Lopirel 75 mg (Clopidogrel) is an oral antiplatelet medication used to prevent cardiovascular events in patients at risk of myocardial infarction (MI), stroke, and peripheral arterial disease. It is especially indicated in Acute Coronary Syndrome (ACS) and for patients with a history of MI, stroke, or established peripheral arterial disease.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

• Anti-platelet Drugs

Pharmacology

Clopidogrel is a prodrug that requires metabolic activation in the liver. Its active metabolite irreversibly inhibits the P2Y12 ADP receptor on platelets, preventing platelet aggregation.

• Onset of Action: Dose-dependent inhibition occurs within 2 hours of a single oral dose.

• Steady-State: Achieved between days 3–7 with daily 75 mg dosing.

• Duration: Platelet inhibition lasts the lifespan of platelets (7–10 days).

By inhibiting platelet aggregation, Clopidogrel reduces the risk of thrombotic cardiovascular events in high-risk patients.

Indications

1. Acute Coronary Syndrome (ACS): To reduce the risk of MI and stroke in patients with unstable angina (UA) or non-ST-elevation MI (NSTEMI).

2. Recent MI, Recent Stroke, or Established Peripheral Arterial Disease: To reduce the risk of subsequent cardiovascular events.

Dosage & Administration

• ACS:

  • Loading Dose: 300 mg orally (4 tablets) for rapid antiplatelet effect.

  • Maintenance Dose: 75 mg once daily thereafter.

• Recent MI, Stroke, or PAD:

  • Maintenance Dose Only: 75 mg once daily, orally, with or without food.

Important: Do not discontinue abruptly; it may increase cardiovascular risk.

Drug Interactions

• Increased bleeding risk: NSAIDs, warfarin, SSRIs/SNRIs.

• Reduced efficacy: CYP2C19 inhibitors (e.g., omeprazole, esomeprazole).

• Avoid co-administration: Repaglinide (CYP2C8 substrate) increases plasma levels.

Contraindications

• Hypersensitivity to Clopidogrel or its components.

• Active pathological bleeding (e.g., peptic ulcer, intracranial hemorrhage).

Side Effects

Common: Bleeding, gastrointestinal discomfort, diarrhea, skin reactions.
Rare: Acquired hemophilia, anemia, angioedema, arthralgia, arthritis, bone marrow disorders.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Precautions & Warnings

• Genetic variation: Poor metabolizers of CYP2C19 may have reduced antiplatelet effect.

• Bleeding risk: Avoid unnecessary surgery; discontinue 5 days before high-risk surgery.

• Thrombotic Thrombocytopenic Purpura (TTP): Rare but requires urgent treatment.

• Hypersensitivity reactions, including rash and angioedema, have been reported.

Pregnancy & Lactation

• Pregnancy: Use only if clearly needed; category C.

• Lactation: Unknown if excreted in breast milk; weigh benefits against potential risks.

Overdose

• May lead to excessive bleeding.

• Management: Platelet transfusion may restore clotting function.

Storage Conditions

• Store below 30°C, protected from light and moisture.

• Do not freeze.

• Keep out of reach of children.

Special Populations

• Pediatric: Safety and efficacy not established.

• Elderly: No dosage adjustment required.

Mode of Action

Clopidogrel irreversibly inhibits platelet P2Y12 ADP receptors, preventing platelet activation and aggregation, which reduces the risk of thrombotic cardiovascular events.