Package Leaflet: Information for the User

Clopidogrel cinfamed 75 mg Film-coated Tablets

Read this package leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this package leaflet, as you may need to read it again.
• If you have any questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others even if they have the same symptoms as you, as it may harm them.
• If you experience any side effects, talk to your doctor or pharmacist. See section 4.

Clopidogrel cinfamed contains clopidogrel and belongs to a group of medications known as antiplatelet agents. Platelets are very small cells that are found in the blood and aggregate when the blood clots. Antiplatelet agents, by preventing this aggregation, reduce the likelihood of blood clots (a process known as thrombosis) forming.

Clopidogrel cinfamed is administered to adults to prevent blood clots (thrombi) from forming in hardened blood vessels (arteries), a process known as atherothrombosis, and which may cause atherothrombotic effects (such as cerebral infarction, myocardial infarction, or death).

You have been prescribed clopidogrel to help prevent blood clots from forming and reduce the risk of these serious events because:

• you have a process that produces the hardening of the arteries (also known as atherosclerosis), and
• you have previously experienced a myocardial infarction, a cerebral infarction, or suffer from a disease known as peripheral arterial disease, or
• you have experienced a severe chest pain, known as “unstable angina” or “myocardial infarction”. Your doctor may have to place a stent in the blocked or narrowed artery to restore adequate blood flow. It is possible that your doctor has also prescribed acetylsalicylic acid (a substance present in many medications used to relieve pain and reduce fever, as well as to prevent blood clots from forming).
• you have experienced symptoms of a stroke that disappear in a short period of time (also known as a transient ischemic attack) or a mild ischemic stroke. Your doctor may also administer acetylsalicylic acid during the first 24 hours.
• you have an irregular heartbeat, a disease known as “atrial fibrillation”, and cannot take medications known as “oral anticoagulants” (vitamin K antagonists) that prevent the formation of new clots and prevent the growth of existing clots. You have been told that “oral anticoagulants” are more effective than acetylsalicylic acid or the combined use of clopidogrel and acetylsalicylic acid for this disease. Your doctor has prescribed clopidogrel in combination with acetylsalicylic acid if you cannot take “oral anticoagulants” and do not have a high risk of severe bleeding.

Do not take Clopidogrel cinfamed

• If you are allergic to clopidogrel or any of the other components of this medication (listed in section 6).
• If you have an active bleeding, such as a stomach ulcer or brain hemorrhage.
• If you have a severe liver disease.

If you think this may affect you, or if you have any doubts, consult your doctor before taking clopidogrel.

Warnings and precautions

Consult your doctor or pharmacist before starting to take Clopidogrel cinfamed.

Before starting treatment with clopidogrel, inform your doctor if you are in any of the following situations:

• If you have a risk of bleeding (bleeding) because:

-You have a disease that involves an increased risk of internal bleeding (such as a stomach ulcer).

-You have a blood disorder that predisposes you to internal bleeding (bleeding in tissues, organs, or joints of the body).

-You have recently suffered a severe injury.

-You have recently undergone a surgical procedure (including dental surgery).

• You are scheduled to undergo a surgical procedure (including dental surgery) within the next seven days.

• You have had a blood clot in a cerebral artery (ischemic stroke) within the last 7 days.
• You have liver or kidney disease.
• You have had an allergy or reaction to any medication used to treat your disease.
• You have a history of non-traumatic cerebral hemorrhage.

During treatment with clopidogrel:

• Inform your doctor if you are scheduled to undergo a surgical procedure (including dental surgery).
• Inform your doctor immediately if you develop a disorder (also known as Thrombotic Thrombocytopenic Purpura or TTP) that includes fever and hematomas (bruises) under the skin that may appear as localized red spots, with or without extreme fatigue, confusion, yellow discoloration of the skin or eyes (jaundice) (see section 4 "Possible side effects").
• If you cut or injure yourself, bleeding may take longer to stop than usual. This is related to the way the medication works, as it prevents the blood from forming clots. For minor cuts or injuries, such as cutting during shaving, this is not a concern. However, if you are concerned about your bleeding, consult your doctor immediately (see section 4 "Possible side effects").
• Your doctor may ask you to have blood tests.

Children and adolescents

This medication should not be administered to children because it is not effective.

Other medications and Clopidogrel cinfamed

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication.

Some medications may affect the use of clopidogrel or vice versa.

You must inform your doctor explicitly if you are taking:

• medications that may increase the risk of bleeding, such as:

• oral anticoagulants, medications used to reduce blood coagulation,
• non-steroidal anti-inflammatory drugs, medications used to treat pain and/or inflammation of muscles or joints,
• heparin, or any other injectable medication used to reduce blood coagulation,
• ticlopidine, or other antiplatelet agents,
• an inhibitor of serotonin reuptake (such as fluoxetine or fluvoxamine and other medications of the same type), medications used to treat depression,
• rifampicin (used to treat serious infections),

-omeprazole or esomeprazole, medications to treat stomach discomfort,

-fluconazole or voriconazole, medications to treat fungal infections,

-efavirenz, or other antiretroviral medications (used to treat HIV infections),

-carbamazepine, a medication to treat certain forms of epilepsy,

-moclobemide, a medication for depression,

-repaglinide, a medication to treat diabetes,

-paclitaxel, a medication to treat cancer,

-opioids: if you are taking clopidogrel, inform your doctor before being prescribed any opioid (used to treat intense pain),

-rosuvastatin (used to reduce cholesterol levels).

If you have had severe chest pain (unstable angina or myocardial infarction), transient ischemic attack, or mild ischemic stroke, you may have been prescribed clopidogrel in combination with acetylsalicylic acid, a substance present in many medications used to relieve pain and reduce fever. A dose of acetylsalicylic acid administered sporadically (not exceeding 1,000 mg in 24 hours) generally should not cause any problems, but prolonged use in other circumstances should be consulted with your doctor.

Taking Clopidogrel cinfamed with food

Clopidogrel can be taken with or without food.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, or think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medication.

It is recommended not to take this medication during pregnancy.

If you become pregnant while taking clopidogrel, consult your doctor immediately, as it is not recommended to take clopidogrel during pregnancy.

You should not breastfeed while taking this medication.

If you are breastfeeding or plan to do so, inform your doctor before taking this medication.

Consult your doctor or pharmacist before using any medication.

Driving and operating machinery

Clopidogrel is unlikely to affect your ability to drive or operate machinery.

Clopidogrel cinfamed contains isomalt and sucrose

If your doctor has told you that you have an intolerance to certain sugars, consult with him before taking this medication.

Follow exactly the administration instructions of this medication as indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

The recommended dose, even for patients with a condition called "atrial fibrillation" (an irregular heart rhythm), is one 75 mg clopidogrel tablet per day, administered orally with or without food and at the same time every day.

If you have experienced severe chest pain (unstable angina or myocardial infarction), your doctor may prescribe 300 mg or 600 mg of clopidogrel (1 or 2 300 mg tablets or 4 or 8 75 mg tablets) to be taken once at the beginning of treatment. After that, the recommended dose is one 75 mg clopidogrel tablet per day, as described above.

If you have experienced symptoms of a transient ischemic attack (also known as a transient ischemic attack) or a mild ischemic stroke, your doctor may prescribe 300 mg of clopidogrel (1 300 mg tablet or 4 75 mg tablets) once at the beginning of treatment. After that, the recommended dose is one 75 mg clopidogrel tablet per day, as described above with acetylsalicylic acid for 3 weeks. After that, your doctor will prescribe either clopidogrel alone or acetylsalicylic acid alone.

You should take clopidogrel for the time your doctor continues to prescribe it.

If you take more Clopidogrel cinfamed than you should

Contact your doctor or go to the nearest hospital emergency service, as there is a higher risk of bleeding.

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicological Information Service, phone: 91 562 04 20, indicating the medication and the amount ingested. It is recommended to bring the packaging and the medication leaflet to the healthcare professional.

If you forgot to take Clopidogrel cinfamed

If you forget to take a dose of clopidogrel, but remember before 12 hours have passed since the time you should have taken the medication, take the tablet immediately and the next one at the usual time.

If you forget for more than 12 hours, simply take the next dose at the usual time. Do not take a double dose to compensate for the missed doses.

In the 28-tablet format, you can check the last day you took a Clopidogrel cinfamed tablet by looking at the calendar printed on the blister pack.

If you interrupt treatment with Clopidogrel cinfamed

Do not stop your treatment unless your doctor tells you to. Contact your doctor or pharmacist before stopping this medication.

If you have any other questions about the use of this medication, ask your doctor or pharmacist.

Like all medicines, this medicine may cause side effects, although not everyone will experience them.

Contact your doctor immediately if you experience:

• Fever, signs of infection, or extreme fatigue. These symptoms may be due to a rare decrease in some blood cells.
• Signs of liver problems, such as yellowing of the skin and/or eyes (jaundice), associated or not with bleeding that appears under the skin as red spots and/or confusion (see section 2 “Warnings and precautions”).
• Swelling of the mouth or skin disorders such as hives and itching, blisters on the skin. These may be signs of an allergic reaction.

The most frequent side effect reported with clopidogrelis bleeding..

Bleeding may appear in the stomach or intestine, bruises, hematomas (abnormal bleeding or bruises under the skin), nasal bleeding, blood in urine. Also, a reduced number of cases of: bleeding of the blood vessels of the eyes, intracranial, pulmonary, or joint bleeding have been reported.

If you experience prolonged bleeding while taking clopidogrel

If you cut or get a wound, it is possible that bleeding may take a little longer than usual to stop. This is related to the mechanism of action of the medication, as it prevents the blood's ability to form clots. For minor cuts or wounds, such as cutting during shaving, this usually does not matter. However, if you are concerned about your bleeding, consult your doctor immediately (see section 2 “Warnings and precautions”).

Other side effects include:

Frequent side effects (may affect up to 1 in 10 patients):

Diarrhea, abdominal pain, indigestion, or heartburn.

Less frequent side effects (may affect up to 1 in 100 patients):

Headache, stomach ulcer, vomiting, nausea, constipation, excessive gas in the stomach or intestine, rashes, itching, dizziness, tingling, and numbness.

Rare side effects (may affect up to 1 in 1,000 patients):

Dizziness, breast enlargement in men.

Very rare side effects(may affect up to 1 in 10,000 patients):

Jaundice; severe abdominal pain with or without back pain; fever, difficulty breathing, sometimes associated with cough; generalized allergic reactions,(for example, generalized feeling of heatwithsudden general malaise up to fainting); swelling of the mouth; blisters on the skin, skin allergy; inflammation of the mucous membrane of the mouth (stomatitis); decreased blood pressure; confusion; hallucinations; joint pain; muscle pain;changes in taste or lossof taste of food.

Side effects of unknown frequency(cannot be estimated from available data):

Hypersensitivity reactions with chest or abdominal pain,persistent symptoms of low blood sugar.

Your doctor may also observe changes in your blood or urine test results.

Reporting side effects

If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this prospectus. You can also report them directly through the Spanish System for the Pharmacovigilance of Medicines for Human Use:https://www.notificaram.es. By reporting side effects, you can contribute to providing more information about the safety of this medication.

Keep this medication out of the sight and reach of children.

Do not use this medication after the expiration date that appears on the packaging after CAD. The expiration date is the last day of the month indicated.

This medication does not require special conditions for conservation.

Medications should not be disposed of through drains or trash. Dispose of packaging and medications you no longer need at the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of packaging and medications you no longer need. By doing so, you will help protect the environment.

Clopidogrel cinfamed Composition

• The active ingredient is clopidogrel. Each tablet contains 75 mg of clopidogrel (as hydrogen sulfate).
• The other components are isomalta (E-953), hydroxypropylcellulose, hydroxypropylcellulose with low substitution, saccharose stearate in the tablet core and hypromellose (E-464), macrogol 400, titanium dioxide (E-171), iron oxide red (E-172) in the tablet coating.

Appearance of the product and contents of the packaging

Clopidogrel cinfamed tablets are pink, round, with biconvex faces.

They are presented in cardboard boxes with 28, 50 and 84 coated tablets, conditioned in aluminum/aluminum blisters.

Holder of the marketing authorization and responsible for manufacturing

Holderof the marketing authorization

Cinfa Laboratories, S.A.

Carretera Olaz-Chipi, 10. Industrial Estate Areta

31620 Huarte (Navarra) - Spain

Responsible for manufacturing

Neuraxpharm Pharmaceuticals, S.L.

Avda. Barcelona 69

08970 Sant Joan Despí

Barcelona – Spain

Last review date of this leaflet:July 2023

Detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/.

You can access detailed and updated information on this medicine by scanning with your smartphone the QR code included in the leaflet and packaging. You can also access this information at the following internet address:https://cima.aemps.es/cima/dochtml/p/71622/P_71622.html

QR code to:https://cima.aemps.es/cima/dochtml/p/71622/P_71622.html