FlexPlus Tablets 75Mg (1 Strip = 10 Tablets)

Requires Prescription (YES/NO)

Yes

Generics

Aspirin, Clopidogrel

Used For

Stroke

How it works

Clopidogrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets. Aspirin inhibits prostaglandin synthesis resulting in inhibition of platelet aggregation for their lifespan of about 7-10 days. The acetyl group of aspirin binds with a serine residue of cyclooxygenase-1 (COX-1), resulting in irreversible inactivation of the enzyme. Inhibition of COX-1 prevents conversion of arachidonic acid to thromboxane A2 (TXA2), which is a potent agonist of platelet aggregation.

Dosage

Aspirin, Clopidogrel

Side Effects

Uncommon: Thrombocytopenia, leucopenia, eosinophiliaRare: Neutropenia, including severe neutropeniaVery rare: Thrombotic thrombocytopenic purpura (TTP), aplastic anaemia, pancytopenia, agranulocytosis, severe thrombocytopenia, acquired haemophilia A, granulocytopenia, anaemia

Drug Interactions

Oral anticoagulants , Heparin , Thrombolytics , NSAIDs , SSRIs . Clopidogrel : Inducers of CYP2C19 , Inhibitors of CYP2C19 , Proton Pump Inhibitors (PPI) , Anti-retroviral therapies (ART) . Aspirin : Uricosurics (benzbromarone, probenecid, sulfinpyrazone) , Methotrexate , Tenofovir , Valproic acid , Alcohol.

Indication

It is indicated for the prevention of ischemic events, myocardial infarction, stroke and cardiovascular death in patients with Acute Coronary Syndrome (ACS).

When not to Use

Due to the presence of both components of the medicinal product, Clopidogrel/Aspirin is contraindicated in case of:• Hypersensitivity to the active substances or to any of the excipients.• Severe hepatic impairment.• Active pathological bleeding such as peptic ulcer or intracranial haemorrhage

Precaution

Due to the risk of bleeding and haematological adverse reactions, blood cell count determination and/or other appropriate testing should be promptly considered whenever clinical symptoms suggestive of bleeding arise during the course of treatment.

Warning 1

Patients should be followed carefully for any signs of bleeding including occult bleeding, especially during the first weeks of treatment and/or after invasive cardiac procedures or surgery. The concomitant administration of Clopidogrel/Aspirin with oral anticoagulants is not recommended since it may increase the intensity of bleeding.

Warning 2

Acquired haemophilia has been reported following use of clopidogrel. In cases of confirmed isolated activated Partial Thromboplastin Time (aPTT) prolongation with or without bleeding, acquired haemophilia should be considered. Patients with a confirmed diagnosis of acquired haemophilia should be managed and treated by specialists, and clopidogrel should be discontinued.

Warning 3

In patients with recent transient ischaemic attack or stroke who are at high risk of recurrent ischaemic events, the combination of ASA and clopidogrel has been shown to increase major bleeding. Therefore, such addition should be undertaken with caution outside of clinical situations where the combination has proven to be beneficial.

Pregnancy category

Always consult your physician before using any medicine.

Storage (YES/NO)

Store this medicine at room temperature, away from direct light and heat.