Clopidogrel is indicated for the reduction of atherosclerotic events like myocardial infarction, stroke and vascular death in patients with atherosclerosis documented by recent stroke, recent myocardial infarction or established peripheral arterial disease.
Clopidogrel is an inhibitor of ADP-induced platelet aggregation acting by direct inhibition of adenosine diphosphate (ADP) binding to its receptor and of the subsequent ADP-mediated activation of the glycoprotein GPIIb/IIIa complex. Clopidogrel also inhibits platelet aggregation induced by agonists other than ADP by blocking the amplification of platelet activation by released A.P. Clopidogrel does not inhibit phosphodiesterase activity.
Prevention of artherosclerotic events in peripheral arterial disease or after myocardial infarction or ischaemic stroke
: 75 mg once daily.
Acute coronary syndrome (without ST-segment elevation): initially 300 mg then 75 mg daily.
Acute myocardial infarction (with ST-segment elevation): initially 300 mg then 75 mg daily; initial dose omitted if patient over 75 years.
Concomitant use of Heparin, Warfarin and NSAIDs with Clopidogrel should be undertaken with caution. Clopidogrel potentiate the effect of Aspirin on collagen-induced platelet aggregation. The safety of chronic concomitant administration of Aspirin and Clopidogrel has not been established.
Clopidogrel is contraindicated in patients with a hypersensitivity to the drug substance or any component of the product, and those with active pathological bleeding such as peptic ulcer or intracranial hemorrhage.
Generally Clopidogrel is well tolerated. However, a few common side effects i.e. Influenza-like symptoms, headache, upper respiratory tract infection, dizziness, muscle and back pain, and rash may occur.
: There are no adequate and well-controlled studies of Clopidogrel in pregnant women. However, Clopidogrel should be used during pregnancy only if clearly needed.
Lactation: Clopidogrel is not recommended for use while breast-feeding. It is not known for sure whether Clopidogrel is excreted in breast milk, although it is suspected that it is.
As with other anti-platelet agents, Clopidogrel should be used with caution in patients who may be at risk of increased bleeding from trauma, surgery, or other pathological conditions. Clopidogrel should be discontinued 7 days prior to surgery. Clopidogrel should be used with caution in hepatically impaired patients who may have bleeding diatheses.
: Prolonged bleeding time and subsequent bleeding complications.
Management: May restore clotting ability with platelet transfusion.
Use in children: Safety and effectiveness of Clopidogrel in pediatric population have not been established.
Store at 25° C.