Clocard 75 Tablet

✔️ How to take Clocard 75

• Take Clocard 75 exactly as prescribed by your doctor.
• Swallow the tablet whole with water.
• Do not chew, crush, or break the tablet unless specifically instructed.
• It may be taken with or without food.
• Taking it at the same time every day can help maintain consistent protection.
• Continue treatment even when you feel well unless your doctor tells you to stop.

✔️ Mode of Action

Clopidogrel is converted in the body to an active metabolite that irreversibly inhibits the platelet P2Y12 ADP receptor. This blocks ADP-mediated platelet activation and reduces activation of the glycoprotein IIb/IIIa pathway.

As a result, fibrinogen binding, platelet adhesion, and platelet aggregation are reduced, decreasing the formation of arterial blood clots.

✔️ Words of Advice:

• Take Clocard 75 at the same time every day for consistent antiplatelet protection.
• Clopidogrel increases the tendency to bleed. Take care when shaving, using sharp objects, or performing activities that may cause injury.
• Inform your doctor or dentist that you are taking clopidogrel before any surgery, dental procedure, or invasive treatment.
• Your doctor may advise temporarily stopping clopidogrel before certain planned procedures. Do not stop it yourself.
• Do not discontinue Clocard 75 without medical advice, especially if you have had a coronary stent or recent acute coronary syndrome.
• Seek medical attention if bleeding is heavy, persistent, or unusual.
• Tell your doctor if you have a history of stomach ulcers, bleeding disorders, liver or kidney disease, or recent surgery or serious injury.
• Avoid taking omeprazole or esomeprazole with clopidogrel unless your doctor specifically considers the combination appropriate, as these medicines may reduce clopidogrel activation.
• Tell your doctor about all medicines and supplements you are taking before starting Clocard 75.

✔️ Clopidogrel should not be used in patients with:

• Hypersensitivity to clopidogrel or any component of the formulation
• Active pathological bleeding, such as peptic ulcer bleeding or intracranial hemorrhage

✔️ Side Effects:

Common Side Effects

• Bleeding or bruising
• Nosebleed
• Gastrointestinal discomfort
• Diarrhea
• Skin rash or other skin reactions

Because clopidogrel reduces platelet aggregation, minor cuts or injuries may take longer than usual to stop bleeding.

Rare but Serious Side Effects

• Severe or persistent bleeding
• Gastrointestinal bleeding
• Intracranial hemorrhage
• Anemia
• Thrombotic thrombocytopenic purpura (TTP)
• Acquired hemophilia
• Severe reduction in blood-cell counts
• Angioedema
• Severe hypersensitivity reactions
• Liver injury or hepatitis

✔️ Dosage:

Adult Dose

Recent MI, Recent Ischemic Stroke, or Established Peripheral Arterial Disease

75 mg once daily, without a loading dose.

Acute Coronary Syndrome – Unstable Angina/NSTEMI

A 300 mg loading dose may be given initially, followed by 75 mg once daily, generally in combination with aspirin, according to the treating physician's assessment.

STEMI

In appropriate patients, clopidogrel may be given with aspirin.

For patients under 75 years, a 300 mg loading dose may be followed by 75 mg once daily. In patients 75 years and older, a loading dose may be omitted and treatment may begin with 75 mg once daily.

The duration of treatment depends on the clinical condition, bleeding risk, coronary intervention status, and the treating physician's recommendation.

Hepatic Impairment

Use with caution in patients with significant liver impairment because clinical experience is limited.

Renal Dose

Routine dose adjustment is generally not required for renal impairment. However, patients with significant kidney disease may have an increased risk of bleeding and should be monitored appropriately.

✔️ Clocard 75 should be used cautiously in patients who have an increased risk of bleeding, including those with:

• Recent surgery or trauma
• Active or previous gastrointestinal ulceration
• Previous bleeding disorders
• Liver disease
• Kidney impairment
• Disorders affecting blood clotting
• Conditions requiring invasive procedures

✔️ Pregnancy & Lactation

Clopidogrel should be used during pregnancy only when the potential benefits justify the possible risks. Pregnant patients with serious cardiovascular conditions should not discontinue necessary antiplatelet therapy without consulting their doctor.

Treatment around labor and delivery may increase the mother's risk of bleeding. When clinically appropriate, the doctor may recommend discontinuation several days before planned delivery or procedures involving neuraxial anesthesia.

It is not fully established whether clopidogrel is present in human breast milk. Breastfeeding during treatment should therefore be discussed with the treating physician, considering the mother's clinical need and the potential risks to the infant.

✔️ Clocard 75 can interact with several medicines:

• NSAIDs: May increase the risk of gastrointestinal bleeding.
• Warfarin: May increase the risk of bleeding when used together.
• SSRIs/SNRIs: May increase bleeding risk.
• Omeprazole and esomeprazole: May inhibit CYP2C19 and reduce activation and antiplatelet effectiveness of clopidogrel; concomitant use should generally be avoided unless specifically advised.
• Repaglinide: Clopidogrel may increase repaglinide exposure; concomitant use should generally be avoided or carefully managed.
• Other CYP2C19 inhibitors may also interfere with clopidogrel activation.

✔️ Precautions & Warnings

• Clopidogrel's antiplatelet effect lasts for the life of the platelet. Therefore, its effects may continue for approximately 7–10 days after treatment is stopped.
• For elective surgery associated with a significant risk of bleeding, the doctor may recommend stopping clopidogrel approximately 5 days beforehand, depending on the patient's cardiovascular risk. Treatment should generally be restarted once adequate hemostasis has been achieved and when the treating physician considers it safe.
• Do not discontinue clopidogrel without medical advice, particularly in patients with recent coronary stenting or acute coronary syndrome.
• Rare cases of thrombotic thrombocytopenic purpura (TTP) have been reported. This is a medical emergency requiring immediate treatment.
• Patients who have previously experienced hypersensitivity to clopidogrel or other thienopyridine antiplatelet medicines should inform their doctor.

✔️ Storage:

• Store below 30°C.
• Keep in a dry place.
• Protect from light.
• Do not freeze.
• Keep out of reach of children.
• Do not use after the expiry date.