Description overdue on 07/12/2014
- Latin name: Lopirel
- ATC code: B01AC04
- Active substance: Clopidogrel (Clopidogrel)
- Manufacturer: Ltd. Actavis, Malta
- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications Lopirela
- Contraindications
- Side effects
- Lopirel, instructions for use (method and dosage)
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Cautions
- Analogs
- Reviews
- Price, where to buy
Composition
The composition includes 75 mg tablets clopidogrel + Microcrystalline cellulose, glyceryl dibehenate, talc, macrogol, red iron oxide colorant, lactose, crospovidone, alcohol poliinilovy lecithin.
Product form
Means produced in the form of round, convex tablet pink. On the one hand - engraved "I". The blisters to 7 or 10 for 2, 4 or 9 in the blister cardboard pack.
Pharmacological action
Antithrombotic means. Antiplatelet agents .
Pharmacodynamics and pharmacokinetics
The active ingredient of the drug selectively inhibits the binding of a molecule ADP with receptors on the surface Platelet . Thus, activation of the complex GPIIb / IIIa and platelet aggregation It becomes impossible. Also clopidogrel inhibits aggregation processes induced by other antagonists . By the end of the life cycle of platelets are damaged and not able to process Aggregation .
After receiving the first batch of the drug begins to take place antithrombotic process, white blood cell count is set to the 3-7 day admission. On average 5 days after cessation of treatment of platelet aggregation, and bleeding time are returned to the initial level.
The drug is rapidly absorbed pretty in GI . However, the concentration of clopidogrel in plasma is very low, absorption - 50%. The drug is well linked to plasma proteins.
Clopidogrel is metabolized in the liver, about 80% detected in plasma metabolites - inactive. Active metabolite, which provides the necessary antiagregatnoe action, formed by an oxidation reaction involving isoenzyme cytochrome P450 - 2B6 and 3A4 . Himself metabolite reacts rapidly with Platelet and it is not detected in plasma.
The half-life of 6 hours to the active ingredient, and 8 - to its inactive metabolite. FUME mainly with urine and feces.
Individuals with severe renal failure, there was a reduction efficacy of 25% as compared with healthy persons.
Indications Lopirela
The drug is used to prevent arterial thrombosis in patients suffering from acute coronary syndrome:
- at unstable angina ;
- at myocardial infarction (without Q wave );
- after Acute myocardial infarction .
It is also an indication for use is atherothrombotic complications in patients who underwent myocardial infarction . stroke Are peripheral arterial occlusive disease . In this case, the drug is used as a preventive.
Contraindications
The tool does not prescribe:
- in severe hepatic insufficiency ;
- pregnant and lactating women;
- at hemorrhagic syndrome ;
- at intracranial hemorrhage . stomach ulcer , Nonspecific ulcerative colitis . lung tumor . tuberculosis and hyperfibrinolysis ;
- Children up to 18 years;
- at allergies components for medication;
- intolerance galactose .
Caution should be used in combination with the drug acetylsalicylic acid . NSAIDs . Heparin . thrombolytic With hepatic and renal failure, before operations.
Side effects
Adverse Reactions, located in the descending order of likelihood:
- nosebleeds . hematoma . indigestion , Bleeding in the GI . diarrhea , Subcutaneous hemorrhage ;
- eosinophilia . headache . thrombocytopenia . paresthesia , loss of consciousness, flatulence . leukopenia . gastritis , Nausea, constipation , Ulcers GI ;
- conjunctival, ocular, intracranial and retinal hemorrhage, reducing the number of neutrophil and Platelet in blood;
- neutropenia . retroperitoneal bleeding ;
- TTP . agranulocytosis Distortion of taste, anaphylactoid reactions . thrombocytopenia . aplastic anemia . hallucinations and confusion . vasculitis , Reduced BP ;
- bronchospasm . colitis , Hemoptysis, bullous dermatitis . pancreatitis . stomatitis . hepatitis , Liver failure, angioedema . myalgia . hives . arthralgia . lichen planus . eczema . arthritis . fever .
Lopirel, instructions for use (method and dosage)
Tablets are inside, regardless of the mode of food intake.
Instructions for use Lopirela (75 mg)
As a rule, myocardial infarction, ischemic stroke , In patients with peripheral arterial diseases prescribed 1 tablet 1 per day.
The duration of the post heart attack - From 1 to 25 days, after stroke - 7 days, or 6 months.
If the patient Coronary Syndrome without lift ST or were held coronary stenirovanie , The treatment begins with the dose of 300 mg and then administered 75 mg (one tablet) 1 every day, for 3 months (course may be extended up to one year). In these diseases are usually administered in addition a tsetilsalitsilovuyu acid Recommended Dosage - 100 mg.
Overdose
With an overdose of drugs may increase the duration of bleeding and further deterioration.
Treatment - according to exhibited symptoms.
Specific antidote medicine has not. In extreme cases, may terminate the preparation by the transfusion victim platelets .
Cooperation
When combined with funds oral anticoagulants , in particular warfarin , May increase the probability of occurrence and duration of bleeding.
Individuals who have an increased risk of bleeding and receiving Lopirel, it is not recommended to take further inhibitors of glycoprotein IIb / IIІa .
It is proved that the combination of clopidogrel - naproxen increases the risk of hidden gastrointestinal bleeding. However, in the case of other NSAIDs such law has not been proved. In this regard, the combination of these drugs with caution.
Despite the good results of the clinical studies of the interaction with the drug Heparin At the same time taking them with caution.
We do not recommend the combination of the drug with thrombolytic As well as the safety of such combinations is not certain.
It is proved that a daily intake acetylsalicylic acid (up to 1000 mg per day) and clopidogrel It does not affect Aggregate properties of the drug. However, the duration of co-administration of these drugs should not be more than 1 year (care must be taken).
The drug can be combined with atenolol . phenobarbital . Estrogen . cimetidine or nifedipine .
The drug inhibits metabolic means, pharmacokinetic indicators which depend on CYP2C9 isoenzymes . In particular, the drug may increase the plasma concentration phenytoin and tolbutamide . We need to be careful.
Perhaps a combination of funds from digoxin, theophylline, antacids .
Terms of sale
It requires a prescription.
Storage conditions
Store in a cool place at room temperature.
Shelf life
3 years.
Cautions
For individuals with acute myocardial infarction with increasing ST, agent therapy should be delayed for 2-3 days.
If during treatment with bleeding occurred, it is necessary to carry out blood tests and liver enzymes .
Particular caution should be observed when combined with funds NSAIDs . aspirin, heparin, thrombolytics , During operations, injuries, increased risk of bleeding.
The drug is not prescribed for persons who have suffered acute ischemic stroke If it took less than a week.
If you have to surgery, at the reception Dentist or another doctor, a specialist should be informed that you are taking this medication. Lopirela should stop taking at least a week before the proposed transaction.
Your doctor must report all cases of bleeding occurring during treatment agent. Keep in mind that to stop it may take longer than usual.
Analogs Lopirela
Zilt
Kardiask
Aspirin Cardio
Atsekardol
Aspinat
Aspikor
Curantil
Plavix
Aspekard
Cardiomagnyl
Analogs of the drug: Clopidogrel, Aviks, Atrogrel, Deplat, Zilt, Karum-Sanovel, Klopidal, Klopikor, Lopigrol, Orogrel, Plavigrel, Plagril, Reodar, Tessiron, Trombonet, Flamogrel 75 Aterokard, Gridoklyayn, Deplatt, Kardogrel, Claudia, Klorelo, Medogrel, Pingel Neo, Plavix, Platogril, Reomaks, Trombeks .
Reviews Lopirele
Reviews of preparation is very good. People accept it, note the high efficiency and the absence of serious adverse reactions compared to similar facilities. Some were confused by the high cost of the drug.
Price Lopirela
Price Lopirela 75 mg (28 tablets) is about 460 rubles.
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