Clopidogrel Bisulphate

Clopidogrel Bisulphate is an antiplatelet medication used to reduce the rate of myocardial infarction (MI) and stroke in patients with non-ST-segment elevation ACS [unstable angina (UA)/non-ST-elevation myocardial infarction (NSTEMI)] and acute ST-elevation myocardial infarction (STEMI). It is also indicated in patients with established peripheral arterial disease or with a history of recent MI or recent stroke to reduce the rate of MI and stroke. Clopidogrel is a prodrug that inhibits platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets. This medication is generally well tolerated but may increase the risk of bleeding.

• Acute Coronary Syndrome (ACS) - Unstable Angina/Non-ST-Elevation MI (NSTEMI)
• Acute ST-Elevation MI (STEMI)
• Recent MI, Recent Stroke, or Established Peripheral Arterial Disease

Clopidogrel is a prodrug. It inhibits platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets. Dose-dependent inhibition of platelet aggregation can be seen 2 hours after single oral doses. Repeated doses of 75 mg per day inhibit ADP-induced platelet aggregation on the first day, and inhibition reaches steady state between Day 3 and Day 7.

Clopidogrel is a prodrug that inhibits platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 ADP receptors on platelets, thereby helping to prevent blood clot formation.

Acute Coronary Syndrome: Initial 300 mg (loading dose), then 75 mg once daily.

Recent MI/Stroke/Peripheral Arterial Disease: 75 mg once daily (without a loading dose).

Take orally with or without food. Take in the dose and duration as advised by your doctor.

If you miss a dose of Clopidogrel Bisulphate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose. Do not double the dose.

Common Side Effects:

• Bleeding
• Diarrhea
• Gastrointestinal discomfort
• Hemorrhage
• Skin reactions

Rare Side Effects:

• Acquired hemophilia
• Anemia
• Angioedema
• Arthralgia
• Arthritis
• Bone marrow disorders
• Thrombotic Thrombocytopenic Purpura (TTP)

• Metabolism to its active metabolite is impaired by genetic variations in CYP2C19 (poor metabolizer) and by CYP2C19 inhibitors such as Omeprazole and Esomeprazole, which may reduce antiplatelet activity.
• As it inhibits platelet aggregation for the lifetime of the platelet (7-10 days), the risk of bleeding may increase.
• Discontinue 5 days prior to elective surgery that has a major risk of bleeding.
• Thrombotic Thrombocytopenic Purpura (TTP) has been reported and requires urgent treatment including plasmapheresis.

• Hypersensitivity
• Active pathological bleeding (peptic ulcer, intracranial hemorrhage)

NSAIDs, warfarin, SSRIs/SNRIs: Increase the risk of bleeding.

CYP2C19 inhibitors (omeprazole or esomeprazole): Avoid concomitant use.

Repaglinide (CYP2C8 substrates): Avoid concomitant use as it increases plasma concentrations of Repaglinide.

Can be taken with or without food.

There are no adequate and well-controlled studies in pregnant women. Should be used during pregnancy only if clearly needed. Pregnancy Category B.

It is unknown whether clopidogrel 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.

Safety and effectiveness in pediatric populations have not been established.

No dosage adjustment is necessary in elderly patients.

Limited information is available regarding the use of Clopidogrel Bisulphate in patients with kidney or liver problems.

Overdose may lead to bleeding complications. Platelet transfusion may restore clotting ability.

Keep below 30°C temperature in a dry place. Protected from light. Do not freeze. Keep out of reach of children.

Clopidogrel Bisulphate