Zesprin - Tablet Aspirin + Clopidogrel - 75mg+75mg 1 Tablet(s) / Tablet Zenith Pharmaceuticals Ltd. Introduction: Zesprin is a combination of two antiplatelet medicines or blood thinner used to reduce the formation of harmful blood clots in blood vessels. This helps to prevent a heart attack or stroke in people with heart disease. Zesprin should be taken with food regularly at a fixed time each day. You should take it regularly at evenly spaced intervals as per the schedule prescribed by your doctor. Taking it at the same time every day will help you remember to take it. The dose and duration of treatment will depend on what you are being treated for. Do not stop... Uses of Zesprin: Heart attack preventionStroke prevention Side effects of Zesprin: Abdominal painBruiseDiarrheaGastrointestinal bleedingIncreased bleeding tendencyNosebleeds How to use Zesprin: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Zesprin is to be taken with food. How Zesprin works: Zesprin is a combination of two antiplatelet medicines: Aspirin and Clopidogrel which prevent heart attack. They work by preventing the platelets from sticking together and decrease the formation of harmful blood clots. Indication: Adult: PO Prevention of ischaemic events Per tab contains clopidogrel 75 mg and aspirin 75 mg: 1 tab once daily. Acute coronary syndrome Per tab contains clopidogrel 75 mg and aspirin 75 mg: Loading dose: 4 tab; maintenance: 1 tab/day. Hepatic impairment: Severe hepatic impairment: Avoid use. Administration: Aspirin: Corticosteroids, phenylbutazone and oxyphenbutazone may increase risk of GI ulceration. Use with coumarins, anagrelide, agatroban, LMWH, bivalirudin, dasatinib, iloprost, lepirudin and tenecteplase may increase the risk of bleeding. Clopidogrel: Co-administration of clopidogrel with NSAIDs may increase the risk of stomach and intestinal bleeding. There is an increased risk of bleeding with coumarins, agatroban, dasatinib, heparin, LMWH, gingko biloba and iloprost. Increased risk of bleeding if clopidogrel and drotrecogin alfa are given within 7 days. May increase bupropion level and side effects (lightheadedness , GI discomfort). Potentially Fatal: Aspirin and clopidogrel: Increased risk of bleeding with dabigatran. Adult Dose: History of peptic ulcer or those prone to dyspepsia and those with gastric mucosal lesion or heavy ethanol consumption; asthma or allergic disorders; tinnitus; dehydrated patients; uncontrolled hypertension; impaired renal or hepatic function; children and elderly; pregnancy. Patients at risk of increased bleeding from trauma, surgery, or other pathological conditions. Increased risk of Reye's syndrome when used in patients with chicken pox, influenza or flu symptoms. Caution when used in patients with nasal allergies or nasal polyps. For patients undergoing elective surgery and an antiplatelet effect is not needed, clopidogrel should be discontinued 7-10 days before surgery. Renal Dose: Aspirin inhibits the formation of thromboxane A2 in the platelets. This inhibits platelet aggregation and coagulation. This action lasts until the enzyme cyclo-oxygenase is regenerated in the platelets. Clopidogrel is a prodrug and is metabolised an active thiol metabolite. The active metabolite selectively inhibits the binding of adenosine diphosphate (ADP) to its platelet receptor and the subsequent ADP-mediated activation of the glycoprotein GP IIb/IIIa complex, thereby inhibiting platelet aggregation. Mode of Action: Should be taken with food. Precaution: Acute coronary syndrome, TIA, Ischaemic events, MI, Stroke Side Effect: Renal impairment: CrCl (ml/min) <10 Avoid use. Pregnancy Category Note: Aspirin: GI disturbances, epigastric discomfort, prolonged bleeding time, rhinitis, urticaria; angioedema, salicylism, tinnitus. Clopidogrel: Dyspepsia, abdominal pain, nausea, vomiting, flatulence, constipation, gastritis, gastric and duodenal ulcers. Serious events include bleeding and GI haemorrhage. GI upset, diarrhoea, paraesthesia, vertigo, headache, dizziness, leucopaenia, eosinophilia, rash and pruritus. Potentially Fatal: Aspirin: Gastric erosion, ulceration and bleeding; severe, occasionally fatal exacerbation of airway obstruction in asthma; Reye's syndrome (childn <12 yrs). Hepatotoxicity; CNS depression, which may lead to coma; CV collapse, resp failure; paroxysmal bronchospasm and dyspnoea. Clopidogrel: Bleeding disorders including GI intracranial haemorrhage and thrombotic thrombocytopenic purpura. Interaction: Hypersensitivity to aspirin, NSAIDs or clopidogrel; active peptic ulceration; children <12 yr; patients with haemophilia or haemorrhagic disorders; gout; severe renal or hepatic impairment; lactation.