Actoplus Met and Plavix

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Clopidogrel may significantly increase the blood levels of pioglitazone. You may be more likely to experience hypoglycemia, or low blood sugar, when these medications are used together. Symptoms of hypoglycemia include headache, dizziness, drowsiness, nervousness, weakness, tremor, nausea, hunger, sweating, and palpitation. The risk of other serious but uncommon side effects of pioglitazone such as fluid retention, macular edema (swelling in the back of the eye), new or worsening heart failure, bone fractures, anemia, and liver problems may also be increased. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor immediately if you experience blurred vision or other visual abnormalities; excessive or rapid weight gain; swelling in the ankles or legs; shortness of breath or difficulty breathing; unusual tiredness; chest pain or tightness; or worsening of existing heart problems. You should also seek prompt medical attention if you develop signs and symptoms of liver damage such as fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and yellowing of the skin or eyes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with clopidogrel may significantly increase the plasma concentrations of pioglitazone. The proposed mechanism is inhibition of the CYP450 2C8-mediated metabolism of pioglitazone by clopidogrel's glucuronide metabolite, which has demonstrated strong inhibition of CYP450 2C8 in vitro. When a single 15 mg dose of pioglitazone was administered to 10 healthy, nonsmoking volunteers on day 1 of treatment with clopidogrel (300 mg on day 1, followed by 75 mg on days 2 and 3), mean pioglitazone systemic exposure (AUC) increased by 2.1-fold and elimination half-life prolonged from 6.7 to 11 hours compared to administration with placebo. The peak plasma concentration (Cmax) of pioglitazone was not affected by clopidogrel, but concentration at 24 hours (Cmin) was increased 4.5-fold. The study reported substantial interpatient variability that may be at least partially attributable to CYP450 2C8 polymorphism, with magnitude of interaction greater in patients who were more extensive metabolizers of the isoenzyme.

MANAGEMENT: Given the potential for dose-related adverse events, reduction of pioglitazone dosage should be considered when used with clopidogrel. Close monitoring for the development of hypoglycemia and other adverse effects is recommended, such as fluid retention; weight gain; new or worsening heart failure; pulmonary, peripheral, and macular edema; bone fractures; anemia; and liver enzyme elevations. Patients should regularly monitor their blood sugar and learn how to recognize and treat hypoglycemia, which may include symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, and palpitation. Likewise, patients should be observed for potential loss of glycemic control following discontinuation of clopidogrel, and the pioglitazone dosage adjusted as necessary.

Actoplus Met

Generic Name: metformin / pioglitazone

Brand name: Actoplus Met, Actoplus Met XR

Synonyms: n.a.

What is Actoplus Met?

Plavix

Generic Name: clopidogrel

Brand name: Plavix

Synonyms: n.a.

What is Plavix?