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CADIX 75MG FILM-COATED TABLETS

Active substance(s): CLOPIDOGREL BESILATE

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Package leaflet: Information for the user

Cadix 75 mg film-coated tablets
Clopidogrel

Read all of this leaflet carefully before you start taking this medicine because it
contains important information for you.
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 get any side effects, talk to your doctor or pharmacist. This includes any
possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:
1.
What Cadix is and what it is used for
2.
What you need to know before you take Cadix
3.
How to take Cadix
4.
Possible side effects
5.
How to store Cadix
6.
Contents of the pack and other information

1.

What Cadix is and what it is used for

Cadix 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).
Cadix 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 Cadix 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 should also be given acetylsalicylic acid (a substance

-

2.

present in many medicines used to relieve pain and lower fever as well as to
prevent blood clotting) by your doctor.
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 Cadix and acetylsalicylic acid for this
condition. Your doctor should have prescribed Cadix plus acetylsalicylic acid if
you cannot take ‘oral anticoagulants’ and you do not have a risk of major
bleeding.
What you need to know before you take Cadix

Do not take Cadix

if you are allergic (hypersensitive) to clopidogrel or any of the 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 Cadix.
Warnings and precautions
If any of the situations mentioned below apply to you, you should tell your doctor before
taking Cadix:

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 (ischaemic 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.
While you are taking Cadix:

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.
You should tell your doctor or pharmacist if you notice any side effect not listed
in section 4 ‘Possible side effects’ or if you notice that a side effect gets serious.

Children and adolescents
Do not give this medicine to children because it does not work.
Other medicines and Cadix
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other
medicines.
Some other medicines may influence the use of Cadix or vice versa.
You should specifically tell your doctor if you take
- medicines that may increase your risk of bleeding such as:
o oral anticoagulants, medicines used to reduce blood clotting,
o a non-steroidal anti-inflammatory medicine, usually used to treat painful and/or
inflammatory conditions of muscle or joints,
o heparin or any other injectable medicine used to reduce blood clotting,
o ticlopidine, other antiplatelet agent,
o a selective serotonin reuptake inhibitor (including but not restricted to fluoxetine or
fluvoxamine), medicines usually used to treat depression,
- omeprazole or esomeprazole medicines to treat upset stomach,
- fluconazole, or voriconazole, medicines to treat fungal infections,
- efavirenz, a medicine to treat HIV (human immunodeficiency virus) infections,
- carbamazepine, or oxcarbazepine, medicines to treat some forms of epilepsy

-

moclobemide, medicine to treat depression
repaglinide, medicine to treat diabetes,
paclitaxel, medicine to treat cancer.

If you have experienced severe chest pain (unstable angina or heart attack), you may be
prescribed Cadix 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.
Cadix with food and drink
Cadix may be taken with or without food.
Pregnancy and breastfeeding
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 Cadix. If you become pregnant while taking Cadix, consult your doctor
immediately as it is recommended not to take clopidogrel while you are pregnant.

You should not breastfeed while taking this medicine.
If you are breastfeeding or planning to breastfeed, talk to your doctor before taking this medicine.
Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines
Cadix is unlikely to affect your ability to drive or to use machines.
Cadix contains lactose
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.
Cadix contains soya oil
If you are allergic to peanut or soya, do not take this medicine.

3.

How to take Cadix

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 Cadix 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 of Cadix (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 Cadix per day as
described above.
You should take Cadix for as long as your doctor continues to prescribe it.
If you take more Cadix than you should
Contact your doctor or the nearest hospital emergency department because of the
increased risk of bleeding.
If you forget to take Cadix
If you forget to take a dose of Cadix, 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 28 56, 84 and 98 tablets pack sizes, you can check the day on which you last took
a tablet of Cadix by referring to the calendar printed on the blister.

If you stop taking Cadix
Do not stop the treatment unless your doctor tells you so. Contact your doctor or pharmacist
before stopping.

If you have any further questions on the use of this medicine, ask your doctor or
pharmacist.

4.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets
them.
Contact your doctor immediately if you experience:
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.

The most common side effect reported with Cadix is bleeding. Bleeding may occur as
bleeding in the stomach or bowels, bruising, haematoma (unusual bleeding or bruising under the
skin), nose bleed, blood in the urine. In a small number of cases, bleeding in the eye, inside the
head, the lung or the joints has also been reported.
If you experience prolonged bleeding when taking Cadix
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’).
Other side effects include:
Common: may affect up to 1 in 10 people
Diarrhoea, abdominal pain, indigestion or heartburn.
Uncommon: 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: may affect up to 1 in 1,000 people
Vertigo, enlarged breasts in males.
Very rare: 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 of food.
In addition, your doctor may identify changes in your blood or urine test results.
Reporting of side effects
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 Yellow Card
Scheme at: www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more information on the safety of this medicine.

5.

How to store Cadix

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 blister,
after EXP. The expiry date refers to the last day of that month.
This medicinal product 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
protect the environment.

6.

Contents of the pack and other information

What Cadix contains
The active substance is clopidogrel as besilate. Each tablet contains 75 mg of
clopidogrel.
The other ingredients are (see section 2 ‘Cadix contains lactose’ and ‘cadix
contains soya oil’):
lactose anhydrous, microcrystalline cellulose, crospovidone Type A, glycerol
dibehenate, talc, polyvinyl alcohol, macrogol 3350, lecithin (soya oil) (E322),
titanium dioxide (E171), iron oxide red (E172).
What Cadix 75 mg film-coated tablets look like and contents of the pack
Film-coated tablet.
Pink 9 mm round, biconvex, film-coated tablet, engraved with “II” on one face.
Pack sizes:
Blisters: 20, 28, 30, 50, 56, 60, 84, 98 and 100 tablets.

Tablet containers: 100 tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Aptil Pharma Limited
Unit 4, Charlwood Court,
County Oak Way,
Crawley,
West Sussex
RH11 7XA
United Kingdom

Manufacturer
Actavis Ltd
B16, Bulebel Industrial Estate, Zejtun ZTN 08
Malta
Or
Actavis UK Limited
Whiddon Valley, Barnstaple, North Devon, EX32 8NS

This leaflet was last revised in 06/2016

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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