Clopidogrel. Instructions, indications for use, price, reviews, analogues

Clopidogrel is an antiplatelet drug with pronounced properties, which is actively used in the treatment of pathologies of the blood, blood vessels and some other diseases. Many patients and even doctors add a soft sign to the end of the name of the drug, but the official name does not contain it.

The indications for the use of the medication are always indicated in the description, it is important to study them before starting therapy.

Composition and form of release

The medicine is available for purchase by patients in the form of oral tablets. They are round and biconvex, pink with a brownish tint. The medicine is packaged in plates of 7 or 10 pieces. There may be 1 plate in a carton, but there are packs of 90 tablets. It depends on the manufacturer, as well as the appearance of the blister.

The drug contains the substance clopidogrel, which has the main therapeutic effect on the body.

Like other medicines, tablets contain auxiliary components:

• Hypromellose.
• Mannitol.
• Silica.
• Macrogol.
• Titanium dioxide.
• Dye.

Excipients do not have medicinal properties. The amount of the main component per 1 tablet is 75 mg.

Terms of sale, prices

Clopidogrel (indications for the use of the drug are described in the official instructions) is dispensed in different pharmacies after presenting a prescription form from a doctor.

The cost of the tablets is approximately 200 rubles. per plate 10 pieces. The price may differ depending on the quantity of the medicine in the package.

Pharmacological properties

The drug prevents platelets from sticking together, which reduces the likelihood of blood clots in patients with a tendency to such complications. The remedy has a positive effect on the state of blood vessels, especially in the presence of pathologies of a chronic form.

Reducing blood viscosity reduces the load on the vascular walls, improves tissue microcirculation and helps reduce the likelihood of complications from the heart and brain.

Pharmacodynamics and pharmacokinetics

The drug acts quite quickly after taking a single dose inside. Its main ingredient acts on blood clotting processes, preventing platelets and clotting factors from sticking together.

As a result, blood clots do not form in the vessels, blood circulation is not disturbed, and the risk of damage to their walls as a result of the attachment of blood clots does not increase.

The tool also has another effect on the body:

• Reduces the load on the vascular walls, as it prevents the impairment of blood circulation as a result of the formation and gradual increase of a blood clot.
• The tool helps to improve blood circulation, reduces the load on the heart, which increases as a result of blood thickening.
• If the patient has vascular abnormalities in the form of atherosclerotic changes, the agent reduces the likelihood an increase in atherosclerotic plaques that can move through the systemic circulation after detachment from the wall vessels.

The action of the drug occurs quickly after oral administration of a single dosage. The maximum concentration of the substance in the blood is reached 2 hours after consumption. A pronounced and lasting effect is observed only after 5-7 days after the start of constant intake.

The bioavailability of the agent is high, and the binding to plasma proteins reaches 95%, which explains the high efficiency. For several hours after consumption, the concentration of the ingredient decreases, but the effect persists.

The metabolism of the ingredient is carried out in the liver, for several hours the metabolites of the main substance are excreted by the kidneys and intestines in approximately equal amounts. In patients with kidney pathologies, a decrease in the level of a component in the blood is often observed after taking a single dosage. Disorders from the digestive tract can affect the absorption of clopidogrel into the bloodstream, which affects the therapeutic effect.

The drug does not accumulate in the blood and tissues, which reduces the likelihood of complications in the form of an overdose. Despite this, uncontrolled use is not recommended.

Indications for use

Clopidogrel is prescribed to patients with various diseases.

The main indications for its use:

• Myocardial infarction in the acute stage. The medicine is prescribed to prevent the formation of blood clots and the development of complications during the recovery period.
• Cerebral circulation disorder. In the acute stage, the agent is used as part of a complex treatment; during the recovery period, it can be prescribed as the only method of therapy.
• Acute coronary syndrome.
• Rehabilitation of the patient after undergoing surgery on the heart and coronary vessels.

The drug can be used to prevent complications in patients with severe heart failure and arterial hypertension. For some neurological disorders, tablets are included in the course of the main treatment.

Contraindications

The tablet remedy is not used for allergies to its components, as the likelihood of complications increases.

The manufacturer indicates in the description other obstacles to the use of tablets:

• Intolerance to auxiliary ingredients in the composition of the product.
• The patient's age is up to 18 years. There is no data on the safety of using the drug for children and adolescents, therefore, if necessary, the doctor selects other medicines.
• The period of gestation and breastfeeding. Women at this time rarely need to use such drugs, but even if indications appear, they are not prescribed.
• Peptic ulcer in the acute stage.
• Internal bleeding associated with the progression of intestinal and stomach pathologies.
• External bleeding when soft tissue is damaged.
• The patient's tendency to bleeding, hereditary blood pathologies, accompanied by a decrease in the number of platelets and coagulation factors.
• Acute or chronic renal failure, in which the patient's organ function is significantly impaired.
• Liver pathology in the acute stage. Tablets are not prescribed for the viral origin of the disease.
• Bleeding provoked by prolonged use of non-steroidal anti-inflammatory drugs, direct anticoagulants.

  

The drug is used with caution when the patient has complications from the blood system in the form of a malfunction of the red bone marrow.

Methods of administration and dosage

Clopidogrel (indications for the use of the drug suggest an appointment with a tendency to thrombosis) can only be used orally in the dosage prescribed by the doctor. Depending on the severity of the manifestations and the specific deviation, the treatment regimen may differ.

For acute myocardial infarction

Carrying out therapy for acute myocardial infarction requires the appointment of drugs from different groups. Clopidogrel is also included in the list, used to prevent the development of complications against the background of a heart attack.

The daily dosage for the patient is 75-150 mg, depending on the initial condition of the patient. Take tablets 1 or 2 times a day. The standard scheme assumes the use of the drug for 35 days, starting from the first day when the symptoms of the disease appeared.

In some cases, treatment is continued longer, but the decision is made by the cardiologist on an individual basis.

In acute coronary syndrome

The dose for patients with this disease does not exceed 75 mg. This is usually enough to obtain a pronounced therapeutic effect. Within 2 weeks, the patient takes pills, after which the doctor assesses his condition and, if necessary, prolongs the course.

The duration of treatment can be up to 4-6 weeks if necessary, but in most cases 3 weeks are enough to obtain the desired result. Repeated courses can be carried out in 3-6 months, if necessary.

In the case of a severe course of the pathological condition, another regimen can be used, which involves a single dose of 300 mg of the drug, followed by a decrease in the dosage to 75 mg.

Preventive reception

Clopidogrel (indications for the use of the drug describe the possibility of prophylactic use) can be used to prevent the formation of blood clots in patients with cardiac and vascular pathologies.

The dosage per day does not exceed 75 mg. Usually, cardiologists do not prescribe a single dose of an increased dose, especially in the absence of any acute manifestations. The duration of a prophylactic admission can reach 3 weeks, but it is determined individually after a preliminary examination.

Side effects

The drug can provoke complications, even if all recommendations are followed. This is due to the pronounced effect of the main substance on the body. Usually complications affect the blood system and blood vessels, but can also manifest from other systems.

The most common reactions are:

• Bleeding, both external and internal, is considered the most common adverse drug reaction. They may be accompanied by large blood loss or slight bleeding. Often, the condition is accompanied by a violation of the integrity of the vessel walls, which manifests itself in the appearance of hematomas on the body. Especially often bleeding develops when the tablets are combined with other medicines that affect blood clotting.
• From the side of the nervous system, disorders do not occur so often. Patients may report weakness and headache, impaired memory and concentration, irritability, and sleep disturbances. The manifestations are aggravated with a history of chronic neurological diseases.
• On the part of the heart and blood vessels, complications manifest themselves in the form of tachycardia and arrhythmias, fluctuations in blood pressure, pain in the heart. The condition of the walls of blood vessels may deteriorate somewhat, especially if the patient is prone to bleeding. Thrombocytopenia is considered a common complication that can be detected on laboratory blood tests.
• Digestive system disorders are also common. They manifest as diarrhea and abdominal pain, heartburn, and worsening of the symptoms of chronic diseases. Rarely, patients may develop pancreatic inflammation, even in the absence of a history of organ pathologies.
• Acute liver failure is considered a rare reaction when treated with pills, but can occur when a patient has complications from this organ.
• Allergy to the drug manifests itself in the form of a rash on the body and severe itching, forcing patients to scratch the affected area, aggravating the condition of the tissues.

If complications occur, doctors recommend stopping treatment immediately. Some patients require the appointment of special drugs, since negative reactions do not disappear on their own.

Overdose

With prolonged use of the drug in high doses, patients develop an overdose, despite the absence of a cumulative effect. The most common manifestation of an overdose is bleeding, the duration of which increases significantly when a large number of tablets are taken.

All negative reactions in case of an overdose are also aggravated, especially from the digestive system. If symptoms appear, you should call an ambulance. The first stage of treatment is the gastric lavage of the patient, allowing it to be cleared of the remnants of the pills.

After that, funds may be prescribed depending on the severity of a particular symptom. The scheme of care for different patients is different. In advanced cases with severe bleeding, patients undergo platelet transfusion to restore the level of cells in the body.

special instructions

Clopidogrel (indications for the use of the drug describe the possibility of prescribing it even to patients old age, while dose adjustment is usually not required) should be used exclusively for destination.

Cardiologists recommend that you first undergo a laboratory blood test, which will determine the indicators of coagulation. Usually, doctors do not prescribe an increased dose to patients over 75 years of age. When treating such patients, it is sufficient to take 75 mg per day.

Do not split the tablet while taking it, chew it or grind it in any other way. The film membrane must dissolve in the patient's intestines, which will allow the component to quickly enter the systemic circulation.

Drug interactions

The drug is often combined with drugs from the group of non-steroidal anti-inflammatory drugs and drugs based on acetylsalicylic acid. With this combination, the likelihood of bleeding increases significantly, so it is important to control the dosage. Usually, specialists prefer to carry out such treatment in a hospital in order to provide assistance to the patient if necessary.

Do not use the drug in combination with Warfarin and its analogues, as the risk of bleeding increases significantly. The appointment of several medications is made only by the doctor, taking into account all the nuances and general condition of the patient.

Analogs

The drug can not always be prescribed to patients, but some analogs are used in this case according to indications. Some have the same properties, others are different, as well as the composition.

Name of the drug	Peculiarities
Aspirin Cardio	The drug is in tablet form with a different dosage of the active ingredient, which is often used to treat patients with vascular and cardiac pathologies. Unlike the original, the drug contains acetylsalicylic acid, which has a different mechanism of action, but has similar properties. The analog can be used as a primary or auxiliary treatment, depending on the patient's condition. In each case, the dosage is determined individually.
Lirta	Tablet preparation based on such an active ingredient. Usually it is prescribed in the case when the patient cannot use the original due to an allergy to excipients in its composition. The substitute may contain other auxiliary ingredients, therefore it is often prescribed to such patients. Like the original, it is taken at a dosage of 75 mg per day, but according to individual indications, it is possible to change the treatment regimen.
Cardiomagnet	A popular medication with a combined composition, produced in the form of tablets. The composition of the drug includes magnesium and acetylsalicylic acid, which has the main effect. The tablets inhibit the process of platelet adhesion, which reduces the likelihood of blood clots forming in the vessels. Despite the different composition, the drug is considered effective, often used for a long time. Experts consider it safer for patients with bleeding tendencies.

When choosing an analogue, the patient's condition and the course of his particular disease are taken into account.

Storage conditions and periods

It is allowed to store the drug for 3 years in a dry place, excluding direct sunlight and protecting it from children.

After the expiration of this period, it is prohibited to use the medicine. The production date is indicated on the packaging.

Clopidogrel is an antithrombotic medication that is actively prescribed to patients in order to prevent the formation of blood clots and circulatory disorders. Indications for its use are indicated in the description, they imply an appointment when diagnosing certain indications, an increase in the level of platelets in the blood. The appointment is made by the doctor after a preliminary examination.

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