Lopirel is an anticoagulant drug that is made in the form of tablets in a film coating. They have a round, biconvex shape, pink in color. Pills in blisters are available in seven or ten pieces.
The drug has one active substance - clopidogrel. In addition to the active component "Lopirel" contains additional trace elements:
- cellulose;
- lactose;
- talc;
- glyceryl dibehenate;
- crospovidone.
What reviews and instructions for use does Lopirel have?
Indications
According to the instructions, Lopirel is used to eliminate the following conditions or diseases:
- Atherosclerosis (a chronic disease of arteries that occurs due to impaired lipid metabolism and is accompanied by the deposition of cholesterol in the inner lining of blood vessels).
- Stroke (an acute violation of the microcirculation of the brain that provokes damage and death of nerve cells).
- Overlapping the blood flow of peripheral arteries, in particular blood clots.
- Thrombosis (intravital formation inside the blood vessels of blood bundles that impede the free flow of blood through the circulatory system).
- Myocardial infarction (ischemic damage to the heart, which occurs with the occurrence of ischemic necrosis of a portion of the heart muscle).
- Unstable angina (represents a period of coronary heart disease, threatening the development of myocardial infarction and related complications and intermediate between a stable course of coronary heart disease and complication).
Contraindications
According to the instructions for use, Lopirel 75 mg has certain prohibitions on use, for example:
- Irreversible loss of blood in a short time. It occurs due to bleeding from damaged vessels.
- Pregnancy.
- Children under eighteen.
- Lactation.
- Hypersensitivity to drug substances.
- Kidney disease.
- Injuries, surgical interventions.
Mode of application
According to the instructions for use, Lopirel 75 mg is used orally regardless of food intake. With myocardial infarction, as well as ischemia, the drug is taken once a day, seventy-five milligrams of Lopirela are prescribed.
In acute coronary syndrome, therapy should begin with a single application of a loading dosage (three hundred milligrams), after which seventy-five milligrams are prescribed once a day (together with a daily dosage of acetylsalicylic acid from 75 to 325 mg). Since the use of higher concentrations of acetylsalicylic acid increases the likelihood of bleeding, the dosage of acetylsalicylic acid, which is recommended for this indication, should not exceed one hundred milligrams.
According to clinical studies, it is advisable to use the medication for up to 1 year. The maximum effect is observed by the third month of therapy.
In acute coronary syndrome, a loading dose of Lopirel is applied once - three hundred milligrams, followed by seventy-five milligrams once a day, together with acetylsalicylic acid.
In the treatment of patients aged seventy-five years and older, therapy with this drug should be carried out without the use of a loading dosage. Comprehensive treatment begins immediately after the onset of symptoms and lasts for four weeks.
The effectiveness of using a combination of acetylsalicylic acid and clopidogrel with these indications for more than one month has not been studied. With atrial fibrillation (atrial fibrillation), seventy milligrams of Lopirel is prescribed once a day. At the same time as clopidogrel, it is necessary to start and continue taking acetylsalicylic acid (daily dosage of 75-100 milligrams).
When skipping the use of the next dosage of the active substance, the following recommendations should be followed:
- If after skipping the drug less than twelve hours have passed, you need to immediately take the dosage of “Lopirela”, and use the next tablet as usual.
- If after skipping the medication more than twelve hours have passed, you must use the next dosage of "Lopirel" in the usual way.
Adverse reactions
According to the instructions, Lopirel 75 mg has certain prohibitions on taking:
- Eosinophilia (a disease in which there is an increase in the number of eosinophils).
- Leukopenia (a decrease in the number of white blood cells in the blood).
- Thrombocytopenia (a condition characterized by a decrease in the number of platelets below normal, which is accompanied by bleeding and problems with stopping bleeding).
- Neutropenia (reduced level of neutrophilic granulocytes in the blood).
- Hereditary or acquired blood pathology due to damage to bone marrow stem cells.
- Thrombotic thrombocytopenic purpura (a serious disease characterized by microangiopathic hemolytic anemia).
- Dizziness.
- Granulocytopenia (low white blood cell count).
- Anemia.
- Intracranial hemorrhage.
- Acquired hemophilia (a rare hereditary disease associated with impaired coagulation).
- Anaphylactoid reactions.
- Confusion.
- Hallucinations.
- Migraine.
- Paresthesia (a disorder of sensitivity, which is characterized by spontaneously appearing sensations of burning and creeping goosebumps).
- Violations of taste.
- Eye hemorrhage.
- Hematomas.
- Severe bleeding.
- Lowering blood pressure.
- Vasculitis (a group of diseases based on immunopathological vascular inflammation).
- Nose bleed.
- Bronchospasm (a pathology that occurs when the smooth muscles of the bronchi are contracted and their lumen is reduced).
- Pulmonary hemorrhage.
According to the instructions to "Lopirel" it is known that, in addition to the side effects described above, the drug can provoke the following negative reactions:
- Eosinophilic pneumonia (a disease in which the accumulation of eosinophils in the pulmonary alveoli occurs).
- Diarrhea (a pathological condition in which a person has rapid emptying, while the stool becomes watery).
- Interstitial pneumonitis (lung damage in which the inflammatory process affects the interstitium).
- Duodenal ulcer (an ulcer resulting from the action of acid and pepsin on the mucous membrane of the duodenum in people with high acidity).
- Bloating.
- Gastritis (a prolonged disease that is characterized by dystrophic and inflammatory changes in the gastric mucosa, proceeds with a violation of regeneration).
- Intestinal obstruction.
- Retroperitoneal bleeding.
- Inflammatory disease of the colon mucosa.
- Pancreatitis (a disease in which inflammation of the pancreas is observed).
- Angioneurotic edema (an acute condition characterized by the rapid development of local edema of the mucous cavity, as well as subcutaneous tissue and the skin itself).
- Nettle rash.
- Arthritis (a disease of the joints, accompanied by inflammation).
- Hemarthrosis (hemorrhage in the joint cavity).
- Arthralgia (joint pain).
- Hematuria (the presence of blood in the urine).
- Glomerulonephritis (a kidney disease characterized by a lesion of glomeruli).
Features
If there are clinical signs that indicate the appearance of bleeding and the likelihood of developing negative effects, it is necessary to provide an urgent clinical blood test, as well as other necessary studies.
According to reviews, Lopirel should be used with extreme caution in patients with an increased risk of bleeding, which is associated with operations, injuries, other pathologies, and people receiving non-steroidal anti-inflammatory drugs.
During the first weeks of treatment with the drug and after an invasive cardiological procedure or operation, you need to carefully monitor the presence of bleeding. Due to a possible increase in bleeding intensity, the combined use of Lopirel and Warfarin is not recommended.
Can I use the drug during pregnancy?
According to reviews of Lopirel, it is known that clopidogrel has not been shown to have a negative effect on pregnancy and childbirth, but due to a lack of clinical information, the drug is contraindicated for pregnant women.
In the course of the studies, it was found that the active substance and its metabolites pass into breast milk, so lactation should be stopped during treatment with the drug. There is no information on the isolation of clopidogrel with mother's milk. "Lopirel" is contraindicated for children under eighteen years of age.
Analogs
Lopirel has certain substitute drugs:
- "Plagril."
- Egithromb.
- Plavix.
- "Deplatt 75".
- Detrombe.
- Clapitax.
- "Listab 75".
- Sylt.
- Avix.
- "Orogrel".
- Brilinta.
- "Platogril."
- Reomax.
- "Medogrel".
- Cardogrel.
- Tessiron.
- "Clorelo."
- Klopikor.
- Claridol
- Gridoklein.
Before replacing the original with an analogue, consult a medical professional.
"Plagril"
The drug is available in the form of tablets, which are coated with a film coating. They have a round, biconvex shape, pink in color. Tablets are packaged in blisters of ten pieces. "Plagril" the analogue of "Lopirel".
Two hours after taking the initial dosage - four hundred milligrams - inhibition of platelet aggregation is observed. The maximum effect is achieved after seven days, with constant use of the drug in a dosage of from fifty to one hundred milligrams per day.
According to the instructions for use with the Lopirel analogue 75 mg, it is known that the effect of the drug lasts for ten days. After the termination of therapy with "Plagril" for 5 days, the bleeding time and the combination of platelets return to their original level. The drug prevents the appearance of atherothrombosis in people with atherosclerotic vascular disease.
Drug therapy should be discontinued seven days before surgery, in which an antiplatelet effect is undesirable. In this case, the person must inform the medical specialist about any case of bleeding during the use of Plagril. In addition, if a person is to undergo surgery or another medication is prescribed, the patient should also tell the doctor about the use of Plagril. During the treatment period, it is necessary to monitor the functioning of the liver.
Klopikor
The medication helps to reduce the platelet pool, which is triggered by other agonists, slowing down their activation by the released adenosine diphosphate.
According to the instructions, the Lopirel analogue is used for prophylactic purposes to prevent the occurrence of atherothrombosis:
- In people who have suffered myocardial infarction, as well as ischemic stroke with a diagnosed lesion of peripheral arteries.
- In individuals with acute coronary syndrome.
- In patients who underwent shunting during coronary angioplasty.
In addition, Klopikor is recommended for prophylactic purposes of thromboembolic, atherothrombotic events with atrial fibrillation.
Zilt
When taking a medicine in a dosage of seventy-five milligrams per day, significant inhibition of platelet aggregation is carried out from the first day of therapy. Over the next seven days, this action increases.
Suppression of platelet formation in equilibrium is on average from forty to sixty percent (when taking the medication at a concentration of seventy-five milligrams per day). After the cessation of bleeding, the degree of association of platelets returned to baseline levels for five days.
According to reviews, the analogue of Lopirel 75 mg - Zilt helps prevent the occurrence of a heart attack or stroke in patients with atherosclerosis of blood vessels.
The active substance is rapidly absorbed after oral administration. The maximum content of clopidogrel is an average of 2.2–2.5 nanograms per milliliter (after ingestion of seventy-five milligrams of the drug). The time to reach maximum concentration is about forty-five minutes. The degree of absorption of the active component, according to information on the excretion of metabolic products of the drug by the kidneys, is fifty percent.
It is not recommended to prescribe the drug to people with acute ischemic stroke with a prescription of less than one week. "Zilt" prolongs the time of bleeding, this should be taken into account when used simultaneously with "Aspirin", non-steroidal anti-inflammatory drugs, "Heparin" and "Warfarin". Such patients should be examined for increased sensitivity to ticlopidine, prazogrel and other thienopyridines, since cross-reactive increased sensitivity between the medicines of this group is possible.
When indicating in the patient’s medical history about increased sensitivity to other thienopyridines, he should be carefully observed during treatment to identify signs of hypersensitivity to the active component. When preparing the patient for a planned operation, the use of the drug must be stopped for five to seven days.
A person should be warned about the possibility of prolonged bleeding during therapy and the need to inform a medical professional about each case of bleeding. When consulting with other doctors, you should always report the use of Zilt, this information is important both when prescribing new drugs, and when visiting a dentist.
Reomax
This is an antithrombotic drug that disrupts platelet association, blocking the process of connecting adenosine diphosphate with receptors that are on the platelet membrane, and also activating glycoprotein receptors. "Reomax" helps to reduce platelet aggregation, which is provoked by other agonists, inhibiting their activation by released adenosine diphosphate.
Egithromb
The active substance (clopidogrel) selectively binds adenosine diphosphate with platelet receptors, inhibiting their association. Irreversibly connecting with these nerve endings, makes blood cells functional throughout their entire "life" cycle. Egithromb is an analogue of Lopirel tablets.
Suppression of the association is noted after two hours, and the maximum effect is observed after five to seven days. It does not affect the activity of the group of enzymes that hydrolyze the phosphodiester bond.
In the presence of chronic diseases of the brain, in which cholesterol and other fats are deposited on the inner wall of arteries in the form of plaques and plaques, and the walls themselves become denser and lose their elasticity, the drug helps prevent thrombosis.
Plavix
The drug represents a pharmacological group of drugs - antiplatelet agents. It is used to prevent atherothrombotic complications in various pathological processes of heart disease.
The active ingredient in Plavix tablets is clopidogrel. It inhibits the process of gluing platelets. This biological effect occurs due to the selective suppression of the process of attachment of adenosine diphosphoric acid to specific nerve endings of platelets and the subsequent activation of the process of their attachment. This effect occurs throughout the life of the platelet (seven to ten days), so the possibility of resuming aggregation appears only after cell regeneration.
The pharmacological effect of Plavix occurs after the exchange of clopidogrel in the liver, and an active metabolic product is formed, which inhibits the process of platelet adhesion. After starting to use Plavix, the implementation of anti-aggregation activity is carried out for two to three days and then reaches a constant level.
After discontinuation of Plavix therapy, platelet activity resumes for five to seven days. Using a medication significantly reduces the likelihood of developing cerebral ischemia, as well as myocardial infarction in various pathologies of the heart and blood vessels, including an increase in atrial contractions, which increases the likelihood of blood clots in their cavity.
"Brilinta"
The drug belongs to the therapeutic group of drugs - antiplatelet agents and anticoagulants. Brilinta is used in the complex treatment of cardiovascular diseases, in which there is an increased risk of blood clots inside the capillaries, which can lead to cerebral stroke or myocardial infarction.
After using the drug, the orally active component of the drug is absorbed into the blood from the small intestine. The pharmacological content in the blood is achieved twenty to thirty minutes after the use of the drug, the maximum concentration is achieved after one and a half hours.
The active component evenly spreads throughout the tissues of the whole body, passing through the barrier into the brain tissue and through the placental barrier into the fetus and milk during lactation. The active substance (ticagrelor) is exchanged in the cells of the liver, its decay products are excreted in the bile. The half-life is about seven hours.