Klopideks - instructions for use, reviews, analogs and forms of release (75 mg tablets) drugs for the prevention of thrombosis with myocardial infarction, ischemic stroke and atrial fibrillation in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Clopidex. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Klopidex in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Clopidex analogs in the presence of existing structural analogues.Use for the prevention of thrombosis with myocardial infarction, ischemic stroke and atrial fibrillation in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Clopidex - inhibitor of platelet aggregation. Selectively inhibits the binding of adenosine diphosphate (ADP) to platelet receptors and the activation of the membrane protein (glycoprotein GP2b / 3a), thereby inhibiting platelet aggregation. Clopidex also inhibits platelet aggregation caused by other agonists by blocking the increase in platelet activity released by ADP. Does not affect the activity of phosphodiesterase (PDE).

Clopidogrel (the active substance of Clopidex) irreversibly changes ADP receptors on platelets, so platelets remain dysfunctional throughout their life, and restoration of normal function occurs as they update (approximately 7 days).

Composition

Clopidogrel + auxiliary substances.

Pharmacokinetics

After ingestion at a dose of 75 mg, Clopidogrel is rapidly absorbed from the gastrointestinal tract (GIT). However, the concentration in the blood plasma increases slightly and 2 hours after admission does not reach a level that can be determined. Clopidex is extensively metabolized in the liver.After ingestion of clopidogrel, approximately 50% of the dose is excreted in the urine and approximately 46% with feces for 120 hours.

Indications

• prevention of thrombotic complications in patients with myocardial infarction, ischemic stroke or peripheral arterial occlusion;
• in combination with acetylsalicylic acid for the prevention of thrombotic complications in acute coronary syndrome with ST-segment elevation, with the possibility of performing thrombolytic therapy, and without ST segment elevation (for example, in unstable angina, myocardial infarction without Q wave), including in patients undergoing Stenting;
• prevention of thrombotic and thromboembolic complications, including stroke, with atrial fibrillation (atrial fibrillation) with at least one risk factor for vascular complications, the inability to take indirect anticoagulants and the low risk of bleeding (in combination with acetylsalicylic acid).

Forms of release

Tablets 75 mg.

Instructions for use and dosing regimen

Clopidex is taken orally once a day. The initial and maintenance doses are 75 mg per day.The loading dose is 300 mg per day. The scheme of application depends on the indications and the clinical situation.

Side effect

• bleeding, including gastrointestinal, nasal, bleeding from the respiratory tract (hemoptysis, pulmonary hemorrhage), bleeding from the place of puncture of the vessel;
• increased bleeding time;
• diarrhea, constipation;
• abdominal pain, indigestion;
• stomach ulcer and duodenal ulcer;
• vomiting, nausea;
• bloating;
• retroperitoneal hemorrhage;
• pancreatitis (inflammation of the pancreas);
• Colitis (including nonspecific ulcerative colitis or lymphocytic colitis);
• stomatitis (inflammation of the oral mucosa);
• acute liver failure;
• hepatitis (inflammation of the liver);
• deviation from the norm of liver function indicators;
• thrombocytopenia, leukopenia, eosinophilia, neutropenia, including severe neutropenia;
• thrombotic thrombocytopenic purpura;
• aplastic anemia, pancytopenia, agranulocytosis, granulocytopenia, anemia;
• intracranial hemorrhage (several cases have been reported with a fatal outcome);
• headache, dizziness;
• paresthesia (spontaneous sensations of burning, tingling, crawling);
• violation of taste perception;
• hallucinations, confusion;
• eye hemorrhage (conjunctival, in the tissue and retina of the eye);
• vertigo (dizziness);
• vasculitis (inflammation of the vascular wall);
• lowering of blood pressure (BP);
• bronchospasm;
• interstitial pneumonia;
• serum sickness;
• anaphylactoid reactions;
• subcutaneous bruising;
• rash, itching, purpura (subcutaneous hemorrhage);
• bullous dermatitis (toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme);
• angioedema;
• erythematous (red color) rash;
• hives;
• eczema;
• flat lichen;
• bleeding in the muscles and joints;
• arthritis (inflammation of the joint);
• arthralgia (joint pain);
• Myalgia (pain in the muscle);
• hematuria (blood in the urine);
• glomerulonephritis (inflammation of the glomeruli of the kidneys);
• increase in the concentration of creatine in the blood;
• fever (high body temperature).

Contraindications

• acute bleeding (including peptic ulcer or intracranial hemorrhage);
• severe hepatic impairment;
• pregnancy;
• lactation period (breastfeeding);
• children and adolescents under 18;
• Hypersensitivity to clopidogrel.

Application in pregnancy and lactation

Adequate and strictly controlled clinical studies of the safety of Clopidex during pregnancy have not been conducted. Application is possible only in cases of extreme necessity.

It is not known whether clopidogrel is excreted in human milk. If it is necessary to use during the lactation period, the question of stopping breastfeeding should be solved.

In experimental animal studies using clopidogrel at doses of 300-500 mg per kg of body weight per day, there was no teratogenic effect and a negative effect on fertility and fetal development.

Use in children

Clopyxide is contraindicated in children and adolescents under the age of 18 years.

Application in elderly patients

Compared to healthy young volunteers, the plasma concentration of the main metabolite of Klopidex is significantly higher in elderly patients (aged 75 years and older), with no changes in platelet aggregation and bleeding time.

special instructions

Caution is used Clopidex with an increased risk of bleeding due to trauma, surgical interventions, violations of the hemostatic system. When planned surgical interventions (if antiaggregant effect is undesirable) clopidogrel should be canceled 7 days before surgery.

Caution is used Clopideks in patients with severe impairment of liver function, which may cause hemorrhagic diathesis.

When symptoms of excessive bleeding (bleeding gums, menorrhagia, hematuria), the study shows the system of hemostasis (time of bleeding, the number of platelets, tests of the functional activity of thrombocytes). It is recommended that the laboratory indicators of the functional activity of the liver be regularly monitored.

Use with caution at the same time with warfarin, heparin, nonsteroidal anti-inflammatory drugs (NSAIDs), and for a long time with acetylsalicylic acid, since at present the safety of this application has not been definitively established.

Impact on the ability to drive vehicles and manage mechanisms

The influence of Clopidex on the ability to drive vehicles and control mechanisms has not been established.

Drug Interactions

When used simultaneously with NSAIDs (including naproxen), the risk of gastrointestinal bleeding increases.

When used simultaneously with acetylsalicylic acid, antiplatelet effect may be increased.

Since clopidogrel can inhibit the activity of the isoenzyme CYP2C9, when used with drugs metabolized with the participation of this isoenzyme (including phenytoin, tolbutamine), it is impossible to exclude an increase in their concentrations in the blood plasma.

Analogues of the drug Klopidex

Structural analogs for the active substance:

• Agregal;
• Payplat 75;
• Detromb;
• Zilt;
• Kardogrel;
• Cardutol;
• Klapitaks;
• Clopidogrel;
• Clopilet;
• Clopirel;
• Lirta;
• Listab 75;
• Lopyrel;
• Pidogrel;
• Plavix;
• Plagril;
• Plyglare;
• Target;
• Troken;
• Thromboreal;
• Fluder;
• Egitromb.

Analogues of the drug Klopidex on the pharmacological group (antiaggregants):

• Agapurin;
• Agregal;
• Agrenoks;
• Agrilin;
• Aclotine;
• Alprostan;
• Aspen;
• Acetylsalicylic acid;
• Brilint;
• Ventavis;
• Vixipine;
• Ginkyo;
• Ginos;
• Godasal;
• Doxylek;
• Ibustrin;
• Integrilin;
• Cardiocipine;
• Cardiomagnet;
• Kardogrel;
• Cardutol;
• Klapitaks;
• Clopidogrel;
• Clopilet;
• Clopirel;
• Collorite;
• Complymine;
• Coplawix;
• Xantinol nicotinate;
• Courantil;
• Lapal;
• Lirta;
• Listab 75;
• Lopyrel;
• Methyl ethylpyridinol;
• Myristin;
• Monophram;
• Muse;
• Parsedil;
• Pentamon;
• Pentylin;
• Pentoxifylline;
• Pentomer;
• Persantin;
• Pidogrel;
• Plavix;
• Radomine;
• Ralofect;
• Tagren;
• Target;
• Tikagrelor;
• Tyclid;
• Ticlo;
• Trenpental;
• Trental;
• Troken;
• Thrombital;
• Thromboreductin;
• Thromboreal;
• Fazostabil;
• Fluder;
• Cilostazol;
• Eikonol;
• Eyferol;
• Eifitol;
• Emoxibel;
• Emoxipine;
• Effective.

Response of a cardiologist

Without the appointment of antiplatelet agents in cardiac practice, it is impossible to manage. And with myocardial infarction, and with atrial fibrillation, there is a high risk of thrombotic complications. Therefore, some patients with this pathology, I prescribe the drug Klopideks. Its convenience is that you take the pill once a day. But not all patients with this medication go smoothly. Quite often there are side reactions, namely: nosebleeds, discomfort and abdominal pain.There were cases of subcutaneous hemorrhage. Of course, I always try to control the state of the blood clotting system in a patient during Clopidex administration, but these undesirable effects can not always be avoided.

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