Nucleophine Tablets (Clopidogrel Hydrogen Sulfate)

Adult dose

1. For patients with ischemic stroke, myocardial infarction, or peripheral arterial disease, administer clopidogrel at 75 mg orally once daily. 2. For patients with acute coronary syndrome (unstable angina or non-Q wave myocardial infarction), start with a loading dose of 300 mg orally on the first day of treatment, followed by a maintenance dose of 75 mg orally once daily. During this period, aspirin 75 - 325 mg should be co-administered once daily.

This medication prevents platelet aggregation and thereby plays a role in preventing the formation of blood clots. The effectiveness of this medication may be reduced in individuals who genetically have impaired function of a specific enzyme (CYP2C19); in such cases, it may be necessary to alter the treatment approach or substitute with another medication. Furthermore, concurrent use of this medication with drugs that activate the CYP2C19 enzyme may increase drug concentration, elevating the risk of bleeding, thus should be avoided. This medication should not be administered to individuals with allergic reactions or bleeding, severe liver impairment, breastfeeding women, or those with specific genetic issues such as lactose intolerance. Patients at high risk of bleeding or those with bleeding disorders should use this medication cautiously, and if symptoms of bleeding occur during treatment, they must immediately consult a physician. Particularly, patients undergoing surgery should discontinue this medication 5 to 7 days prior to surgery and resume once hemostasis is confirmed. There is an increased risk of bleeding when this medication is used in conjunction with other anticoagulants, so caution is advised. During treatment, it may take longer than usual for bleeding to stop; if bleeding persists or becomes severe, healthcare personnel should be informed immediately. Rarely, this medication may cause thrombocytopenia or serious blood disorders; thus, patients should undergo blood tests if symptoms of infection or bleeding appear. The risks to the fetus during pregnancy are unknown, but there may be an increased risk of bleeding during childbirth; therefore, it is advisable to cease this medication 5 to 7 days prior to delivery or neuraxial blocks. In the case of breastfeeding, as it is uncertain whether this medication is secreted in breast milk, it is recommended to consult with a physician regarding whether to continue breastfeeding or discontinue the medication. Elderly patients or those with reduced renal function may have a higher risk of bleeding, requiring careful monitoring and dose adjustments. In cases of overdose, the risk of bleeding may increase, but there is no specific antidote; if necessary, bleeding can be managed with platelet transfusion. This medication should be kept out of reach of children and should not be transferred to other containers to ensure safety.

Serious side effects

Hives, severe swelling (edema), chest tightness, difficulty breathing, cold sweat, pallor, severe rash with high fever, blisters, mucosal pain in mouth/eyes, shortness of breath or difficulty breathing, asthma attack, respiratory issues with coughing and fever, jaundice (yellowing of skin or eyes), extreme lethargy, sudden and severe headache, thunderclap headache, seizures, confusion, visual disturbances, paralysis, urination.

Mild side effects

• Chest pain
• accidental injury
• influenza-like illness
• pain
• fatigue
• hypertension
• edema
• headache
• dizziness
• abdominal pain

This medication must be stored in a tightly sealed container to protect it from air or moisture. The appropriate storage temperature is recommended to be between 1°C and 30°C at room temperature.

Appearance

Pink round film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle