Secondary prevention of atherothrombotic events in adults suffering from MI (from a few days to <35 days), ischaemic stroke (from 7 days to <6 mth) or established peripheral arterial disease; non-ST segment elevation acute coronary syndrome (unstable angina or non-Q-wave MI), including patients undergoing stent placement following percutaneous coronary intervention, in combination w/ acetylsalicylic acid (ASA); ST segment elevation acute MI, in combination w/ ASA in medically treated patients eligible for thrombolytic therapy. Prevention of atherothrombotic & thromboembolic events in adults w/ atrial fibrillation who have at least 1 risk factor for vascular events, not suitable for treatment w/ vit K antagonists (VKA) & have a low bleeding risk, in combination w/ ASA.
Reports of cross-reactivity among thienopyridines (eg, clopidogrel, ticlopidine, prasugrel). Reduced effectiveness in poor clopidogrel metabolizers. Risk of bleeding & haematological disorders; thrombotic thrombocytopenic purpura; acquired haemophilia. Not recommended during the 1st 7 days after acute ischaemic stroke. Avoid use w/ strong or moderate CYP2C19 inhibitors. Caution when co-administered w/ CYP2C8 substrate medicinal products. Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption. Stomach upset & diarrhoea due to hydrogenated castor oil. Patients w/ renal impairment & moderate hepatic disease. Pregnancy & lactation. Should not be used in childn.
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