Clopidogrel is a prescription medication. It
inhibits platelet activation and aggregation by irreversible binding of its
active metabolite to platelet P2Y12 ADP receptors. Platelet aggregation can be
inhibited dosage-dependently 2 hours after a single oral dose. On the first
day, repeated doses of 75 mg per day reduce ADP-induced platelet aggregation,
and inhibition achieves a stable state between Days 3 and 7.
Acute Coronary Syndrome: In patients who need an
antiplatelet effect within hours, initiate clopidogrel with a single 300 mg (4
tablets) oral loading dose and then continue at 75 mg once daily. Initiating it
without a loading dose will delay the establishment of an antiplatelet effect
by several days.
Recent MI, Recent Stroke, or Established Peripheral
Arterial Disease: 75 mg once daily orally without a loading dose.
It is given orally with or without food.
- NSAIDs, warfarin, selective serotonin, and
serotonin-norepinephrine reuptake inhibitors (SSRIs, SNRIs): Increases the
chance of bleeding
- Inhibitors of CYP2C19 (omeprazole or esomeprazole): Avoid
taking omeprazole or esomeprazole at the same time.
- Clopidogrel (CYP2C8 substrates): Avoid using Clopidogrel
concurrently with Repaglinide since it raises plasma concentrations of
Clognil is not recommended if you have any of the
following conditions: Hypersensitivity to the medication substance or any
product component. Pathological bleeding that is active, such as a peptic ulcer
or cerebral hemorrhage.
Clognil is a medication that is typically
- Bleeding, diarrhea, stomach pain, hemorrhage, and skin
responses are all common adverse effects.
- Acquired hemophilia, anemia, angioedema, arthralgia,
arthritis, and bone marrow abnormalities are rare adverse effects.
In pregnant women, there are no appropriate and
well-controlled trials. It should only be taken during pregnancy if absolutely
necessary. Clognil is not known to be excreted in human breast milk.
Considering the relevance of the medicine to the mother, a choice should be
taken whether to cease breastfeeding or the drug.
- Because it is a prodrug, metabolism to its active metabolite
is hampered by CYP2C19 genetic variants (poor metabolizer) and medications
that block CYP2C19, such as Omeprazole and Esomeprazole. Concurrent usage
with these medicines, as well as a CYP2C19 poor metaboliser, may decrease
Clopidogrel's antiplatelet action.
- Because it inhibits platelet aggregation over the platelet's
whole lifetime (7-10 days), the risk of bleeding may rise. Platelet
transfusions within 4 hours of the loading dosage or 2 hours of the
maintenance dose may be less successful in restoring hemostasis.
- Clopidogrel discontinuation raises the risk of cardiovascular
events. Discontinue 5 days before elective surgery with a high risk of
bleeding. Clopidogrel should be resumed as soon as hemostasis is obtained.
- TTP (Thrombotic Thrombocytopenic Purpura) has been
documented, which necessitates immediate treatment, including
plasmapheresis (plasma exchange).
- Patients taking clopidogrel who have a history of
hypersensitivity to other thienopyridines have suffered hypersensitivity,
including rash, angioedema, or hematologic response.
In a dry area, keep the temperature below 30°C.
Light is kept out. Do not get paralyzed. Keep out of children's reach.