Pfertzel tablets 75mg/75mg Davipharm prevent blood vessels, treat myocardial infarction (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Clopidogrel, aspirin

Ingredient

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Composition information	Content
Clopidogrel	75mg
Aspirin	75mg

Uses

indications

PFERTZEL drugs are indicated in the following cases:

Preventive prevention of thrombosis disorders such as myocardial infarction, stroke and peripheral artery disease.

Secondary control and preventive prevent in patients with atherosclerosis have a new stroke, new myocardial infarction, or peripheral artery disease.

Clopidogrel is a precursor, converted by CYP450 into metabolites with platelet aggregation inhibitors. This activity selectively inhibits the cohesion of adenosin diphosphate (ADP) with P2Y receptor, platelet and the next ADP intermediate activation of the Glycoprotein GPIIB/IIIA complex, thus inhibiting platelets. Because this cohesion is not reversible, this platelet maintains a maximum longevity (about 7-10 days) and the normal platelet rehabilitation appears when the platelet amount is replaced at a certain rate. The inhibition of platelet collection by other ADP agents is also inhibited by the preventive amplification 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.

aspirin (acetylsalicylic acid)

Aspirin inhibits cyclooxygenase by acetylation reaction, thus inhibiting prostaglandin synthesis. Platelets are non -nuclei cells, unable to synthesize new cyclooxygenase, so cyclooxygenase is inhibited, until platelets are formed. Thus, aspirin is not inhibited with platelets, until platelets are formed.

Use a combination of clopidogrel and aspirin that increases the efficiency compared to each single drug for platelet training on collagen. However, there is also an increase in bleeding side effects if they share two drugs so they need to be cautious when used.

pharmacokinetics

clopidogrel

After taking the single dose and the repeated dose of 75mg/day, Clopidogrel is quickly absorbed and metabolized mainly in the liver into two forms: active (derivative) and inactive (carboxylic acid derivatives).

Thiol metabolites are quickly and not recovered from platelet ADP receptors. This metabolite is not detected in plasma. Carboxylic acid derivative accounts for 85% of the drugs circulating in plasma.

The semi -exhaust time of the main metabolites circulating in plasma is 8 hours after the single dose or the repeated dose. About 50% of the drug is excreted in urine and 46% in stool after taken 120 hours.

aspirin (acetylsalicylic acid)

Oral bioavailability is 68 ± 13%. About 49% of the drug ingredients are associated with plasma proteins. Increasing blood urea reduces the ability to attach to the plasma protein of the drug.

East clearance: 9.3 ± 1.1ml/min/kg. The clearance changes in the elderly, people with cirrhosis. Distribution volume: 0.15 ± 0.03 liters/kg. The sale time of 0.25 ± 0.03 hours. Eliminating the kidneys mainly in the form of free salicylic acid and conjugate metabolites.

Before taking Pfertzel tablets 75mg/75mg Davipharm prevent blood vessels, treat myocardial infarction (3 blisters x 10 tablets)

How to use

Take oral use.

Dosage

Ischemic prophylaxis (due to myocardial infarction, stroke, coronary artery disease ...):

Adults: 1 capsule 1 time/ day.

Acute coronary syndrome:

Adults: 4 tablets/day attack dose, maintenance dose of 1 tablet/day.

Do not take drugs in patients with liver failure, severe kidney failure.

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? Proper treatment if observed bleeding.

There is no specific antidote for clopidogrel. Causing the urinary tract with alkalinization of urine to increase salicylate excretion. However, oral bicarbonate should not be used, as it can increase the absorption of salicylate. If using acetazolamid, it is necessary to carefully consider the risk of serious metabolic acid infection and Salicylate poisoning (caused by increased salicylate penetration into the brain due to metabolic acid infection).

Perform blood transfusion, hemorrhage, peritoneal separation if needed in case of serious overdose.

Monitor pulmonary edema, convulsions and appropriate therapy if needed.

Blood transfusion or use vitamin K if needed to treat bleeding.

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 pfertzel, you may experience unwanted effects (ADR).

Bleeding, increased bleeding time, abdominal pain, digestive disorders, gastritis, constipation, foreigner and other skin disorders. Leukopenia, platelet reduction, fatigue, insomnia, restlessness, irritability, anaphylaxis, can cause impaired liver, kidney, bronchial spasm, shortness of breath ...

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

PFERTZEL drugs are contraindicated in the following cases:

Too hypersensitivity to clopidogrel, aspirin or any ingredient of the drug.

Pregnant and lactating women.

There is pathological bleeding such as bleeding/gastrointestinal ulcer, retinal hemorrhage or laparoscopic hemorrhage.

severe liver failure.

Severe kidney failure.

Moderate and heavy heart failure.

platelet reduction.

Related to aspirin: Due to the risk of cross allergy, not taking aspirin for people who have asthma, rhinitis or urticaritis when taking aspirin or other nonsteroidal anti -inflammatory drugs before.

Be cautious when used

The drug increases the risk of bleeding due to trauma, surgery or other diseases. Should stop the drug before surgery 7 days. The experience of treating patients with severe liver disease is limited, so cautious use for these patients.

Be cautious when treated simultaneously with anticoagulant drugs or when there is another risk of bleeding. Not combined with nonsteroidal anti -inflammatory drugs and glucocorticoids. When treating people with mild heart failure, kidney disease or liver disease, especially when used simultaneously with diuretics, it is necessary to carefully consider the risk of water retention and the risk of reducing kidney function. In children when using aspirin has caused some cases of Reye syndrome, so many indicators use aspirin for children. Elderly people may be prone to aspirin poisoning, which is likely to reduce kidney function. Need to use lower dose than usual for adults.

The ability to drive and operate machinery

No report.

Pregnancy

Contraindications for pregnant women.

Lactation period

Contraindications for breastfeeding women.

Drug interaction

related to clopidogrel: Sharing clopidogrel with NSAID drugs may increase the risk of stomach ulcers and intestinal bleeding. Increased risk of bleeding when used with Coumarin, Agatroban, Dasatinib, Heparin, Gingko Biloba and Iloprost. Increased risk of bleeding if clopidogrel and Drotrecogin Alfa are used for 7 days apart. Can increase the concentration of bupropion and unwanted effects (dizziness, discomfort to the gastrointestinal tract).

Regarding aspirin: generally plasma salicylate concentrations are less affected by other drugs, but simultaneous use with aspirin reduces the concentration of indomethacin, naproxen and fenoprofen. Aspirin's interaction with warfarin increases the risk of bleeding; Methotrexate, sulphonylurea, Phenytoin, Valproic acid, increases the concentration of this drug in serum and increases toxicity. Another interactive of aspirin includes antagonism to sodium di by spironolacton and the positive transportation of penicillin from cerebrospinal fluid into the bloodstream. Aspirin reduces the effect of urinary uric acid such as Probenecid and SulphinPyrazol.

Interactive is likely to be fatal: aspirin and clopidogrel increase the risk of bleeding if used with dabigatran.

Storage

In a dry place, avoid light, temperature below 30 ° C.

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