Clorix tablets

Clorix

  • Active Ingredient: Clopidogrel
  • 75 mg
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What is Clorix?

The active ingredient of Clorix brand is clopidogrel. Clopidogrel helps to prevent platelets in your blood from sticking together and forming a blood clot. Unwanted blood clots can occur with certain heart or blood vessel conditions. Pharmacodynamic and pharmacokinetic parameters measured in these studies showed that the interaction was highest with omeprazole and least with dexlansoprazole. Effect of Clopidogrel on other drugs In vitro studies have shown that the glucuronide metabolite of Clopidogrel is a strong inhibitor of CYP2C8. Concomitant administration of repaglinide with Clopidogrel increased the systemic exposure to repaglinide (AUC0-∞) by 5.1-fold following the loading dose (300 mg) and by 3.9-fold on day 3 of the maintenance dose (75 mg) of Clopidogrel [see Drug Interactions (7.5)].

Used for

Clorix is used to treat diseases such as: Acute Coronary Syndrome, Acute Coronary Syndrome, Prophylaxis, Heart Attack, Ischemic Stroke, Ischemic Stroke, Prophylaxis, Percutaneous Coronary Intervention, Peripheral Arterial Disease, Platelet Aggregation Inhibition, Transient Ischemic Attack.

Side Effect

Possible side effects of Clorix include: skin blisters; Chest pain; diarrhea; indigestion; shortness of breath.

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What are the uses for Clorix?

Clorix is used for preventing strokes, heart attacks, and death in individuals who have had a previous stroke, unstable angina, heart attack or have peripheral arterial disease (PAD). The combination of Clorix and aspirin is better than aspirin or Clorix alone in preventing another heart attack but the risk of bleeding is higher.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Taking Clorix with NSAIDs may increase your risk of bleeding in your stomach and intestines. Examples of these drugs include:

Hidden costs

If you’re being treated for acute coronary syndrome, you might have to take Clorix with aspirin. Your doctor can tell you more.

After single and repeated oral doses of 75 mg per day, Clorix is rapidly absorbed. Absorption is at least 50%, based on urinary excretion of Clorix metabolites.

Plavix can be administered with or without food. In a study in healthy male subjects when Plavix 75 mg per day was given with a standard breakfast, mean inhibition of ADP-induced platelet aggregation was reduced by less than 9%. The active metabolite AUC0-24 was unchanged in the presence of food, while there was a 57% decrease in active metabolite Cmax. Similar results were observed when a Plavix 300 mg loading dose was administered with a high-fat breakfast.

Q: I have been taking Plavix for 2 years because of an infarct and 5 stents in 2008. Should I continue or is it enough?

A: Plavix (Clorix) is an anti-platelet agent that keeps the platelets from sticking together to form a blood clot. Plavix is used to prevent blood clots after a recent heart attack or stroke and in people who have certain problems with the heart or blood vessels. According to the prescribing information, Plavix has been shown to reduce the rate of death from any cause and the rate of any of the following: death, another heart attack, and stroke. The duration of therapy is best determined by your health care provider based on your current health status and current medications. Do not stop or change the dose of your medication without talking to your healthcare provider first. Michelle McDermott, PharmD

What other drugs will affect Clorix?

Certain other medicines may increase your risk of bleeding, including aspirin. Avoid taking aspirin unless your doctor tells you to.

Tell your doctor about all your other medicines, especially:

any other medicines to treat or prevent blood clots;

a stomach acid reducer such as omeprazole, Nexium, or Prilosec;

an opioid medication;

This list is not complete. Other drugs may affect Clorix, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Forms and strengths

Generic: Clorix

  • Form: oral tablet
  • Strengths: 75 mg and 300 mg

Brand: Plavix

  • Form: oral tablet
  • Strengths: 75 mg and 300 mg

Diminished Antiplatelet Activity In Patients With Impaired CYP2C19 Function

Clorix is a prodrug. Inhibition of platelet aggregation by Clorix is achieved through an active metabolite. The metabolism of Clorix to its active metabolite can be impaired by genetic variations in CYP2C19 .

The metabolism of Clorix can also be impaired by drugs that inhibit CYP2C19, such as omeprazole or esomeprazole. Avoid concomitant use of Plavix with omeprazole or esomeprazole because both significantly reduce the antiplatelet activity of Plavix .

Important Information

You should not use Clorix if you have any active bleeding such as a stomach ulcer or bleeding in the brain.

Clorix increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, if you have blood in your urine, black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds.

Do not stop taking Clorix without first talking to your doctor, even if you have signs of bleeding. Stopping Clorix may increase your risk of a heart attack or stroke.

Serious side effects

More serious side effects can include:

  • rashes and itching
  • severe stomach ache or abdominal pain
  • uncontrolled bleeding or unusual bruising
  • vomiting with blood
  • weakness or numbness in an arm or leg
  • blood in your urine (haematuria)
  • blood in your stools

Speak to your GP or call the NHS 24 111 service immediately if you experience any of these side effects or any other unusual problems while taking Clorix.

Q: My pharmacy wanted to give me a new generic medicine - Grepid, Clorix, instead of Plavix, which I have bought until now. This Grepid was so much cheaper I was told, but I don't know if I dare. I have had two apoplexies and two TIAs since 1992.

A: Unfortunately we

Is Clorix safe to take if I'm pregnant or breastfeeding?

There are no adequate studies of Clorix in pregnant women.

Studies in rats have shown that Clorix appears in breast milk; however, it is not known whether it also appears in human breast milk. Because of a potential for side effects in the nursing infant, the physician must weigh the potential benefits and possible risks before prescribing Clorix to nursing mothers.

What is clop >

Clorix is used to lower your risk of having a stroke, blood clot, or serious heart problem after you've had a heart attack, severe chest pain (angina), or circulation problems.

Clorix may also be used for purposes not listed in this medication guide.

Clorix is metabolized to its active metabolite in part by CYP2C19. Concomitant use of certain inhibitors of this enzyme results in reduced plasma concentrations of the active metabolite of Clorix and a reduction in platelet inhibition.

Contraindications

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

Effects of Drug Abuse

  • No information provided

  • See "What Are Side Effects Associated with Using Clorix?"

  • See "What Are Side Effects Associated with Using Clorix?"

  • Use with caution in patients with bleeding or platelet disorders
  • Premature discontinuation increases risk of cardiovascular events; discontinue 5 days prior to elective surgery that has a major risk of bleeding
  • Use caution in patients with atrial fibrillation; assess bleeding risk carefully; significant increase in major bleeding events reported in patients receiving Clorix plus aspirin instead of aspirin alone
  • Patients allergic to aspirin who are undergoing percutaneous coronary intervention (PCI); see American Heart Association (AHA)/American College of Chest Physicians (ACCP)/American College of Cardiology (ACC) recommendations
  • Rare but potentially fatal thrombotic thrombocytopenic purpura associated with use
  • Risk of bleeding with potentially fatal outcome
  • Hepatic or renal impairment
  • Allergic cross-reactivity including rash, angioedema, or hematologic reaction among thienopyridines (e.g., ticlopidine, prasugrel) reported; evaluate patient for history of hypersensitivity
  • Use caution in patients with severe hepatic or renal impairment
  • Use caution or avoid in patients with hypersensitivity or hematologic reactions to previous thienopyridine use, including ticlopidine and prasugrel
  • Use caution in patients receiving either anticoagulants, including heparin and warfarin, or other platelet aggregation inhibitors; risk of bleeding increases
  • Premature interruption of therapy may result in stent thrombosis with subsequent fatal and nonfatal myocardial infarction; duration of therapy is determined by type of stent placed
  • May increase risk of major hemorrhage in patients with recent lacunar stroke
  • Metabolism of Clorix to its active metabolite can be impaired by genetic variations in CYP2C19
  • Clorix is a pro-drug and requires CYP2C19 to convert to active metabolite; inhibition of platelet aggregation is entirely due to active metabolite
  • CYP2C19*2 and *3 alleles have no functional metabolism of Clorix to active metabolite; CYP2C19*4, *5, *6, *7, and *8 may be associated with absent or reduced metabolism of Clorix but are less frequent than CYP2C19*2 and *3
  • More than 50% of Asians have CYP2C19 genetic variants that inhibit Clorix metabolism
  • Use of CYP2C19 inhibitors (e.g., proton pump inhibitors ) or use in poor metabolizers may decrease formation of active metabolite, thereby decreasing antiplatelet effect; observational studies and 1 randomized clinical trial have shown concomitant use of Clorix and PPIs to have inconsistent effects on cardiovascular outcomes

  • There are no adequate and well-controlled studies of Clorix use in pregnant women; because animal reproduction studies are not always predictive of human response, Clorix should be used during pregnancy only if clearly needed
  • It is not known whether Clorix is excreted in human milk; because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Clorix, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account importance of drug to mother

How to use Clorix

Read the Medication Guide provided by your pharmacist before you start taking Clorix and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually once daily. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

The dosage and length of treatment are based on your medical condition and response to treatment. If you are taking this medication to prevent clots after a stent implant or other procedure, take this medication with aspirin for many months to years after the procedure (depending on the procedure/type of stent) as directed by your doctor. Consult your doctor for more details and about the risks of stopping early. It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor.

Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.

Get medical help right away if you have any signs that this medication is not working, such as symptoms of a new heart attack or stroke (such as chest/jaw/left arm pain, shortness of breath, unusual sweating, weakness on one side of the body, slurred speech, sudden vision changes, confusion).

Storage And Handling

Plavix (Clorix bisulfate) 75 mg tablets are available as pink, round, biconvex, film-coated tablets debossed with “75” on one side and “1171” on the other. Tablets are provided as follows:

NDC 63653-1171-6 Bottles of 30 NDC 63653-1171-1 Bottles of 90 NDC 63653-1171-5 Bottles of 500 NDC 63653-1171-3 Blisters of 100

Plavix (Clorix bisulfate) 300 mg tablets are available as pink, oblong, film-coated tablets debossed with “300” on one side and “1332” on the other. Tablets are provided as follows:

NDC 63653-1332-2 Unit-dose packages of 30

Store at 25°C (77°F); excursions permitted to 15°C-30°C (59°F-86°F) .

Distributed by: Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership, Bridgewater, NJ 08807. Revised: Oct 2018

Q: I had a heart attack three weeks ago and was told that Plavix, that I had been on for 3 years, was not working for me. The cardiologist then doubled the dosage that I had been taking. Is there an alternative to Plavix?

A: Medications such as aspirin, Plavix (Clorix bisulfate), Ticlid (ticlopidine) and Aggrenox (aspirin/ dipyridamole) impair platelet function, so that platelets do not stick together as well. In laymen's terms this is called making "platelets less sticky"; in medical terms this is called "inhibiting platelet aggregation". The end result is that people do not clot as easily and this effect is mainly seen in the arteries. Talk to your doctor to find out if an alternative medication is appropriate. For more specific information, consult with your doctor or local pharmacist for guidance based on your specific condition and current medications. Shereen A. Gharbia, PharmD

Clorix dosing information

Usual Adult Dose for Acute Coronary Syndrome:

Unstable Angina (UA)/Non-ST-Elevation Myocardial Infarction (NSTEMI):-Loading dose: 300 mg orally once-Maintenance dose: 75 mg orally once a day-Duration of therapy: Optimal duration unknown.

ST-Elevation Myocardial Infarction (STEMI):-Loading dose: 300 mg orally once (OPTIONAL)-Maintenance dose: 75 mg orally once a day, with or without thrombolytics-Duration of therapy: Optimal duration unknown.

Comments: -Administer this drug in combination with aspirin 75 mg to 325 mg orally once a day.-The benefit of this drug for patients who undergo primary percutaneous coronary intervention is unknown.

Uses: Prevention of atherothrombotic events in patients with non-ST-segment elevation acute coronary syndrome (UA, NSTEMI, those who are to be managed medically, those who are to be managed with coronary revascularization) and STEMI.

Usual Adult Dose for Ischemic Stroke:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Usual Adult Dose for Myocardial Infarction:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Usual Adult Dose for Peripheral Arterial Disease:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.


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