2010/12/12

Acecardol

Release form, composition and packing

Tablets, enteric-coated cover white or almost white, round, biconvex. 1 tab. acetylsalicylic acid 50 mg - - 100 mg - - 300 mg.

Other ingredients: povidone, corn starch, lactose, microcrystalline cellulose, magnesium stearate, talc, atsetilftaliltsellyuloza, titanium dioxide, castor oil.

Clinico-pharmacological group: NSAID. Antiaggregant.

Pharmacological action

Nonsteroidal anti-inflammatory drug (NSAID). The mechanism of action of aspirin is irreversible inhibition of COX, as a result of this blockade is the synthesis of thromboxane A2 and inhibited platelet aggregation.

It is believed that aspirin has other mechanisms of suppression of platelet aggregation, which expands the scope of its application in various vascular diseases. Aspirin also has anti-inflammatory, analgesic, antipyretic action.

Pharmacokinetics

Suction

After oral acetylsalicylic acid absorbed from the upper part of the small intestine. Cmax plasma levels observed after an average of 3 hours after taking the drug inside.

Metabolism

Acetylsalicylic acid undergoes partial metabolism in the liver with formation of less active metabolites.

Breeding

Excreted by the kidneys as unchanged or as metabolites; T1 / 2 of acetylsalicylic acid is about 15 minutes, metabolites - about 3 hours

Statement
prevention of acute myocardial infarction in the presence of risk factors (eg, diabetes mellitus, hyperlipidemia, hypertension, obesity, smoking, older age) and re-infarction;
prevention of recurrent myocardial infarction;
unstable angina;
prevention of stroke (including patients with transient ischemic attack);
prevention of transient ischemic attacks;
prevention of thromboembolism after surgery and invasive procedures on vessels (eg, coronary artery bypass surgery, carotid endarterectomy, arterio-venous bypass, angioplasty of the carotid arteries);
prevention of deep vein thrombosis and pulmonary embolism and its branches (eg, prolonged immobilization as a result of a large surgical intervention).

Dosing regimen

Tablets, taken orally, before eating, drinking plenty of fluids. The drug is designed for prolonged use. The duration of therapy is determined by your doctor.

Prophylaxis for suspected acute myocardial infarction: 100-200 mg / day or 300 mg a day (the first pill must be chewed for faster absorption). Prevention first mooted acute myocardial infarction in the presence of risk factors: 100 mg or 300 mg every other day.

Prevention of recurrent myocardial infarction, unstable angina, prevention of stroke and transient ischemic attacks, prevention of thromboembolic complications after surgery or invasive investigations: 100-300 mg / day.

Prevention of deep vein thrombosis and pulmonary embolism and its branches: 100-200 mg / day or 300 mg every other day.

Side effect

Allergic reactions: urticaria, angioedema, anaphylactic reaction.
From the digestive system: nausea, heartburn, vomiting, abdominal pain, ulceration of the mucous membrane of the stomach and duodenum (including perforated), gastrointestinal bleeding, elevated liver enzymes.
With the respiratory system: bronchospasm.
From the hemopoietic system: increased bleeding, rarely - anemia.
CNS: dizziness, ringing in the ears.

Contraindications
erosive and ulcerative lesions of the gastrointestinal tract;
gastrointestinal bleeding;
hemorrhagic diathesis;
Bronchial asthma induced by intake of salicylates and NSAIDs, Fernand-Widal triad (a combination of asthma, recurrent polyposis of the nose and paranasal sinuses and the intolerance of ASA);
combined use with methotrexate 15 mg / week. and more;
I and III trimesters of pregnancy;
Lactation (breastfeeding);
age 18;
Hypersensitivity to acetylsalicylic acid and / or other drug compounds;
hypersensitivity to other NSAIDs.

Caution should be used drug to treat gout, hyperuricemia, with guidance on the history of gastrointestinal ulceration or gastrointestinal bleeding, renal and liver failure, asthma, chronic respiratory disease, hay fever, nasal polyposis, allergic reactions to other drugs in the II trimester of pregnancy, in combination with methotrexate at a dose of less than 15 mg / week., with a deficit of vitamin K deficiency of glucose-6-phosphate dehydrogenase.

Pregnancy and lactation

The use of salicylates in high doses in the I trimester of pregnancy is associated with an increased frequency of fetal defects (split the sky, heart defects).

In the II trimester salicylate may be given only on the basis of strict evaluation of the expected benefit of therapy for the mother and the potential risk to the fetus.

In the III trimester of pregnancy salicylates in high doses (300 mg / day) cause inhibition of labor, premature closure of the ductus arteriosus in the fetus, increased bleeding in the mother and fetus, and the appointment immediately before delivery may cause intracranial hemorrhage, especially in preterm infants.

Appointment of salicylates (including aspirin) in the III trimester of pregnancy is contraindicated. Salicylates and their metabolites in small amounts are excreted in breast milk. Incidental taking of salicylates during lactation is not accompanied by the development of adverse reactions in children and does not require stopping breastfeeding. However, prolonged use of a drug or appointing him to a high dose of breast-feeding should be stopped immediately.

Use in hepatic dysfunction

Be wary of with liver failure.

Use in renal impairment

Be wary of renal failure.

Cautions

The patient may take medication after a doctor's prescription. Aspirin can provoke bronchospasm and cause bronchial asthma and other hypersensitivity reactions. Risk factors are the presence of asthma history, hay fever, nasal polyposis, chronic respiratory system diseases, and allergic reactions to other drugs (eg, skin reactions, pruritus, urticaria). Aspirin can cause bleeding of varying severity during and after surgery.

The combination of aspirin with anticoagulants, thrombolytic and antiplatelet drugs is accompanied by an increased risk of bleeding. Aspirin in low doses can provoke the development of gout in susceptible individuals (who have a decreased excretion of uric acid). Combined therapy with acetylsalicylic acid and methotrexate is accompanied by a high incidence of side effects of hematopoiesis. Aspirin in high doses has a hypoglycaemic effect, which must be borne in mind when assigning it to patients with diabetes receiving hypoglycemic medications.

When combined appointment of the SCS and salicylates should be remembered that during treatment the level of salicylate in the blood is reduced, and after withdrawal of GCS possible overdose of salicylates. Not recommended combination of acetylsalicylic acid and ibuprofen, as the latter affects the beneficial effect Atsekardola on life expectancy. Excess doses of aspirin carries a risk of gastrointestinal bleeding. Overdose is especially dangerous in elderly patients.

In combination with acetylsalicylic acid and alcohol increased the risk of damaging the mucous membrane of the gastrointestinal tract and prolongation in bleeding time.

Effects on ability to drive vehicles and management mechanisms

Is not observed its influence on ability to drive vehicles and management mechanisms.

Overdose

Symptoms of an overdose of moderate severity: nausea, vomiting, tinnitus, hearing loss, dizziness, confusion.

Treatment: a reduction in dose. Symptoms of severe overdose: fever, hyperventilation, ketoacidosis, respiratory alkalosis, coma, cardiovascular and respiratory insufficiency, severe hypoglycemia.

Treatment: immediate hospitalization in a specialized department for emergency treatment - gastric lavage, determination of the acid-alkaline balance, alkaline and forced alkaline diuresis, hemodialysis, the introduction of solutions, activated charcoal, symptomatic therapy.

During alkaline diuresis is necessary to achieve pH values between 7.5 and 8. Forced alkaline diuresis should be undertaken when the concentration of salicylate in plasma is more than 500 mg / L (3.6 mg / dL) in adults and 300 mg / L (2.2 mg / dL) in children.

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