Anclog Plus 75 mg+75 mg

Description

Indications
Anclog Plus is used to reduce the incidence of myocardial infarction (MI) and stroke in patients with acute coronary syndrome (ACS). It is effective in both non-ST-segment elevation ACS (such as unstable angina [UA] and non-ST-elevation myocardial infarction [NSTEMI]) and acute ST-segment elevation ACS (ST-elevation myocardial infarction [STEMI]).

Additionally, it is indicated for patients with a history of recent MI, recent stroke, or established peripheral arterial disease, aiming to reduce the rate of MI and stroke in these individuals.

Take this medication as advised by a registered physician.

Pharmacology
Clopidogrel, a prodrug, prevents platelet activation and aggregation by irreversibly binding to the P2Y12 ADP receptors on platelets. The active metabolite of Clopidogrel inhibits ADP-induced platelet aggregation, with noticeable effects seen 2 hours after oral doses. Repeated 75 mg daily doses achieve steady-state platelet inhibition within 3-7 days.

Aspirin works by irreversibly inhibiting cyclooxygenase in platelets, thus preventing the formation of thromboxane A2, a potent mediator of platelet aggregation and vasoconstriction.

Pharmacokinetics
Following repeated 75 mg oral doses of Clopidogrel, plasma concentrations of the parent compound are minimal. The liver extensively metabolizes Clopidogrel into its active form, which makes up about 85% of the circulating drug metabolites. The primary circulating metabolite has no platelet inhibitory effect. About 50% of Clopidogrel is excreted in urine, and 46% in feces, within 5 days after dosing.

Clopidogrel is rapidly absorbed, with peak plasma levels of the active metabolite reached approximately 1 hour after oral administration. The pharmacokinetics of the active metabolite are linear, with increased plasma concentrations in proportion to the dose. Clopidogrel binds to plasma proteins at a rate of 98%, and its active metabolite binds at 94%.

Dosage & Administration
The recommended dose of Clopidogrel is 75 mg once daily, which can be taken with or without food. For patients with acute coronary syndrome (unstable angina/non-Q-wave MI), Clopidogrel should initially be administered as a 300 mg loading dose, followed by 75 mg once daily. Aspirin (75 mg-325 mg daily) should also be started and continued in combination with Clopidogrel. Most patients receiving treatment for acute coronary syndrome also receive heparin.

Use this medication under the guidance of a registered physician.

Interaction

• Aspirin: Aspirin does not interfere with Clopidogrel’s antiplatelet effects but enhances its effect on collagen-induced platelet aggregation.
• Heparin: No modification of heparin dosage is required, as it does not affect Clopidogrel’s action.
• NSAIDs: Concomitant use with NSAIDs can increase the risk of gastrointestinal bleeding, so caution is advised.
• Warfarin: The safety of combining Clopidogrel with warfarin has not been fully established. Caution is necessary when using both medications together.

Contraindications
Anclog Plus should not be used in patients with hypersensitivity to Clopidogrel, aspirin, or any component of the formulation. It is contraindicated in individuals with active pathological bleeding conditions, such as peptic ulcer disease or intracranial hemorrhage.

Side Effects
Anclog Plus is generally well tolerated. However, common side effects may include bleeding, gastrointestinal discomfort, diarrhea, and skin reactions. Rare side effects could include acquired hemophilia, anemia, angioedema, joint pain, arthritis, and bone marrow disorders.

Pregnancy & Lactation
Clopidogrel has not been studied in pregnant women, so it should be used during pregnancy only when the potential benefits justify the risks. It is contraindicated during the third trimester of pregnancy. Aspirin is known to be excreted in breast milk, and Clopidogrel’s excretion in breast milk is unknown. Discontinue breastfeeding if the medication is necessary for the mother.

Precautions & Warnings

• Bleeding risk: Anclog Plus may prolong bleeding time, so caution is advised, especially in patients with active bleeding disorders.
• Thrombotic Thrombocytopenic Purpura (TTP): Rare cases of TTP have been reported and require urgent treatment.
• Reye’s Syndrome: Children under 12 years old should not use Anclog Plus, especially during viral infections like chickenpox or influenza, as it may contribute to Reye’s syndrome.

Use in Special Populations

• Children: Should not be given to children under 12 unless the expected benefits outweigh the risks.
• Elderly: No dosage adjustment is necessary for elderly patients.
• Renal Impairment: No dosage adjustment is required in patients with renal impairment.

Overdose Effects
In cases of Clopidogrel overdose, bleeding complications may occur. Platelet transfusion may be needed to restore clotting ability. In cases of aspirin overdose, symptoms such as dizziness, tinnitus, confusion, and gastrointestinal distress can occur. Severe aspirin overdose can cause respiratory and metabolic acidosis, hyperthermia, dehydration, and may require hemodialysis.

Therapeutic Class
Antiplatelet drugs

Storage Conditions
Store below 30°C in a cool, dry place, away from light and moisture. Keep out of reach of children.