Clopidogrel, 75 mg, film-coated tablets, 14 pcs.

Clopidogrel tablets

An unhealthy lifestyle and unbalanced diet lead to the development of atherosclerosis, a disease that has extremely serious consequences. To reduce the risk of atherosclerotic changes, Clopidogrel tablets are prescribed, which inhibit the process of platelet concentration. An additional advantage of the drug is that it can be included in complex antithrombotic therapy in patients who require long-term courses of oral anticoagulant drugs. This category includes patients with prosthetic heart valves.

Compound

The drug is available in the form of biconvex, round tablets coated with a pink film. Composition of one tablet:

Pharmacodynamics and pharmacokinetics

The drug actively suppresses the process of platelet aggregation and selectively reduces the binding of adenosine diphosphate (ADP) to platelet receptors, and also reduces the ability to activate glycoprotein receptors under the action of adenosine diphosphate. The drug reduces platelet aggregation that is caused by any antagonists by inhibiting their activation by released ADP. The drug molecules bind to platelet ADP receptors, after which platelets permanently lose sensitivity to ADP stimulation.

The effect of inhibiting platelet aggregation occurs two hours after consuming the first dose. The degree of suppression of aggregation increases over 4-7 days and reaches its peak at the end of this period. In this case, the daily intake should be 50-100 mg per day. If atherosclerotic vascular damage is present, then taking the drug prevents the progression of the disease.

After administration, the drug is absorbed in the gastrointestinal tract in a short period of time. The bioavailability of the drug is 50%; this level is not affected by food intake. Metabolism of the drug occurs in the liver. In blood plasma, maximum values ​​are reached an hour after taking the drug. The half-life is eight hours and is excreted by the kidneys and intestines.

Indications for use of the drug Clopidogrel

The drug is prescribed for the treatment and prevention of atherosclerotic diseases and associated complications:

1. Prevention of blood clots in patients with myocardial infarction, peripheral arterial occlusive disease, or ischemic stroke.
2. Prevention of atherothrombic consequences in patients with acute coronary syndrome:
3. Without ST elevation (non-Q wave myocardial infarction or unstable angina), including patients after stenting during percutaneous coronary surgery.
4. With an increase in the ST region (acute myocardial infarction) during treatment with medications and when thrombolysis is available.

Description and composition

1 tablet of the drug Clopidogrel contains 75 mg of the active component clopidogrel hydrosulfite.

Additional composition elements:

• anhydrous milk sugar;
• pregelatinized starch;
• hydrogenated castor oil;
• polyethylene glycol 6000;
• microcrystalline cellulose;
• Magnesium stearate.

Shell composition:

• Allura Red food coloring;
• indigo carmine dye;
• hypromellose;
• lactose monohydrate;
• titanium dioxide;
• triacetin.

Instructions for use of Clopidogrel

The drug is taken orally regardless of food intake. The following regimens and recommendations for administration have been developed:

1. To prevent complications of thrombus formation in patients with myocardial infarction, peripheral artery occlusion, ischemic stroke: 75 mg once a day.
2. In order to prevent thrombus formation in acute coronary syndrome due to unstable angina or myocardial infarction without a Q wave, the drug is prescribed with a single loading dose of 300 mg and then 75 mg/day. The course lasts up to one year.
3. To prevent thrombus formation in acute coronary syndrome with ST region enlargement (acute myocardial infarction): 75 mg/day. The first dose is increased.

Indications for use

The drug Clopidogrel is used for the treatment and prevention of various disorders of the cardiovascular system associated with platelet aggregation.

for adults

The main indications for medicinal use of the drug are:

• prevention of atherothrombotic complications in patients suffering from an acute form of coronary syndrome (in combination with acetylsalicylic acid): without ST segment elevation or with ST segment elevation;
• prevention of atherothrombic complications in patients suffering from myocardial infarction, ischemic stroke or peripheral arterial occlusive disease.

for children

Clopidogrel is contraindicated for children under 18 years of age.

for pregnant women and during lactation

During pregnancy and breastfeeding, it is prohibited to use the product for preventive and therapeutic purposes.

special instructions

The use of the drug involves the need for constant monitoring of the patient's condition. The following special indications exist:

1. In patients whose age exceeds 75 years, the rule of the first increased dose should be abolished.
2. During therapy, it is necessary to monitor the readings of the hemostatic system and analyze the functional state of the liver.
3. Use with caution in patients at increased risk of blood loss due to injury or other reasons.
4. In the presence of diseases associated with blood loss, it is necessary to take into account that the drug prolongs the bleeding time.
5. When driving, keep in mind that Clopidogrel may cause dizziness.

Xarelto

Manufacturer: Germany (Bayer Schering Pharma AG), Italy (Bayer Healthcare Manufacturing)
Release form: tablets

Active ingredient: rivaroxaban

Xarelto is a direct inhibitor of coagulation factor Xa, which is key to the coagulation mechanism. Factor Xa is part of the prothrombinase complex, thanks to which prothrombin is converted into thrombin. As a result, a blood clot is formed and platelets are activated. Xarelto blocks this “thrombin burst.”

The use of this Clopidogrel analogue does not require monitoring of blood clotting parameters; the dosage calculation is based on an assessment of the risks of thrombosis. The effect occurs after taking the first dose of the drug.

The disadvantages of Xarelto include its high cost.

During pregnancy

To date, there are no full-fledged studies and no experimental basis has been developed on the effect of Clopidogrel on the course of pregnancy and on fetal development. For this reason, the drug is not prescribed during pregnancy. There is no data on the concentrations in which the drug passes into breast milk, so taking Clopidogrel is not recommended during breastfeeding.

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Clopidogrel or Plavix – which is better, what’s the difference?

Manufacturer: France (Sanofi-Winthrop Industry)
Release form: film-coated tablets

Active ingredient: clopidogrel

Synonyms: Aggregal, Cardutol, Plogrel, Clopilet, etc.

Original Plavix is ​​considered the drug of choice among clopidogrel-based drugs. The medicine has passed clinical trials. Often prescribed when other antithrombotic drugs are ineffective.

The high cost often forces patients to switch to more affordable anticoagulant analogues, especially when long-term use is required.

Drug interactions

Clopidogrel may interact with other medications in different ways. Common combinations:

• oral anticoagulants, warfarin increase the intensity of bleeding;
• use caution in combination with glycoprotein receptor inhibitors, acetylsalicylic acid and other non-steroidal anti-inflammatory drugs, thrombolytic agents containing silicon;
• Omeprazole, Fluoxetine, Fluconazole, Ciprofloxacin, Cimetidine, Carbamazepine reduce the concentration of the active metabolite in plasma and the clinical effectiveness of the drug.

Clopidogrel or Cardiomagnyl – which is better?

Manufacturer: Germany (Takeda GmbH, Nycomed, Denmark (Takeda Pharma A/S), Russia (Takeda Pharmaceuticals LLC)
Release form: film-coated tablets

Active ingredient: acetylsalicylic acid + magnesium hydroxide

It is possible to replace Clopidogrel with Cardiomagnyl, but only according to a doctor’s indications. Clopidogrel is preferable for patients with gastrointestinal diseases and angina pectoris. These analogues are not accepted in parallel.

If the conditions for use are met, Cardiomagnyl can be taken for years, even for life.

The fact that Cardiomagnyl is cheaper does not mean it is ineffective. According to reviews from cardiologists, this is one of the best drugs for thromboprophylaxis. Dispensed only with a doctor's prescription.

Side effects

Taking Clopidogrel-c3, in the first month you may encounter a common side effect in the form of bleeding. Other negative reactions from taking the medicine include:

• thrombocytopenia, leukopenia, neutropenia, agranulocytosis;
• hallucinations, confusion, intracranial bleeding with a risk of severe complications;
• hematomas, hemorrhages, vasculitis;
• bronchospasm, pneumonia, diarrhea, malfunction of the glands;
• stomach ulcer, gastritis;
• vomiting, constipation, nausea, flatulence, breathing problems, decreased immunity;
• stomatitis (inflamed gums), anemia, hepatitis, hematuria;
• acute liver failure, itching, bullous dermatitis;
• angioedema, urticaria;
• arthralgia, arthritis, myalgia;
• glomerulonephritis.

Answers on questions

What to do if you miss a dose of Clopidogrel tablet?

There are 2 options: if no more than 12 hours have passed since you missed a dose, then you need to take the next dose as quickly as possible; If more time has passed, the next dose should be taken at the usual time. Since the regimen for taking Clopidogrel tablets is once a day, there are usually no problems with taking it.

Does clopidogrel thin the blood or not?

Yes, it belongs to the disaggregants.

Contraindications

The drug has a number of contraindications. For these factors and diseases, its use is prohibited:

• hypersensitivity to components;
• severe liver failure (reduced creatinine clearance);
• hemorrhagic syndrome;
• acute bleeding, intracranial hemorrhage;
• peptic ulcer of the stomach and duodenum at the acute stage;
• nonspecific ulcerative colitis;
• lactation;
• galactose intolerance.

Warfarin

Manufacturer: Denmark (Nycomed Denmark), Poland (Nycomed Pharma)
Release form: tablets

Active ingredient: warfarin sodium

Synonyms: Warfarex, Marevan, Warfarin Nycomed

The active substance of Warfarin is a coumarin derivative. Refers to indirect anticoagulants. Blocks the formation of vitamin K in the liver, which leads to inhibition of activation of blood clotting factors II, VII, IX, X.

The effect of the drug begins 2–3 days from the start of administration and ends only after 4–5 days.

Sometimes bleeding occurs while taking Warfarin. Taking the drug requires constant monitoring of the INR.

The analogue Warfarin is inexpensive and continues to be actively prescribed.

Analogs

A direct analogue of the drug is Clopidogrel-Zentiva with the same active substance. Possible drug substitutes are drugs with the same effect, but with different components. Analogues of the drug:

• Agrenox - a drug to reduce the risk of strokes;
• Aklotin - for the prevention of thrombosis after ischemia;
• Anopyrine - to reduce platelet aggregation.

Pharmacological group

Clopidogrel belongs to the group of antiplatelet drugs. The mechanism of action of the drug is to suppress the ability of platelets to stick together and selectively inhibit the binding of receptors located on the walls of platelets to adenosine diphosphate. The drug also suppresses the induction of the GPIIb/IIIa complex, which in turn prevents platelet aggregation. Clopidogrel blocks platelet aggregation caused by other agonists by inhibiting the stimulation of formed elements by adenosine diphosphate. The active component of the drug does not affect the activity of the phosphodiesterase enzyme and creates conditions for the irreversible transformation of adenosine diphosphate receptors on the surface of platelets, which makes it possible to stop their functionality before they die. Restoring the functional abilities of the receptors takes an average of a week.

Clopidogrel is rapidly absorbed from the gastrointestinal tract, but its plasma concentration increases rather slowly. Serum protein binding – 96%. Subject to hepatic metabolism. It is excreted by the kidneys and intestines in almost equal quantities. The half-life is about 8 hours.

Clopidogrel price

You can buy medicine at prices depending on the number of tablets in the pack, the manufacturer and the pricing policy of the pharmacy. Approximate cost in Moscow and St. Petersburg:

Aspirin Cardio

Manufacturer: Germany (Bayer)
Release form: film-coated tablets

Active ingredient: acetylsalicylic acid

Synonyms: Acekor Cardio, Acekardol, Anopyrin, ASK-Cardio, etc.

Aspirin Cardio is a drug from the group of non-steroidal anti-inflammatory drugs (NSAIDs). The main effects are inhibition of COX-1, which suppresses platelet aggregation, and inhibition of thromboxane A2 formation in platelets.

The difference between Aspirin-Cardio and simple Aspirin is the presence of a special coating on the tablets, which withstands the effects of hydrochloric acid and reduces the effect of acetylsalicylic acid on the gastric mucosa.

It is recommended to take the tablet after meals, and in case of exacerbation of stomach diseases, taking it is contraindicated. This analogue of Clopidogrel 75 mg tablets is affordable for most patients.