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Grepid Tablet

Generic Name(s): Clopidogrel

Why it's used

Grepid Tablet is used to reduce the rate of stroke and heart attack. This medicine works by preventing the blood clot formation. Grepid is also used to treat poor circulation in the legs (peripheral arterial disease) and chest pain due to heart problems, and to prevent conditions like irregular heartbeat and sudden reduction of blood flow to the heart.
Grepid Tablet may also be used together with other medicines to treat certain conditions as recommended by the doctor. It is used in combination with Aspirin to lower the chances of heart attack, stroke, or blood clot formation.
Antiplatelet
Grepid is a prescription medicine that belongs to a class of medicines called Antiplatelet. An antiplatelet drug is used for the treatment and prevention of heart attacks, stent thrombosis, and stroke caused by a blood clot. These medicines decrease the ability of platelets to stick together and hence reduce the formation of blood clots.

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How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Grepid Tablet. If you have any questions related to this medicine, ask your doctor or pharmacist. Eat this medicine as recommended by your doctor.
Grepid Tablet is eaten with or without food.

Typical Dosage

The typical dose of Grepid is 75 mg/day. Grepid is commonly used at the same time every day. This medicine is not known to be habit-forming.
This medicine should be used on an as-needed basis. You should continue to use this medicine as directed by the doctor even if you feel well.

Talk to Your Doctor

Talk to your doctor if your condition worsens. Tell your doctor if blood in the urine, black colored stools, vomiting with blood, and blood clot formation. You should consult with your doctor before stopping the use of Grepid.
When stopping this medicine, you may experience withdrawal symptoms such as heart attack, and stroke.

Use in Children

The safety and effectiveness of using Grepid Tablet in children has not been established. This medicine does not work in children.

Storage

You should store Grepid Tablet at room temperature 25° C (77° F), away from moisture, and away from light. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Grepid Tablet for conditions for which it was not prescribed. Do not give Grepid Tablet to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Grepid

The dose and frequency of using Grepid will depend on the following factors:
  • age of the patient
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements being used

Grepid Dosage

Dosage for irregular heartbeat (atrial fibrillation)

Adult
  • Recommended: 75 mg/day

Dosage for blood flow reduction to the heart

Adult
  • Recommended: 75 mg once daily
  • Initial: 300 mg loading dose
  • Maximum: acute coronary syndrome

Dosage for heart attack

Adult
  • Recommended: 75 mg once daily

Dosage for stroke

Adult
  • Recommended: 75 mg once daily

Dosage for poor blood circulation in the legs

Adult (peripheral arterial disease)
  • Recommended: 75 mg once daily

Forms

Tablet
Strength: 75 mg, and 300 mg
Tablet, Film coated
Strength: 75 mg, and 300 mg

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Overdose

What to do if you overdose on Grepid?
No specific antidote is available for the Grepid. In the case of overdose, another alternative method called platelet transfusion may be used to reverse the effects (prolonged bleeding time) of Grepid.
Symptoms of an overdose of Grepid
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Grepid Tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Grepid

Before you use Grepid, tell your doctor of your medical and health history including the following:
  • allergic to Grepid
  • bleeding problems
  • bleeding within the brain
  • kidney disease
  • plan to have surgery and dental procedures
  • severe liver disease
  • stomach ulcers
Use of Grepid in these existing conditions may lead to an increased risk of bleeding.
Before you use Grepid Tablet, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic to clopidogrel, ticlopidine, or prasugrel.
Before having any surgery when using Grepid, tell your doctor and dentist about all the medicinal products you use including prescription and non-prescription medicines, and any herbal supplements.

Use in Pregnancy

Grepid Tablet should be used in pregnancy only when required. Grepid should be used in pregnancy only if it is needed because no adequate and well-controlled studies have been carried out.

Use while Breastfeeding

Consult with your doctor on the use of Grepid during breastfeeding. It is unknown whether Grepid passes into the breast milk.

Impact on Fertility

Consult with your doctor on the use of Grepid Tablet, if you are trying to conceive. It is unknown whether this medicine will harm the unborn baby.

Seizures

Grepid Tablet may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.

Increased Risk

This medicine can cause stomach bleeding. The use of alcohol/tobacco with Grepid may increase the risk. Talk to your doctor if you drink alcohol or smoke regularly.

Grepid Side-effects

The following side-effects may commonly occur when using Grepid Tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Grepid Tablet may cause the following side-effects:
The following severe side-effects may also occur when using Grepid Tablet:
  • Stomach and intestinal disorders (possibly fatal)
    Symptoms: inflammation of the large intestine (colitis), inflammation in the pancreas (pancreatitis), painful swelling and sores inside the mouth, bleeding behind the peritoneum space (retroperitoneal hemorrhage) stomach ulcers
  • Immune system disorders
    Symptoms: life-threatening allergic reactions (anaphylactoid reactions) allergic reaction to an injection of foreign protein
  • Symptoms: tightening of the muscles of the lungs (bronchospasm), inflammation within the lungs (interstitial pneumonitis), build-up of white blood cells in the lungs (eosinophilic pneumonia), coughing up of blood (haemoptysis) bleeding from the lung (pulmonary hemorrhage)
  • Blood vessel disorders
    Symptoms: inflammation of a blood vessel (vasculitis), low blood pressure bleeding (haemorrhage) after surgical procedure
  • Bone disorders
    Symptoms: bleeding into joint spaces (haemarthrosis)
  • Blood and lymphatic system disorders (possibly fatal)
    Symptoms: deficiency of granulocytes in the blood, deficiency of blood cells (aplastic anemia), deficiency of red blood cells, white blood cells, and platelets (pancytopenia), clot formation in the small blood vessels, life-threatening blood disorder (acquired hemophilia A), low count of thrombocytes in the blood, low count of neutrophils in the blood, decreased number of white blood cells high levels of eosinophils in the blood
  • Liver disorders
    Symptoms: acute liver failure, inflammation of the liver (hepatitis) blood creatinine increased
  • Brain related disorders
    Symptoms: confusion, hallucinations bleeding inside the brain (intracranial bleeding)
  • Skin and subcutaneous tissue disorders
    Symptoms: skin allergic reaction caused by infection (erythema multiforme), life-threatening drug-induced skin reaction, swelling in the lower layer of skin, drug induced life-threatening allergic reaction, fluid-filled blisters on the skin (bullous dermatitis) severe skin reaction (Stevens-Johnson Syndrome)
  • Heart disorders
    Symptoms: chest pain or heart attack due to allergic reaction (kounis syndrome)
Your doctor has prescribed Grepid Tablet because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Grepid Tablet.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Use of NSAIDs

Patients using NSAIDs (Non-steroidal anti-inflammatory drugs) with Grepid may increase the risk of bleeding. Such patients should take necessary precautions while using NSAIDs with Grepid especially during the first weeks of therapy.

Use of Oral Anticoagulants

Patients who are taking Grepid with oral anticoagulants (warfarin) may increase the risk of bleeding. The combined use of Grepid with oral anticoagulants is not recommended.

Planning to have Surgery

Such patients are at an increased risk when using this medicine. Discontinue the use of Grepid seven days before undergoing the surgical procedure.

Patients with Pathological Conditions

Patients undergoing surgery or trauma are at an increased risk of bleeding when using this medicine. Patients should carefully monitor for any signs of bleeding, especially during the first week of treatment and after surgery.

Life-Threatening Blood Disorder

The patients who are using Grepid are at an increased risk of a life-threatening blood disorder (acquired haemophilia). Proper management by specialists or discontinuation of Grepid is required in such patients.

Recurrent Episodes of Stroke

Patients with the continual episodes of stroke are at an increased risk when using this medicine. Avoid the use of Grepid during the first seven days after an incidence of stroke.

Abnormal Functioning of the Kidney

Patients with abnormal functioning of the kidney are at an increased risk when using this medicine. Such patients should take necessary precautions while taking Grepid.

Abnormal Functioning of the Liver

Patients with liver disease are at an increased risk when using this medicine. Take necessary precautions while using Grepid.

Patients Using CYP2C8 Substrates

Patients using CYP2C8 substrates (repaglinide) are at an increased risk while using this medicine. The use of Grepid with repaglinide may increase the level of repaglinide in the body. Patients should take necessary precautions while taking both drugs in combination.

Patients using CYP2C19 Inhibitors

Patients having poor metabolic activity are at an increased risk when using this medicine. Use of Grepid with omeprazole decreases the blood clotting activity of Grepid in patients with abnormal metabolism. Avoid the use of CYP2C19 inhibitors (omeprazole or esomeprazole) in such patients. Use another platelet inhibitors (P2Y12) in patients having poor metabolic activity.

Bleeding Disorders

Patients who are taking thienopyridines are at an increased risk of bleeding. Thienopyridines may lead to blockage of blood clotting activity for 7-10 days. The process of platelet transfusion should be followed within 4 hours of starting dose or 2 hours of the maintenance dose.

Discontinuation of Grepid

Patients who discontinue Grepid therapy may at an increased risk of heart diseases.

Bleeding Disorder

Patients with bleeding disorder with clotting in small blood vessels are at an increased risk when using this medicine. This condition may cause low thrombocytes in the blood, deficiency of red blood cells (microangiopathic hemolytic anemia), fever, and kidney disorders. This condition requires urgent medical treatment including exchange of blood proteins (plasmapheresis).

Allergic Reaction among Thienopyridines

Patients who are taking thienopyridines are at an increased risk of allergic reactions. This allergic condition may lead to side effects such as swelling of the lower layer of the skin, low thrombocytes in the blood, skin rash, deficiency of neutrophils in the blood, and life-threatening allergic reaction. Regular monitoring for signs of allergic reaction in patients with a known allergy to thienopyridines is recommended.

Interactions with Grepid

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Grepid Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Paclitaxel

Your doctor's guidelines may need to be followed while taking this medicine along with paclitaxel, which is used to treat cancer. Grepid may increase the level of paclitaxel in the blood. Patients should take necessary precautions while taking both drugs in combination.

SSRIs and SNRIs

Grepid Tablet interacts with selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, which are used to treat depression. The use of Grepid with these reuptake inhibitors increases the risk of bleeding. Patients should take necessary precautions while taking both drugs in combination.

Warfarin

There may be an interaction of Grepid with warfarin, which is used to treat blood clots. The long-term use of Grepid with warfarin increases the risk of bleeding. The use of Grepid with warfarin is not recommended.

NSAIDs

Grepid Tablet may interact with nonsteroidal anti-inflammatory drugs, which are used to treat pain, fever, swelling, and inflammation. The combined use of Grepid with nonsteroidal anti-inflammatory drugs may increase the risk of stomach and intestinal bleeding. Patients should take necessary precautions while taking both drugs in combination.

Repaglinide

Special instructions need to be followed while taking this medicine along with repaglinide, which is used to treat high blood sugar. Use of Grepid with repaglinide may increase the level of repaglinide in the body. Take necessary precautions while taking both drugs in combination and proper dose adjustment is recommended.

Acetylsalicylic Acid

Your doctor's guidelines may need to be followed while taking this medicine along with acetylsalicylic acid, which is used to treat pain, fever, and inflammation. The use of Grepid with acetylsalicylic acid may increase the risk of bleeding. Take necessary precautions while taking both drugs in combination.

Dexlansoprazole, Lansoprazole, and Pantoprazole

Grepid Tablet interacts with dexlansoprazole, lansoprazole, and pantoprazole, which are used to treat stomach acid production. Use of these medicines may decrease the blood clotting activity of Grepid.

Glycoprotein IIb/IIIa Inhibitors

Special instructions need to be followed while taking this medicine along with glycoprotein IIb/IIIa inhibitors, which are used to prevent blood clotting. The use of Grepid with glycoprotein IIb/IIIa inhibitors may increase the risk of bleeding. Patients should take necessary precautions while taking both drugs in combination.

Proton Pump Inhibitors

There may be an interaction of Grepid with proton pump inhibitors (omeprazole or esomeprazole), which are used to treat stomach ulcers. Use of these inhibitors may reduce the level of the Grepid metabolites in the blood and decrease the blood clotting activity. The combined use of proton pump inhibitors and Grepid should be avoided.

CYP2C19 Inhibitors

Grepid Tablet may interact with CYP2C19 inhibitors (fluvoxamine, moclobemide, fluoxetine, voriconazole, fluconazole, ticlopidine, carbamazepine, and efavirenz), which are used to treat depression, fungal or viral infections, stroke, and seizure. Use of Grepid with CYP2C19 inhibitors may decrease the level of an active metabolite of Grepid. Avoid the use of CYP2C19 inhibitors in patients who are on treatment with Grepid.

Heparin or Thrombolytics

Grepid Tablet may interact with heparin or thrombolytics, which are used to treat blood clots. The use of Grepid with heparin or thrombolytics may increase the risk of bleeding. Patients should take necessary precautions while taking both drugs in combination.

Pentoxifylline

There may be an interaction of Grepid with pentoxifylline, which is used to treat muscle pain. The use of Grepid with pentoxifylline increases the risk of bleeding. Such patients should take necessary precautions while using pentoxifyllin with Grepid especially during the first weeks of therapy.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Grepid is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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