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Plavix
Generic Name: Clopidogrel bisulfate
Brand Name: Plavix
Indications
Plavix (clopidogrel bisulfate) is indicated for the reduction of atherothrombotic events as Recent MI, Recent Stroke or Established Peripheral Arterial Disease and Acute Coronary Syndrome.
Dosage and Administration
Plavix is available as 75mg and 300mg tablets.
Normal Dosage:
Recent MI, Recent Stroke, or Established Peripheral Arterial Disease: The recommended daily dose of Plavix is 75 mg once daily.
Acute Coronary Syndrome: For patients with non-ST-segment elevation acute coronary syndrome (unstable angina/non-Q-wave MI), Plavix should be initiated with a single 300-mg loading dose and then continued at 75 mg once daily.
Overdose: Overdose symptoms are unknown but might include vomiting, difficulty in breathing, and exhaustion.
Drug Description
Plavix (clopidogrel bisulfate) is an inhibitor of ADP-induced platelet aggregation acting by direct inhibition of adenosine diphosphate (ADP) binding to its receptor and of the subsequent ADP-mediated activation of the glycoprotein GPIIb/IIIa complex. Chemically it is methyl (+)-(S)-α-(2-chlorophenyl)-6,7-dihydrothieno[3,2-c]pyridine-5(4H)-acetate sulfate (1:1). The empirical formula of clopidogrel bisulfate is C16H16ClNO2S•H2SO4 and its molecular weight is 419.9.
The structural formula is as follows:
Clopidogrel bisulfate is a white to off-white powder. It is practically insoluble in water at neutral pH but freely soluble at pH 1. It also dissolves freely in methanol, dissolves sparingly in methylene chloride, and is practically insoluble in ethyl ether. It has a specific optical rotation of about +56°.
Side effects
The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Bleeding, for example nosebleeds, blood in the urine, bleeding in the stomach or bowels. Very rarely, bleeding in the eye, lungs or joints.
- Increased time taken to stop bleeding
- Bruising
- Disturbances of the gut such as indigestion, diarrhoea, constipation, nausea, vomiting or abdominal pain
- Inflammation of the stomach (gastritis)
- Ulceration of the stomach or intestines
- Headache
- Dizziness
- Pins and needles sensations (paraesthesia)
- Decrease in the number of platelets in the blood (thrombocytopenia)
- Decrease in the number of a type of white blood cell (neutrophil) in the blood (neutropenia)
- Skin reactions such as rash, itching
- Balance problems involving the inner ear (vertigo)
- Fever
- Taste disturbance
- Confusion
- Hallucinations
- Liver problems
- Pain in the muscles or joints
Precautions
- Tell your doctor and dentist that you are taking this medication before having any surgical procedures.
- Do not take aspirin, ibuprofen (Motrin, Advil, Nuprin, others), naproxen (Aleve, Anaprox, Naprosyn, others), ketoprofen (Orudis, Orudis KT, Oruvail), indomethacin (Indocin), nabumetone (Relafen), oxaprozin (Daypro), or other non-steroidal anti-inflammatory medications (NSAIDs) without first talking to your doctor.
- It may take longer than usual for you to stop bleeding, even from minor wounds. Tell your doctor about any unusual bleeding or bruising that you experience.
- This drug belongs to the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.
- Do not take this medication if you have active bleeding anywhere in the body such as the stomach (ulcer) or in the head (type of stroke).
Drug Interactions
- Before taking this medication tell your doctor if you are taking:
- aspirin
- warfarin (Coumadin)
- heparin, ardeparin (Normiflo), dalteparin (Fragmin), danaparoid (Orgaran), enoxaparin (Lovenox), or tinzaparin (Innohep)
- a non-steroidal anti-inflammatory medication such as ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, Aleve), ketoprofen (Orudis KT, Orudis, Oruvail), indomethacin (Indocin), diclofenac (Cataflam, Voltaren), diflunisal (Dolobid), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), or tolmetin (Tolectin).
- May also interact with the following medications:
- phenytoin (Dilantin)
- tamoxifen (Nolvadex)
- tolbutamide (Orinase)
- torsemide (Demadex )
- fluvastatin (Lescol)
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