Cavapro
Generic Name
Clopidogrel
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cavapro 75 mg tablet | ৳ 6.00 | ৳ 60.00 |
Description
Overview of the medicine
Cavapro 75 mg Tablet contains Clopidogrel, an antiplatelet medication used to prevent blood clots in conditions such as recent heart attack, stroke, or established peripheral arterial disease. It works by preventing platelets from clumping together and forming harmful clots.
Uses & Indications
Dosage
Adults
The usual recommended dose is 75 mg once daily, with or without food. For Acute Coronary Syndrome (unstable angina or non-ST-elevation MI), an initial single loading dose of 300 mg (or 600 mg, followed by 75 mg once daily, in combination with aspirin) may be given.
Elderly
No dose adjustment is generally required for elderly patients.
Renal_impairment
No dose adjustment is necessary for patients with mild to moderate renal impairment. Caution is advised in patients with severe renal impairment due to limited experience.
How to Take
Cavapro 75 mg Tablet should be taken orally once daily, with or without food. Swallow the tablet whole with a glass of water.
Mechanism of Action
Clopidogrel is a prodrug that is metabolized to its active form. The active metabolite selectively inhibits the binding of adenosine diphosphate (ADP) to its platelet receptor (P2Y12), thereby inhibiting ADP-mediated platelet activation and aggregation. This inhibition is irreversible; platelets exposed to clopidogrel are affected for their lifespan.
Pharmacokinetics
Onset
Platelet inhibition is observed within 2 hours of a single oral dose. Significant and stable inhibition of platelet aggregation is achieved after 3-7 days of daily 75 mg dosing.
Excretion
Approximately 50% of the dose is excreted in the urine and 46% in the feces after 5 days, primarily as metabolites.
Half life
The parent drug has a very short plasma half-life of approximately 0.5-1 hour. The active metabolite has a half-life of approximately 7-8 hours.
Absorption
Clopidogrel is rapidly absorbed from the gastrointestinal tract after oral administration, but its bioavailability is low due to extensive first-pass metabolism. Peak plasma levels of the parent drug occur approximately 45 minutes after dosing.
Metabolism
Clopidogrel is extensively metabolized in the liver, primarily by CYP450 enzymes (especially CYP2C19, CYP1A2, CYP2B6, CYP3A4), to form both an active metabolite (which inhibits platelet aggregation) and inactive carboxylic acid derivatives.
Side Effects
Contraindications
- Active pathological bleeding, such as peptic ulcer or intracranial hemorrhage.
- Hypersensitivity to clopidogrel or any component of the tablet.
- Severe hepatic impairment.
Drug Interactions
SSRIs/SNRIs
Increased risk of bleeding, particularly gastrointestinal, when co-administered with clopidogrel.
Proton Pump Inhibitors (PPIs)
Avoid concomitant use of omeprazole or esomeprazole with clopidogrel as they may reduce the antiplatelet activity of clopidogrel by inhibiting CYP2C19. Other PPIs (e.g., pantoprazole, lansoprazole) may have less effect.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding. Close clinical and laboratory monitoring is recommended.
NSAIDs (Non-Steroidal Anti-inflammatory Drugs)
Concomitant use may increase the risk of gastrointestinal bleeding. Use with caution.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose of clopidogrel may lead to prolonged bleeding time and subsequent bleeding complications. In case of bleeding, appropriate symptomatic treatment should be initiated. Platelet transfusions may be considered if rapid reversal of antiplatelet effects is required and severe bleeding occurs. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. It is not known whether clopidogrel is excreted in human milk, so caution should be exercised, and breastfeeding should generally be avoided.
Side Effects
Contraindications
- Active pathological bleeding, such as peptic ulcer or intracranial hemorrhage.
- Hypersensitivity to clopidogrel or any component of the tablet.
- Severe hepatic impairment.
Drug Interactions
SSRIs/SNRIs
Increased risk of bleeding, particularly gastrointestinal, when co-administered with clopidogrel.
Proton Pump Inhibitors (PPIs)
Avoid concomitant use of omeprazole or esomeprazole with clopidogrel as they may reduce the antiplatelet activity of clopidogrel by inhibiting CYP2C19. Other PPIs (e.g., pantoprazole, lansoprazole) may have less effect.
Anticoagulants (e.g., Warfarin, Heparin)
Increased risk of bleeding. Close clinical and laboratory monitoring is recommended.
NSAIDs (Non-Steroidal Anti-inflammatory Drugs)
Concomitant use may increase the risk of gastrointestinal bleeding. Use with caution.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Overdose of clopidogrel may lead to prolonged bleeding time and subsequent bleeding complications. In case of bleeding, appropriate symptomatic treatment should be initiated. Platelet transfusions may be considered if rapid reversal of antiplatelet effects is required and severe bleeding occurs. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed. It is not known whether clopidogrel is excreted in human milk, so caution should be exercised, and breastfeeding should generally be avoided.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Pharmacies nationwide
Approval Status
Approved (Generic)
Patent Status
Generic available (Patent expired)
WHO Essential Medicine
YesClinical Trials
Clopidogrel has been extensively studied in large-scale clinical trials such as CAPRIE, CURE, and COMMIT/CCS-2, demonstrating its efficacy in reducing atherothrombotic events in various patient populations.
Lab Monitoring
- Complete Blood Count (CBC) including platelet count, hemoglobin, and hematocrit, especially if bleeding is suspected or before surgery.
- Coagulation parameters (e.g., PT/INR, aPTT) if co-administered with anticoagulants.
- CYP2C19 genotyping may be considered for patients with reduced efficacy or at high risk of thrombotic events.
Doctor Notes
- Emphasize patient compliance, as premature discontinuation significantly increases the risk of thrombotic events.
- Be aware of potential drug interactions, especially with PPIs and other antithrombotic agents.
- Consider CYP2C19 testing in patients with recurrent ischemic events despite clopidogrel therapy.
Patient Guidelines
- Inform your doctor or dentist that you are taking Cavapro before any surgery or dental procedure, as it increases the risk of bleeding.
- Report any unusual bleeding, bruising, or purple spots under the skin to your doctor immediately.
- Do not stop taking Cavapro without consulting your doctor, as discontinuing it prematurely can increase your risk of heart attack or stroke.
Missed Dose Advice
If you miss a dose of Cavapro, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Cavapro is not known to affect the ability to drive or operate machinery. However, if you experience side effects like dizziness or headache, avoid driving or operating machinery until you feel well.
Lifestyle Advice
- Avoid activities that may lead to injury and bleeding, such as contact sports.
- Limit alcohol consumption, as it may increase the risk of gastrointestinal bleeding.
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