Plavix: dosage and contraindications
If you decide to treat with Plavix, get to know about necessary dosage and possible contraindications to this medication.
After myocardial infarction, ischemic stroke or recently diagnosed occlusive peripheral arterial disease – Plavix should be taken orally, 1 time per day, regardless of the meal. For prevention of ischemic in adults, including the elderly, Plavix is prescribed at 75mg 1 time a day. In patients with myocardial infarction, treatment can be started from the first days to 35 days of myocardial infarction. In patients with ischemic stroke treatment can be started in period of 7 days to 6 months after ischemic stroke.
Because of insufficient data Plavix should not be used in acute ischemic stroke (the first 7 days).
Acute coronary syndrome without elevation ST (unstable angina / myocardial infarction without tooth Q). Plavix treatment should be initiated with a single oral loading dose of 300mg, and then continued at a dose of 75mg once daily in combination with acetylsalicylic acid in doses of 75-100mg per day. Because the use of aspirin in high doses is associated with increased risk of bleeding, it’s recommended not to exceed 100mg dose per day. The maximum beneficial effect was observed at 3-month treatment. The course of treatment – up to 1 year.
Acute coronary syndrome-segment elevation ST (myocardial infarction without tooth Q). Plavix is assigned in a single dose of 75mg 1 time per day with initial loading dose of a single dose (300mg/day) in combination with acetylsalicylic acid (75-100mg/day) and thrombolytic (with or without thrombolysis).
Combination therapy begins as soon as possible after the onset of symptoms and continued for at least 4 weeks.
For patients over 75 years Plavix treatment should be carried out without the use of a loading dose.
Treatment with the help of Plavix should not be initiated within the first few days after a heart attack due to insufficient data on the drug in these patients.
Plavix contraindications include:
After myocardial infarction, ischemic stroke or recently diagnosed occlusive peripheral arterial disease – Plavix should be taken orally, 1 time per day, regardless of the meal. For prevention of ischemic in adults, including the elderly, Plavix is prescribed at 75mg 1 time a day. In patients with myocardial infarction, treatment can be started from the first days to 35 days of myocardial infarction. In patients with ischemic stroke treatment can be started in period of 7 days to 6 months after ischemic stroke.
Because of insufficient data Plavix should not be used in acute ischemic stroke (the first 7 days).
Acute coronary syndrome without elevation ST (unstable angina / myocardial infarction without tooth Q). Plavix treatment should be initiated with a single oral loading dose of 300mg, and then continued at a dose of 75mg once daily in combination with acetylsalicylic acid in doses of 75-100mg per day. Because the use of aspirin in high doses is associated with increased risk of bleeding, it’s recommended not to exceed 100mg dose per day. The maximum beneficial effect was observed at 3-month treatment. The course of treatment – up to 1 year.
Acute coronary syndrome-segment elevation ST (myocardial infarction without tooth Q). Plavix is assigned in a single dose of 75mg 1 time per day with initial loading dose of a single dose (300mg/day) in combination with acetylsalicylic acid (75-100mg/day) and thrombolytic (with or without thrombolysis).
Combination therapy begins as soon as possible after the onset of symptoms and continued for at least 4 weeks.
For patients over 75 years Plavix treatment should be carried out without the use of a loading dose.
Treatment with the help of Plavix should not be initiated within the first few days after a heart attack due to insufficient data on the drug in these patients.
Plavix contraindications include:
- idiosyncrasy (including hypersensitivity) components of Plavix;
- severe hepatic impairment;
- acute hemorrhage (bleeding from peptic ulcer disease, intracranial hemorrhage, etc.);
- pregnancy and lactation;
- children up to age 18 (safety and efficacy not established);
Plavix is prescribed with caution:
- liver disease, moderate hepatic failure (may cause hemorrhagic diathesis);
- renal dysfunction, renal failure;
- injury;
- period before and after surgery;
- disease predisposing to bleeding, particularly gastrointestinal and intraocular;
- concomitant use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), including: selective COX-2 inhibitors;
- concomitant use of warfarin, heparin, glycoprotein IIb / IIIa.