Clopid-AS
Generic Name
Clopidogrel 75 mg and Aspirin 75 mg Tablet
Manufacturer
Example Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| clopid as 75 mg tablet | ৳ 12.04 | ৳ 120.40 |
Description
Overview of the medicine
Clopid-AS 75 mg Tablet is a combination of two antiplatelet medicines, Clopidogrel and Aspirin, used to prevent blood clots in patients at risk of heart attack or stroke.
Uses & Indications
Dosage
Adults
Usually one tablet (Clopidogrel 75 mg + Aspirin 75 mg) once daily. For acute coronary syndrome, a loading dose may be given as per physician's instruction.
Elderly
No specific dose adjustment required, but caution in patients over 75 years due to increased bleeding risk with Aspirin.
Renal_impairment
No dose adjustment for mild to moderate renal impairment. Caution with severe renal impairment due to increased risk of bleeding.
How to Take
Take orally with or without food. Swallow whole, do not crush or chew.
Mechanism of Action
Clopidogrel is a prodrug that inhibits platelet aggregation by irreversibly binding to the P2Y12 ADP receptor on platelets. Aspirin irreversibly inhibits cyclooxygenase-1 (COX-1), preventing the formation of thromboxane A2, a potent inducer of platelet aggregation.
Pharmacokinetics
Onset
Clopidogrel: 2 hours to 2 days for significant antiplatelet effect. Aspirin: within 30-60 minutes.
Excretion
Primarily renal, some fecal. Clopidogrel metabolites: ~50% renal, ~48% fecal. Aspirin metabolites: mainly renal.
Half life
Clopidogrel (parent drug): approx. 6 hours; active metabolite: short. Aspirin: approx. 2-3 hours (for unchanged drug); active metabolite (salicylic acid): 2-20 hours depending on dose.
Absorption
Clopidogrel is rapidly absorbed, but bioavailability is low (approx. 30%) due to extensive first-pass metabolism. Aspirin is rapidly and completely absorbed.
Metabolism
Clopidogrel is extensively metabolized in the liver by CYP2C19 and other enzymes to an active thiol metabolite and an inactive carboxylic acid derivative. Aspirin is rapidly hydrolyzed to salicylic acid by esterases in the GI tract, liver, and blood.
Side Effects
Contraindications
- Hypersensitivity to clopidogrel, aspirin, or any excipients
- Active pathological bleeding (e.g., peptic ulcer, intracranial hemorrhage)
- Severe hepatic impairment
- Severe renal impairment
- Children and adolescents with viral infections (due to Reye's syndrome risk with Aspirin)
Drug Interactions
SSRIs/SNRIs
Increased risk of bleeding.
Thrombolytics
Increased risk of bleeding.
NSAIDs (e.g., Ibuprofen, Naproxen)
Increased risk of gastrointestinal bleeding.
Warfarin, Heparin, other Anticoagulants
Increased risk of bleeding.
Proton Pump Inhibitors (PPIs) (e.g., Omeprazole)
May reduce the antiplatelet effect of clopidogrel, especially CYP2C19 inhibitors. Esomeprazole/pantoprazole might have less interaction.
Other antiplatelet agents (e.g., Prasugrel, Ticagrelor)
Increased bleeding risk.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include bleeding, prolonged bleeding time, gastrointestinal upset, ringing in the ears (tinnitus), confusion, hyperventilation. Management involves supportive care, gastric lavage/activated charcoal if recent ingestion, and managing bleeding. Platelet transfusions may be considered for severe bleeding.
Pregnancy & Lactation
Pregnancy Category D for Aspirin (especially in 3rd trimester), Category B for Clopidogrel. Use only if clearly needed and benefits outweigh risks. Not recommended during late pregnancy due to risk of premature closure of ductus arteriosus and increased maternal/fetal bleeding. Avoid during lactation as both components are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by regulatory authorities worldwide (e.g., FDA, EMA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Numerous large-scale clinical trials (e.g., CURE, CLARITY-TIMI 28, COMMIT/CCS-2) have demonstrated the efficacy and safety of clopidogrel and aspirin combination in reducing cardiovascular events in high-risk patients.
Lab Monitoring
- Complete Blood Count (CBC) including platelet count (especially if bleeding occurs)
- Coagulation parameters (PT/INR, aPTT) if bleeding risk is high or during concomitant anticoagulant use
- Liver function tests (LFTs) periodically, especially in patients with hepatic impairment
- Renal function tests (RFTs) periodically
Doctor Notes
- Assess bleeding risk factors before initiating therapy and regularly during treatment.
- Consider genetic testing for CYP2C19 poor metabolizers, especially in patients who fail therapy or have recurrent events.
- Counsel patients on adherence and symptoms of bleeding.
Patient Guidelines
- Do not stop taking this medication without consulting your doctor, as it can increase your risk of heart attack or stroke.
- Report any unusual bleeding or bruising immediately to your doctor.
- Inform your doctor or dentist that you are taking this medication before any surgery or dental procedures.
- Avoid concomitant use of NSAIDs unless advised by your doctor.
- Take with food if stomach upset occurs.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
Generally, it does not affect the ability to drive or operate machinery. However, if you experience dizziness or visual disturbances, avoid such activities.
Lifestyle Advice
- Maintain a healthy lifestyle, including a balanced diet and regular exercise.
- Quit smoking and limit alcohol intake to reduce cardiovascular risk and bleeding risk.
- Manage underlying conditions like high blood pressure, diabetes, and high cholesterol.
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Global Brand Names
International brand names for this medicine
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