Pragril 75 mg Tablet

Antiplatelet medicine for:

• Prevention of heart attack, stroke and vascular death after a recent heart attack, ischaemic stroke, or with established peripheral arterial disease
• Acute coronary syndrome (unstable angina, heart attack) — with aspirin
• After coronary stent insertion — with aspirin (dual antiplatelet therapy)
• Minor stroke/high-risk TIA (short course with aspirin)
• Atrial fibrillation with aspirin when anticoagulants cannot be used

Adults: 75 mg once daily, with or without food.

Acute coronary syndrome / before stenting: loading dose 300–600 mg once, then 75 mg daily with aspirin 75–100 mg, usually for 6–12 months.

Minor stroke/TIA: 300 mg loading, then 75 mg daily with aspirin for 21 days, then clopidogrel alone.

• Do not stop without your cardiologist's advice, especially after a stent (risk of stent thrombosis).
• Tell your surgeon/dentist; it may need stopping 5–7 days before surgery.

• Active bleeding (peptic ulcer, brain haemorrhage)
• Severe liver impairment
• Allergy to clopidogrel

Common: bruising, nosebleeds, bleeding gums, diarrhoea, stomach pain, indigestion.

Less common: stomach/intestinal bleeding, blood in urine, rash, itching, headache, dizziness.

Rare but serious: major bleeding (including brain), thrombotic thrombocytopenic purpura (TTP) (fever, purple spots, confusion, kidney problems — emergency), low white cells, severe skin reactions, angioedema.

• Report black stools, vomiting blood, blood in urine, severe headache or unusual bleeding.
• Higher bleeding risk with age, low body weight, kidney disease, recent trauma or surgery.
• Some people are poor metabolisers (CYP2C19) and get less effect.

Use in pregnancy only if clearly needed (e.g. recent stent). Avoid breastfeeding during treatment.

• Omeprazole and esomeprazole reduce its effect — pantoprazole is preferred if a PPI is needed
• Aspirin, NSAIDs, anticoagulants (warfarin, rivaroxaban), SSRIs (bleeding)
• Fluconazole, fluvoxamine, fluoxetine (reduce activation)
• Repaglinide (levels rise — avoid)
• Opioids such as morphine (delay absorption in acute settings)

Prolonged bleeding. Platelet transfusion may be needed; seek emergency care.

Store below 30°C.