Medicine Information

Clogrel-Plus

Name: Clogrel-Plus
Brand: Clogrel-Plus
Rating: 4.5 (117 reviews)

TabletClopidogrel 75 mg and Aspirin 75 mgAntiplateletATC: B01AC30

Generic Name

Clopidogrel and Aspirin

Manufacturer

XYZ Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
clogrel plus 75 mg tablet	৳ 11.00	৳ 110.00

Description

Overview of the medicine

Clogrel-Plus 75 mg Tablet is a combination antiplatelet medication used to prevent blood clots in patients with cardiovascular diseases. It contains Clopidogrel and Aspirin, which work synergistically to inhibit platelet aggregation.

Uses & Indications

Prevention of atherothrombotic events in patients with recent myocardial infarction (MI), recent stroke, or established peripheral arterial disease (PAD).

Prevention of atherothrombotic and thromboembolic events, including stroke, in patients with acute coronary syndrome (ACS) with or without ST-elevation (STEMI/NSTEMI), managed medically or with percutaneous coronary intervention (PCI).

After stent placement to prevent stent thrombosis.

Dosage

Adults

Typically one tablet (Clopidogrel 75 mg + Aspirin 75 mg) once daily, usually after a meal. For acute coronary syndrome, a loading dose might be prescribed as per physician's advice.

Elderly

No specific dose adjustment generally required, but use with caution due to increased risk of bleeding.

Renal_impairment

Use with caution. No dose adjustment typically required for mild to moderate impairment, but not recommended in severe impairment.

How to Take

Oral administration. Take with food to minimize gastrointestinal upset. Swallow whole, do not crush or chew the tablet.

Mechanism of Action

Clopidogrel is a prodrug that, once metabolized, selectively inhibits the binding of adenosine diphosphate (ADP) to its platelet receptor (P2Y12), thereby inhibiting ADP-mediated platelet activation and aggregation. Aspirin irreversibly inhibits cyclooxygenase-1 (COX-1) enzyme, leading to reduced thromboxane A2 production, which is a potent inducer of platelet aggregation.

Pharmacokinetics

Onset

Clopidogrel: 2 hours (antiplatelet effect); Aspirin: within 1 hour.

Excretion

Clopidogrel: ~50% in urine, ~48% in feces. Aspirin/salicylates: primarily renal.

Half life

Clopidogrel: Parent drug ~8 hours, active metabolite ~30 minutes. Aspirin: 2-3 hours (parent drug), ~15-30 minutes (antiplatelet effect).

Absorption

Clopidogrel is rapidly absorbed. Aspirin is rapidly absorbed from the GI tract.

Metabolism

Clopidogrel is a prodrug, extensively metabolized by CYP450 enzymes (primarily CYP2C19) to an active metabolite and inactive metabolites. Aspirin is rapidly hydrolyzed to salicylic acid, which is primarily metabolized in the liver.

Side Effects

Contraindications

Active pathological bleeding (e.g., peptic ulcer, intracranial hemorrhage).
Hypersensitivity to clopidogrel, aspirin, or any component of the product.
Severe hepatic impairment.
Severe renal impairment.
Asthma, rhinitis, or urticaria induced by NSAIDs, including aspirin.
Children/adolescents with viral infections (Reye's syndrome risk with Aspirin).

Drug Interactions

SSRIs/SNRIs

Increased risk of bleeding.

Warfarin, other anticoagulants

Increased risk of bleeding.

NSAIDs (e.g., ibuprofen, naproxen)

Increased risk of gastrointestinal bleeding.

Other antiplatelet agents (e.g., ticagrelor, prasugrel)

Increased risk of bleeding.

Proton Pump Inhibitors (PPIs, e.g., Omeprazole, Esomeprazole)

May reduce the antiplatelet effect of Clopidogrel by inhibiting CYP2C19.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Symptoms may include prolonged bleeding time, gastrointestinal bleeding, tinnitus, headache, confusion. Management involves supportive care, bleeding control, and potentially platelet transfusions.

Pregnancy & Lactation

Generally not recommended during pregnancy, especially in the third trimester due to potential fetal harm (e.g., premature closure of ductus arteriosus, bleeding risk). Consult a doctor. Avoid during lactation as aspirin passes into breast milk.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per pack30 tablets per pack

Shelf Life

24-36 months from manufacturing date

Availability

Pharmacies, Hospitals

Approval Status

Approved by regulatory authorities

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials (e.g., CHARISMA, CURE, COMMIT/CCS-2 for Clopidogrel + Aspirin) have demonstrated efficacy in reducing cardiovascular events such as MI and stroke.

Lab Monitoring

Complete blood count (CBC) with platelet count, especially during initial therapy or if bleeding occurs.
Renal and liver function tests, especially in patients with pre-existing conditions or prolonged use.

Doctor Notes

It is crucial to balance the risk of bleeding against the benefit of preventing thrombotic events. Individualize therapy based on patient risk factors and clinical presentation.
Avoid concomitant use with strong CYP2C19 inhibitors if possible. If co-administration is necessary, monitor antiplatelet response closely.
Patients should be advised to inform all healthcare providers about their use of Clopidogrel-Aspirin combination, especially before any surgical or dental procedures.

Patient Guidelines

Take exactly as prescribed by your doctor. Do not stop taking this medication without consulting your doctor, as it may increase your risk of cardiovascular events.
Inform your doctor or dentist about this medication before any surgery or dental procedure.
Report any unusual bleeding or bruising (e.g., black or tarry stools, persistent nosebleeds) to your doctor immediately.

Missed Dose Advice

If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once.

Driving Precautions

Generally, this medicine does not impair the ability to drive or operate machinery. However, if you experience dizziness or other side effects, avoid such activities.

Lifestyle Advice

Maintain a healthy lifestyle, including a balanced diet, regular exercise, and smoking cessation, to support cardiovascular health.
Limit alcohol intake, as it can increase the risk of gastrointestinal bleeding.