Coronary heart disease and any clinical situations where it is advisable to inhibit platelet aggregation: prevention of myocardial infarction in high-risk individuals; recent myocardial infarction or suspected acute myocardial infarction; unstable coronary disease; secondary prevention in people after myocardial infarction; condition after coronary artery bypass grafts, coronary angioplasty; prevention of attacks of transient cerebral ischemia (TIA) and ischemic stroke in patients with TIA; after ischemic stroke in patients with TIA; in people with obliterative atherosclerosis of peripheral arteries; prevention of coronary thrombosis in patients with multiple risk factors; prevention of venous thrombosis and embolism in long-term immobilized patients, eg after major surgery as a supplement to other methods of prophylaxis.
Composition:
1 tabl enteric contains 75 mg or 150 mg of acetylsalicylic acid.
Action:
Acetylsalicylic acid is an irreversible inhibitor of cyclooxygenase, an enzyme that synthesizes prostaglandins from arachidonic acid. This mechanism is responsible for anti-inflammatory, antipyretic and analgesic effects. The most important effect of Acetylsalicylic acid at a dose of 75-150 mg is inhibition of thromboxane A synthesis2, a compound that increases platelet aggregation and shrinking blood vessels. After absorption, acetylsalicylic acid is rapidly metabolised to salicylic acid, which is approximately 90% bound to plasma proteins and is partially eliminated unchanged and partly as metabolites.
Contraindications:
Hypersensitivity to the preparation ingredients or other salicylates. Hemorrhagic diathesis. Active stomach ulcer and / or duodenal ulcer. Severe renal or hepatic failure. Robberies A history of aspirin-induced asthma caused by the administration of salicylates or substances with similar effects, especially NSAIDs. Co-administration with Methotrexate at doses ≥ 15mg per week. Third trimester of pregnancy. Do not use in children under 12 years of viral infection (risk of Reye's syndrome). Severe heart failure (Table 150 mg).
Precautions:
A significant part of the warnings given below concern acetylsalicylic acid at doses of 1-3 g / day and these reactions are unlikely at low doses. Use with caution in case of hypersensitivity to NSAIDs, antirheumatic drugs or other allergens (use only after consideration of the risk / benefit ratio), when co-administered with anticoagulants or Ibuprofen, in patients with impaired liver or kidney function, peptic ulceration or gastrointestinal bleeding in interview, G-6-PD deficiency. Table. 75 mg should be used with caution in patients with severe heart failure. Carefully use in patients with bronchial asthma, chronic respiratory disease, hay fever with nasal polyps and in patients with allergic reactions (eg skin reactions, pruritus, urticaria) to other substances. In patients with an increased bleeding tendency (haemophilia, vitamin K deficiency) taking anticoagulants (eg coumarin derivatives or Heparin - with the exception of heparin in low doses), the use of acetylsalicylic acid should be considered taking into account the risk / benefit ratio. Do not give acetylsalicylic acid 5 days before planned surgery, especially ophthalmologic and otologic. Acetylsalicylic acid, even in small doses, inhibits the excretion of uric acid. In patients with reduced uric acid excretion, it can trigger a gout attack.
Pregnancy and lactation:
The preparation should not be used in women in the I and II trimester of pregnancy, unless it is absolutely necessary (increased risk of miscarriage, congenital heart defects and gastroschisis). Acetylsalicylic acid in doses of 100 mg per day or more is contraindicated in the third trimester of pregnancy. Salicylic acid and its metabolites are excreted in breast milk in small amounts.During short-term use of salicylates by mothers, no adverse reactions were found in breastfed infants, interruption of breastfeeding is generally unnecessary. If you regularly take high doses of acetylsalicylic acid, breast-feeding should be stopped earlier.
Side effects:
Common: heartburn, nausea, vomiting and abdominal pain. The following may occur: increased risk of bleeding (perioperative hemorrhage, haemorrhage, epistaxis, bleeding of the genitourinary tract, bleeding of the gums), prolonged bleeding time, hypersensitivity reactions (including asthma, skin reactions, rash, urticaria, edema, pruritus), cardiac and respiratory disorders, dizziness and tinnitus. Rarely: inflammation of the stomach and intestines, peptic ulcer of the stomach and / or duodenum (very rarely haemorrhages and perforations), transient abnormal liver function with increased transaminases. Very rare: severe allergic reactions (including anaphylactic shock), renal dysfunction, hypoglycaemia. Rarely or very rarely: gastrointestinal haemorrhage and cerebral haemorrhage (especially in patients with uncontrolled hypertension and / or concomitant administration of hemostatic agents that may potentially be life-threatening).
Dosage:
Orally. Prevention of myocardial infarction in high-risk patients, unstable coronary heart disease, secondary prevention in patients after myocardial infarction, status after coronary artery bypass grafts, coronary angioplasty, prevention of transient cerebral ischemic attacks (TIA) and ischemic stroke in patients with TIA after follow-up of ischemic stroke in patients with TIA, in patients with peripheral arterial atherosclerosis: 75 or 150 mg per day. Fresh myocardial infarction or suspected acute myocardial infarction (gastro-resistant tablets may be used when ASA is not available in uncoated tablets): 300 mg once, enteric should be thoroughly broken up to speed up absorption. Prevention of coronary thrombosis in patients with multiple risk factors, prevention of venous thrombosis and embolism in long-term immobilized patients, eg after major surgery as a supplement to other methods of prophylaxis: 75-150 mg per day. The tablets should be taken after a meal, swallowed whole.
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