Medicine Information

Dorel Plus

Name: Dorel Plus
Brand: Dorel Plus
Rating: 4.5 (117 reviews)

TabletClopidogrel 75 mg + Aspirin 75 mgAntiplateletATC: B01AC

Generic Name

Clopidogrel 75 mg + Aspirin 75 mg Tablet

Manufacturer

Incepta Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
dorel plus 75 mg tablet	৳ 12.50	৳ 125.00

Description

Overview of the medicine

Dorel Plus 75 mg Tablet is a combination antiplatelet medication used to prevent blood clots in patients at risk of cardiovascular events like heart attack and stroke. It contains Clopidogrel and Aspirin, which work together to inhibit platelet aggregation.

Uses & Indications

Prevention of atherothrombotic events in patients with acute coronary syndrome (ACS), including ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA)

Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease

Secondary prevention of cardiovascular events in high-risk patients

Dosage

Adults

Usually one Dorel Plus 75 mg Tablet once daily. For acute coronary syndrome, an initial loading dose may be prescribed by the physician.

Elderly

No specific dosage adjustment is generally required for elderly patients, but caution is advised due to increased risk of bleeding.

Renal_impairment

No dosage adjustment is generally required for mild to moderate renal impairment. Caution is advised in severe renal impairment due to potential for increased bleeding risk.

How to Take

Take the tablet orally with or without food, usually at the same time each day. Swallow whole with water.

Mechanism of Action

Clopidogrel is a prodrug that, once metabolized, selectively inhibits the binding of adenosine diphosphate (ADP) to its platelet P2Y12 receptor, thereby inhibiting ADP-mediated platelet activation and aggregation. Aspirin irreversibly inhibits cyclooxygenase (COX) enzyme, leading to decreased synthesis of thromboxane A2 (TXA2) in platelets, a potent inducer of platelet aggregation.

Pharmacokinetics

Onset

Clopidogrel: Antiplatelet effect seen within 2 hours of a single dose. Aspirin: Antiplatelet effect within 30-60 minutes.

Excretion

Clopidogrel: Approximately 50% via urine and 48% via feces. Aspirin: Primarily via urine as salicylic acid and its metabolites.

Half life

Clopidogrel: Parent drug ~6 hours, active metabolite ~30 minutes. Aspirin: Acetylsalicylic acid 15-20 minutes, Salicylic acid ~2-3 hours (dose-dependent).

Absorption

Clopidogrel: Rapidly absorbed after oral administration, extensively metabolized. Aspirin: Rapidly and extensively absorbed after oral administration.

Metabolism

Clopidogrel: Hepatic, primarily by CYP2C19 to its active metabolite and other inactive metabolites. Aspirin: Rapidly hydrolyzed to salicylic acid in the GI wall and liver.

Side Effects

Contraindications

Hypersensitivity to Clopidogrel, Aspirin, or any component of the tablet
Active pathological bleeding, such as peptic ulcer or intracranial hemorrhage
Severe hepatic impairment
History of asthma, rhinitis, or urticaria induced by salicylates or other NSAIDs
Third trimester of pregnancy (due to Aspirin component)

Drug Interactions

Anticoagulants (e.g., Warfarin)

Increased risk of bleeding. Close monitoring required.

NSAIDs (e.g., Ibuprofen, Naproxen)

Increased risk of gastrointestinal bleeding. Concomitant use generally not recommended.

SSRIs (e.g., Fluoxetine, Sertraline)

Increased risk of bleeding due to effects on platelet function.

Other Antiplatelet Agents (e.g., Ticagrelor)

Increased risk of bleeding.

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

May reduce the antiplatelet effect of Clopidogrel, especially Omeprazole, by inhibiting CYP2C19. Consider alternative PPIs or H2 blockers.

Storage

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

Overdose

Overdose may lead to increased bleeding complications. Symptoms may include prolonged bleeding time, gastrointestinal bleeding, or hemorrhagic complications. Management is primarily supportive and symptomatic. Platelet transfusions may be considered in severe cases of bleeding. There is no specific antidote.

Pregnancy & Lactation

Pregnancy Category C for Clopidogrel. Aspirin is Category C in the first and second trimesters and Category D in the third trimester (due to potential for premature closure of ductus arteriosus). This combination should be avoided during pregnancy, especially in the third trimester. Consult your doctor. It is not known whether Clopidogrel is excreted in human milk. Aspirin and its metabolites are excreted in human milk. A decision must be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per strip30 tablets per box (3 strips of 10 tablets)

Shelf Life

Typically 2-3 years from the date of manufacture, as indicated on the packaging.

Availability

Pharmacies, hospitals

Approval Status

Approved by DGDA (Bangladesh)

Patent Status

Generic product available, patents expired for active ingredients

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials (e.g., CURE, CLARITY-TIMI 28, COMMIT/CCS-2, CREDO) have established the efficacy and safety of Clopidogrel and Aspirin combination therapy in various cardiovascular settings, demonstrating superior outcomes compared to monotherapy.

Lab Monitoring

Complete Blood Count (CBC) with platelet count (periodically to monitor for bleeding and blood dyscrasias)
Liver function tests (periodically, especially in patients with pre-existing hepatic impairment)
Stool occult blood tests (if gastrointestinal bleeding is suspected)

Doctor Notes

Crucial for physicians to assess bleeding risk versus thrombotic risk when prescribing Dorel Plus.
Patients must be educated on reporting any signs of bleeding immediately and the importance of adherence.
Review concomitant medications for potential interactions, especially NSAIDs, warfarin, and certain PPIs (e.g., omeprazole).

Patient Guidelines

Take exactly as prescribed by your doctor. Do not stop taking the medicine without consulting your doctor, even if you feel well, as this may increase your risk of heart attack or stroke.
Inform your doctor or dentist about taking Dorel Plus before any surgery or dental procedures, as it increases the risk of bleeding.
Report any unusual bleeding or bruising immediately to your doctor.
Avoid concomitant use of NSAIDs unless advised by your doctor.

Missed Dose Advice

If you miss a dose, 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. Continue with your regular dosing schedule.

Driving Precautions

Dorel Plus is not known to affect the ability to drive or operate machinery. However, if you experience dizziness or other side effects that could impair your judgment, avoid these activities.

Lifestyle Advice

Maintain a healthy lifestyle, including a balanced diet and regular exercise.
Avoid excessive alcohol consumption, as it can increase the risk of stomach bleeding.
Manage underlying conditions like high blood pressure and diabetes.
Quit smoking to reduce cardiovascular risk.

Alternative Medicines in Bangladesh

Similar medicines available in the market

Clopid A (Square Pharmaceuticals Ltd.)Lopirel A (Incepta Pharmaceuticals Ltd.)Clorel A (Beximco Pharmaceuticals Ltd.)Plafor A (ACI Pharmaceuticals Ltd.)

Global Brand Names

International brand names for this medicine

MediCore Pharmaceuticals Ltd.

Tablet100 mg

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