Clopidogrel( Clopidogrel): instructions for use, price, reviews, counterparts, contraindications for pregnancy

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Clopidogrel, Clopidogrel( also known as Clopidogrelum) is used to reduce the tendency for platelets to aggregate. The drug showed good prophylactic effect of atherothrombotic complications, which can be exposed to people who underwent ischemic stroke or myocardial infarction, as well as suffering from occlusive disease of peripheral arteries.

Therefore, today we will talk about the drug Klopidogrel, its instructions for use, prices, reviews and analogs.

Features of the preparation

Composition of

75 mg of clopidogrel bisulfate is contained in one tablet of the drug. It also includes lactose and such substances as( as auxiliary):

• mannitol,
• microcrystalline cellulose,
• colloidal silicon dioxide,
• hydroxypropylcellulose,
• castor oil hydrogenated,
• polyethylene glycol 6000,
• pink opadrai and red iron oxide.

On whether Clapidogrel affects mortality, this video story will tell:

Dosage forms

The drug is available in one dosage form - tablets. The medicine package contains 1 or 2 blisters with 10 or 14 tablets( coated) in each of them.

It is not recommended to store the substance at a temperature above 25 degrees C, nor should it be exposed to sunlight. Prices for the drug in pharmacies in Moscow start from 236 rubles for 14 tablets produced by the "North Star".

Next, we'll talk about the mechanism of action of clopidogrel.

This drug is included in the pharmacological group of drugs that affect blood clotting - Antiaggregants. Clopidogrel selectively slows down the binding of adenosine diphosphate to platelet receptors, which in turn prevents the glycoproteins IIb / IIIa complex from acting freely. That is, the ability of platelets to aggregate is significantly reduced.

The drug increases the bleeding time. Also interferes with the absorption of fibrinogen.

Farmakodinamika

The effect of taking medication is preserved throughout the life span of platelets( from a week to 10 days).In the event that a patient has atherosclerosis of the vessels, the drug will not allow atherothrombosis to develop.

For interaction with other drugs, the following can be noted:

• No particularly significant effect of clopidogrel interaction with Nifedipine, as well as atenolol, was not revealed.
• Pharmacodynamic activity of preperate remained almost without impurities when used together with phenobarbital and cimetidine, as well as with digoxin or theophylline.
• When combined with clopidogrel with acetylsalicylic acid, the risk of bleeding increases.
• Combining with the intake of NSAIDs increases the possibility of developing gastrointestinal ulcers and related bleeding.

Pharmacokinetics

The drug shows a high bioavailability, rapidly absorbed. The highest level of concentration is achieved in 1 hour of time. Biotransformation of the drug occurs in the liver, the main metabolite is the carboxyl derivative.

Inhibition of aggregation begins its activity after 2 hours from the moment of taking the drug. After 4 days-a week, the maximum aggregation effect is achieved with a responsible and constant intake of the medication. In elderly people( from age 75), there is a much higher concentration of the main metabolite in plasma.

Next we will tell you about the indications for the use of Clopidogrel.

For more details on pharmacokinetics and pharmacodynamics in the treatment of clopidogrel, see the video below:

Indications for Clopidogrel

In addition to peripheral arterial thrombosis, indications for the use of this drug are:

• prevention of atherosclerosis in patients who have had a heart attack or ischemic stroke;
• prevention of atherosclerosis in patients with peripheral arterial disease;
• discontinuation or prevention of atherothrombosis in acute coronary syndrome:
  • with ST segment elevation( with acute infarction), when there is a risk of thrombolysis;
  • without its rise( including stenocardia of unstable type).

Instruction

The drug should be consumed once a day for 75 mg, regardless of eating. Drug therapy is started in time:

• from several days to 35 days after a heart attack;
• from 1 week to 6 months after ischemic stroke.

For patients with ACS( without ST segment elevation), drug therapy starts with a single dose of 300 mg of the substance, continuing to receive 75 mg daily with acetylsalicylic acid, which should not be increased( no more than 100 mg) because of the high probability of bleeding.

There are no data on the taking of the drug by pregnant women, so they can use the medicine only in consultation with the doctor. With regard to breastfeeding, it should be suspended during such medication because of the possibility of getting the substance into the milk.

In case of an overdose, the drug may increase the duration of bleeding with subsequent complications, difficulties with the respiratory system. In case of taking an increased dose of clopidogrel, hemodialysis is possible.

Contraindications

This drug is not assigned to people under the age of 18 years. Also from its reception it is necessary to refuse patients with:

• hypersensitivity to the components of the drug,
• by active bleeding,
• to severe liver diseases;
• is the stomach ulcer and 12 duodenal ulcer.

Side effects of

• From the side of the central nervous system:
  • headaches;
  • dizziness;
  • anesthesia( "goose bumps", numbness)
  • hallucinations;
  • is a disorder in the functioning of taste buds.
• From the digestive tract:
  • abdominal pain( in the abdomen);
  • digestive disorders;
  • gastritis,
  • diarrhea and constipation;
  • nausea or vomiting;
  • flatulence;
  • confusion;
  • is a gastric ulcer and 12 duodenal ulcer.
• From the side of the circulatory system
  • gastrointestinal bleeding;
  • decrease in the volume of neutrophils in the blood;
  • hemorrhagic stroke;
  • thrombocytopenia.

It is also possible an allergic reaction like a rash on the skin such as urticaria, bronchospasm, and Quincke's edema. At times there are:

• eosinophilia,
• palpitation,
• syncope,
• asthenia,
• vertego,
• cough,
• arrhythmia.

If you notice any of these symptoms, seek medical advice immediately.

Special instructions

• Clopidogrel is prescribed by doctors with extreme caution if the patient has an injury in which the risk of bleeding is likely.
• When a patient is undergoing surgery, a week before surgery, the doctor usually cancels the medication.
• It is important not to forget to inform new doctors, including the dentist, about taking Clopidogrel.

Reviews

In general, patients note a positive dynamics when taking Klopidogrel. Negative reviews are mostly associated with the side effect of the components of the tablets.

Some patients experience numbness of the fingers while taking clopidogrel with omez after ischemic stroke. Also, some people noticed that papillomas and moles are inflated, and sometimes they start to bleed. Often there are pains in the stomach.

Analogs

As analogues of Clopidogrel are called:

• Listab( from 526 rubles.);
• Lopyrel( from 308 rubles.);
• Plavix( from 2700 rub.);
• Agrelid( the price is not specified).

Also doctors sometimes designate Zilt and Agregal as a substitute for Clopidogrel.

On how to distinguish the original tablets Clapidogrel and Plavex from a fake, this video will tell: