Lopirel
Generic Name
Clopidogrel 75 mg Tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lopirel 75 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Lopirel 75 mg Tablet contains Clopidogrel, an antiplatelet medication used to prevent blood clots. It reduces the risk of heart attack, stroke, and other cardiovascular events in patients with certain conditions like recent heart attack, recent stroke, or established peripheral arterial disease.
Uses & Indications
Dosage
Adults
For MI/stroke/PAD: 75 mg orally once daily. For ACS: Loading dose 300 mg (or 600 mg for PCI), then 75 mg orally once daily, typically with aspirin.
Elderly
No specific dose adjustment is generally required, but caution is advised due to increased risk of bleeding.
Renal_impairment
No dose adjustment needed for mild to moderate renal impairment. Use with caution in severe renal impairment.
How to Take
Lopirel 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 selectively inhibits the binding of adenosine diphosphate (ADP) to its platelet P2Y12 receptor, thereby preventing ADP-mediated platelet activation and aggregation. This action is irreversible, and platelets exposed to clopidogrel are affected for their lifespan.
Pharmacokinetics
Onset
Antiplatelet effect begins within 2 hours, reaching maximal effect within 3-7 days with repeated doses.
Excretion
Approximately 50% is excreted via urine and 46% via feces within 5 days.
Half life
Parent drug (Clopidogrel) has a half-life of approximately 6 hours. The active metabolite has a half-life of about 8 hours.
Absorption
Rapidly absorbed after oral administration, but bioavailability is low (around 50%) due to extensive first-pass metabolism.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 enzymes (CYP2C19, CYP3A4, CYP2B6, CYP1A2) 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 (Clopidogrel) or any of the excipients.
- Severe hepatic impairment.
Drug Interactions
SSRIs and SNRIs
May increase the risk of bleeding. Use with caution.
NSAIDs, Warfarin, Heparin
Increased risk of bleeding due to additive antiplatelet/anticoagulant effects. Use with caution.
Other Antiplatelet Agents
Concomitant use with other antiplatelet agents (e.g., aspirin, prasugrel, ticagrelor) increases the risk of bleeding.
Proton Pump Inhibitors (PPIs)
Co-administration with certain 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 of clopidogrel may lead to prolonged bleeding time and subsequent bleeding complications. Management is primarily supportive. Platelet transfusion may be considered if severe bleeding occurs or if rapid reversal of antiplatelet effect is required.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus. However, there are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed after careful risk-benefit assessment. It is not known whether clopidogrel or its metabolites are excreted in human milk; therefore, caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Clopidogrel has been extensively studied in large-scale clinical trials such as CAPRIE, CURE, COMMIT, and CREDO, demonstrating its efficacy in reducing cardiovascular events in various patient populations.
Lab Monitoring
- Complete Blood Count (CBC) with platelet count, especially if bleeding is suspected or before surgery.
- Liver function tests (LFTs) if hepatic impairment is suspected or develops.
Doctor Notes
- Assess bleeding risk factors before initiating Clopidogrel and periodically throughout treatment.
- Consider CYP2C19 genetic testing in high-risk patients (e.g., post-PCI, recurrent thrombotic events) or those with suspected treatment failure.
- Advise patients to immediately report any signs of bleeding and to avoid concurrent use of NSAIDs or other blood thinners without consultation.
Patient Guidelines
- Take Lopirel exactly as prescribed by your doctor; do not stop taking it without consulting your doctor.
- Inform your doctor or dentist that you are taking Clopidogrel before any surgical procedures or dental work.
- Report any signs of unusual bleeding or bruising (e.g., prolonged nosebleeds, blood in urine/stool, severe headache) immediately to your doctor.
- Do not take any other medications, especially NSAIDs or blood thinners, without consulting your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Lopirel is not known to affect the ability to drive or operate machinery. However, if you experience side effects like dizziness, avoid driving or operating heavy machinery.
Lifestyle Advice
- Avoid activities that carry a high risk of injury to minimize the risk of bleeding.
- Maintain a healthy lifestyle, including a balanced diet and regular exercise, as advised by your doctor.
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