Aspirin. corticosteroids, phenylbutazone and oxyphenbutazone may increase risk of GI ulceration

Use with coumarins, anagrelide , agartroban , LMWH bivalirudin, dasatinib, liprorost, leprirudin and tenecteplase may increase risk of bleeding.

Clopidogrel- coadmin. of clopidogrel with NSAIDs may increase the risk of stomach and intestinal bleeding. There is an increased risk of bleeding with coumarins, agartroban, 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)

Aspirin and clopidogrel - increased risk of bleeding with dabigatran

Prophylaxis of ischemic events

Aspirin- GI disturbance, epigastric discomfort, prolonged bleeding time, rhinitis, urticaria, angioedema, tinnitus,

Gastric erosion, ulceration and bleeding, severe occasionally fatal excaberation of airway obstruction in asthma,

Ryes syndrome children < 12 years hepatotoxicity CNS depression, which may lead to coma, CV collapse , respiratory failure, paraxysmal and dyspnoea,

Clopidogrel- dyspepsia, abdominal pain, nausea, vomiting, gastritis, gastric and duodenal ulcers, serious events include bleeding, & GI discomfort, diarrhoea, paraesthesia, vertigo,

headache, dizziness, leucopenia, eosinophilla, rash and pruritus, bleeding disorders, including GI intracranial haemorrhage and thrombotic thrombocytopenic purpura

Hypersensitivity to aspirin NSAIDs or Clopidrogrel

Active peptic ulceration child < 12 years patients with haemophilia or haemorrhage disorders gout,

severe renal or hepatic impairment lactation

Special precaution-

History of peptic ulcer or those prone to dyspepsia and those with gastric mucosa lesions or heavy ethanol consumption.

Asthma or allergic disorders tinnitus, dehydrated patients uncontrolled hypertension impaired renal or hepatic function child and elderly

Patients with increased bleeding from trauma, surgery or other pathologial conditions

Increased risk of Reyes syndrome when used wih patients with chicken pox

Caution when used in patients with nasal allergies or nasal polyps for patients undergoing elective surgery an antiplatelet effect is not needed

Clopidrogrel should be discontinued 7-10 days before surgery

Indication

Prophylaxis of ischemic events

Dosage-

Adults - each tablet contains clopidogrel 75mg and aspirin 75mg- 1 tablet once daily

Acute coronary syndrome- Adult- each tablet contains clopidogrel 75mg and aspirin 75mg- loading dose - 4 tablets maintenance - 1 tablet daily

Pregnancy

Observe caution and use only if needed.

Lactation-

Contraindicated for use during lactation