Clopidogrel is a prodrug. It inhibits platelet activation and aggregation by irreversibly binding its active metabolites to ADP P2Y12 receptors on platelets. Dose-dependent inhibition of platelet aggregation can be observed 2 hours after a single oral administration. A repeated daily dose of 75 mg inhibits ADP-induced platelet aggregation on the first day and the inhibition reaches a steady-state between the third and seventh day.
Dosage & Administration
Acute Coronary Syndrome: In patients who need an antiplatelet effect within hours, initiate Replet 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 norepinephrine, and serotonin reuptake inhibitors (SSRIs, SNRIs): increase the risk of bleeding
CYP2C19 inhibitors (omeprazole or esomeprazole): avoid simultaneous use of omeprazole or esomeprazole
Repaglinide (repaglinide will increase) and CYP8 the plasma concentration of repaglinide
Replet is contraindicated in the following situations: Allergic to any component of the drug or product. Active pathological bleeding, such as a peptic ulcer or intracranial hemorrhage.
Replet is usually a well-tolerated drug.
Common side effects: bleeding, diarrhea, gastrointestinal discomfort, bleeding, skin reactions.
Rare side effects: acquired hemophilia, anemia, angioedema, joint pain, arthritis, bone marrow disease.
There are no adequate and well-controlled studies in pregnant women. It should be used during pregnancy only when clearly necessary. It is not clear whether clopidogrel is excreted in human milk. The importance of the drug to the mother should be considered and a decision made to stop breastfeeding or discontinue the drug.
As with other antiplatelet agents, Clopidogrel or Aspirin should be used with caution in patients who may be at risk of increased bleeding from trauma, surgery, or other pathological conditions. If a patient is to undergo elective surgery and an antiplatelet effect is not desired, the drug should be discontinued 5 days prior to surgery. Clopidogrel and Aspirin prolong the bleeding time. Patients should be told that it might take them longer than usual to stop bleeding when they take drugs and that they should report any unusual bleeding to their physician.
Keep below 30°C temperature in a dry place. Protected from light. Do not freeze. Keep out of the reach of children.