Antiagrex 75 mg film-coated tablets – clopidogrel to prevent heart attack, stroke and thrombosis

Antiagrex is a medicine containing the active substance clopidogrel and belongs to the group of platelet aggregation inhibitors (antiplatelet medicines). It prevents platelets from sticking together and thus reduces the risk of clots forming in narrowed blood vessels.

In Serbia it is authorised as 75 mg film-coated tablets (pack of 28 tablets). It is used in adults after a heart attack or ischaemic stroke, in peripheral arterial disease, acute coronary syndrome, after stent placement, in TIA/minor stroke and in certain patients with atrial fibrillation – often together with acetylsalicylic acid. Treatment is decided by a doctor.

What is Antiagrex (clopidogrel) used for and how should it be taken correctly?

Key facts about the medicine

What is Antiagrex used for?

According to the Summary of Product Characteristics, clopidogrel is indicated in adults for:

• secondary prevention of atherothrombotic events after myocardial infarction (from a few days up to 35 days after the infarction), ischaemic stroke (from day 7 up to 6 months) or in established peripheral arterial disease
• acute coronary syndrome without ST-segment elevation (unstable angina, non-Q-wave infarction), including patients with a stent, in combination with acetylsalicylic acid (ASA)
• acute ST-segment elevation myocardial infarction, in combination with ASA, in patients undergoing percutaneous coronary intervention or thrombolytic therapy
• moderate-to-high-risk transient ischaemic attack (TIA) or minor ischaemic stroke, in combination with ASA, started within 24 hours
• prevention of atherothrombotic and thromboembolic events in atrial fibrillation, in combination with ASA, in patients unsuitable for vitamin K antagonists and with a low bleeding risk

How is it used and dosed?

• The usual dose is one 75 mg tablet once daily, with or without food.
• In acute coronary syndrome and some other indications the doctor starts treatment with a loading dose (300 mg or 600 mg), then continues with 75 mg daily together with ASA 75–100 mg daily; the duration of combined treatment (e.g. up to 12 months, at least 4 weeks or 21 days in TIA) is determined by the doctor.
• In patients over 75 years, loading doses are used with caution or omitted, as the doctor decides.
• Missed dose: if less than 12 hours have passed since the usual time, take the tablet immediately and the next one at the normal time; if more than 12 hours have passed, take the next dose at the normal time without doubling.

This is the general dosing from the Summary of Product Characteristics and not an individual recommendation.

Special patient groups

• Children: clopidogrel is not used in children because of insufficient efficacy data.
• Kidney impairment: limited therapeutic experience – caution is needed.
• Moderate liver impairment (possible bleeding tendency): limited experience, caution; severe liver impairment is a contraindication.
• People with reduced CYP2C19 enzyme activity (“poor metabolisers”) form less active metabolite, so the medicine may work less well in them.

Contraindications – when the medicine must not be used

• hypersensitivity to clopidogrel or any of the excipients
• severe liver impairment
• active pathological bleeding such as peptic ulcer or intracranial haemorrhage

Precautions and warnings

• Caution with increased bleeding risk (trauma, surgery, lesions prone to bleeding in the digestive tract or eye) and together with ASA, heparin, GP IIb/IIIa inhibitors, NSAIDs, SSRIs or pentoxifylline.
• Use with oral anticoagulants is not recommended; triple antiplatelet therapy (clopidogrel + ASA + dipyridamole) after stroke is not recommended.
• Thrombotic thrombocytopenic purpura (TTP) and acquired haemophilia have rarely been reported – they require urgent treatment.
• There are insufficient data on use in recent ischaemic stroke (less than 7 days).
• Cross-hypersensitivity with other thienopyridines (ticlopidine, prasugrel) is possible.
• The medicine contains lactose – it must not be used in rare hereditary galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption.

Interactions with other medicines, alcohol and food

• Medicines that increase bleeding risk: oral anticoagulants (warfarin – not recommended), heparin, thrombolytics, GP IIb/IIIa inhibitors, ASA (possible increased bleeding, although the combination is used under medical supervision), NSAIDs including COX-2 inhibitors, SSRI antidepressants.
• Omeprazole and esomeprazole (proton pump inhibitors) reduce formation of the active metabolite – as a precaution concomitant use should be avoided; the same applies to other strong or moderate CYP2C19 inhibitors (fluvoxamine, fluoxetine, moclobemide, voriconazole, fluconazole, ticlopidine, carbamazepine, efavirenz).
• Rifampicin (a strong CYP2C19 inducer) may increase the effect and bleeding risk – avoid.
• Clopidogrel increases exposure to medicines metabolised by CYP2C8 (repaglinide, paclitaxel).
• Opioids (e.g. morphine) may delay and reduce clopidogrel absorption in acute coronary syndrome.
• The medicine can be taken with or without food.

Pregnancy and breastfeeding

As a precaution clopidogrel is not used during pregnancy because there are no clinical data; animal studies have not shown harmful effects. If you become pregnant during treatment, tell your doctor immediately.

Breastfeeding should be stopped during treatment, as clopidogrel is excreted in milk in animals.

Driving and using machines

Clopidogrel has no or negligible influence on the ability to drive and use machines.

Possible side effects

• Most common: bleeding – in the stomach or intestines, bruising and haematomas, nosebleeds, blood in the urine; less often bleeding in the eye, head, lungs or joints.
• Common (up to 1 in 10): diarrhoea, abdominal pain, indigestion or heartburn.
• Uncommon (up to 1 in 100): headache, stomach or duodenal ulcer, vomiting, nausea, constipation, wind, rash, itching, dizziness, tingling and numbness.
• Rare: vertigo, breast enlargement in men.
• Very rare: jaundice and liver inflammation, severe abdominal pain (pancreatitis), fever, breathing difficulty with cough, generalised allergic reactions, TTP, blood count changes.

Report suspected side effects to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose can prolong bleeding time and lead to bleeding complications – contact your doctor or emergency services. No specific antidote is known; platelet transfusion may be used if needed.
• Missed dose: follow the 12-hour rule described in the dosing section; do not take a double dose.
• Stopping treatment: do not stop the medicine without advice from your doctor or pharmacist.

Related information

• How to lower high blood pressure without drugs – measures that complement treatment
• How to measure your pulse and why it matters

For additional care and support with high blood pressure and heart conditions (regular blood pressure checks), see also the Blood pressure monitors category – products in this category do not replace the medicine you have been prescribed.

Composition, packaging and manufacturer

• Active substance: clopidogrel 75 mg (as clopidogrel hydrogen sulphate) in one film-coated tablet.
• Core: anhydrous lactose (78.13 mg), microcrystalline cellulose, crospovidone, glycerol dibehenate, talc.
• Film coating Opadry II Pink: polyvinyl alcohol, talc, titanium dioxide (E171), macrogol 3350, lecithin (E322), red iron oxide (E172).
• Pack: Al/Al blister with 7 tablets; carton with 4 blisters (28 tablets) and a package leaflet.
• Marketing authorisation holder: ACTAVIS D.O.O. BEOGRAD, Đorđa Stanojevića 12, Belgrade.

Storage

• Store below 30 °C.
• Keep out of the sight and reach of children; do not use after the expiry date (shelf life 3 years).
• Return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

Should Antiagrex be stopped before a tooth extraction?

This is decided by the doctor. According to the Summary of Product Characteristics, for planned surgery where an antiplatelet effect is undesirable the medicine is stopped 7 days beforehand, but in many patients (e.g. with a stent) stopping can be dangerous. Always tell your dentist and doctor that you take clopidogrel.

Can I take omeprazole with Antiagrex?

As a precaution, concomitant use of omeprazole or esomeprazole is not recommended because they reduce formation of the active form of clopidogrel. If you need stomach protection, your doctor will choose a suitable medicine.

What if I forget an Antiagrex tablet?

If less than 12 hours have passed since the usual time, take the tablet immediately and the next one at the normal time. If more than 12 hours have passed, take the next dose at the usual time without doubling.

Is it normal to bruise more easily?

Yes, bruising and longer bleeding from small cuts are common because of how the medicine works. However, blood in the stool or urine, vomiting blood and bleeding that does not stop require urgent medical attention.

Sources

• ALIMS – Summary of Product Characteristics Antiagrex®, 75 mg, film-coated tablets (September 2024)
• ALIMS – Package leaflet Antiagrex®, 75 mg, film-coated tablets (September 2024)

Sources checked on: 23 October 2026.