Preclot AS
Generic Name
Clopidogrel and Aspirin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| preclot as 75 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Preclot AS is a combination of two antiplatelet agents, Clopidogrel and Aspirin, used to prevent blood clots in patients with cardiovascular disease.
Uses & Indications
Dosage
Adults
Acute Coronary Syndrome (ACS): A single 300 mg loading dose of Clopidogrel, followed by 75 mg once daily, in combination with Aspirin 75 mg to 150 mg daily. Recent MI, Stroke, or Established PAD: 75 mg Clopidogrel once daily, in combination with Aspirin 75 mg to 150 mg daily.
Elderly
No dosage adjustment is generally required for elderly patients unless they have severe renal or hepatic impairment.
Renal_impairment
Caution is advised in patients with renal impairment. Dosage adjustment may be necessary in severe cases.
How to Take
Take orally, with or without food. Swallow the tablet whole with water.
Mechanism of Action
Clopidogrel selectively inhibits ADP binding to its platelet receptor, and subsequent ADP-mediated activation of the GPIIb/IIIa complex, thereby inhibiting platelet aggregation. Aspirin irreversibly inhibits cyclooxygenase-1 (COX-1) enzyme, leading to decreased thromboxane A2 (TXA2) production, which is a potent inducer of platelet aggregation and vasoconstriction.
Pharmacokinetics
Onset
Clopidogrel: within 2 hours. Aspirin: within 1 hour.
Excretion
Clopidogrel: primarily renal and fecal. Aspirin: mainly renal as salicylic acid and its metabolites.
Half life
Clopidogrel: 6 hours (active metabolite). Aspirin: 2-3 hours (salicylic acid).
Absorption
Clopidogrel is rapidly absorbed from the gastrointestinal tract. Aspirin is also rapidly and completely absorbed.
Metabolism
Clopidogrel: extensive hepatic metabolism by cytochrome P450 enzymes (mainly CYP2C19) to active and inactive metabolites. Aspirin: hydrolyzed to salicylic acid in the GI tract and liver.
Side Effects
Contraindications
- Hypersensitivity to Clopidogrel, Aspirin, or any component of the formulation
- Active pathological bleeding such as peptic ulcer or intracranial hemorrhage
- Severe hepatic impairment
- Severe renal impairment
- Bronchial asthma, rhinitis, or urticaria associated with NSAIDs or salicylates
- Children under 16 years of age with fever or viral infections (risk of Reye's syndrome with Aspirin)
Drug Interactions
Corticosteroids
Increased risk of gastrointestinal bleeding.
Warfarin/Other Anticoagulants
Increased risk of bleeding. Concurrent use should be approached with caution.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Increased risk of gastrointestinal bleeding. Concurrent use should be avoided or used with extreme caution.
Proton Pump Inhibitors (e.g., Omeprazole, Esomeprazole)
May reduce the antiplatelet effect of Clopidogrel by inhibiting CYP2C19. Avoid concomitant use if possible, or consider alternative PPIs with less CYP2C19 inhibition (e.g., Pantoprazole).
SSRIs/SNRIs (Selective Serotonin Reuptake Inhibitors / Serotonin-Norepinephrine Reuptake Inhibitors)
Increased risk of bleeding due to their effects on platelet function. Use with caution.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include bleeding and prolonged bleeding time. Treatment is symptomatic and supportive. Platelet transfusions may be considered if rapid reversal of antiplatelet effect is required.
Pregnancy & Lactation
Pregnancy: Not recommended during pregnancy, especially during the third trimester, due to potential adverse effects on the fetus (e.g., premature closure of the ductus arteriosus, impaired platelet function). Use only if the potential benefit outweighs the potential risk to the fetus. Lactation: Both Clopidogrel and Aspirin are excreted in breast milk. Avoid use during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Available in all pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials, such as the CURE study and the COMMIT/CCS2 trial, have demonstrated the efficacy and safety of combined clopidogrel and aspirin therapy in reducing cardiovascular events.
Lab Monitoring
- Complete Blood Count (CBC) with platelet count (monitor for bleeding and thrombocytopenia)
- Liver Function Tests (LFTs) (baseline and periodically)
- Renal Function Tests (RFTs) (baseline and periodically)
- Stool for occult blood (if indicated)
Doctor Notes
- Emphasize patient education on bleeding symptoms and the importance of adherence.
- Consider CYP2C19 genotype testing in select patients, especially those who experience thrombotic events despite therapy.
- Review concomitant medications carefully to avoid drug interactions, particularly with PPIs and other antiplatelets/anticoagulants.
Patient Guidelines
- Do not stop taking this medication without consulting your doctor, even if you feel well, as it can increase the risk of a cardiovascular event.
- Report any signs of unusual bleeding or bruising immediately to your doctor.
- Inform all healthcare providers, including dentists and pharmacists, that you are taking Preclot AS before any surgery or dental procedure.
- Avoid taking other medications, especially NSAIDs, without consulting your doctor.
Missed Dose Advice
If a dose is missed within 12 hours of the scheduled time, take it as soon as remembered. If more than 12 hours have passed, skip the missed dose and continue with the regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Preclot AS usually does not affect the ability to drive or operate machinery. However, if you experience dizziness or headache, avoid these activities until you feel better.
Lifestyle Advice
- Adopt a heart-healthy lifestyle, including a balanced diet and regular exercise, as advised by your doctor.
- Avoid activities that have a high risk of injury or trauma that could lead to bleeding.
- Limit alcohol consumption.
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