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• Clopimed indications
• Uses of Clopimed in details
• Clopimed description
• Clopimed dosage
• Clopimed interactions
• Clopimed side effects
• Clopimed contraindications

What is Clopimed?

Clopimed is used alone or together with aspirin to lessen the chance of a heart attack or stroke. It is given to patients who have already had a heart attack, severe chest pain, or a stroke, or to patients with other circulation problems that could cause a stroke or heart attack.

A heart attack or stroke may occur when a blood vessel is blocked by a blood clot. Clopimed is a platelet inhibitor. It reduces the chance that a harmful blood clot will form by preventing platelets from clumping together in the blood. Clopimed may also increase the chance of serious bleeding in some people.

Clopimed is available only with your doctor's prescription.

Clopimed indications

Prevention of atherothrombotic events in: Recent MI, Recent Stroke or Established Peripheral Arterial Disease: For patients with a history of recent myocardial infarction (MI), recent stroke, or established peripheral arterial disease, Clopimed has been shown to reduce the rate of a combined endpoint of new ischemic stroke (fatal or not), new MI (fatal or not), and other vascular death.

Acute Coronary Syndrome: For patients with non-ST-segment elevation acute coronary syndrome (unstable angina/non-Q-wave MI) including patients who are to be managed medically and those who are to be managed with percutaneous coronary intervention (with or without stent) or coronary artery bypass graft (CABG), Clopimed has been shown to decrease the rate of a combined endpoint of cardiovascular death, MI or stroke as well as the rate of a combined endpoint of cardiovascular death, MI, stroke or refractory ischemia.

For patients with ST-segment elevation acute MI, Clopimed has been shown to reduce the rate of death from any cause and the rate of a combined endpoint of death, reinfarction or stroke.

Atrial Fibrillation: In patients with atrial fibrillation (AF) at increased risk of vascular events who can take vitamin K antagonist (VKA) therapy, VKA has been shown to be associated with a better clinical benefit than acetylsalicylic acid (aspirin) alone or the combination of Clopimed and aspirin for the reduction of stroke.

In patients with atrial fibrillation who have at least 1 risk factor for vascular events and who cannot take VKA therapy [eg, specific risk of bleeding, physician assessment that patient is unable to comply with international normalized ratio (INR) monitoring or that VKA use is inappropriate], Clopimed is indicated in combination with aspirin for the prevention of atherothrombotic and thromboembolic events, including stroke. Clopimed in combination with aspirin has been shown to reduce the rate of the combined endpoint of stroke, myocardial infarction (MI), non-CNS systemic embolism, or vascular death, largely through a reduction in stroke.

How should I use Clopimed?

Use Clopimed as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Clopimed by mouth with or without food.
• Take Clopimed on a regular schedule to get the most benefit from it.
• Do not stop taking Clopimed without talking to your doctor. This may increase the risk of heart problems.
• If you miss a dose of Clopimed, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Clopimed.

Uses of Clopimed in details

Use: Labeled Indications

Acute coronary syndrome:

ST-segment elevation myocardial infarction: To reduce the rate of myocardial infarction (MI) and stroke in conjunction with aspirin in patients with acute ST-elevation MI who are to be managed medically.

Non-ST-segment elevation acute coronary syndromes: To decrease the rate of MI and stroke in conjunction with aspirin in patients with non-ST-segment elevation acute coronary syndromes (unstable angina/non-ST-elevation MI), including patients who are to be managed medically and those who are to be managed with coronary revascularization.

Myocardial infarction, ischemic stroke, or peripheral atherosclerotic disease: To reduce the rate of MI and stroke in patients with a history of recent MI, recent stroke, or established peripheral atherosclerotic disease.

Off Label Uses

Carotid artery atherosclerosis, symptomatic

Based on the American College of Chest Physicians guidelines for antithrombotic therapy in peripheral artery disease, Clopimed is effective and recommended for patients with symptomatic carotid artery atherosclerosis.

Carotid artery stenting

A randomized, controlled trial with blinded end point adjudication evaluated carotid artery stenting versus carotid endarterectomy in patients with carotid artery stenosis. In this trial, aspirin in combination with Clopimed was used for patients who underwent carotid artery stenting, which suggests that this antiplatelet combination is effective.

Clopimed description

Each film-coated tablet contains Clopidogrel hydrogen sulphate 97.875 mg (molar equivalent of Clopimed base 75 mg) or Clopimed hydrogen sulphate 391.5 mg (molar equivalent of Clopimed base 300 mg).

Clopimed also contains the following excipients: Hydrogenated castor oil, hydroxypropyl cellulose, mannitol E421, microcrystalline cellulose and polyethylene glycol 6000 as inactive ingredient. The pink film coating contains ferric oxide E172, hypromellose 2910, lactose, titanium dioxide and triacetin. The tablets are polished with carnauba wax.

Clopimed hydrogen sulfate is methyl(+)-(S)-α-(2-chlorophenyl)-6,7-dihydrothieno[3,2-c]pyridine-5(4H)-acetate sulfate (1:1). It has an empirical formula of C₁₆H₁₆CINO₂S·H₂SO₄ and a molecular weight of 419.9.

Clopimed hydrogen sulfate 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.

Clopimed hydrogen sulfate 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 slightly in methylene chloride, and is practically insoluble in ethyl ether. It has a specific optical rotation of about +56°.

Clopimed dosage

Clopimed Dosage

Generic name: Clopimed 75mg

Dosage form: tablet, film coated

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Acute Coronary Syndrome

Clopimed can be administered with or without food.

• For patients with non-ST-elevation ACS (UA/NSTEMI), initiate Clopimed with a single 300 mg oral loading dose and then continue at 75 mg once daily. Initiate aspirin (75–325 mg once daily) and continue in combination with Clopimed.
• For patients with STEMI, the recommended dose of Clopimed is 75 mg once daily orally, administered in combination with aspirin (75–325 mg once daily), with or without thrombolytics. Clopimed may be initiated with or without a loading dose.

Recent MI, Recent Stroke, or Established Peripheral Arterial Disease

The recommended daily dose of Clopimed is 75 mg once daily orally, with or without food.

CYP2C19 Poor Metabolizers

CYP2C19 poor metabolizer status is associated with diminished antiplatelet response to Clopimed. Although a higher dose regimen in poor metabolizers increases antiplatelet response, an appropriate dose regimen for this patient population has not been established.

Use with Proton Pump Inhibitors (PPI)

Avoid using omeprazole or esomeprazole with Clopimed. Omeprazole and esomeprazole significantly reduce the antiplatelet activity of Clopimed. When concomitant administration of a PPI is required, consider using another acid-reducing agent with minimal or no CYP2C19 inhibitory effect on the formation of Clopimed active metabolite.

More about Clopimed (Clopimed)

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Consumer resources

• Clopimed
• Clopimed (Advanced Reading)

Professional resources

• Clopimed (AHFS Monograph)
• Clopimed (FDA)

Related treatment guides

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• Acute Coronary Syndrome
• Acute Coronary Syndrome, Prophylaxis
• Ischemic Stroke, Prophylaxis
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Clopimed interactions

See also:
What other drugs will affect Clopimed?

In vitro studies using higher concentrations of Clopimed showed inhibition of CYP2C9 isoenzyme. Interaction of Clopimed with drugs eg, tamoxifen, phenytoin, tolbutamide, warfarin, torsemide, fluvastatin and many nonsteroidal anti-inflammatory drugs may be possible. But there are no data to predict the magnitude of these interactions.

The anticoagulant properties of heparin were unaffected by concurrent administration of clinically relevant dosages of Clopimed.

Concomitant administration of aspirin ≥300 mg/day plus Clopimed 75 mg/day did not prolong bleeding time to a significantly greater extent than that attributable to Clopimed alone. The safety of chronic concomitant administration of aspirin and Clopimed is not established. Clopimed potentiated the effect of aspirin on collagen-induced platelet aggregation.

Concomitant administration of Clopimed and naproxen resulted in an increase of occult gastrointestinal blood loss in healthy volunteers.

Co-administration with warfarin has not been studied. Consequently, concomitant administration of these 2 agents should be undertaken with caution.

The steady-state pharmacokinetics profile of digoxin and theophylline was unaffected by co-administration of Clopimed for 10 days. Similarly, the platelet anti-aggregating properties of Clopimed were unchanged by co-administration of theophylline in these studies.

There is no evidence of pharmacodynamic interaction between Clopimed and commonly prescribed cardiovascular medication in patients with symptomatic atherothrombotic disease. Clopimed retained its full antiplatelet effect, in patients with peripheral arterial obstructive disease taking nifedipine, atenolol or nifedipine and atenolol.

Food: Clopimed can be taken either before or after food.

Laboratory Tests: None known.

Clopimed side effects

See also:
What are the possible side effects of Clopimed?

Adverse effects occurring in at least 2.5% of patients with recent MI, stroke, or established peripheral arterial occlusive disease receiving Clopimed in the Clopimed versus Aspirin in Patients at Risk of Ischemic Events (CAPRIE) study included chest pain, accidental injury, influenza-like symptoms, pain, fatigue, edema, hypertension, headache, dizziness, abdominal pain, dyspepsia, diarrhea, nausea, hypercholesterolemia, arthralgia, back pain, purpura (bruising), epistaxis, depression, upper respiratory tract infection, dyspnea, rhinitis, bronchitis, coughing, rash, pruritus, and urinary tract infection. Rash and diarrhea were reported more frequently with Clopimed therapy. Rash classified as severe was more common with Clopimed therapy.

Adverse effects occurring in at least 2% of patients with unstable angina or non-ST-segment elevation acute coronary syndromes receiving Clopimed and aspirin in the CURE study included chest pain, headache, dizziness, abdominal pain, dyspepsia or diarrhea. The incidence of major bleeding (principally GI hemorrhage and bleeding at puncture sites), including life-threatening bleeding, was substantially greater in patients receiving Clopimed and aspirin.

Patients with ST-segment elevation MI, the incidence of major bleeding (intracranial hemorrhage or bleeding associated with a decrease in hemoglobin >5 mg/dL) was similar in patients receiving Clopimed and aspirin.

The incidence of severe neutropenia (neutrophil count <450/mm³) was similar in patients receiving Clopimed or aspirin.

Clopimed contraindications

See also:
What is the most important information I should know about Clopimed?

Clopimed should not be used whenever stimulation of gastrointestinal motility might be dangerous, e.g., in the presence of gastrointestinal hemorrhage, mechanical obstruction, or perforation.

Clopimed is contraindicated in patients with pheochro-mocytoma because the drug may cause a hypertensive crisis, probably due to release of catecholamines from the tumor. Such hypertensive crises may be controlled by phen-tolamine.

Clopimed is contraindicated in patients with known sensitivity or intolerance to the drug.

Clopimed should not be used in epileptics or patients receiving other drugs which are likely to cause extrapyramidal reactions, since the frequency and severity of seizures or extrapyramidal reactions may be increased.

Active ingredient matches for Clopimed:

Clopidogrel in Philippines.

Clopidogrel bisulfate in Philippines.

References

1. PubChem. "clopidogrel". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
2. DrugBank. "clopidogrel". http://www.drugbank.ca/drugs/DB00758 (accessed September 17, 2018).
3. DTP/NCI. "clopidogrel: The NCI Development Therapeutics Program (DTP) provides services and resources to the academic and private-sector research communities worldwide to facilitate the discovery and development of new cancer therapeutic agents.". https://dtp.cancer.gov/dtpstandard/s... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology