Clopidogrel

When ATH:
B01AC04

Pharmacological action.
Antiagregatine.

Application.

Prevention of ischemic disorders (myocardial infarction, ischemic stroke, thrombosis of peripheral arteries) patients atherosclerosis.

Contraindications.

Hypersensitivity, active bleeding, severe liver disease, gastric ulcer and duodenal ulcer.

Restrictions apply.

Age to 18 years (Safety and efficacy have not been determined).

Pregnancy and breast-feeding.

Assign only in case of emergency.

Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

Side effects.

There are dyspepsia, diarrhea, gastrointestinal bleeding, intracranial hemorrhage, neutropenia, skin rashes.

Cooperation.

Potentiates the effect of acetylsalicylic acid on platelet aggregation, collagen-induced. It increases the risk of gastrointestinal bleeding against the backdrop of NSAIDs.

Dosing and Administration.

Inside, by 75 mg 1 once a day, regardless of the meal. Treatment should begin within the period of a few days before 35 day in patients after myocardial infarction and by 7 days before 6 months in patients after ischemic stroke.

Precautions.

Be wary appoint patients with an increased risk of bleeding (trauma, surgery, coagulopathy et al.). When treating patients with severely impaired liver function should take into account the possibility of hemorrhagic diathesis.

Cooperation

Active substance	Description of interaction
Alteplaza	FMR: synergism. Against the backdrop of clopidogrel increases the risk of bleeding complications; with a joint appointment caution.
Atenolol	Do not weaken (mutually) effects; permissible combined use.
Acetylsalicylic acid	FMR: synergism. Strengthens (mutually) antiplatelet effect and increase the risk of bleeding complications.
Warfarin	FKV. FMR: synergism. Against the background of enhanced effect of clopidogrel, perhaps, due to inhibition of CYP2C9 and slow biotransformation (shows in vitro); the combined appointment of caution.
Dalteparin sodium	FMR: synergism. Against the backdrop of intensified clopidogrel effect and increased risk of bleeding complications; with a joint appointment caution.
Diclofenac	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases the level of blood; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.
Diclofenac potassium	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases the level of blood; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.
Ibuprofen	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases the level of blood; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.
Indomethacin	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases the concentration in the tissues; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.
Ketoprofen	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases the level of blood; the combined use is not excluded increase of hidden blood loss in the gastrointestinal tract.
Ketorolac	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases the level of blood; the combined use is not excluded increase of hidden blood loss in the gastrointestinal tract.
Meloxicam	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases the level of blood; the combined use is not excluded increase of hidden blood loss in the gastrointestinal tract.
Metoprolol	Do not weaken (mutually) effects; permissible combined use.
Naproxen	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases in the tissue; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.
Piroxicam	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases the level of blood; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.
Tamoxifen	FKV. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), can be slow biotransformation, amplified and prolonged effect.
Phenylbutazone	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases in the tissue; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.
Phenytoin	FKV. Against the backdrop of clopidogrel, inhibitory at high concentrations CYP2C9 (shows in vitro), It can be slow biotransformation and increases the concentration in the tissues.
Fluvastatin	FKV. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), can be slow biotransformation, to raise the level in the tissues and enhances the effect of.
Flurbyprofen	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), It can be slow biotransformation and increases in plasma; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.
Celecoxib	FKV. FMR. Against the backdrop of clopidogrel, at high concentrations inhibited CYP2C9 (shows in vitro), slows down and increases the level of biotransformation in the tissues; the combined increase in the appointment can not be ruled hidden bleeding in the digestive tract.