CoPlavix

Clopidogrel 75 mg, ASA 100 mg

Secondary prevention of atherothrombotic events in adults already taking both clopidogrel & ASA. For continuation of therapy in non-ST segment elevation acute coronary syndrome (unstable angina or non-Q-wave MI) including patients undergoing a stent placement following percutaneous coronary intervention; ST segment elevation acute MI in medically treated patients eligible for thrombolytic therapy.

Adult & elderly 75/100 mg as single daily dose.

May be taken with or without food.

Hypersensitivity. Severe hepatic impairment. Active pathological bleeding eg, peptic ulcer or intracranial haemorrhage. Due to ASA: Hypersensitivity to NSAIDs; syndrome of asthma, rhinitis, & nasal polyps; patients w/ pre-existing mastocytosis. History of GI bleeding or perforation, related to previous NSAIDs therapy; active, or history of recurrent peptic ulcer/haemorrhage. Severe renal impairment (CrCl <30 mL/min). 3rd trimester of pregnancy.

Risk of bleeding & haematological adverse reactions; GI adverse events including bleeding, ulceration & stomach/intestine perforation. Reports of TTP (very rare); acquired haemophilia. Increased major bleeding in patients w/ recent transient ischaemic attack or stroke. Caution in patients at risk of increased bleeding from trauma, surgery or other pathological conditions & in patients receiving treatment w/ other NSAIDs including COX-2 inhibitors, heparin, glycoprotein IIb/IIIa inhibitors, SSRIs, thrombolytics or other medicinal products associated w/ bleeding risk eg, pentoxifylline; patients who have lesions w/ a propensity to bleed (particularly GI & intraocular); patients w/ history of peptic ulcer or gastroduodenal haemorrhage or minor upper GI symptoms; poor CYP2C19 metabolisers; patients w/ mild to moderate renal impairment; moderate hepatic disease. Long-term administration of NSAIDs has resulted in renal papillary necrosis & other renal injury. Not recommended in patients w/ advanced renal disease. Cross-reactivity among thienopyridines eg, ticlopidine, prasugrel. Concomitant use of strong or moderate CYP2C19 inhibitors or strong CYP2C19 inducers should be discouraged. Caution w/ concomitant CYP2C8 substrates. Not recommended w/ oral anticoagulants. Patients w/ rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine. Contains hydrogenated castor oil. Do not use during the 1st 2 trimesters of pregnancy. Discontinue breastfeeding during treatment. Not recommended in childn & adolescents <18 yr. Due to ASA: Caution in patients w/ history of asthma or allergic disorders; gout; G6PD deficiency; alcohol consumption.

Haematoma; epistaxis; GI haemorrhage, diarrhoea, abdominal pain, dyspepsia; bruising; bleeding at the puncture site.

Increased risk of bleeding due to potential additive effect w/ oral anticoagulants, glycoprotein IIb/IIIa inhibitors, heparin, thrombolytics, NSAIDs including COX-2 inhibitors, SSRIs. Increased occult GI blood loss w/ concomitant administration of clopidogrel & naproxen. Reduced effect of ASA w/ metamizole. Potential delayed & reduced absorption of clopidogrel w/ opioid agonists. Clopidogrel: Increased levels of the active metabolite w/ strong CYP2C19 inducers (eg, rifampicin). Reduced levels of the active metabolite w/ strong or moderate CYP2C19 inhibitors (eg, omeprazole, esomeprazole, fluvoxamine, fluoxetine, moclobemide, voriconazole, fluconazole, ticlopidine, carbamazepine, efavirenz). Decreased exposure of the active metabolite w/ PPIs eg, omeprazole, esomeprazole. Reduced platelet inhibition in HIV patients treated w/ ritonavir- or cobicistat-boosted anti-retroviral therapy. Increased exposure of CYP2C8 substrates eg, repaglinide & paclitaxel. ASA: May inhibit the effect of uricosurics (eg, benzbromarone, probenecid, sulfinpyrazone). Can inhibit renal clearance of MTX. Increased risk of renal failure w/ tenofovir disoproxil fumarate. Increased serum levels of total & free valproic acid. Risk of Reye's syndrome w/ varicella vaccine. Do not give salicylates for an interval of 6 wk after receiving varicella vaccine. Increased risk of metabolic acidosis w/ acetazolamide. Increased risk of GI ulceration, perforation & haemorrhage w/ nicorandil. Increased risk of GI injury w/ alcohol.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

B01AC30 - combinations ; Belongs to the class of platelet aggregation inhibitors excluding heparin. Used in the treatment of thrombosis.

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