Iscover
clopidogrel
clopidogrel
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or your pharmacist.
This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
If you have any side effects, including any side effects not listed in this leaflet, talk to your
doctor or pharmacist. See section 4.
What Iscover is and what it is used for
What you need to know before you take Iscover
How to take Iscover
4. Possible side effects
5 How to store Iscover
6. Contents of the pack and other information
Iscover contains clopidogrel and belongs to a group of medicines called antiplatelet medicinal products. Platelets are very small structures in the blood which clump together during blood clotting. By preventing this clumping, antiplatelet medicinal products reduce the chances of blood clots forming (a process called thrombosis).
Iscover is taken by adults to prevent blood clots (thrombi) forming in hardened blood vessels (arteries), a process known as atherothrombosis, which can lead to atherothrombotic events (such as stroke, heart attack, or death).
You have been prescribed Iscover to help prevent blood clots and reduce the risk of these severe events because:
You have a condition of hardening of arteries (also known as atherosclerosis), and
You have previously experienced a heart attack, stroke or have a condition known as peripheral arterial disease, or
You have experienced a severe type of chest pain known as ‘unstable angina’ or ‘myocardial infarction’ (heart attack). For the treatment of this condition your doctor may have placed a stent
in the blocked or narrowed artery to restore effective blood flow. You may also be given acetylsalicylic acid (a substance present in many medicines used to relieve pain and lower fever as well as to prevent blood clotting) by your doctor.
You have experienced symptoms of a stroke which go away within a short period of time (also known as transient ischemic attack) or an ischemic stroke mild in severity. You may also be
given acetylsalicylic acid by your doctor starting within the first 24 hours.
You have an irregular heartbeat, a condition called ‘atrial fibrillation’, and you cannot take medicines known as ‘oral anticoagulants’ (vitamin K antagonists) which prevent new clots from
forming and prevent existing clots from growing. You should have been told that ‘oral
anticoagulants’ are more effective than acetylsalicylic acid or the combined use of Iscover and acetylsalicylic acid for this condition. Your doctor should have prescribed Iscover plus
acetylsalicylic acid if you cannot take ‘oral anticoagulants’ and you do not have a risk of major
bleeding.
If you are allergic (hypersensitive) to clopidogrel or any of the other ingredients of this medicine (listed in section 6).
If you have a medical condition that is currently causing bleeding such as a stomach ulcer or bleeding within the brain.
If you suffer from severe liver disease.
If you think any of these apply to you, or if you are in any doubt at all, consult your doctor before taking Iscover.
If any of the situations mentioned below apply to you, you should tell your doctor before taking Iscover:
if you have a risk of bleeding such as
a medical condition that puts you at risk of internal bleeding (such as a stomach ulcer).
a blood disorder that makes you prone to internal bleeding (bleeding inside any tissues, organs or joints of your body).
a recent serious injury.
a recent surgery (including dental).
a planned surgery (including dental) in the next seven days.
if you have had a clot in an artery of your brain (ischemic stroke) which occurred within the last seven days.
if you have kidney or liver disease.
if you have had an allergy or reaction to any medicine used to treat your disease.
if you had a past medical history of non-traumatic brain hemorrhage.
While you are taking Iscover:
You should tell your doctor if a surgery (including dental) is planned.
You should also tell your doctor immediately if you develop a medical condition (also known as Thrombotic Thrombocytopenic Purpura or TTP) that includes fever and bruising under the skin that may appear as red pinpoint dots, with or without unexplained extreme tiredness, confusion, yellowing of the skin or eyes (jaundice) (see section 4 ‘Possible side effects’).
If you cut or injure yourself, it may take longer than usual for bleeding to stop. This is linked to the way your medicine works as it prevents the ability of blood clots to form. For minor cuts and injuries e.g., cutting yourself, shaving, this is usually of no concern. However, if you are concerned by your bleeding, you should contact your doctor straightaway (see section 4 ‘Possible side effects’).
Your doctor may order blood tests.
Do not give this medicine to children because it does not work.
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription.
Some other medicines may influence the use of Iscover or vice versa.
You should specifically tell your doctor if you take
medicines that may increase your risk of bleeding such as:
oral anticoagulants, medicines used to reduce blood clotting,
a non-steroidal anti-inflammatory medicine, usually used to treat painful and/or
inflammatory conditions of muscle or joints,
heparin or any other injectable medicine used to reduce blood clotting,
ticlopidine, other antiplatelet agent,
a selective serotonin reuptake inhibitor (including but not restricted to fluoxetine or fluvoxamine), medicines usually used to treat depression,
rifampicin (used to treat severe infections)
omeprazole or esomeprazole, medicines to treat upset stomach,
fluconazole or voriconazole, medicines to treat fungal infections,
efavirenz, or other anti-retroviral medicines (used to treat HIV infections),
carbamazepine, a medicine to treat some forms of epilepsy,
moclobemide, medicine to treat depression,
repaglinide, medicine to treat diabetes,
paclitaxel, medicine to treat cancer,
opioids: while you are treated with clopidogrel, you should inform your doctor before being prescribed any opioid (used to treat severe pain).
If you have experienced severe chest pain (unstable angina or heart attack), transient ischemic attack or ischemic stroke in mild severity, you may be prescribed Iscover in combination with acetylsalicylic acid, a substance present in many medicines used to relieve pain and lower fever. An occasional use of acetylsalicylic acid (no more than 1,000 mg in any 24 hour period) should generally not cause a problem, but prolonged use in other circumstances should be discussed with your doctor.
Iscover may be taken with or without food.
It is preferable not to take this product during pregnancy.
If you are pregnant or suspect that you are pregnant, you should tell your doctor or your pharmacist before taking Iscover. If you become pregnant while taking Iscover, consult your doctor immediately as it is recommended not to take clopidogrel while you are pregnant.
You should not breast-feed while taking this medicine.
If you are breast-feeding or planning to breast-feed, talk to your doctor before taking this medicine.
Ask your doctor or pharmacist for advice before taking any medicine.
Iscover is unlikely to affect your ability to drive or to use machines.
If you have been told by your doctor that you have an intolerance to some sugars (e.g. lactose), contact your doctor before taking this medicine.
This may cause stomach upset or diarrhoea.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The recommended dose, including for patients with a condition called ‘atrial fibrillation’ (an irregular heartbeat), is one 75 mg tablet of Iscover per day to be taken orally with or without food, and at the same time each day.
If you have experienced severe chest pain (unstable angina or heart attack), your doctor may give you 300 mg or 600 mg of Iscover (1 or 2 tablets of 300 mg or 4 or 8 tablets of 75 mg) once at the start of treatment. Then, the recommended dose is one 75 mg tablet of Iscover per day as described above.
If you have experienced symptoms of a stroke which go away within a short period of time (also known as transient ischemic attack) or an ischemic stroke mild in severity, your doctor may give you 300 mg of Iscover (1 tablet of 300 mg or 4 tablets of 75 mg) once at the start of treatment. Then, the recommended dose is one 75 mg tablet of Iscover per day as described above with acetylsalicylic acid for 3 weeks. Then the physician would prescribe either Iscover alone or acetylsalicylic acid alone. You should take Iscover for as long as your doctor continues to prescribe it.
Contact your doctor or the nearest hospital emergency department because of the increased risk of bleeding.
If you forget to take a dose of Iscover, but remember within 12 hours of your usual time, take your tablet straightaway and then take your next tablet at the usual time.
If you forget for more than 12 hours, simply take the next single dose at the usual time. Do not take a double dose to make up for a forgotten tablet.
For the 7, 14, 28 and 84 tablets pack sizes, you can check the day on which you last took a tablet of
Iscover by referring to the calendar printed on the blister.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
fever, signs of infection or extreme tiredness. These may be due to rare decrease of some blood cells.
signs of liver problems such as yellowing of the skin and/or the eyes (jaundice), whether or not associated with bleeding which appears under the skin as red pinpoint dots and/or
confusion (see section 2 ‘Warnings and precautions’).
swelling in the mouth or skin disorders such as rashes and itching, blisters of the skin. These may be the signs of an allergic reaction.
If you cut or injure yourself, it may take longer than usual for bleeding to stop. This is linked to the way your medicine works as it prevents the ability of blood clots to form. For minor cuts and injuries e.g., cutting yourself, shaving, this is usually of no concern. However, if you are concerned by your bleeding, you should contact your doctor straightaway (see section 2 ‘Warnings and precautions’).
Common side effects (may affect up to 1 in 10 people): Diarrhoea, abdominal pain, indigestion or heartburn.
Uncommon side effects (may affect up to 1 in 100 people):
Headache, stomach ulcer, vomiting, nausea, constipation, excessive gas in stomach or intestines,
rashes, itching, dizziness, sensation of tingling and numbness.
Rare side effect (may affect up to 1 in 1000 people): Vertigo, enlarged breasts in males.
Very rare side effects (may affect up to 1 in 10,000 people):
Jaundice; severe abdominal pain with or without back pain; fever, breathing difficulties sometimes associated with cough; generalised allergic reactions (for example, overall sensation of heat with
sudden general discomfort until fainting); swelling in the mouth; blisters of the skin; skin allergy; sore
mouth (stomatitis); decrease in blood pressure; confusion; hallucinations; joint pain; muscular pain;
changes in taste or loss of taste of food.
Side effects with frequency not known (frequency cannot be estimated from the available data):
Hypersensitivity reactions with chest or abdominal pain, persistent low blood sugar symptoms.
In addition, your doctor may identify changes in your blood or urine test results.
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system
listed in Appendix V. By reporting side effects you can help provide more information on the safety of
this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and on the blister, after EXP. The expiry date refers to the last day of that month.
Refer to the storage conditions on the carton.
If Iscover is supplied in PVC/PVDC/aluminium blisters, store below 30°C.
If Iscover is supplied in all aluminium blisters, it does not require any special storage conditions.
Do not use this medicine if you notice any visible sign of deterioration.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
The active substance is clopidogrel. Each tablet contains 75 mg of clopidogrel (as hydrogen sulphate).
The other ingredients are (see section 2 ‘Iscover contains lactose’ and ‘Iscover contains hydrogenated castor oil’):
Tablet core: mannitol (E421), hydrogenated castor oil, microcrystalline cellulose,
macrogol 6000 and low-substituted hydroxypropylcellulose,
Tablet coating: lactose monohydrate (milk sugar), hypromellose (E464), triacetin (E1518), red iron oxide (E172) and titanium dioxide (E171),
Polishing agent: carnauba wax.
Iscover 75 mg film-coated tablets are round, biconvex, pink, engraved on one side with the number ‘75’ and on the other side with the number ‘1171’. Iscover is supplied in cardboard cartons containing:
7, 14, 28, 30, 84, 90 and 100 tablets in PVC/PVDC/Aluminium blisters or in all
aluminium blisters
50x1 tablets in PVC/PVDC/Aluminium blisters or in all aluminium unit-dose blisters. Not all pack sizes may be marketed.
Marketing Authorisation Holder:
sanofi-aventis groupe
54, rue La Boétie F-75008 Paris France
Manufacturers:
Sanofi Winthrop Industrie
1, rue de la Vierge, Ambarès & Lagrave, F-33565 Carbon Blanc cedex, France or
Delpharm Dijon
6, boulevard de l'Europe, F-21800 Quétigny, France
or
Sanofi S.r.l.
Strada Statale 17, Km 22 67019 Scoppito (AQ) – Italy
For any information about this medicine, please contact the local representative of the Marketing
Authorisation Holder:
Sanofi Belgium
Tél/Tel: +32 (0)2 710 54 00
Swixx Biopharma UAB Tel: +370 5 236 91 40
Swixx Biopharma EOOD
Тел: +359 (0)2 4942 480
Sanofi Belgium
Tél/Tel: +32 (0)2 710 54 00 (Belgique/Belgien)
SANOFI-AVENTIS Zrt. Tel.: +36 1 505 0050
Sanofi A/S
Tlf: +45 45 16 70 00
Sanofi S.r.l.
Tel: +39 02 39394275
Sanofi-Aventis Deutschland GmbH Tel.: 0800 52 52 010
Tel. aus dem Ausland: +49 69 305 21 131
Genzyme Europe B.V. Tel: +31 20 245 4000
Swixx Biopharma OÜ Tel: +372 640 10 30
sanofi-aventis Norge AS
Tlf: +47 67 10 71 00
sanofi-aventis AEBE
Τηλ: +30 210 900 16 00
sanofi-aventis GmbH
Tel: +43 1 80 185 – 0
sanofi-aventis, S.A.
Tel: +34 93 485 94 00
sanofi-aventis Sp. z o.o. Tel: +48 22 280 00 00
sanofi-aventis France
Tél: 0 800 222 555
Appel depuis l’étranger: +33 1 57 63 23 23
Sanofi - Produtos Farmacêuticos, Lda Tel: +351 21 35 89 400
Swixx Biopharma d.o.o.
Tel: +385 1 2078 500
Sanofi Romania SRL
Tel: +40 (0) 21 317 31 36
sanofi-aventis Ireland Ltd. T/A SANOFI
Tel: +353 (0) 1 403 56 00
Swixx Biopharma d.o.o
Tel: +386 1 235 51 00
Vistor hf.
Sími: +354 535 7000
Sanofi S.r.l.
Tel: 800.536 389
Sanofi Oy
Puh/Tel: +358 (0) 201 200 300
C.A. Papaellinas Ltd.
Τηλ: +357 22 741741
Sanofi AB
Tel: +46 (0)8 634 50 00
Swixx Biopharma SIA Tel: +371 6 616 47 50