The composition of the tablets includes 75 mg clopidogrel + microcrystalline cellulose, glyceryl dibehenate, talc, macrogol, red iron oxide dye, lactose, crospovidone, polyinyl alcohol, lecithin.
The product is released in the form of round, convex pink tablets. On the one hand - engraving “I”. In blisters for 7 or 10 pieces, 2, 4 or 9 blisters in a cardboard box.
Antithrombotic means. Antiplatelet agent.
Pharmacodynamics and pharmacokinetics
The active component of the drug selectively inhibits molecule binding ADP with receptors located on the surface platelet count. Thus, the activation of the complex GPIIb / IIIa and platelet aggregation becomes impossible. Also clopidogrel inhibits aggregation processes induced by others antagonists. Platelets remain damaged and unable to process until the end of their life cycle. aggregation.
After receipt of the first batch of medication, an antithrombotic process begins to occur, the level of leukocytes is established by 3-7 days of administration. On average, 5 days after discontinuation of treatment, platelet aggregation and the duration of bleeding return to the initial level.
The medicine is pretty quickly absorbed into Gastrointestinal tract. However, the concentration clopidogrelin plasma is very low, absorption is 50%. The drug binds well to blood plasma proteins.
Clopidogrel is metabolized in the liver, about 80% of the metabolites found in plasma are inactive. Active metabolite, which provides the necessary anti-aggregate action, formed by an oxidation reaction, involving isoenzyme of cytochrome P450 - 2B6 and 3A4. The metabolite itself quickly reacts with platelets and is not detected in blood plasma.
The half-life is 6 hours for the active substance and 8 for its inactive metabolite. Products are excreted mainly with urine and feces.
Persons suffering from severe renal failure, a decrease in the effectiveness of the drug by 25% compared with healthy people.
Indications for use of Lopirel
The drug is used to prevent arterial thrombosis in individuals suffering from acute coronary syndrome:
- at unstable angina;
- at myocardial infarction (without Q wave);
- after acute myocardial infarction.
Also indicated for use are atherothrombotic complications in patients who have suffered myocardial infarction, strokehave peripheral arterial occlusion disease. In this case, the medicine is used as a prophylaxis.
The drug is not prescribed:
- in severe liver failure;
- pregnant and lactating women;
- at hemorrhagic syndrome;
- at intracranial hemorrhage, stomach ulcernon-specific ulcerative colitis, lung tumors, tuberculosis and hyperfibrinolysis;
- children under 18 years old;
- at allergies on the components of the drug;
- with intolerance galactose.
Caution should be exercised when combining the drug with acetylsalicylic acid, NSAIDs, heparin, thrombolytics, with renal and hepatic insufficiency, before surgery.
Adverse reactions, arranged in order to reduce the likelihood of occurrence:
- nosebleeds, hematomas, indigestionbleeding in Gastrointestinal tract, diarrheasubcutaneous hemorrhage;
- eosinophilia, headache, thrombocytopenia, paresthesia, loss of consciousness, flatulence, leukopenia, gastritisnausea constipationsores in Gastrointestinal tract;
- conjunctival, ophthalmic, intracranial and retinal hemorrhages, decrease in number neutrophils and platelet count in blood;
- neutropenia, retroperitoneal bleeding;
- TTP, agranulocytosistaste distortion anaphylactoid reactions, thrombocytopenia, aplastic anemia, hallucinations and confusion, vasculitislowered HELL;
- bronchospasm, colitishemoptysis, bullous dermatitis, pancreatitis, stomatitis, hepatitis, liver failure, Quincke's edema, myalgia, hives, arthralgia, lichen planus, eczema, arthritis, fever.
Lopirel, instructions for use (method and dosage)
Tablets are taken orally, regardless of the meal regimen.
Instructions for use Lopirel (75 mg)
As a rule, with myocardial infarction ischemic stroke, patients with arterial diseases in the periphery are prescribed 1 tablet 1 time per day.
Duration of admission after heart attack - from 1 to 25 day, after stroke - 7 days or 6 months.
If the patient coronary syndrome without lifting ST or was held coronary stenting, then treatment begins with a dose of 300 mg, and then 75 mg (one tablet) is prescribed once a day for 3 months (the course can be extended to one year). In such diseases, as a rule, additionally prescribed butcetyl salicylic acidThe recommended dosage is 100 mg.
With an overdose of drugs, an increase in the duration of bleeding and a further deterioration of the condition are possible.
Treatment - according to the symptoms.
Specific antidote the medicine does not have. In extreme cases, the termination of the drug by transfusion to the victim is possible. platelet mass.
When combined with oral anticoagulants, in particular warfarin, the likelihood of occurrence and the duration of bleeding may increase.
In people who have an increased risk of bleeding and are taking Lopirel, it is not recommended to additionally take glycoprotein IIb / IIІa inhibitors.
Proven combination clopidogrel - naproxen increases the risk of latent gastrointestinal bleeding. However, in the case of others NSAIDs such a pattern has not been proven. In this regard, with a combination of these drugs should be careful.
Despite the good results of clinical studies of drug interactions with heparin, at their simultaneous reception it is necessary to be careful.
The combination of the drug with thrombolytics, since the safety of such a combination is not exactly established.
Proven daily intake acetylsalicylic acid(up to 1000 mg per day) and clopidogrel does not affect aggregate properties of the drug. However, the duration of co-administration of these drugs should not be more than 1 year (care must be taken).
The medicine can be combined with atenolol, phenobarbital, estrogen, cimetidine or nifedipine.
The drug inhibits the metabolism of drugs, pharmacokinetic indicators that depend on isoenzyme CYP2C9. In particular, a drug may increase plasma concentration phenytoin and tolbutamide. Care must be taken.
Perhaps a combination of tools with digoxin, theophylline, antacids.
Terms of sale
Store in a cool place at room temperature.
For persons with acute myocardial infarction with increasing ST,therapy with the drug should be postponed for 2-3 days.
If bleeding occurs during treatment with the drug, blood tests should be performed and liver enzymes.
Particular care must be taken when combining with NSAIDs, aspirin, heparin, thrombolytics, during operations, injuries, increased risk of bleeding.
The drug is not prescribed to persons undergoing acute ischemic strokeif less than a week has passed.
If you have surgery, take the dentist or another doctor, you must inform the specialist that you are taking this drug. Stop taking Lopirel should not less than a week before the proposed operation.
Your doctor must report all cases of bleeding that occur during treatment with the drug. It should be remembered that it may take longer to stop it than usual.
Analogs LopirelaMatches for ATX Level 4 code:PersantineEgithrombAcetylsalicylic acidPlavixCoplavixChimesCardiomagnylPolokardThrombo ACCBrilintaMagnikorPluggedDipyridamoleClopidogrelSyltCardiaskAspirin CardioAcecardolAspinatAspicore
Analogues of the drug: Clopidogrel, Avix, Atrogrel, Deplat, Zilt, Karum Sanovel, Clopidale, Klopikor, Lopigrol, Orogrel, Plavigrel, Plagril, Reodar, Tessiron, Trombone, Flamogrel 75, Aterocardium, Gridoklein, Deplatt, Cardogrel, Medrogrel, Krelogrel, Krelogrel, Krelogrel, Krelogrel, Krelogrel Neo, Plavix, Platogril, Reomax, Trombeks.
Reviews about Lopirel
Reviews about the drug are very good. People who took it, note high efficacy and the absence of serious adverse reactions compared with similar drugs. Some are embarrassed by the high cost of the drug.
The price of Lopirel 75 mg (28 tablets) is approximately 460 rubles.
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