleeding, diarrhea, abdominal pain, indigestion .

Skin and subcutaneous tissue disorders: bruising.

Systemic disorders and at the position of using the drug: bleeding at the needle puncture position.

Uncommon: 1/1000 ≤ ADR

Blood disorders and lymphatic systems: leukopenia, thrombocytopenia, Eosin leukemia.

Nervous disorders: intracranial bleeding (some deaths), headache, abnormal, dizziness.

Eye disorders: Eye bleeding (conjunctiva, eyeball, retina).

Gastrointestinal disorders: Gastrointestinal and duodenal ulcer, gastritis, vomiting, nausea, flatulence.

Skin and subcutaneous tissue disorders: skin rash, itching, skin bleeding (bleeding).

Kind and urinary tract disorders: bloody urination.

Test results: Extend bleeding time, neutropenia, thrombocytopenia.

Rare: 1/10,000 ≤ ADR

Blood disorders and lymphatic systems: neutropenia, including serious neutrophils.

Disorders of ears and mesmerizing: dizziness .

Gastrointestinal disorders: post -abdominal bleeding.

Very rare: ADR

Object of thrombocytopenia, property anemia, all hemorrhage, granulocytosis, severe thrombocytopenia, anemia.

Mental disorders: Business, confusion.

neurological disorders: taste disorders.

vascular disorders: serious bleeding, bleeding wounds, vasculitis, hypotension.

Respiratory disorders, chest and mediastinum: respiratory bleeding (coughing blood, pulmonary artery bleeding), trachea spasm, interstitial pneumonia.

Gastrointestinal disorders: gastrointestinal bleeding and hemorrhage after clumsy membranes can cause death, pancreatitis, colitis (including ulcerative or lymphocytic colitis), stomatitis.

Liver disorders: Acute liver failure, hepatitis, abnormal liver function test.

Skin and subcutaneous tissue disorders: blistering dermatitis (epidermal poisoning necrosis, Stevens Johnson syndrome, diverse erythematosus), angioedema, hypersensitivity syndrome due to drugs, drugs due to eosin -preferred leukemia and systemic syndrome, erythema, itching, eCzema, Eczema, Liken flat. bone and connective tissue disorders: musculoskeletal bleeding (joint hematoma), arthritis , joint pain, muscle pain.

Renal and urinary tract disorders: Globalitis, hyperactive blood creatinine.

Systemic disorders and at the position of drug use: fever.

Not determined frequency

The immune system disorders: serum disease, anaphylactic reaction, cross -sensitivity reactions between Thienopyridine (such as ticlopidine, prasugrel ).

Instructions on how to handle

Notify the doctor with unwanted effects when taking the drug.

Warnings

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

Contraindicated

Noklot drug contraindicated in the following cases:

Hypersensitivity to clopidogrel or any ingredient of the drug.

Patients with pathological bleeding such as digestive ulcers or intracranial bleeding.

Patients with severe liver failure.

Be cautious when using

Clopidogrel is metabolized by CYP2C19 into active metabolites. Simultaneous use of clopidogrel with active inhibitors of CYP2C19 enzyme inhibitors reduces the concentration of metabolites with the activity of clopidogrel, reducing anti -platelet aggregation.

Experience using clopidogrel for kidney failure is limited, so be careful when taking medication for patients with renal impairment. Like other platelet anti -platelets, Noklot must be used carefully in patients at risk of increased bleeding due to trauma, surgery or other pathological conditions. If a patient undergo selective and unexpected surgery, platelet resistance effects, Clopidogrel should stop using Clopidogrel 7 days before surgery.

Be cautious when using clopidogrel for patients with lesions that can lead to bleeding (such as ulcers). The drugs that are likely to cause these lesions such as aspirin and nonsteroidal anti -inflammatory drugs should be used carefully in patients who are using clopidogrel. Not much experience using clopidogrel in patients with severe liver disease, who may have organs with bleeding. Be cautious when using clopidogrel for these patients.

The safety and effectiveness of the drug when used for children has not been determined. Only use clopidogrel for pregnant and lactating women when essential.

The ability to drive and operate machinery

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

Pregnancy

There is no adequate and controlled study when taking drugs for pregnant women. Therefore, do not use clopidogrel for pregnant women unless necessary and have a doctor's appointment.

Breastfeeding period

Unknown whether Clopidogrel is excreted through breast milk, need to be cautious when using clopidogrel for breastfeeding women.

Drug interaction

Proton pump inhibitors: Avoid simultaneous use of clopidogrel with omeprazol or esomeprazol. In clinical studies, Omeprazol causes a decrease in the anti -platelet collection effect of clopidogrel when used simultaneously or 12 hours apart. The reduction of anti -platelet gathering effects are also observed when using Esomeprazol and Clopidogrel simultaneously.

Be cautious when using clopidogrel with aspirin, other nonsteroidal anti -inflammatory drugs, heparin and warfarin can increase the risk of bleeding. There is no significant clinical pharmacological interaction with clinical significance when using clopidogrel with Atenolol, Nifedipin, Digoxin or Theophyllin. The pharmacological effect of Clopidogrel is not significantly affected when used simultaneously with phenobarbital, cimetidine or estrogen.

Clopidogrel may affect the metabolism of Phenytoin, Tamoxifen, Tolbutamid, Warfarin, Torsemid, Fluvastatin, and many nonsteroidal anti -inflammatory drugs, but no forecast data about the effects of these interactions. Should be cautious when using these drugs with clopidogrel.

In addition to the aforementioned interactive studies, patients participating in Caprie study at the same time with many drugs including diuretics, beta blockers, angiotensin transfusion inhibitors, calcium antagonists, cholesterol lowering drugs, coronary expansion drugs, blood sugars, anti -seizure drugs and hormonal replacement therapy do not show any significant desired interactive.

Storage

Store at temperatures below 30 ° C, avoiding light.

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