30 pieces
Oral
75mg
Twix® Clopidogrel
75 mg coated tablet
This medicine has been prescribed for the treatment of your current condition, so do not use it in similar cases or recommend it to others.
General instructions:
Tell your doctor if you are allergic to this medicine, other ingredients, foods, preservatives or dyes.
There is no specific information on its use in children compared to other age groups.
Although the amount of clopidogrel in the blood may be higher in the elderly than in adults, it is not expected to have different side effects or problems compared to other age groups.
Tell your doctor if you are taking painkillers and anti-inflammatory drugs other than narcotics.
Tell your doctor if you have bleeding problems, liver disease (severe) or digestive disease (stomach ulcer).
Take the medicine as directed by your doctor and in the same amount as prescribed.
If you take the medicine regularly, if you forget to take a dose, take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Use in pregnancy and breastfeeding:
Pregnancy: This medicine has not been studied in pregnant women. Tell your doctor if you are pregnant or think you may be pregnant.
Breastfeeding: There are no adequate studies on the use of this medicine during breastfeeding. Consult your doctor before using this medicine.
Precautions:
If you need surgery or dentistry, tell your doctor that you are taking this medicine, as it may increase bleeding. Therefore, you may need to stop taking this medicine 7 days before the surgery.
If you notice bruising or bleeding, especially bleeding that does not stop easily, see your doctor immediately. Internal bleeding sometimes appears as bloody or tarry stools and weakness.
Dosage and administration:
The amount of each medicine is determined by your doctor. However, the usual dose of this medicine is as follows.
To prevent heart attack or stroke:
Adults: 1 tablet (75 mg) once a day.
Children: This medicine is not for use in children, but if necessary, the doctor will determine the dose.
Side effects:
Every medicine, along with its intended therapeutic effect, may cause some unwanted effects. Although not all of these effects are seen in an individual, consult a doctor immediately if any of the following symptoms occur.
Most common:
Red or purple spots on the skin, large and small bruises of various sizes.
Less common:
Nosebleeds, vomiting blood or coffee grounds.
Rare:
Black tarry stools, blisters, scaly and peeling skin, bloody stools or urine, fever, chills, sore throat, sudden or severe headache, stomach pain (severe), white sores or patches in the mouth, unusual bruising or bleeding, sudden weakness.
If any of the following symptoms occur, see a doctor as soon as possible:
Most common:
Chest pain, cough, general aches, runny nose, sneezing.
Less common:
Fainting, frequent urination, irregular heartbeat, joint pain, painful or difficult urination, shortness of breath, swelling of the legs or lower extremities.
The following side effects may occur that do not require medical attention. These may go away on their own with continued use of the medication, but if they persist or become bothersome, you should see a doctor.
Most common:
Abdominal or stomach pain, muscle pain, back pain, dizziness, general feeling of illness or discomfort, headache, heartburn.
Less common:
Anxiety, constipation, diarrhea, itching, hot feet, depression, numbness or tingling, nausea, skin rash, sleep disorders, unusual fatigue, vomiting, weakness.
Storage conditions:
Keep the medicine out of reach of children.
Avoid storing and using expired medicine.
Store the medicine away from light and moisture and at a temperature below 30 degrees Celsius.
Packaging:
Each pink coated tablet of Twix 75 mg contains 75 mg of clopidogrel (as bisulfate) and is packaged in a box of 30 (3 blisters of 10).
Clopidogrel is a medication that is prescribed to prevent blood clots in the arteries. It helps people who are at risk of heart attacks, strokes, and other heart conditions. Clopidogrel helps reduce the risk of blood clots by preventing platelets from sticking together. It is usually used in combination with other medications, such as aspirin, for heart patients or after heart surgery.
Clopidogrel Uses
Prevention of heart attacks (myocardial infarction)
Prevention of stroke
Prevention of transient ischemic attacks (TIA)
Prevention of thrombosis in patients after coronary artery bypass grafting (CABG)
Treatment of coronary artery disease (CAD)
Prevention of blood clots in patients with coronary stents
Prevention of thrombosis in patients with peripheral artery disease (PAD)
Reducing the risk of thrombosis in patients with high risk factors such as diabetes and high blood pressure
Clopidogrel prevents platelets from clumping together. Platelets are small cells that naturally stick together and form clots at the site of vascular damage. These clots can block blood vessels and cause heart attacks or strokes. Clopidogrel inhibits this process and prevents blood clots from forming.
1. Absorption
After oral administration, it is rapidly absorbed from the gastrointestinal tract.
The initial bioavailability is about 50%, since part of the drug is inactivated during the first pass through the liver.
2. Metabolism
Clopidogrel is metabolized in two stages:
a- Hydrolysis by esterases → conversion to an inactive metabolite.
b- Oxidative metabolism by CYP450 enzymes (mainly CYP2C19) → conversion to an active metabolite. (Only 15% of the drug is converted to the active metabolite.)
c- The active metabolite has a short half-life (~30 minutes) and binds irreversibly to the P2Y12 receptor.
3. Distribution
Volume of distribution (Vd): approximately 105 liters.
Plasma protein binding: approximately 98% (mainly bound to albumin).
4. Excretion
The main route of excretion is via the kidneys (~50%) and feces (~46%).
The overall half-life of the drug is about 6 hours, but its antiplatelet effect persists for 5-7 days after discontinuation of the drug, as inhibited platelets require regeneration.
Aspirin: May increase the risk of bleeding.
Antifungal drugs (such as ketoconazole): May reduce the effect of clopidogrel.
Antihypertensive drugs: May lower blood pressure too much.
Anticoagulants (such as warfarin): Combining these drugs can increase the risk of severe bleeding.
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