Anplat
Generic Name
Clopidogrel
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| anplat 75 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Anplat 75 mg Tablet contains Clopidogrel, an antiplatelet medication used to prevent blood clots in conditions such as heart attack, stroke, and peripheral arterial disease. It works by preventing platelets from sticking together and forming harmful clots.
Uses & Indications
Dosage
Adults
75 mg orally once daily. For acute coronary syndrome, a loading dose of 300 mg or 600 mg may be given, followed by 75 mg once daily.
Elderly
No dosage adjustment is generally required.
Renal_impairment
No dosage adjustment is generally required, but caution is advised in severe renal impairment.
How to Take
Take orally with or without food. Swallow the tablet whole with a glass of water. Do not crush or chew.
Mechanism of Action
Clopidogrel is a prodrug that, once metabolized, irreversibly inhibits the P2Y12 ADP receptors on platelets. This prevents the activation of the glycoprotein IIb/IIIa complex, thereby inhibiting platelet aggregation.
Pharmacokinetics
Onset
Within 2 hours for antiplatelet effect; full effect in 3-7 days with daily dosing.
Excretion
Approximately 50% renally and 46% fecally.
Half life
Parent drug: approximately 6 hours; active metabolite: approximately 30 minutes (but irreversible binding leads to prolonged effect).
Absorption
Rapidly absorbed from the gastrointestinal tract; it is a prodrug.
Metabolism
Extensively metabolized in the liver, primarily by CYP2C19, to an active thiol metabolite and an inactive carboxylic acid derivative.
Side Effects
Contraindications
- Active pathological bleeding (e.g., peptic ulcer or intracranial hemorrhage).
- Hypersensitivity to the active substance or to any of the excipients.
- Severe hepatic impairment.
Drug Interactions
SSRIs (e.g., fluoxetine)
Increased risk of bleeding.
NSAIDs (e.g., ibuprofen, naproxen)
Increased risk of gastrointestinal bleeding. Concomitant use should be with caution.
Warfarin and other oral anticoagulants
Increased risk of bleeding. Co-administration should be undertaken with caution.
Proton Pump Inhibitors (PPIs, e.g., Omeprazole, Esomeprazole)
May reduce the antiplatelet effect of clopidogrel by inhibiting CYP2C19. Avoid concomitant use if possible; consider alternative PPIs with less CYP2C19 inhibition (e.g., pantoprazole) or H2 blockers.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to prolonged bleeding time and subsequent bleeding complications. Management involves observation for bleeding and appropriate supportive measures. Platelet transfusion may be considered if rapid reversal of effects is required.
Pregnancy & Lactation
Pregnancy Category B. Should be used during pregnancy only if clearly needed. It is not known whether clopidogrel is excreted in human milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Active pathological bleeding (e.g., peptic ulcer or intracranial hemorrhage).
- Hypersensitivity to the active substance or to any of the excipients.
- Severe hepatic impairment.
Drug Interactions
SSRIs (e.g., fluoxetine)
Increased risk of bleeding.
NSAIDs (e.g., ibuprofen, naproxen)
Increased risk of gastrointestinal bleeding. Concomitant use should be with caution.
Warfarin and other oral anticoagulants
Increased risk of bleeding. Co-administration should be undertaken with caution.
Proton Pump Inhibitors (PPIs, e.g., Omeprazole, Esomeprazole)
May reduce the antiplatelet effect of clopidogrel by inhibiting CYP2C19. Avoid concomitant use if possible; consider alternative PPIs with less CYP2C19 inhibition (e.g., pantoprazole) or H2 blockers.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to prolonged bleeding time and subsequent bleeding complications. Management involves observation for bleeding and appropriate supportive measures. Platelet transfusion may be considered if rapid reversal of effects is required.
Pregnancy & Lactation
Pregnancy Category B. Should be used during pregnancy only if clearly needed. It is not known whether clopidogrel is excreted in human milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Check the expiry date on the packaging.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by DGDA (Bangladesh)
Patent Status
Generic available (original patent expired)
WHO Essential Medicine
YesClinical Trials
Clopidogrel has been extensively studied in major clinical trials such as CAPRIE, CURE, COMMIT, and CREDO, demonstrating its efficacy in reducing cardiovascular events.
Lab Monitoring
- Regular monitoring for signs of bleeding (e.g., complete blood count).
- In some cases, platelet function tests may be considered (e.g., VerifyNow) if there is concern for inadequate response.
- Liver function tests (LFTs) in patients with hepatic impairment.
Doctor Notes
- Assess bleeding risk carefully before initiating and during clopidogrel therapy.
- Consider genetic testing for CYP2C19 poor metabolizers, especially in patients with recurrent thrombotic events.
- Advise patients to avoid concomitant use of omeprazole/esomeprazole. If a PPI is necessary, consider pantoprazole or ranitidine.
- Strict adherence to treatment is crucial; abrupt discontinuation increases thrombotic risk.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Inform your doctor or dentist about taking Clopidogrel before any surgery or dental procedure.
- Report any unusual bleeding or bruising immediately to your doctor.
- Do not stop taking the medicine without consulting your doctor, as this may increase your risk of heart attack or stroke.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose (within 12 hours). In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose.
Driving Precautions
Anplat is not known to impair the ability to drive or operate machinery. However, if you experience dizziness, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise.
- Quit smoking and limit alcohol consumption to reduce cardiovascular risk.
- Manage other risk factors such as high blood pressure and diabetes.
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