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Therapeutic indications
Prevention of vascular ischaemia associated with secondary atherothrombotic events (MI,stroke and vascular death) in patients with a history of symptomatic atherosclerotic disease.
Acute coronary syndrome
Clopidogrel is indicated in combination with aspirin for patients with:
• Unstable angina or non-ST elevation MI. Clopidogrel is indicated for early and long-term
reduction of atherothrombotic events (myocardial infarction, stroke, vascular death and
refractory ischaemia) whether or not patients undergo cardiac revascularisation (surgical
or PCI, with or without stent).
• ST-segment elevation acute myocardial infarction. In this population, clopidogrel has been shown to reduce the rate of death from any cause and the rate of a combined endpoint of death, re-infarction or stroke.
Dose and method of administration
Clopidogrel should be taken once a day with or without food.
Adults
Generally, clopidogrel should be given as a single daily dose of 75 mg.
In patients with acute coronary syndrome:
• unstable angina or non-ST elevation myocardial infarction - clopidogrel treatment should be initiated with a single 300 mg loading dose and then continued long-term at 75 mg once a day (with aspirin 75 mg-325 mg daily).
• ST elevation acute myocardial infarction - clopidogrel treatment should be given as a single daily dose of 75 mg initiated with or without a 300 mg loading dose in combination with aspirin and with or without thrombolytics.
No dosage adjustment is necessary for either elderly patients or patients with renal impairment
Children and adolescents
Safety and efficacy in subjects below the age of 18 have not been established.