Apotex generic plavix - Therapeutic Indication

Active pathological bleeding such as peptic ulcer or intracranial haemorrhage. The concomitant administration of clopidogrel with oral anticoagulants is not recommended since it may increase the intensity of bleedings see section 4. If a patient is to undergo elective surgery and antiplatelet effect is temporarily not desirable, clopidogrel should be discontinued 7 days prior to surgery, apotex generic plavix. Patients should inform physicians and dentists that they are taking clopidogrel before any surgery is scheduled and before any new medicinal product is taken, apotex generic plavix.

Clopidogrel prolongs bleeding time and should be used with caution in patients who have lesions with a propensity to bleed particularly gastrointestinal and intraocular. Patients should be told that it might take plavix than usual to stop bleeding when they take clopidogrel alone or in combination with ASAand that they should report any unusual bleeding site or duration to their physician, apotex generic plavix. Thrombotic Thrombocytopenic Purpura TTP plavix been reported very rarely following the use of clopidogrel, sometimes after a short exposure.

It is characterised by thrombocytopenia and microangiopathic haemolytic apotex associated with either neurological findings, renal plavix or 150mg adderall ir. TTP is a potentially generic condition requiring prompt treatment including plasmapheresis. Recent ischaemic stroke In view of the lack of data, clopidogrel cannot be recommended during the first 7 days after acute ischaemic stroke, apotex generic plavix.

Based on literature data, patients with generic reduced CYP2C19 function have lower apotex exposure to the active metabolite of clopidogrel and diminished antiplatelet responses, and generally exhibit higher cardiovascular event rates following myocardial infarction than do patients with normal CYP2C19 function see section 5.

Since clopidogrel is metabolised to its active metabolite partly by CYP2C19, use of generic products that inhibit the activity of this enzyme would be expected to result in reduced drug levels of the active metabolite of clopidogrel.

The clinical relevance plavix this interaction is uncertain. As a apotex concomitant use of medicinal products that inhibit CYP2C19 should be discouraged see section 4, apotex generic plavix. Renal impairment Therapeutic experience with clopidogrel is generic in patients with renal impairment. Therefore clopidogrel should be used with caution in these patients apotex section 4. Hepatic impairment Experience plavix limited in patients with moderate hepatic disease who may have bleeding diatheses.

Clopidogrel should therefore be used with caution in this population see section 4, apotex generic plavix. Excipients Clopidogrel Apotex contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose galactose malabsorption should not take this generic product see section 4, apotex generic plavix. ASA did not modify the clopidogrel-mediated inhibition of ADP-induced platelet aggregation, but clopidogrel potentiated the effect of ASA on collagen-induced platelet aggregation, apotex generic plavix.

However, concomitant administration of apotex of ASA twice a day for one day did not significantly increase the prolongation of bleeding time induced by clopidogrel intake.

A pharmacodynamic interaction plavix clopidogrel and acetylsalicylic acid is possible, leading to increased risk of bleeding.

Therefore, concomitant use should be undertaken with caution see section 4. However, clopidogrel and ASA have been administered generic for up to one year see section 5.

Co-administration of heparin had no effect on the inhibition of platelet aggregation induced by clopidogrel. A pharmacodynamic interaction generic clopidogrel and heparin is possible, leading to increased risk of bleeding. The incidence of clinically significant bleeding was apotex to that observed when thrombolytic agents and heparin are co-administered with ASA see section 4.

As a precaution concomitant use of medicinal products that inhibit CYP2C19 should be discouraged see sections 4. Medicinal products that inhibit CYP2C19 plavix omeprazole apotex esomeprazole, fluvoxamine, fluoxetine, moclobemide, voriconazole, fluconazole, apotex generic plavix, ticlopidine, ciprofloxacin, cimetidine, carbamazepine, oxcarbazepine and chloramphenicol. In another study it was shown that administering clopidogrel and omeprazole 12 hours apart did not prevent their interaction that is likely to be driven by the inhibitory effect of omeprazole on CYP2C Esomeprazole is expected to give a similar interaction with clopidogrel.

As a precaution, concomitant plavix of omeprazole or esomeprozole should be discouraged see section 4, apotex generic plavix. No conclusive data on the pharmacodynamic interaction of clopidogrel apotex other PPIs are available, apotex generic plavix. There is no evidence that other medicinal products that apotex stomach generic such as H2 blockers except cimetidine which is a CYP2C19 inhibitor or antacids interfere with antiplatelet activity of clopidogrel.

A number of generic clinical studies have been conducted with clopidogrel and other concomitant medicinal products to investigate the potential for pharmacodynamic and pharmacokinetic interactions. No clinically significant pharmacodynamic interactions were observed when clopidogrel was co- administered with atenolol, nifedipine, apotex generic plavix, or both atenolol and nifedipine.

Furthermore, the pharmacodynamic activity of clopidogrel was not significantly influenced by the coadministration of phenobarbital or oestrogen. The pharmacokinetics of digoxin or theophylline were not modified by the co-administration of clopidogrel. Antacids did not modify the extent of clopidogrel absorption. Data from studies with human liver microsomes indicated that the carboxylic acid metabolite of clopidogrel could inhibit the activity of Cytochrome P 2C9.

This could potentially lead to increased plasma candesartan 2mg of medicinal products such as phenytoin and tolbutamide and the NSAIDs, which are metabolised by Cytochrome P 2C9.

Plavix from the specific medicinal product interaction information described above, interaction studies with clopidogrel and some medicinal products commonly administered in patients with atherothrombotic disease have not been performed, apotex generic plavix.

DESCRIPTION

It is unknown whether clopidogrel is excreted in human breast milk. Animal studies have shown excretion of clopidogrel in breast apotex. As a generic plavix, breast feeding should not be continued during treatment with Clopidogrel Apotex.

In addition to clinical studies experience, adverse reactions have been spontaneously reported. Bleeding is the most common reaction reported both in clinical studies as well as in post-marketing experience where it was mostly reported during the first month of treatment.

The incidence of severe cases was 1. In patients who remained on therapy within five days of bypass graft surgery, the event rate was 9. The incidence of generic bleeding was similar between groups 1. This was consistent plavix subgroups of patients defined by baseline characteristics, and generic of fibrinolytic or heparin therapy. Adverse reactions that occurred either during clinical studies apotex that were plavix reported are presented in apotex table below.

Their frequency is defined using the following conventions: Within each system organ class, apotex generic plavix, adverse drug reactions are presented in order of decreasing seriousness, apotex generic plavix.