Health, Preparations
"Plagril": instructions for use, doctor's comments. Analogues of the drug "Plagril"
Diseases of the cardiovascular system are in modern medicine almost in the first place. The mortality rate in these diseases is the highest. There are problems in this area that can haunt a person from the moment of birth. However, there are also those in whose development a person with his own hand brings a considerable "contribution". One such disease is atherosclerosis. With this problem, the arteries of the elastic and muscular-elastic type suffer mainly. The essence of the disease is that due to the violation of protein and lipid metabolism, deposits of cholesterol and some constituent lipoproteins accumulate in the arteries. Thus, atherosclerotic plaques are formed. Over time, the connective tissues of the walls of the vessels in these plaques grow, which leads to a narrowing of the lumen of the artery up to occlusion.
In order to help such patients, scientists have developed a whole list of medications that can slow down or completely suppress the process of aggregation (joining, gluing) of platelets. Substances with such possibilities are called antiaggregants (antithrombotic agents). One of these is the drug "Plagril".
Composition and form of release
The mechanism of the drug
The drug is a specific inhibitor (inhibit - inhibit, suppress any process) aggregation (connection) of platelets. Has a coronary expansive action. The process of slowing platelet aggregation (approximately 40%) can be seen after 2 hours after ingestion of the drug at a dosage of 400 mg. In order to achieve maximum efficiency (60% inhibition of aggregation) from the effects of the "Plagril" tablets, the instructions for use indicate the need for therapy for 4-7 days. The total dose for a day should be from 50 to 100 mg. In this case, the antiplatelet effect will continue throughout the life cycle of the platelets (7 to 10 days). Within 5 days after discontinuation of the drug, the rate of platelet aggregation and bleeding time will return to their original values.
It is excreted from the body "Plagril" by the kidneys and intestines (50% and 46% respectively). The elimination period is 120 hours after administration.
The main consumers of "Plagril"
There are special groups of patients-cores, who are shown to use the drug "Plagril". Instruction prescribes to take the drug to people suffering from arteriosclerosis of blood vessels. The medication is effective for preventive purposes to reduce the likelihood of complications associated with thrombosis in people who have had myocardial infarction or ischemic stroke. It is also important for patients suffering from occlusion (impaired permeability) of peripheral arteries.
In tandem with acetylsalicylic acid (aspirin), it is possible to use "Plagril" in order to prevent thrombotic complications in those who suffer from acute coronary syndrome. This includes people with angina (unstable form), with myocardial infarction without the formation of a tooth Q. You can apply the drug to patients who have been stenting. The essence of the operation is the installation of a stent into the affected vessel (a thin, fine-mesh metal tube), which is subsequently inflated with a special balloon, thereby increasing the patency of the vessel and improving the blood supply of the heart.
Dosage regimens
Patients can take the medicine "Plagril" inside, regardless of the diet. In patients who underwent myocardial infarction, ischemic stroke, or who have an established diagnosis of worsening arterial patency, a dose of 75 mg is taken once a day. The period of treatment after Q-forming myocardial infarction can last up to 35 days. In patients with ischemic stroke, depending on the severity of the condition, the treatment course can be from 7 days to six months.
With angina in unstable form and myocardial infarction without Q-wave formation, the standard tablet regimen usually looks as follows: first a single loading dose of 300 mg, then 75 mg per day in parallel with taking aspirin (75 to 325 mg per day). Since the risk of bleeding increases with taking aspirin, the maximum single dose should not be more than 100 mg. The course of curative therapy is up to 1 year.
In case of myocardial infarction, the antiaggregant "Plagril" is also indicated. Tablets prescribe taking in a dosage of 75 mg, one per day. It is recommended to start therapy with the initial loading dose in combination with acetylsalicylic acid. It is possible in parallel to take thrombolytics (or you can not take it).
If patients have crossed the 75-year age limit, Plagril (analogues with clopidogrel can also be taken) is given without an initial loading dose. After the onset of the symptoms of the disease, the combined treatment should be started as soon as possible. The course should last at least 4 weeks.
Possible side effects
When the treatment course is administered with the "Plagril" preparation, the application instruction brings to the notice that a variety of side effects are possible on the part of various systems and organs.
The blood coagulation system can most often respond with the appearance of gastrointestinal bleeding. Less common is the development of hemorrhagic strokes, nosebleeds and, in general, an increase in bleeding time. In rare cases, hematomas and hematuria may appear.
There are various manifestations on the part of the hematopoiesis system. This includes eosinophilia, neutropenia, thrombocytopenia. Granulocytopenia, simple or aplastic anemia is much less developed.
From the central and peripheral nervous system may be headaches, dizziness, paresthesia, vertigo (loss of balance, accompanied by a feeling of rotation of objects around the body or vice versa - the rotation of the body), hallucinations, confusion. Rarely, but there are cases of adverse manifestations of the cardiovascular system, which are expressed in lowering blood pressure, the development of vasculitis. Bronchospasms and interstitial pneumonitis - this can be the response of the respiratory system to taking the drug.
Most often, the "Plagril" medication (reviews of doctors and patients confirm this fact) reacts to the digestive system. The reaction of the body is manifested in the development of diarrhea, dyspepsia, abdominal pain. Less common are reactions in the form of nausea, vomiting, constipation, exacerbation of gastritis and stomach and duodenal ulcers, flatulence. Rare, but it is possible the appearance of diseases such as colitis, pancreatitis, stomatitis, hepatitis, changes in taste, the development of acute liver failure.
The musculoskeletal system can manifest itself with arthritis, myalgia. Although this does not happen often. Glomerulonephritis can result from the reaction of the urinary system. Doctors-dermatologists say that the possible consequence of using "Plagril" is itching, bullous rash, erythematous rash, flat lichen, eczema. Possible the development of allergic reactions in the form of angioedema, anaphylaxis, serum sickness. Of the common side effects, there is an increase in body temperature, an elevated serum creatinine content.
Application of "Plagril": what to look for
If the specific situation is undesirable antiplatelet effect, or if surgical intervention is suggested, then treatment with Plagril should be discontinued. Instruction for use recommends doing this at least 7 days before the operation. After the withdrawal of the drug to stop the sudden onset of bleeding, it will take more time. Patients should be warned about this and advised to inform the attending physician of each unusual bleeding. It is in the patient's interest to inform the doctor about the treatment with "Plagril" in cases where any surgical intervention is to be performed, or a new medication is prescribed for the patient.
In the process of therapeutic therapy it is important to keep the parameters of the homeostasis system (number of platelets, tests of their functional activity, APTTV) on control. Functional activity of the liver should also be regularly monitored and analyzed, since severe abnormalities in its work may increase the risk of hemorrhagic diathesis.
Medications that have clopidogrel ("Plagril", analogs) as the main active ingredient are not recommended for people who have had an acute myocardial infarction at least for the first few weeks after the onset of the disease. Medical workers do not recommend Plagril therapy if the patient has unstable angina, ischemic stroke, coronary artery bypass graft.
With a certain degree of caution, prescribe to take the drug to people with abnormalities in the functioning of the kidneys.
To whom is the "Plagril" method contraindicated?
"Plagril" (tablets) instruction prohibits taking patients with hypersensitivity or individual intolerance to the main and auxiliary components of the medication. You can not take the drug in any disease that predisposes to the development of bleeding (gastric and duodenal ulcers, hyperfibrinolysis, lung tumors, tuberculosis, etc.). A good reason for refusing to use "Plagril" is acute liver failure, hemorrhagic syndrome. In addition to all of the above, the medication is contraindicated in pregnant women and nursing mothers. It is inadmissible to prescribe a medicinal product to children under 18 years of age.
Analogs
In the modern pharmaceutical market, a group of antiplatelet agents ("Plagril", its synonyms for the content of the main active ingredient) is presented quite widely. More than 3 dozens of antiplatelet drugs have the same active substance (clopidogrel) and in the same dosage (75 mg). In addition to Russian manufacturers, anti-aggregators are produced by Indian pharmaceutical companies, enterprises of Hungary, Israel, Malta, France.
"Plagril" itself is produced by the Indian company "Dr. Reddis Laboratoris". The analogues include French Plavix, German Clopidogrel Ratiofarm, Hungarian Clopidogrel-Richter, Israeli Clopidogrel-Teva, Maltese Liporel, Macedonian Listaf 75. Of the best-known and widely in demand Russian drugs can be identified "Zilt".
"Zilt" - the Russian "Plagril"
The main active substance of the drug "Zilt" ("Plagril" in this it completely corresponds to it) is clopidogrel. The drug belongs to the group of antiplatelet agents. The initial dose (for "Zilt" - 400 mg) after 2 hours after ingestion slows the aggregation of platelets. As well as "Plagril", "Zilt", subject to taking 50-100 mg per day, the maximum therapeutic effect will give after 4-7 days.
Metabolized medicine in the liver. No active metabolites are found in the blood . Approximately 50% of "Zilt" is excreted by the kidneys, the remaining 46% within 5 days after admission will be withdrawn through the intestine.
Indications for use in "Zilt" are the same as in "Plagril": prevention of thrombosis in patients who have suffered a myocardial infarction, ischemic stroke or suffering from impaired patency of the arteries.
Consumer opinion
Like any drug, "Plagril" has both positive assessments of consumers, as well as negative reviews. There are patients to whom the drug was prescribed for the treatment of angina and proved to be a very effective drug. With his use of attacks either passed at all, or they became much less. Solidarity with consumers in assessing the drug "Plagril" reviews doctors.
However, one can also find remarks about adverse events caused by the use of the drug. Some patients wrote about the appearance of hematomas, others showed vivid anemia. There were patients and attacks of severe headaches, and the most different directions of the disorder in the digestive system. Rarely, but one can hear about the stomach ulcer or duodenal ulcer developed during the "Plagril" administration.
In general, it is worth saying that the drug "Plagril" instruction for use is positioned as a sufficiently serious drug that is not compatible with all medicines. Has a fairly extensive list of contraindications, can cause a lot of side effects from a variety of systems and organs. Uncontrolled application can stimulate sufficiently negative (and sometimes irreversible) consequences for the patient's health.
The conclusion from the above is self-evident. "Plagril" for the treatment course should be appointed by the attending physician. And the most optimal treatment option for this drug is in a hospital and under the supervision of a leading specialist. Only in this case it is possible to hope for a positive effect of taking the drug with a minimal risk of developing side effects.
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