Lopirel Plus
Generic Name
Clopidogrel + Aspirin
Manufacturer
Popular Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lopirel plus 75 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Lopirel Plus is a combination antiplatelet medication containing Clopidogrel and Aspirin, used to prevent blood clots in patients with cardiovascular diseases, such as those with a history of heart attack, stroke, or peripheral artery disease.
Uses & Indications
Dosage
Adults
Typically, one tablet (Clopidogrel 75 mg + Aspirin 75 mg) once daily.
Elderly
No specific dose adjustment is generally required for elderly patients.
Renal_impairment
Use with caution in patients with severe renal impairment. No dose adjustment for mild to moderate impairment.
How to Take
Should be taken orally with or without food. Swallow the tablet whole with water.
Mechanism of Action
Clopidogrel selectively inhibits the binding of ADP to its platelet P2Y12 receptor, thereby inhibiting ADP-mediated activation of the GPIIb/IIIa complex and subsequent platelet aggregation. Aspirin inhibits platelet aggregation by irreversibly inhibiting cyclooxygenase-1 (COX-1), which leads to reduced production of thromboxane A2 (TXA2).
Pharmacokinetics
Onset
Clopidogrel: Antiplatelet effect seen within 2 hours, maximal effect within 3-7 days. Aspirin: Antiplatelet effect within 30 minutes.
Excretion
Clopidogrel: ~50% in urine, ~48% in feces. Aspirin: Primarily renal excretion of salicylic acid and its metabolites.
Half life
Clopidogrel: 6 hours (active metabolite). Aspirin: 2-3 hours (parent compound, but antiplatelet effect lasts longer).
Absorption
Clopidogrel is rapidly absorbed and extensively metabolized. Aspirin is rapidly absorbed from the GI tract.
Metabolism
Clopidogrel: Hepatic (CYP2C19, CYP3A4, CYP1A2, CYP2B6, CYP2C9) to active metabolite and inactive carboxylic acid derivative. Aspirin: Rapidly hydrolyzed to salicylic acid in the liver and GI tract.
Side Effects
Contraindications
- Hypersensitivity to Clopidogrel, Aspirin, or any component of the formulation
- Active pathological bleeding (e.g., peptic ulcer, intracranial hemorrhage)
- Severe hepatic impairment
- Children and adolescents with viral infections (due to risk of Reye's syndrome with Aspirin)
Drug Interactions
NSAIDs
Increased risk of gastrointestinal bleeding.
SSRIs/SNRIs
Increased risk of bleeding.
Other antiplatelet agents
Increased risk of bleeding.
Warfarin and other oral anticoagulants
Increased risk of bleeding.
Proton Pump Inhibitors (e.g., Omeprazole)
May reduce the antiplatelet effect of Clopidogrel (CYP2C19 inhibition).
Storage
Store in a cool, dry place below 30°C, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include prolonged bleeding time, gastrointestinal bleeding, tinnitus, dizziness, headache, confusion. Management involves symptomatic and supportive measures. Consider platelet transfusion for severe bleeding.
Pregnancy & Lactation
Pregnancy Category B for Clopidogrel, Category D in the third trimester for Aspirin. Use only if potential benefit justifies the potential risk to the fetus. Aspirin is excreted in breast milk; advise against use during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date.
Availability
Available in pharmacies, hospitals, and clinics nationwide
Approval Status
Approved by regulatory bodies (e.g., DGDA in Bangladesh)
Patent Status
Generically available (Clopidogrel patent expired)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Clopidogrel and Aspirin in reducing cardiovascular events in high-risk patients. Key trials include CURE, COMMIT/CCS-2, and CHARISMA for Clopidogrel, and numerous trials for Aspirin.
Lab Monitoring
- Complete Blood Count (CBC) with platelet count (especially if bleeding occurs)
- Liver function tests (LFTs) periodically
- Renal function tests (RFTs) periodically
Doctor Notes
- Emphasize patient compliance, especially in ACS patients. Assess bleeding risk periodically.
- Consider CYP2C19 testing in select patients, particularly those with recurrent ischemic events despite treatment.
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 heart attack or stroke.
- Inform your doctor or dentist about taking this medication before any surgery or dental procedures due to increased bleeding risk.
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 continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medication is not expected to impair the ability to drive or operate machinery.
Lifestyle Advice
- Maintain a healthy diet and regular exercise.
- Avoid smoking and excessive alcohol consumption.
- Regularly monitor blood pressure and cholesterol levels.
Alternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.