Clopidogrel is a prodrug that is used to treat blood clots. The irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets suppresses platelet activation and aggregation. Platelet aggregation inhibition is dose-dependent and visible 2 hours after single oral dosages. On the first day, repeated 75 mg doses decrease 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, and selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs, SNRIs): NSAIDs, warfarin, and selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs, SNRIs): CYP2C19 inhibitors (omeprazole or esomeprazole): Increases the risk of bleeding. Avoid taking omeprazole or esomeprazole at the same time.
Repaglinide (substrates for CYP2C8): Clopidogrel should not be taken with Repaglinide since it raises Repaglinide plasma level.
Platrel should not be used if you have any of the following conditions: Hypersensitivity to the medicine or any of the product's components. Peptic ulcer or cerebral hemorrhage are examples of active pathological bleeding.
Platrel is a generally well-tolerated drug.
Common side effects: Bleeding, Diarrhoea, gastrointestinal discomfort, hemorrhage, Skin reactions.
Rare side effects: Acquired hemophilia, anemia, angioedema, arthralgia, arthritis, bone marrow disorders.
There are no adequate and well-controlled studies on pregnant women. It should be used during pregnancy only if clearly needed. It is unknown whether Platrel is excreted in human breast milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
As it is a prodrug, so metabolism to its active metabolite is impaired by genetic variations in CYP2C19 (poor metabolizer) and by the drugs that inhibit CYP2C19 such as Omeprazole and Esomeprazole. Concomitant use with these drugs and in CYP2C19 poor metabolizer may reduce the antiplatelet activity of Clopidogrel.
As it inhibits platelet aggregation for the lifetime of the platelet (7-10 days), the risk of bleeding may increase. To restore hemostasis, platelet transfusions within 4 hours of the loading dose or 2 hours of the maintenance dose may be less effective.
Protect from light and moisture by storing in a cool, dry place below 30°C. Keep out of children's reach.