Lopirel tabs 75mg #28

Lopirel user manual

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Composition

The tablet contains 75 mg of clopidogrel + microcrystalline cellulose, glyceryl dibehenate, talc, macrogol, red iron oxide, dye, lactose, crospovidone, polyvinyl alcohol, lecithin.

Form of issue

The product is produced in the form of round, convex tablets of pink color. On the one hand - engraving "I". In blisters for 7 or 10 pieces, for 2, 4 or 9 blisters in a cardboard bundle.

pharmachologic effect

Antithrombotic. Antiaggregant.

Pharmacodynamics and pharmacokinetics

The active component of the drug selectively inhibits the binding of the ADP molecule to receptors located on the surface of platelets. Thus, the activation of the GPIIb / IIIa complex and the aggregation of platelets become impossible. Also clopidogrel inhibits aggregation processes induced by other antagonists. Until the end of the life cycle, platelets remain damaged and incapable of aggregation.
After receipt of the first batch of medication, an antithrombotic process begins, the level of white blood cells is established by the 3-7 day of admission. On average, 5 days after discontinuation of treatment, platelet aggregation and bleeding time return to baseline.
The medicine is pretty quickly absorbed into the digestive tract. However, the concentration of clopidogrel in the plasma is very low, the absorption is 50%. The drug binds well to blood plasma proteins.
Clopidogrel is metabolized in the liver, about 80% of the metabolites found in the plasma are inactive. The active metabolite, which has the necessary anti-aggregative effect, is formed by an oxidation reaction involving the cytochrome P450-2B6 and 3A4 isoenzyme. The metabolite itself quickly reacts with platelets and is not found in the blood plasma.
The half-life is 6 hours for the active substance and 8 for its inactive metabolite. Products are excreted mainly with urine and feces.
In persons suffering from severe renal insufficiency, there was a decrease in the effectiveness of the drug by 25% compared with healthy people.

Indications for use

The drug is used to prevent thrombosis of the arteries in people with acute coronary syndrome:
    with unstable angina;
    with myocardial infarction (without Q wave);
    after acute myocardial infarction.
Also indications for use are atherothrombotic complications in patients who have suffered myocardial infarction, stroke, have occlusive disease of peripheral arteries. In this case, the medicine is used as a prophylaxis.

Contraindications

The agent is not prescribed:
    with severe hepatic insufficiency;
    pregnant and breastfeeding women;
    with hemorrhagic syndrome;
    with intracranial hemorrhage, stomach ulcer, ulcerative colitis, lung tumor, tuberculosis and hyperfibrinolysis;
    children under 18;
    when allergic to the components of the medicine;
    with intolerance to galactose.
Care should be taken when the drug is combined with acetylsalicylic acid, NSAIDs, heparin, thrombolytic agents, with renal and hepatic insufficiency, before surgery.

Side effects

Adverse reactions, arranged in order to reduce the likelihood of occurrence:
    nosebleeds, hematomas, indigestion, bleeding in the digestive tract, diarrhea, subcutaneous hemorrhage;
    eosinophilia, headache, thrombocytopenia, paresthesia, loss of consciousness, flatulence, leukopenia, gastritis, nausea, constipation, ulcers in the gastrointestinal tract;
    conjunctival, ocular, intracranial and retinal hemorrhages, a decrease in the number of neutrophils and platelets in the blood;
    neutropenia, retroperitoneal bleeding;
    TTP, agranulocytosis, taste distortion, anaphylactoid reactions, thrombocytopenia, aplastic anemia, hallucinations and confusion, vasculitis, low blood pressure;
    bronchospasm, colitis, hemoptysis, bullous dermatitis, pancreatitis, stomatitis, hepatitis, hepatic insufficiency, Quincke's edema, myalgia, urticaria, arthralgia, flat lichen, eczema, arthritis, fever.

Lopirel, instructions for use (method and dosage)

Tablets are taken orally, regardless of the mode of eating.
As a rule, with myocardial infarction, ischemic stroke, patients with arterial diseases on the periphery are prescribed 1 tablet 1 time per day.
The duration of admission after a heart attack is from 1 to 25 days, after a stroke - 7 days or 6 months.
If the patient has a coronary syndrome without ST elevation or a coronary stenosis was performed, then the treatment starts with a dose of 300 mg, and then 75 mg (one tablet) is administered once a day, for 3 months (the course can be extended to one year ). With such diseases, as a rule, additionally prescribe acetylsalicylic acid, the recommended dosage is 100 mg.

Overdose

When an overdose of drugs may increase the duration of bleeding and further deterioration of the condition.
Treatment - according to the manifested symptoms.
The drug does not have a specific antidote. In extreme cases, it is possible to stop the drug by transfusing the affected platelet mass.

Interaction

When combined with oral anticoagulants, in particular warfarin, the likelihood of occurrence and duration of bleeding may increase.
In persons who have an increased risk of bleeding and who take Lopirel, it is not recommended to take additional inhibitors of glycoprotein IIb / IIa.
It has been proven that the combination of clopidogrel - naproxen increases the risk of developing latent gastrointestinal bleeding. However, in the case of other NSAIDs, this pattern has not been proven. In this regard, with the combination of these drugs should be careful.
Despite the good results of clinical studies of drug interactions with heparin, caution should be exercised when they are taken concomitantly.
It is also not recommended to combine the drug with thrombolytics, since the safety of this combination is not exactly established.
It is proved that the daily intake of acetylsalicylic acid (up to 1000 mg per day) and clopidogrel does not affect the aggregate properties of the drug. However, the duration of joint intake of these drugs should not be more than 1 year (you need to be careful).
The medicine can be combined with atenolol, phenobarbital, estrogen, cimetidine or nifedipine.
The drug inhibits the metabolism of agents whose pharmacokinetic indices depend on the isoenzyme CYP2C9. In particular, the drug can increase the plasma concentration of phenytoin and tolbutamide. Care must be taken.
Possible combination of the drug with digoxin, theophylline, antacids.

Terms of sale

The prescription is not required to buy Lopirel online.

Storage conditions

Store in a cool place, at room temperature.
Shelf life - 3 years.

special instructions

For people who underwent an acute myocardial infarction with an increase in ST, the therapy should be postponed for 2-3 days.
If bleeding occurs during treatment with the drug, blood and liver enzymes should be analyzed.
Particular care should be taken when combining the drug with NSAIDs, aspirin, heparin, thrombolytics, in operations, injuries, increased risk of bleeding.
The drug is not prescribed to persons who underwent an acute ischemic stroke, if less than a week has passed.
If you have an operative intervention, an appointment with a dentist or other doctor, you need to inform a specialist that you are taking this medication. Stop taking Lopirel should be at least a week before the proposed operation.
It is necessary for the attending physician to report all cases of bleeding occurring during the treatment with the drug. It should be remembered that it may take longer than usual to stop it.

Reviews about Lopirel

Reviews about the drug are very good. People who took it noted the high efficiency and the absence of serious adverse reactions compared to similar drugs. Some people are confused by the high cost of the drug.