Apolets Dosage/Direction for Use

Recommended Doses: Recent MI, Recent Stroke or Established Peripheral Arterial Disease: The recommended daily dose of clopidogrel tablets is 75 mg once daily.
Acute Coronary Syndrome: For patients with acute coronary syndrome (unstable angina/non-Q-wave MI), clopidogrel should be initiated with a single 300 mg loading dose and then continued at 75 mg once daily. Aspirin (75 mg - 325 mg daily) should be initiated and continued in combination with clopidogrel.
Since a higher dose of ASA was associated with higher bleeding risk it is recommended that the dose of ASA should not be higher than 100 mg. The optimal duration of treatment has not been formally established. Clinical data support use up to 12 months, and the maximum benefit was seen at 3 months.
For patients with ST-segment elevation acute myocardial infarction, the recommended dose of clopidogrel is 75 mg once daily, administered in combination with aspirin, with or without thrombolytics. Clopidogrel may be initiated with or without a loading dose 300 mg.
For patients over 75 years of age clopidogrel should be initiated without a loading dose. Combined therapy should be started as early as possible after symptoms start and continued for at least 4 weeks. The benefit of the combination of clopidogrel with ASA beyond 4 weeks has not been studied in this setting.
Prevention of atherothrombotic and thromboembolic events in atrial fibrillation: In patients with atrial fibrillation, clopidogrel should be given as a single daily dose of 75 mg. ASA (75-100 mg daily) should be initiated and continued in combination with clopidogrel.
If a Dose is Missed: If the patient misses a dose or forgets to use the medicine, use as soon as the patient can.
If it is almost time for the next dose, wait until then to use the medicine and skip the missed dose.
Do not use extra medicine to make up for a missed dose.
Dose Adjustments: Renal impairment: Experience is limited in patients with moderate (creatinine clearance of 30-60 mL/minute) or severe (creatinine clearance of 5-15 mL/minute) renal impairment; use with caution. Inhibition of ADP-induced platelet aggregation may be decrease by 25%, but prolongation of bleeding time is similar in patients with renal impairment compared with that in healthy individuals.
Hepatic Insufficiency: Dosage adjustments are not necessary in patients with hepatic impairment. No dosage adjustment is necessary for mild to moderate cirrhosis.
Geriatric Patients: No dosage adjustments are necessary.
Other Disease States: CYP2C19 Poor Metabolizers: Patients who are CYP2C19 poor metabolizers have lower antiplatelet response to clopidogrel. Higher dosages of 600 mg loading dose followed by 150 mg once daily in this patient population had resulted in higher antiplatelet response. However, an appropriate dosage regimen has not been established.
Mode of administration: Clopidogrel oral tablets can be administered with or without food.