Ogrel

Description Oogrel Tablets 75mg contain Clopidogrel (as Clopidogrel Bisulfate), an antiplatelet prodrug used to prevent blood clots in patients at risk of cardiovascular events. It requires activation by CYP450 enzymes (primarily CYP2C19) to form a metabolite that irreversibly inhibits the P2Y12 ADP receptor on platelets, blocking ADP-induced aggregation and GPIIb/IIIa activation. This reduces clot formation and platelet amplification, with effects lasting 7-10 days until new platelets form. Manufactured by Bosch Pharmaceuticals (Pvt) Ltd in Pakistan, this oral tablet is suitable for adults with a history of heart issues, providing secondary prevention without direct thrombin inhibition.

Ingredients Clopidogrel Bisulfate 75mg (equivalent to 75mg Clopidogrel base).

Drug Class Antiplatelet Agent / P2Y12 Inhibitor / Thienopyridine.

Dosage Form Tablet (1 box = 1 strip; 1 strip = 10 tablets).

Uses Oogrel Tablets are prescribed for:

• Secondary prevention of atherothrombotic events in recent myocardial infarction (3-35 days post-event), ischemic stroke (7 days to 6 months), or established peripheral arterial disease.
• Prevention of atherothrombotic and thromboembolic events in atrial fibrillation patients with vascular risk factors, unsuitable for vitamin K antagonists, and low bleeding risk (combined with aspirin).
• Reducing risk of stent thrombosis post-percutaneous coronary intervention.
• Management of acute coronary syndrome (unstable angina/NSTEMI/STEMI).
• Adjunct in preventing stroke or heart attack in high-risk cardiovascular patients.

Doctor’s Review Cardiologists commonly prescribe Oogrel for its role in long-term clot prevention after cardiac events. As one specialist observes: “Oogrel 75mg is a cornerstone for secondary stroke and MI prevention, offering irreversible platelet inhibition with once-daily convenience. It’s especially valuable in atrial fibrillation when warfarin isn’t an option, though genetic testing for CYP2C19 poor metabolizers can guide alternatives like prasugrel.”

Dosage (Follow physician’s instructions — typical guideline)

• Adults: 75mg once daily, orally, with or without food.
• Acute coronary syndrome: Loading dose 300mg (4 tablets), followed by 75mg daily.
• Recent MI/stroke/PAD: 75mg once daily, often with aspirin 75-325mg.
• Atrial fibrillation: 75mg once daily with aspirin 75-100mg.
• No adjustment for mild renal/hepatic impairment; avoid in severe liver disease.
• Continue long-term; do not stop without doctor advice to avoid rebound clotting risk.

In Case of Overdose Overdose may cause prolonged bleeding time or hemorrhage, with symptoms like bruising, epistaxis, or GI bleed. Seek immediate medical attention. Treatment is supportive (e.g., platelet transfusion if active bleeding, activated charcoal if recent ingestion). No specific antidote; monitor coagulation and vital signs in hospital.

Missed Dose Take as soon as remembered unless close to the next dose. Do not double up to avoid excessive bleeding risk. Resume your regular schedule and inform your doctor if doses are frequently missed, as it may increase clot formation risk.

How to Use

• Swallow tablet whole with water, at the same time daily for consistency.
• Can take with or without food; avoid crushing or chewing.
• Use with aspirin if prescribed for dual therapy.
• Monitor for unusual bleeding (e.g., gums, bruises); report promptly.
• Inform all healthcare providers (dentists, surgeons) of use before procedures.

When Not to Use Avoid Oogrel if:

• Hypersensitive to Clopidogrel or excipients.
• Active pathological bleeding (e.g., peptic ulcer, intracranial hemorrhage).
• Severe hepatic impairment.
• Recent ischemic stroke (within first 7 days).
• Concurrent use with strong CYP2C19 inhibitors if poor metabolizer status known.

Side Effects Common:

• Abdominal pain, dyspepsia, diarrhea, nausea, vomiting, constipation.
• Rash, pruritus.
• Headache, dizziness, fatigue.

Uncommon / Severe (Stop and seek medical help):

• Gastrointestinal hemorrhage or ulceration.
• Neutropenia, thrombotic thrombocytopenic purpura (TTP: fever, weakness, purpura).
• Acquired hemophilia (prolonged aPTT with bleeding).
• Severe rash, angioedema, or anaphylaxis.

Precautions & Warnings

• Monitor for bleeding signs (occult or overt), especially first weeks or post-procedure; perform blood counts if symptoms arise.
• Discontinue if confirmed acquired hemophilia (prolonged aPTT).
• Use cautiously in moderate hepatic impairment or bleeding diathesis.
• Genetic variation (CYP2C19 poor metabolizers) may reduce efficacy—consider testing or alternatives.
• Avoid in recent ischemic stroke (first 7 days) due to hemorrhagic risk.

Drug Interactions

• Warfarin, heparin, thrombolytics, GPIIb/IIIa inhibitors: Increased bleeding risk.
• Aspirin (ASA), NSAIDs: Heightened GI hemorrhage potential.
• SSRIs (e.g., fluoxetine, fluvoxamine), omeprazole/esomeprazole: Reduce antiplatelet effect via CYP2C19 inhibition.
• CYP2C19 inhibitors (e.g., voriconazole, fluconazole, moclobemide): May impair activation—avoid or monitor.
• Inducers (e.g., carbamazepine, efavirenz, rifampicin): Decrease efficacy.
• Ticlopidine: Avoid concurrent use.

Food Interactions

• Can take with or without meals; no major restrictions.
• Limit alcohol to reduce bleeding risk.
• Grapefruit juice may affect CYP enzymes—moderate intake.
• Maintain a balanced diet; no specific food interactions noted.

Storage/Disposal

• Store at room temperature (15-30°C), away from direct light and heat.
• Keep in original strip, out of reach of children.
• Dispose via pharmacy returns; do not flush or trash to avoid accidental ingestion.

Quick Tips

• Carry a medical alert card noting antiplatelet use for emergencies.
• Use a soft toothbrush and electric razor to minimize bleeding.
• Avoid NSAIDs (e.g., ibuprofen) unless prescribed.
• Report black stools, easy bruising, or prolonged bleeding immediately.
• For surgery: Stop 5-7 days prior if possible, per doctor.

Disclaimer This information is provided for educational purposes only and does not replace medical advice. Use only under the supervision of a licensed physician. Do not self-medicate.