Clopirad 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. Clopirad is a platelet inhibitor. It reduces the chance that a harmful blood clot will form by preventing platelets from clumping together in the blood. Clopirad may also increase the chance of serious bleeding in some people.
Clopirad is available only with your doctor's prescription.
Clopirad indications
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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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, Clopirad 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), Clopirad 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, Clopirad 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 Clopirad 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], Clopirad is indicated in combination with aspirin for the prevention of atherothrombotic and thromboembolic events, including stroke. Clopirad 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 Clopirad?
Use Clopirad as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Take Clopirad by mouth with or without food.
Take Clopirad on a regular schedule to get the most benefit from it.
Do not stop taking Clopirad without talking to your doctor. This may increase the risk of heart problems.
If you miss a dose of Clopirad, 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 Clopirad.
Uses of Clopirad in details
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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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, Clopirad 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 Clopirad was used for patients who underwent carotid artery stenting, which suggests that this antiplatelet combination is effective.
Clopirad description
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Each film-coated tablet contains Clopidogrel hydrogen sulphate 97.875 mg (molar equivalent of Clopirad base 75 mg) or Clopirad hydrogen sulphate 391.5 mg (molar equivalent of Clopirad base 300 mg).
Clopirad 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.
Clopirad 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.
Clopirad 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.
Clopirad 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°.
Clopirad dosage
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Clopirad Dosage
Generic name: Clopirad bisulfate 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
Clopirad can be administered with or without food.
For patients with non-ST-elevation ACS (UA/NSTEMI), initiate Clopirad 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 Clopirad.
For patients with STEMI, the recommended dose of Clopirad is 75 mg once daily orally, administered in combination with aspirin (75–325 mg once daily), with or without thrombolytics. Clopirad may be initiated with or without a loading dose.
Recent MI, Recent Stroke, or Established Peripheral Arterial Disease
The recommended daily dose of Clopirad is 75 mg once daily orally, with or without food.
CYP2C19 Poor Metabolizers
CYP2C19 poor metabolizer status is associated with diminished antiplatelet response to Clopirad. 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 Clopirad. Omeprazole and esomeprazole significantly reduce the antiplatelet activity of Clopirad. 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 Clopirad active metabolite.
In vitro studies using higher concentrations of Clopirad showed inhibition of CYP2C9 isoenzyme. Interaction of Clopirad 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 Clopirad.
Concomitant administration of aspirin ≥300 mg/day plus Clopirad 75 mg/day did not prolong bleeding time to a significantly greater extent than that attributable to Clopirad alone. The safety of chronic concomitant administration of aspirin and Clopirad is not established. Clopirad potentiated the effect of aspirin on collagen-induced platelet aggregation.
Concomitant administration of Clopirad 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 Clopirad for 10 days. Similarly, the platelet anti-aggregating properties of Clopirad were unchanged by co-administration of theophylline in these studies.
There is no evidence of pharmacodynamic interaction between Clopirad and commonly prescribed cardiovascular medication in patients with symptomatic atherothrombotic disease. Clopirad retained its full antiplatelet effect, in patients with peripheral arterial obstructive disease taking nifedipine, atenolol or nifedipine and atenolol.
Food: Clopirad can be taken either before or after food.
Adverse effects occurring in at least 2.5% of patients with recent MI, stroke, or established peripheral arterial occlusive disease receiving Clopirad in the Clopirad 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 Clopirad therapy. Rash classified as severe was more common with Clopirad therapy.
Adverse effects occurring in at least 2% of patients with unstable angina or non-ST-segment elevation acute coronary syndromes receiving Clopirad 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 Clopirad 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 Clopirad and aspirin.
The incidence of severe neutropenia (neutrophil count <450/mm3) was similar in patients receiving Clopirad or aspirin.
Clopirad should not be used whenever stimulation of gastrointestinal motility might be dangerous, e.g., in the presence of gastrointestinal hemorrhage, mechanical obstruction, or perforation.
Clopirad 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.
Clopirad is contraindicated in patients with known sensitivity or intolerance to the drug.
Clopirad 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.
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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