Plagerine tablets

Plagerine

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

The active ingredient of Plagerine 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

Plagerine 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 Plagerine include: sweating; reddening of the skin, especially around the ears; difficulty with speaking; loss of appetite; weakness (sudden).

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Q: I had a heart attack in May of 2009 and a single stent was put in place. I have been taking 81 mg of aspirin and 75 mg of Plavix since then. Still advisable?

A: Aspirin is in a medication class called salicylates. Aspirin, in prescription form, is used to treat symptoms of osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and other conditions associated with pain and swelling. Over-the-counter aspirin is used to lessen fever and treat pain from a variety of conditions. In addition, over-the-counter aspirin is used to prevent heart attack in people who have had a heart attack or who experience angina; and it is used in the treatment of a heart attack. Over-the-counter aspirin is also used to prevent certain types of strokes. Aspirin works by blocking the production of certain naturally-occurring substances that lead to fever, pain, swelling, and blood clots. Aspirin can cause serious side effects including bleeding and gastric ulcers. Plavix (Plagerine) is in a drug class called antiplatelet drugs. Plavix is used to prevent heart attack and stroke in people who are at risk for these events. Plavix works by preventing blood clots that can cause heart attack or stroke. There is a recent addition to the warnings with Plavix. In order for Plavix to work in the body, the medication needs to be converted in the body to the active form. Some people may not be able to convert the medication as well as others. It is advised to speak with your health care provider in regards to this warning. Some of the risks of Plavix therapy may include abdominal pain, vomiting, constipation, and increased risk of bleeding. Aspirin therapy may have benefits, but it is not without risks. Some of the benefits of aspirin may include: prevention of first and second heart attack; reduction in heart disease risk; and prevention of stroke. Some of the risks involved in aspirin therapy include: hemorrhagic stroke, gastrointestinal bleeding, allergic reaction, and tinnitus (ringing in the ears). Both the benefits and risks of aspirin therapy are patient specific and may depend on certain factors including heart disease risks, age, sex, and other medical conditions. Only your health care provider can recommend which treatment is appropriate for you. Please consult with your health care provider in regards to your treatment with aspirin and Plavix. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kristen Dore, PharmD

What Is Plagerine and How Does It Work?

Plagerine is also used with aspirin to treat new/worsening chest pain (new heart attack, unstable angina) and to keep blood vessels open and prevent blood clots after certain procedures (such as cardiac stent).

Plagerine works by blocking platelets from sticking together and prevents them from forming harmful clots. It is an antiplatelet drug. It helps keep blood flowing smoothly in your body.

Plagerine is available under the following different brand names: Plavix.

Dosages of Plagerine:

Dosage Forms and Strengths

Dosage Considerations – Should be Given as Follows:

Unstable angina, non-ST-segment elevation heart attack (myocardial infarction ) (NSTEMI): 300 mg loading dose; initiating therapy without a loading dose will delay establishment of antiplatelet effect by several days; following the loading dose, administer 75 mg/day orally for up to 12 months; may administer beyond 12 months if used in combination with aspirin (75-100 mg/day); long-term combination therapy with aspirin, following stent placement, is individualized depending on how a patient tolerates long-term dual antiplatelet therapy (DAPT), whether they have stable coronary artery disease, and do NOT have risk factors (e.g., transient ischemic attack or stroke, age over 75 years, bleeding risk, low body weight, concurrent medications)

ST-segment elevation myocardial infarction (MI) (STEMI): 75 mg/day orally in combination with aspirin 162-325 mg/day and then 81-162 mg/day

Age under 75 years

  • 300 mg loading dose followed by 75 mg for 14 days up to 12 months (if no bleeding)
  • Concomitant therapy with aspirin: Administer in combination with aspirin 75-325 mg once/day with or without thrombolytics

Age over 75 years

  • No loading dose
  • 75 mg for 14 days up to 12 months (if no bleeding)

Recent heart attack (Myocardial Infarction ), Stroke, or Established Peripheral Arterial Disease

  • 75 mg orally once/day without a loading dose; recommended as alternative to aspirin or concomitantly with aspirin if patient not at increased risk for bleeding but at high risk for cardiovascular disease

  • Prophylaxis if patient not candidate for oral anticoagulation
  • 75 mg/day orally

  • Renal impairment: Dose adjustment not necessary
  • Hepatic impairment: Use caution; experience limited

  • CYP2C19 poor metabolizers associated with diminished antiplatelet response to Plagerine; although higher-dose regimen (600 mg loading dose followed by 150 mg once daily) in poor metabolizers increases antiplatelet response, no appropriate dosing regimen for poor metabolizers has been established in clinical outcome trials
  • Not recommended for pediatric use

1. About clop >

Plagerine is an antiplatelet medicine, or blood thinner. It makes your blood flow through your veins more easily.

This means that your blood will be less likely to make a dangerous blood clot.

Taking Plagerine helps prevent blood clots if you have an increased risk of having them.

Your risk is higher if you have or have had:

Plagerine comes as tablets and is only available on prescription.

Thrombotic Thrombocytopenic Purpura (TTP)

TTP, sometimes fatal, has been reported following use of Plavix, sometimes after a short exposure ( 25 times that in humans at the recommended daily dose of 75 mg.

Plagerine was not genotoxic in four in vitro tests (Ames test, DNA-repair test in rat hepatocytes, gene mutation assay in Chinese hamster fibroblasts, and metaphase chromosome analysis of human lymphocytes) and in one in vivo test (micronucleus test by oral route in mice).

Plagerine was found to have no effect on fertility of male and female rats treated prior to pairing and throughout gestation at oral doses up to 400 mg/kg per day (52 times the recommended human dose on a mg/m² basis).

Diminished Antiplatelet Activity In Patients With Impaired CYP2C19 Function

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

The metabolism of Plagerine 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 .

COMMON BRAND(S): Plavix

GENERIC NAME(S): Plagerine

OTHER NAME(S): Plagerine Tablet

Plagerine is used to prevent heart attacks and strokes in persons with heart disease (recent heart attack), recent stroke, or blood circulation disease (peripheral vascular disease).

It is also used with aspirin to treat new/worsening chest pain (new heart attack, unstable angina) and to keep blood vessels open and prevent blood clots after certain procedures (such as cardiac stent).

Plagerine works by blocking platelets from sticking together and prevents them from forming harmful clots. It is an antiplatelet drug. It helps keep blood flowing smoothly in your body.

What you should do about this interaction:

While you are taking this medicine, you should avoid eating grapefruit or drinking grapefruit juice. You may choose an alternative citrus beverage (such as orange juice). In the event that you are instructed by a healthcare professional (e.g., doctor, pharmacist, or dietitian) to eat grapefruit or drink grapefruit juice you should discuss with your doctor the effects of grapefruit on the blood levels of this medicine. These effects can occur even if grapefruit is not consumed at the same time of the Plagerine dose This interaction may occur at any time in your treatment with Plagerine if grapefruit or grapefruit juice is consumed.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Holmberg MT, Tornio A, Neuvonen M, Neuvonen PJ, Backman JT, Niemi M. Grapefruit juice inhibits the metabolic activation of Plagerine. Clin Pharmacol Ther 2014 Mar;95(3):307-13..

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Missed or extra doses

If you forget to take your dose of Plagerine, take that dose as soon as you remember, then continue to take your course of Plagerine as normal.

However, if it's almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

If you have to take 2 doses closer together than normal, there is an increased risk of side effects.

The patient information leaflet that comes with your medicine should also give you advice about what to do.

If you accidentally take an extra dose or doses of Plagerine, contact your GP or call the NHS 24 111 service for advice.

Q: I had a stent put in my artery on 2007. I take everyday one tablet of Plavix 75 mg. Fow how long must I take the Plavix?

A: The recommended daily dose of Plavix (Plagerine) is 75 mg once daily, indefinitely or until your physician says otherwise. Did you know that a generic does exist? For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.

What is the dosage for Plagerine?

Plagerine bisulfate usually is taken once daily. It can be taken with or without food. Plagerine is activated by enzymes in the liver to its active form. Individuals who have reduced activity of liver enzymes that activate Plagerine due to liver disease may not adequately respond to Plagerine. Alternative treatments should be used for these patients. The recommended dose for treating unstable angina or heart attack is 300 mg initially followed by 75 mg daily in combination with 75-325 mg of aspirin. Peripheral arterial disease or recent stroke is treated with 75 mg daily.

Side effects

Although serious reactions are rare, Plagerine can cause side effects including indigestion and nausea.

Plagerine can also interact with other medicines. Always read the patient information leaflet that comes with your medicine to check it is safe to take with Plagerine. If you are unsure, ask your pharmacist or GP.

Forms and strengths

Generic: Plagerine

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

Brand: Plavix

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

Warnings

  • Plagerine's antiplatelet activity is dependent on conversion to an active metabolite by the cytochrome P450 (CYP) system, principally CYP2C19
  • Tests are available to identify patients who are CYP2C19 poor metabolizers
  • Consider use of another platelet P2Y12 inhibitor in patients identified as CYP2C19 poor metabolizers
  • This medication contains Plagerine. Do not take Plavix if you are allergic to Plagerine or any ingredients contained in this drug
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately

More common side effects

The more common side effects that can occur with Plagerine include:

If you have itchy skin, it may go away within a few days or a couple of weeks. If it is more severe or doesn’t go away, talk to your doctor or pharmacist.

Available data from cases reported in published literature and postmarketing surveillance with Plagerine use in pregnant women have not identified any drug-associated risks for major birth defects or miscarriage .There are risks to the pregnant woman and fetus associated with myocardial infarction and stroke . No evidence of fetotoxicity was observed when Plagerine was administered to pregnant rats and rabbits during organogenesis at doses corresponding to 65 and 78 times the recommended daily human dose .

The estimated background risk of major birth defects and miscarriage for the indicated populations is unknown. All pregnancies have a background risk of birth defects, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

3. Who can and can't take clop >

Plagerine can be taken by adults aged 18 and over.

Plagerine isn't suitable for some people. To make sure this medicine is safe for you, tell your doctor if you:

  • have had an allergic reaction to Plagerine or any other medicines in the past
  • have a stomach ulcer or have had stomach ulcers in the past
  • have had bleeding in your brain (a brain haemorrhage)
  • have a bleeding disorder, such as haemophilia
  • have liver or kidney problems
  • are trying to get pregnant, already pregnant or breastfeeding


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