Clognil 75 mg

Description

Indications

Acute Coronary Syndrome (ACS)

Clognil tablets are prescribed to lower the risk of myocardial infarction (MI) and stroke in individuals with non-ST-segment elevation ACS, including unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI). It is also indicated for reducing the risk of MI and stroke in patients experiencing an acute ST-elevation myocardial infarction (STEMI).

Recent Myocardial Infarction, Stroke, or Peripheral Arterial Disease

Clognil tablets are used to reduce the incidence of MI and stroke in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Take this medication only as prescribed by a registered physician.

Pharmacology

Clopidogrel is a prodrug that works by inhibiting platelet activation and aggregation. Its active metabolite irreversibly binds to the P2Y12 class of ADP receptors on platelets, preventing clot formation. The drug begins to show dose-dependent inhibition of platelet aggregation within two hours of administration. A daily dose of 75 mg provides significant inhibition of ADP-induced platelet aggregation from the first day, reaching a steady state between days 3 and 7.

Dosage & Administration

Acute Coronary Syndrome (ACS)

• For patients requiring immediate antiplatelet effects, a 300 mg oral loading dose (four tablets) should be administered, followed by a maintenance dose of 75 mg once daily.
• If a loading dose is not given, achieving full antiplatelet activity will take several days.

Recent MI, Stroke, or Peripheral Arterial Disease

• The recommended dose is 75 mg once daily without a loading dose.

Clognil can be taken with or without food.

Use only as directed by a registered physician.

Drug Interactions

• Increased bleeding risk: Use with NSAIDs, warfarin, SSRIs, or SNRIs may heighten the risk of bleeding.
• CYP2C19 inhibitors (omeprazole, esomeprazole): Avoid concurrent use as they can reduce clopidogrel’s effectiveness.
• Repaglinide (CYP2C8 substrate): Co-administration with repaglinide should be avoided, as it may increase plasma concentrations of repaglinide.

Contraindications

Clopidogrel should not be used in individuals with:

• Hypersensitivity to clopidogrel or any of its components.
• Active pathological bleeding, such as peptic ulcer or intracranial hemorrhage.

Side Effects

Common Side Effects

• Bleeding
• Diarrhea
• Gastrointestinal discomfort
• Hemorrhage
• Skin reactions

Rare Side Effects

• Acquired hemophilia
• Anemia
• Angioedema
• Joint pain (arthralgia), arthritis
• Bone marrow disorders

Use in Pregnancy & Lactation

• There are no well-controlled studies on the use of clopidogrel during pregnancy. It should only be used if the benefits outweigh the risks.
• It is unknown whether clopidogrel passes into breast milk. A healthcare provider should assess whether to discontinue the medication or stop breastfeeding.

Precautions & Warnings

• Clopidogrel requires metabolic activation via the CYP2C19 enzyme. Patients with genetic variations affecting CYP2C19 function (poor metabolizers) or those using CYP2C19 inhibitors (e.g., omeprazole, esomeprazole) may experience reduced drug efficacy.
• Since clopidogrel irreversibly inhibits platelet function for the lifespan of platelets (7–10 days), there is an increased risk of bleeding. In cases requiring restoration of hemostasis, platelet transfusions within four hours of the loading dose or two hours of the maintenance dose may have limited effectiveness.
• Discontinuing clopidogrel prematurely may increase the risk of cardiovascular events. If undergoing elective surgery with a significant bleeding risk, stop the medication at least five days before the procedure and resume it once hemostasis is achieved.
• Cases of Thrombotic Thrombocytopenic Purpura (TTP) have been reported, necessitating immediate treatment, including plasma exchange therapy.
• Hypersensitivity reactions such as rash, angioedema, or hematologic reactions may occur, especially in patients with a history of allergic reactions to other thienopyridines.

Use in Special Populations

• The safety and effectiveness of clopidogrel in pediatric patients have not been established.
• No dose adjustment is necessary for elderly patients.

Overdose Effects

• Overdosing on clopidogrel may result in excessive bleeding. Platelet transfusion may help restore normal clotting function.

Therapeutic Class

• Antiplatelet drugs

Storage Conditions

• Store below 30°C in a dry place, away from light and moisture.
• Do not freeze.
• Keep out of reach of children.