Aspicard
Aspicard: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Aspicard
ATX code: B01AC06
Active ingredient: acetylsalicylic acid (Acetylsalicylic acid)
Producer: JSC Borisov Plant of Medical Products (JSC "BZMP") (Republic of Belarus)
Description and photo update: 2019-09-07
Aspicard is a non-steroidal anti-inflammatory drug (NSAID) with antiaggregatory, anti-inflammatory, analgesic and antipyretic action.
Release form and composition
The drug is available in the form of enteric tablets, film-coated: round, biconvex, pink (10 pcs. In blisters, in a cardboard box 2, 3 or 5 packs and instructions for use of Aspikard).
1 tablet contains:
- active substance: acetylsalicylic acid in terms of 100% - 75 mg or 150 mg;
- auxiliary components: stearic acid, partially pregelatinized corn starch, starch 1500, microcrystalline cellulose;
- composition of the film shell: Opadry colorless (hypromellose, triacetin, talc), Acryl-From pink [ethyl acrylate and methacrylic acid copolymer (1 ÷ 1), triethyl citrate, colloidal anhydrous silicon dioxide, sodium lauryl sulfate, sodium carbonate, talc, coloring pigment - titanium, iron oxide red (in the form of a premix with talc (1 ÷ 3) and iron oxide yellow].
Pharmacological properties
Pharmacodynamics
Aspicardium is an NSAID, the active substance of which is acetylsalicylic acid. It has antiaggregatory, anti-inflammatory, analgesic and antipyretic effects.
The antipyretic effect is due to the property of acetylsalicylic acid to induce an indiscriminate inhibition of the activity of cyclooxygenase-1 and -2 (COX1 and COX2), which regulate the synthesis of prostaglandins (PG), providing the formation of edema and increasing the pain response (hyperalgesia). A decrease in the content of GHGs, mainly PGE 1, in the center of thermoregulation promotes vasodilation of the skin and an increase in sweating, which leads to a decrease in body temperature.
The analgesic effect of Aspicard is due to its central and peripheral action.
The antiplatelet effect is achieved by suppressing the synthesis of thromboxane A 2 in platelets. After a single dose, the drug maintains a decrease in aggregation, platelet adhesion and thrombus formation for 7 days. The antiplatelet effect in unstable angina pectoris reduces the risk of myocardial infarction and mortality; it is more pronounced in men than in women. Taking the drug is effective for the primary prevention of diseases of the cardiovascular system, mainly myocardial infarction in men over the age of 40. Aspicardium is also indicated for the secondary prevention of myocardial infarction.
Suppression of prothrombin synthesis and an increase in prothrombin time is achieved while taking 6 g of the drug per day or more.
Acetylsalicylic acid potentiates an increase in the fibrinolytic activity of plasma and a decrease in the concentration of vitamin K-dependent blood coagulation factors (II, VII, IX, X). During surgical operations, taking the drug contributes to an increase in hemorrhagic complications, while anticoagulant therapy increases the risk of bleeding.
High doses of Aspicard interfere with the reabsorption of uric acid in the renal tubules and stimulate its excretion.
The consequence of blocking COX1 in the gastric mucosa is the inhibition of gastroprotective prostaglandins, causing ulceration of the mucous membrane and subsequent bleeding. Enteric-coated dosage forms containing buffering agents or special effervescent tablets are less irritating to the mucous membrane of the gastrointestinal tract (GIT).
Pharmacokinetics
After oral administration, absorption of acetylsalicylic acid occurs mainly in the proximal small intestine. Its maximum concentration (C max) in the blood serum is reached after about 3 hours. For tablets at a dose of 150 mg C max is on average 0.0127 mg / ml, for tablets at a dose of 75 mg - 0.006 72 mg / ml. In the presence of food in the gastrointestinal tract, absorption slows down. The area under the concentration-time curve (AUC) for tablets at a dose of 150 mg is 0.108 08 mg × h / ml, 75 mg - 0.056 42 mg × h / ml. During absorption, the active substance undergoes presystemic elimination in the intestinal wall and in the liver. Hydrolysis of the resorbed part by special enzymes occurs very quickly, therefore T 1/2 (half-life) is no more than 15-20 minutes.
The binding of acetylsalicylic acid to albumin is 75–90%. In the body, it circulates in the form of an anion, which is rapidly distributed in most tissues and fluids. The relative volume of distribution is approximately 0.15-0.2 l / kg, its increase is caused by an increase in the concentration of the active substance in the blood serum. The degree of protein binding depends on the concentration of albumin.
In children, patients with renal insufficiency and pregnant women, the binding of acetylsalicylic acid to serum proteins is reduced as a result of hypoalbuminemia and drug substitution due to protein by endogenous factors.
Acetylsalicylic acid quickly crosses the placenta and is excreted in breast milk in small amounts.
It is metabolized mainly in the liver with the formation of the following metabolites: salicylic acid, glycine-conjugate of salicylic acid, gentisic acid, glycine-conjugate of gentisic acid. They are found in many body tissues and urine.
It is excreted mainly through the kidneys 60% in unchanged form and in the form of metabolites. The excretion of the unchanged active substance depends on the acidity of the urine, against the background of alkalinization of the urine, ionization of salicylates increases, reabsorption worsens and their elimination increases significantly.
When taking Aspicard at a dose of 150–300 mg T 1/2 of the salicylate ion is 120–180 minutes. The rate of elimination of salicylates in newborns is much slower than in adult patients.
Indications for use
- unstable angina pectoris (including with suspected development of acute myocardial infarction);
- stable angina pectoris;
- the presence of risk factors for the development of myocardial infarction in the patient, including obesity, diabetes mellitus, hyperlipidemia, smoking, arterial hypertension, old age - for the purpose of primary prevention of acute and repeated myocardial infarction;
- stroke prevention (including patients with transient cerebrovascular accident);
- prevention of transient disorders of cerebral circulation;
- prevention of thromboembolism after surgical operations and invasive interventions on vessels (including coronary artery bypass grafting, arteriovenous bypass grafting, carotid endarterectomy, carotid artery angioplasty, angioplasty and coronary artery stenting);
- prevention of deep vein thrombosis and thromboembolism of the pulmonary artery and its branches (including, with prolonged immobilization after extensive surgical intervention).
Contraindications
Absolute:
- bronchial asthma caused by taking NSAIDs and salicylates, a combination of acetylsalicylic acid intolerance with bronchial asthma, recurrent polyposis of the nose and paranasal sinuses;
- gastrointestinal bleeding;
- period of exacerbation of erosive and ulcerative lesions of the gastrointestinal tract;
- hemorrhagic diathesis;
- chronic heart failure III – IV functional class according to NYHA classification (New York Heart Association);
- severe liver failure (class B and higher on the Child-Pugh scale);
- renal failure with creatinine clearance (CC) less than 30 ml / min;
- concomitant therapy with methotrexate at a dose of 15 mg per week or more;
- I and III trimester of the gestation period;
- breast-feeding;
- age up to 18 years;
- established hypersensitivity to other NSAIDs;
- individual intolerance to the components of the drug.
Care should be taken to start taking Aspicard tablets only after prior consultation with a doctor in patients with gout, hyperuricemia, a history of ulcerative lesions of the gastrointestinal tract or gastrointestinal bleeding, impaired liver function (class A on the Child-Pugh scale), impaired renal function (CC more than 30 ml / min), chronic respiratory diseases, bronchial asthma, hay fever, nasal polyposis, drug allergies (including analgesics, anti-inflammatory and antirheumatic drugs of the NSAID group), in the II trimester of pregnancy, when planning a surgical intervention (including tooth extraction and other minor operations).
Special care is required if it is necessary to simultaneously use the drug with other NSAIDs and salicylic acid derivatives in high doses, with methotrexate at a dose of less than 15 mg per week, thrombolytic or antiplatelet agents, anticoagulants, digoxin, valproic acid, oral hypoglycemic agents (sulfonylurea derivatives), selective serotonin reuptake inhibitors, ibuprofen, ethanol-containing drugs for oral administration (including alcoholic beverages).
Aspicard, instructions for use: method and dosage
Aspicard tablets are taken orally, preferably before meals, with plenty of liquid, 1 time per day.
The drug is intended for long-term use. The period of treatment is determined by the doctor, taking into account clinical indications.
Recommended daily dosage of Aspicard:
- suspicion of the development of acute myocardial infarction with unstable angina pectoris: the initial dose is 75-100 mg, the first dose should be taken as soon as possible after the suspicion of the development of acute myocardial infarction appears, chewing the tablet for faster absorption. After the development of myocardial infarction, 200–300 mg should be taken within 30 days. Then the patient is prescribed therapy appropriate for the prevention of recurrent myocardial infarction;
- primary prevention of acute myocardial infarction in patients with risk factors: 75–100 mg;
- prevention of re-infarction, unstable and stable angina pectoris: 75-100 mg;
- prevention of transient disorders of cerebral circulation and stroke: 75-100 mg;
- prevention of deep vein thrombosis and thromboembolism of the pulmonary artery and its branches: 75-100 mg;
- prevention of thromboembolism after operations or invasive interventions on the vessels: 75-100 mg.
Side effects
- from the hematopoietic system: an increase in the frequency of bleeding gums, nosebleeds, hematomas (bruises), bleeding from the urinary tract or postoperative bleeding; possibly - severe cases of gastrointestinal bleeding, cerebral hemorrhage (more often with arterial hypertension, concomitant anticoagulant therapy), including life-threatening; acute or chronic iron deficiency or posthemorrhagic anemia as a result of latent bleeding (accompanied by symptoms such as pallor of the skin, asthenia, hypoperfusion);
- from the digestive system: most often - abdominal pain, heartburn, nausea, vomiting; rarely - ulcers of the mucous membrane of the stomach and duodenum; very rarely - perforation of ulcers of the mucous membrane of the stomach and duodenum, gastrointestinal bleeding, increased activity of hepatic transaminases, transient liver dysfunction;
- from the immune system: hypersensitivity reactions - mild to moderate severity of reactions from the skin, gastrointestinal tract, respiratory tract and / or cardiovascular system (including skin rash, itching, urticaria, rhinitis, swelling of the nasal mucosa, Quincke's edema, cardiorespiratory distress syndrome); bronchospasm (asthmatic syndrome), anaphylactic shock and other severe reactions;
- from the central nervous system: possibly - dizziness, hearing loss, headache, tinnitus.
Overdose
- symptoms of mild and moderate severity of acetylsalicylic acid overdose: nausea, vomiting, profuse increased sweating, headache, dizziness, hearing impairment, tinnitus, confusion, respiratory alkalosis, tachypnea, hyperventilation;
- treatment of an overdose of mild to moderate severity: when symptoms appear, immediate measures are required to detoxify the body, including gastric lavage (dialysis), repeated use of activated carbon, restoration of water-electrolyte balance and acid-base state, forced alkaline diuresis;
- symptoms of a severe overdose of acetylsalicylic acid: extremely high body temperature, tinnitus and / or deafness, respiratory alkalosis with compensatory metabolic acidosis, depression of the central nervous system (confusion, drowsiness, convulsions, coma), respiratory failure (including hyperventilation, depression respiration, noncardiogenic pulmonary edema, asphyxia), arterial hypotension, cardiac arrhythmias, inhibition of cardiac activity, impaired water and electrolyte balance (including dehydration, impaired renal function, oliguria, renal failure, hypernatremia, hypokalemia, hyponatremia), impaired glucose metabolism [hypoglycemia (mainly in children), hyperglycemia, ketoacidosis], gastrointestinal bleeding, hematological disorders (prolongation of prothrombin time,inhibition of platelet aggregation, coagulopathy, hypoprothrombinemia), toxic encephalopathy;
- treatment of severe overdose with salicylates: immediate appointment of emergency specialized therapy in a hospital setting is required, including gastric lavage and repeated intake of activated carbon. The use of hemodialysis, forced alkaline diuresis, measures to restore the water-electrolyte balance and acid-base state is shown, if necessary, the appointment of symptomatic therapy.
special instructions
Aspicard is a non-prescription drug, but it should be started after consulting a doctor. The doctor must be informed about all medications that the patient is already taking. In addition, during the period of treatment, the patient should not start taking any medication without prior agreement with the doctor. This will avoid the consequences of unwanted interactions.
Risk factors for the development of bronchospasm, attacks of bronchial asthma and other hypersensitivity reactions include bronchial asthma in the patient's history, hay fever, nasal polyposis, chronic diseases of the respiratory system, allergic reactions to other drugs.
Due to the persistence of the inhibitory effect of acetylsalicylic acid on platelet aggregation for several days after taking the last dose, when planning a surgical intervention, Aspicard should be discontinued in the preoperative period. This will reduce the risk of bleeding during surgery or in the postoperative period.
It should be borne in mind that low doses of Aspicard can provoke the development of gout in patients with reduced uric acid excretion.
As a result of the cancellation of systemic glucocorticosteroids, an increase in the level of salicylates in the blood is possible.
Exceeding the recommended dosage increases the likelihood of gastrointestinal bleeding. In elderly patients, overdose is especially dangerous.
In the event of any side effects, you should immediately consult a doctor.
After a long course of therapy, the abolition of Aspicard should be carried out by gradually reducing the daily dose.
Influence on the ability to drive vehicles and complex mechanisms
Reception of Aspicard in the recommended doses does not adversely affect the patient's ability to perform potentially hazardous activities, including driving and driving complex mechanisms.
Application during pregnancy and lactation
The use of Aspicard is contraindicated in the I and III trimester of pregnancy and during breastfeeding.
Caution should be exercised in the second trimester of the gestation period; Aspicard can only be taken as prescribed by a doctor (for a short time, in doses not exceeding 150 mg per day), in cases where the expected benefit from therapy for the mother is significantly higher than the potential threat to the course of pregnancy, growth and fetal development.
Taking Aspicard in high doses (more than 300 mg per day) in the first trimester of pregnancy increases the risk of fetal developmental defects (heart defects, cleft palate). In the third trimester, premature closure of the ductus arteriosus in the fetus, inhibition of labor, increased bleeding in the fetus and mother, intracranial hemorrhages are likely.
Pediatric use
It is contraindicated to use Aspicard for the treatment of patients under the age of 18 years (children and adolescents).
With impaired renal function
The use of Aspicard is contraindicated for the treatment of patients with severe renal failure (CC less than 30 ml / min).
Acetylsalicylic acid should be taken with caution in case of impaired renal function with CC more than 30 ml / min.
For violations of liver function
The use of Aspicard is contraindicated for the treatment of patients with severe hepatic insufficiency (class B and higher on the Child-Pugh scale).
Aspicard should be taken with caution in case of liver dysfunction (class A on the Child-Pugh scale).
Use in the elderly
It should be borne in mind that overdose for elderly patients is of particular danger.
Drug interactions
With simultaneous use with Aspicard, the following drug interaction reactions are possible:
- methotrexate, heparin and indirect anticoagulants, thrombolytic and antiplatelet agents (ticlopidine), anticoagulants, selective serotonin reuptake inhibitors, digoxin, hypoglycemic agents for oral administration (sulfonylurea derivatives) and insulin, valproic acid, the indicated clinical action … Therefore, if necessary, the appointment of concomitant therapy with one of the listed drugs should consider reducing its dose;
- thrombolytic, antiplatelet and anticoagulant agents, high doses of salicylic acid derivatives, NSAIDs, selective serotonin reuptake inhibitors: enhance the harmful effect of the drug on the mucous membrane of the digestive tract and increase the risk of gastrointestinal bleeding;
- ethanol: the use of alcohol and ethanol-containing drugs causes a synergistic effect, increasing the risk of damage to the gastrointestinal mucosa and lengthening the bleeding time;
- diuretics, angiotensin-converting enzyme inhibitors, benzbromarone, probenecid: there is a weakening of the therapeutic effect of these drugs, requiring a correction of their dose;
- ibuprofen: causes antagonism in relation to irreversible inhibition of platelets and a decrease in the cardioprotective effect of Aspicard. Therefore, with an increased risk of cardiovascular disease, combination with ibuprofen should be avoided;
- glucocorticosteroids (except for hydrocortisone, which is used as replacement therapy for Addison's disease): there is a weakening of the action of salicylates, due to an increase in their elimination due to the simultaneous use with glucocorticosteroids.
Analogs
Aspicard's analogs are ASK-cardio, Acetylsalicylic acid, Acetylsalicylic acid Cardio, Aspinat, Aspirin, Aspirin Cardio, CardiASK, Sanovask, Acecardol, Taspir, Trombo ACC, Trombogard 100, Upsarin UPSA etc., Thrombogard
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C, protected from moisture and light.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about Aspikard
Reviews about Aspikard are extremely positive. Patients indicate the effectiveness of the drug in unstable angina pectoris or the prevention of myocardial infarction, as well as deep vein thrombosis. They note its fast action, good tolerance, and affordable price.
The disadvantages of Aspikard include the possible development of undesirable phenomena and a large list of contraindications.
Aspicard price in pharmacies
The price of Aspicard, depending on the dosage of tablets and their quantity in the package, can be:
- tablets 75 mg: 30 pcs. - from 27 rubles; 50 pcs. - from 38 rubles;
- tablets 150 mg: 30 pcs. - from 38 rubles; 50 pcs. - from 57 rubles.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
