Ecosprin Gold Forte 20(L)

INTRODUCTION ABOUT ECOSPRIN GOLD FORTE 20(L)

ECOSPRIN GOLD FORTE 20(L) is a combination of Aspirin, Clopidogrel and Atorvastatin which belongs to the group of medicines called Antiplatelets and HMG-CoA reductase inhibitors respectively. ECOSPRIN GOLD FORTE 20(L) is indicated in the management of patients with percutaneous coronary intervention (PCI) and myocardial infarction (also known as heart attack which occurs when blood flow to the heart muscle is blocked or interrupted).

Percutaneous coronary intervention (also known as angioplasty with stent) is a non-surgical procedure used among patients with heart problems (such as cardiogenic shock, acute severe heart failure or ischemic symptoms) to unclog blood vessels in the heart that have been narrowed by plaque buildup by placing a stent.        

Along management with ECOSPRIN GOLD FORTE 20(L) follow a healthy low-fat diet as advised by your doctor to achieve better results. Avoid drinking alcohol during management with ECOSPRIN GOLD FORTE 20(L), as it could increase the risk of bleeding in the gastrointestinal tract.    

ECOSPRIN GOLD FORTE 20(L) is not recommended for use in patients with severe liver or kidney disease, recent ischemic stroke, gout, active or recurrent peptic ulcer with or without gastrointestinal bleeding and bleeding disorders (such as bleeding in the brain or hemophilia).

ECOSPRIN GOLD FORTE 20(L) is generally not recommended for use in pregnant or breastfeeding women and in children or adolescents (aged below 18 years). It should be used with caution in elderly patients (aged 70 years or above) because of increased risk of gastro-intestinal bleeding.

The most common side effects of taking ECOSPRIN GOLD FORTE 20(L) are increased bleeding tendency, nausea, indigestion, diarrhea, stomach pain, constipation, muscle pain, dizziness and headache. Consult your doctor if any of these side effects worsen.

USES OF ECOSPRIN GOLD FORTE 20(L)

• Manage patients with percutaneous coronary intervention (PCI) and myocardial infarction

HOW ECOSPRIN GOLD FORTE 20(L) WORKS

ECOSPRIN GOLD FORTE 20(L) effectively improves cardiac function and reduces the risk of heart problems, where clopidogrel acts by inhibiting platelet aggregation in the coronary arteries, aspirin acts by blocking the actions of an enzyme called cyclo-oxygenase 1 which is believed to be responsible for catalyzing the synthesis of platelets and atorvastatin acts by inhibiting the action of an enzyme called HMG-CoA reductase, which is required to catalyze the formation of cholesterol, thus managing clot or plaque formation in the coronary arteries leading to an uninterrupted supply of oxygen and blood to the heart.

DIRECTIONS FOR USE

Take ECOSPRIN GOLD FORTE 20(L) as advised by your physician. Swallow ECOSPRIN GOLD FORTE 20(L) with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.

SIDE EFFECTS OF ECOSPRIN GOLD FORTE 20(L)

HOW TO MANAGE SIDE EFFECTS

Nausea:

Try to take ECOSPRIN GOLD FORTE 20(L) with or just after a meal or a snack. Stick to simple meals. Avoid eating oil rich or spicy foods. Consult your doctor if the symptom does not improve.

Diarrhea:

Drink lot of fluids such as water or fruit juices to keep yourself hydrated. Avoid taking any medicine on your own for managing diarrhea. Consult your doctor if the symptom does not improve.

Headache:  

Rest and relax. Drink plenty of fluids such as water or electrolytes. Apply a pain-relieving balm on the forehead if required. Do not consume too much of alcohol. Consult your doctor if the symptom does not improve.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines while you are feeling dizzy. Do not consume too much of alcohol, as it can aggravate your dizziness. Consult your doctor if the symptom does not improve.

Constipation: 

Eat fiber rich foods such as fresh fruits, vegetables, cereals and drink plenty of water. Try to exercise more regularly. Consult your doctor if the symptom does not improve.

Stomach pain:

Rest and relax. Eat and drink slowly or try to have smaller and frequent meals. Keep a heat pad on your stomach. Do not self-manage on your own and consult your doctor if the symptom does not improve.

WARNING & PRECAUTIONS

PREGNANCY

ECOSPRIN GOLD FORTE 20(L) is not recommended for use in pregnant women. However, consult your doctor before taking ECOSPRIN GOLD FORTE 20(L). Women of child-bearing potential should use suitable contraceptive method to avoid pregnancy while taking ECOSPRIN GOLD FORTE 20(L).

BREASTFEEDING

ECOSPRIN GOLD FORTE 20(L) is not recommended for use in breastfeeding women. Consult your doctor before taking ECOSPRIN GOLD FORTE 20(L).

DRIVING AND USING MACHINES

ECOSPRIN GOLD FORTE 20(L) does not impair your ability to drive or operate any machines. Consult your doctor before taking ECOSPRIN GOLD FORTE 20(L).

ALCOHOL

Avoid consumption of alcohol while taking ECOSPRIN GOLD FORTE 20(L) as it may increase the risk of stomach bleeding and aggravate your existing condition. Consult your doctor before taking ECOSPRIN GOLD FORTE 20(L).

KIDNEY

ECOSPRIN GOLD FORTE 20(L) is not recommended for use in patients having severe kidney disease and should be used with caution in patients with kidney impairment. Consult your doctor before taking ECOSPRIN GOLD FORTE 20(L). 

LIVER

ECOSPRIN GOLD FORTE 20(L) is not recommended for use in patients having severe liver impairment and active liver disease (including persistent elevations of serum transaminases exceeding three times the upper limit) and should be used with caution in patients with liver impairment. Consult your doctor before taking ECOSPRIN GOLD FORTE 20(L).

ALLERGY

Do not take ECOSPRIN GOLD FORTE 20(L) if you are allergic to Clopidogrel, Atorvastatin, Aspirin or Prostaglandin synthetase inhibitors (Ex. naproxen, ibuprofen, mefenamic acid and indomethacin).

LUNGS

ECOSPRIN GOLD FORTE 20(L) should be used with caution in patients with interstitial lung disease or other respiratory problems such as hay fever, asthma or chronic respiratory diseases due to increased risk of bronchospasm and asthma attacks. Consult your doctor before taking ECOSPRIN GOLD FORTE 20(L).

HEART DISEASE

ECOSPRIN GOLD FORTE 20(L) is not recommended for use in patients with recent ischemic stroke and should be used with caution in patients with high blood pressure. Consult your doctor before taking ECOSPRIN GOLD FORTE 20(L).

INTERACTIONS

A. Drug-Drug interactions:

Before taking ECOSPRIN GOLD FORTE 20(L) inform to your doctor, if you are taking any of these medicines:

• other anticoagulants (used for blood thinning) Ex. warfarin, coumarin, heparin, phenindione
• other cholesterol-lowering medicines (Ex. clofibrate, gemfibrozil, fenofibrate, ezetimibe, colestipol)
• other non-steroidal anti-inflammatory drugs (Ex. ibuprofen, indomethacin)
• medicines used to manage HIV infection (Ex. glecaprevir/pibrentasvir, delavirdine, ritonavir with lopinavir and/or atazanavir or sofosbuvir with velpatasvir and voxilaprevir)
• st. john's wort (herbal medicine), selective serotonin reuptake inhibitors (used to manage depression) Ex. fluoxetine, sertraline, paroxetine or fluvoxamine 
• medicines used to manage stomach ulcers such as antacids (Ex. aluminium hydroxide, magnesium hydroxide) and proton-pump inhibitors (Ex. omeprazole or esomeprazole)
• other medicines used during percutaneous coronary intervention (Ex. abciximab, eptifibatide and tirofiban)
• antibiotics (used to manage bacterial infections) such as macrolides (Ex. azithromycin, telithromycin, erythromycin, roxithromycin, and clarithromycin) or fusidic acid
• medicines used to manage epilepsy (Ex. phenytoin, valproic acid, stiripentol)
• medicines used to manage diabetes (Ex. insulin, glipizide, glimepiride)
• ciclosporin or tacrolimus (used to manage graft rejection or manage auto-immune disease)
• azole antifungal agents (used to manage fungal infection) Ex. clotrimazole, fluconazole
• methotrexate (used to manage cancer or other auto-immune diseases)
• lithium (used to manage mental illness)
• corticosteroids (used to manage pain and inflammation) Ex. prednisolone, dexamethasone
• acetazolamide (used to manage or manage altitude sickness)
• mifepristone (used to manage pregnancy)
• metoclopramide (used to manage vomiting)
• deferasirox (used to manage iron overload)
• zafirlukst (used to manage asthmatic symptoms)
• digoxin, amiodarone and verapamil (used to manage abnormal heart rhythm)
• angiotensin-converting enzyme (ACE) inhibitors such as captopril, enalapril and diuretics such as hydrochlorothiazide (used to manage high blood pressure)
• rifampin (used to manage tuberculosis)
• colchicine, probenecid or sulfinpyrazone (used to manage gout)

B. Drug - Food interaction:

During management with ECOSPRIN GOLD FORTE 20(L), do not take more than one or two small glasses of grapefruit juice per day because large quantities of grapefruit juice can alter the effects of this medicine.

Overdosage:

If you or anyone else accidentally take too much of ECOSPRIN GOLD FORTE 20(L), contact your doctor immediately or go to a hospital straight away. Overdosage symptoms of ECOSPRIN GOLD FORTE 20(L) includes increased bleeding, confusion, disorientation, coma, convulsions, vomiting (sometimes with blood), increased body temperature, low blood sugar levels, tinnitus (ringing in the ears), vertigo (spinning sensation), sweating, warm extremities with bounding pulses, kidney failure, increased respiratory rate and hyperventilation. 

SYNOPSIS

MORE INFORMATION

• Keep ECOSPRIN GOLD FORTE 20(L) out of reach of children
• Store ECOSPRIN GOLD FORTE 20(L) at room temperature

FAQs ABOUT ECOSPRIN GOLD FORTE 20(L)

Q: Can I try to get pregnant while taking ECOSPRIN GOLD FORTE 20(L)?

A: No, ECOSPRIN GOLD FORTE 20(L) should be discontinued from use if you are trying to get pregnant because it may cause severe abnormalities to the growing fetus. Also, it is advised that women of child-bearing potential should use suitable contraceptive method to avoid pregnancy while taking ECOSPRIN GOLD FORTE 20(L).

Q: Can I consume alcohol while taking ECOSPRIN GOLD FORTE 20(L)?

A: No, avoid consumption of alcohol while taking ECOSPRIN GOLD FORTE 20(L) as it could aggravate your existing disease condition and increase the risk of bleeding. Before taking ECOSPRIN GOLD FORTE 20(L) inform your doctor if you are alcoholic.  

Q: Can ECOSPRIN GOLD FORTE 20(L) cause dizziness?

A: Yes, ECOSPRIN GOLD FORTE 20(L) may cause dizziness in some people. To manage this effect, try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines while you are feeling dizzy. Do not consume too much of alcohol, as it can aggravate your dizziness. Consult your doctor if the symptom does not improve.

Q: What to do if I forget to take ECOSPRIN GOLD FORTE 20(L)?

A: You should take ECOSPRIN GOLD FORTE 20(L) immediately when you remember. If it is time for your next dose of ECOSPRIN GOLD FORTE 20(L) skip the dose and follow your regular dose schedule. Do not double the dose of ECOSPRIN GOLD FORTE 20(L) to match up your missed dose.  

Q: Is ECOSPRIN GOLD FORTE 20(L) safe to use in patients with liver disease?

A: ECOSPRIN GOLD FORTE 20(L) is not recommended for use in patients with severe liver impairment and active liver disease (including persistent elevations of liver enzymes exceeding three times the upper limit) and should be used with caution in patients with liver impairment. Your doctor will regularly monitor your liver function tests during management with ECOSPRIN GOLD FORTE 20(L) to manage the risk of liver damage.  

Q: Can ECOSPRIN GOLD FORTE 20(L) be used in elderly patients?

A: ECOSPRIN GOLD FORTE 20(L) should be used with caution in elderly patients (aged 70 years and above) because of increased risk of gastro-intestinal bleeding and perforation when used for prolonged duration (if prolonged therapy is essential, patients should be reviewed regularly). Consult your doctor before taking ECOSPRIN GOLD FORTE 20(L).

REFERENCES

1. KD. Tripathi. Drugs Affecting Coagulation, Bleeding and Thrombosis and Hypolipidemic Drugs and Plasma Expanders. Essentials of medical pharmacology. Seventh edition. 2013. Page – 629-633 & 636-638

2. Jeffery I. Weitz. Blood coagulation and Anticoagulant, Fibrinolytic and Antiplatelet Drugs. Thomas P. Bersot. Drug therapy for hypercholesterolemia and dyslipidemia. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 868-870 & 892-898

3. Ospedale Misericordia e Dolce. Atorvastatin and Clopidogrel High Dose in Stable Patients With Residual High Platelet Activity (ACHIDO). NIH U.S. National Library of Medicine ClinicalTrials.gov. [Revised in January 2012] [Accessed on 7th October 2021] https://clinicaltrials.gov/ct2/show/NCT01335048

4. Hospital do Coracao. Statins Evaluation in Coronary Procedures and Revascularization Trial (SECURE-PCI). NIH U.S. National Library of Medicine ClinicalTrials.gov. [Revised in June 2019] [Accessed on 7th October 2021] https://clinicaltrials.gov/ct2/show/NCT01448642

5. Goeng Bae Kim, Jeong Kyung Kim, Sul Park, Jae Jin Jeong, Hyung Sik Yoon, Sang Hun Ko, Jae Ee Ko, Soo Jin Park, Seon Woo Nam, Jae Hwan Lee and Min Soo Hyon. Effect of Atorvastatin and Clopidogrel Co-Administration After Coronary Stenting in Korean Patients With Stable Angina. NCBI; PMC US National Library of Medicine, National Institute of Health. January 2011. [Accessed on 7th October 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3040400/

6. Rolf P Kreutz, Jeffrey A Breall Anjan Sinha, Elisabeth von der Lohe, Richard J Kovacs and David A Flockhart. Simultaneous administration of high-dose atorvastatin and clopidogrel does not interfere with platelet inhibition during percutaneous coronary intervention. NCBI; PMC US National Library of Medicine, National Institute of Health. June 2016. [Accessed on 7th October 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4902146/

7. HamidReza Pourhosseini , Reza Lashkari, Arya Aminorroaya, Danesh Soltani, Arash Jalali, Masih Tajdini. Effects of high dose atorvastatin before elective percutaneous coronary intervention on highly sensitive troponin T and one year major cardiovascular events; a randomized clinical trial. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov. January 2019 [Accessed on 7th October 2021] https://pubmed.ncbi.nlm.nih.gov/30671535/

8. Torrent Pharmaceuticals Ltd. Deplatt-CV. Torrentian.com. [Revised in July 2019]. [Accessed on 7th October 2021] https://www.torrentian.com/pisheet/Upload/PI_Sheet/2538.pdf

9. Torrent Pharmaceuticals Ltd. Deplatt-CV 20 Forte (Clopidogrel, Atorvastatin and Aspirin Capsules). Torrentian.com. [Revised in July 2019] [Accessed on 7th October 2021]  https://www.torrentian.com/pisheet/Upload/PI_Sheet/2741.pdf

USEFUL DIAGNOSTIC TESTS

• Kidney function test
• Liver function test
• Complete blood count

AUTHOR DETAILS

Written By Dr. R. Dinesh John Rajkumar - Pharm.D

Last updated on 23 Jan 2023 | 06:15 PM(IST)