CLOPIDOGREL BISULFATE (clo-pi'do-grel) Plavix Classifications: blood formers, coagulators, and anticoagulants; antiplatelet agent Pregnancy Category: B
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75 mg tablets
Inhibits platelet aggregation by selectively preventing the binding of adenosine diphosphate to its platelet receptor. It
is an analog of ticlopidine. The drug's effect on the adenosine diphosphate receptor of a platelet is irreversible.
Consequently, clopidrogrel prolongs bleeding time.
Secondary prevention of MI, stroke, and vascular death in patients with recent MI, stroke, unstable angina or established
peripheral arterial disease.
Reduction of restenosis after stent placement.
Hypersensitivity to clopidogrel; intracranial hemorrhage, peptic ulcer, or any other active pathologic bleeding; pregnancy
(category B). Discontinue clopidogrel 7 d before surgery and during lactation. Safety and efficacy not established in children.
Concurrent use with drugs that might induce gastrointestinal bleeding; GI bleeding; hepatic impairment (moderate to severe);
patients at risk for increased bleeding.
Secondary Prevention Adult: PO 75 mg q.d.
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Oral
- Do not administer to persons with active pathologic bleeding.
- Discontinue drug 7 d prior to surgery.
- Store at 15°30° C (59°86° F) in tightly closed container and protect from light.
Body as a Whole: Flu-like syndrome, fatigue, pain, arthralgia, back pain. CV: Chest pain, edema, hypertension, thrombocytic purpura. GI: Abdominal pain, dyspepsia, diarrhea, nausea, hypercholesterolemia. Hematologic: Thrombotic thrombocytopenic purpura, epistaxis. CNS: Headache, dizziness, depression. Respiratory: URI, dyspnea, rhinitis, bronchitis, cough. Skin: Rash, pruritus.
Drug:
nsaids may increase risk of bleeding events. Herbal:
Feverfew,
garlic,
ginger,
ginkgo may increase risk of bleeding.
Absorption: Rapidly absorbed from GI tract. Onset: 2 h; reaches steady state in 37 d. Distribution: 9498% protein bound. Metabolism: Rapidly hydrolyzed in plasma to active metabolite. Elimination: 50% excreted in urine and 50% in feces. Half-Life: 8 h.
Assessment & Drug Effects
- Carefully monitor for and immediately report S&S of GI bleeding, especially when coadministered with NSAIDs, aspirin, heparin, or warfarin.
- Lab tests: Periodic platelet count and lipid profile.
- Evaluate patients with unexplained fever or infection for myelotoxicity.
Patient & Family Education
- Report promptly any unusual bleeding (e.g., black, tarry stools).
- Avoid chronic aspirin or NSAID use unless approved by physician.
- Do not breast feed while taking this drug.