SANOVASK
SANOVASK: 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: Sanovasc
ATX code: B01AC06
Active ingredient: acetylsalicylic acid (Acetylsalicylic acid)
Producer: JSC "Irbitskiy Khimfarmzavod" (Russia)
Description and photo update: 2019-17-12
Prices in pharmacies: from 16 rubles.
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SANOVASK is an antiplatelet agent.
Release form and composition
The drug is produced in the form of enteric film-coated tablets: round, convex on both sides, almost white or white; the cross section shows a thin strip of the shell and a core of almost white or white color (in a cardboard box, instructions for the use of SANOVASK and 3 or 6 cell contour packs of 10 tablets each or 1 polymer can containing 30 or 60 tablets).
Composition for 1 tablet:
- active substance: acetylsalicylic acid (ASA) - 50, 75 or 100 mg;
- auxiliary components: colloidal silicon dioxide, microcrystalline cellulose, sodium carboxymethyl starch, lactose monohydrate;
- enteric coating: talc, povidone K17, copolymer of methacrylic acid and ethyl acrylate [ratio 1 ÷ 1], macrogol 4000.
Pharmacological properties
Pharmacodynamics
ASA is a drug from the group of non-steroidal anti-inflammatory drugs (NSAIDs). Its mechanism of action is based on the ability to irreversibly inhibit cyclooxygenase 1 (COX-1). This leads to blocking the synthesis of prostaglandins (PG), prostacyclins (PC) and thromboxanes (Th).
By suppressing the synthesis of TxA2 in platelets, the drug helps to reduce the adhesion and aggregation of platelets, and reduces thrombus formation.
ASA reduces the content of coagulation factors dependent on vitamin K (II, VII, IX, X). Strengthens the fibrinolytic activity of blood plasma.
The antiplatelet property of the drug is most pronounced in platelets, since they cannot synthesize COX again.
An antiplatelet effect develops after taking small doses of ASA, a single dose of the drug provides a therapeutic effect for 7 days.
Acetylsalicylic acid also has antipyretic, analgesic and anti-inflammatory activity.
Pharmacokinetics
After oral administration of SANOVASK, ASA is rapidly and completely absorbed in the gastrointestinal tract (GIT).
Upon absorption, the drug undergoes partial metabolism, the rest is metabolized in the liver by hydrolysis. The main metabolite is formed - salicylic acid, which is metabolized mainly in the liver under the action of liver enzymes, as a result of which glucuronide salicylate and phenyl salicylate are formed. All metabolites are found in urine and many tissues. Due to the lower activity of enzymes in the blood serum in women, the metabolism is slower.
Acetylsalicylic and salicylic acids bind well to plasma proteins (depending on the dose 66–98%) and are quickly distributed in the body. Salicylic acid can cross the placenta and into breast milk.
The half-life (T 1/2) of ASA from plasma is approximately 15–20 minutes.
Unhydrolyzed ASA with repeated administration does not accumulate in blood serum, unlike other salicylates. It is excreted by the kidneys: in the form of non-hydrolyzed ASA - only 1% of the dose, the rest - in the form of salicylates and their metabolites. In patients without impaired renal function, 80 to 100% of a single dose of ASA is excreted within 24-72 hours.
Indications for use
SANOVASK is used to prevent the following diseases and conditions:
- repeated myocardial infarction;
- acute myocardial infarction in patients with risk factors (diabetes mellitus, arterial hypertension, hyperlipidemia, obesity, as well as in old age and in smokers);
- transient disorders of cerebral circulation;
- stroke, including those with transient cerebrovascular accident;
- thromboembolism in patients who have undergone surgery or invasive intervention on the vessels (angioplasty, stenting of the coronary arteries, coronary artery bypass grafting or arteriovenous bypass grafting, endarterectomy of the carotid arteries);
- deep vein thrombosis, thromboembolism of the pulmonary artery and its branches, including in long-term immobilized patients due to extensive surgical intervention.
SANOVASK is also prescribed for stable and unstable angina pectoris.
Contraindications
Absolute:
- lactose intolerance, glucose / galactose malabsorption syndrome, lactase deficiency (due to the content of lactose monohydrate in tablets);
- age up to 18 years;
- I and III trimesters of pregnancy;
- lactation period;
- gastrointestinal bleeding;
- hemorrhagic diathesis;
- exacerbation of erosive and ulcerative lesions of the gastrointestinal tract;
- chronic heart failure of III and IV functional classes in accordance with the NYHA classification;
- severe hepatic impairment (Child-Pugh grades B and C);
- severe renal failure [creatinine clearance (CC) <30 ml / min];
- a combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses with ASA intolerance;
- bronchial asthma while taking salicylates or other NSAIDs;
- concomitant use of methotrexate at a dose of ≥ 15 mg / week;
- hypersensitivity to any of the constituents of the drug or other drugs of the NSAID group.
Relative (SANOVASK tablets should be used with caution):
- peptic ulcer and 12 duodenal ulcer, history of gastrointestinal bleeding;
- renal failure with CC ≥ 30 ml / min;
- liver failure (class B on the Child - Pugh scale);
- hyperuricemia, gout;
- cardiovascular disorders (including hypovolemia, chronic heart failure, cases of massive bleeding, sepsis, and major surgery);
- severe forms of glucose-6-phosphate dehydrogenase deficiency;
- nasal polyposis, hay fever, chronic respiratory diseases, bronchial asthma;
- the proposed surgery (including minor, such as tooth extraction);
- drug allergy, including to analgesics, drugs of the NSAID group, antirheumatic and anti-inflammatory drugs;
- II trimester of pregnancy;
- concomitant use of the following drugs: methotrexate at a dose of <15 mg / week, NSAIDs and salicylic acid derivatives in large doses, ibuprofen, antiplatelet and thrombolytic drugs, anticoagulants, selective serotonin reuptake inhibitors, valproic acid, digoxins, insulin and oral sulfonylurea derivatives), ethanol-containing preparations;
- alcohol consumption.
SANOVASK, instructions for use: method and dosage
SANOVASK tablets are taken orally, optimally before meals, once a day. They should be swallowed whole with plenty of water.
The duration of treatment is determined individually. The daily (aka single) dose depends on the indication and clinical picture:
- stable and unstable angina pectoris, primary and secondary prevention of acute myocardial infarction, prevention of thromboembolism after vascular interventions: 50-100 mg;
- prevention of transient disorders of cerebral circulation and stroke: 75-100 mg;
- prevention of thromboembolism of the pulmonary artery and its branches, deep vein thrombosis: 100-200 mg;
- suspicion of the development of acute myocardial infarction with unstable angina pectoris: the first dose is 100 mg, the pill should be taken as soon as possible after the suspicion of a heart attack appears, it is recommended to chew it in order to achieve rapid absorption and development of the effect. The next 30 days, the maintenance daily dose of SANOVASK is 200-300 mg. After 30 days, therapy is prescribed to prevent a recurrent heart attack.
Side effects
SANOVASK can cause the following side effects:
- from the immune system: edema of the nasal mucosa, rhinitis, bronchospasm, urticaria, itching, skin rash, Quincke's edema, cardiorespiratory distress syndrome, severe allergic reactions (for example, anaphylactic shock);
- from the central nervous system (these symptoms may be signs of an overdose of ASA): tinnitus, hearing loss, dizziness;
- from the urinary system: renal failure (including acute);
- from the digestive system: often - pain in the abdomen, heartburn, nausea, vomiting; rarely - stomach and duodenal ulcer; very rarely - transient functional disorders of the liver with increased activity of liver enzymes, gastrointestinal bleeding, perforated ulcers of the mucous membrane of the stomach and duodenum;
- from the hematopoietic system: an increased frequency of hematomas (bruises), bleeding gums, nosebleeds, bleeding from the urinary tract, intra- and postoperative bleeding. There have been reports of serious bleeding, including gastrointestinal and cerebral hemorrhage (especially in the presence of concomitant hypertension in cases where blood pressure targets were not achieved and / or anticoagulants were used concomitantly). Bleeding can cause the development of acute and chronic iron deficiency / posthemorrhagic anemia with corresponding symptoms (pallor, asthenia, hypoperfusion), in some cases, bleeding can be life-threatening. There are reports of the development of hemolysis and hemolytic anemia in patients with deficiency of glucose-6-phosphate dehydrogenase,proceeding in a severe form.
Overdose
ASA overdose can cause more severe complications, especially in children and the elderly.
When the drug is taken in a daily dose of more than 100 mg / kg for two days in a row, or with a single accidental or intentional intake of a toxic dose, salicylism syndrome develops.
Symptoms of mild to moderate overdose (due to a single dose of less than 150 mg / kg): headache, increased sweating, tinnitus, dizziness, confusion, hearing loss, hyperventilation, tachypnea, nausea, vomiting, respiratory alkalosis.
Treatment: gastric lavage is performed, repeated intake of activated charcoal is prescribed, forced alkaline diuresis is performed, measures are taken to help restore the acid-base state and water-electrolyte balance.
Overdose symptoms of moderate and severe (moderate - 150-300 mg / kg, severe -> 300 mg / kg):
- neurological disorders: depression of the function of the central nervous system (confusion, drowsiness, convulsions, coma), toxic encephalopathy;
- cardiovascular disorders: suppression of cardiac activity, a marked decrease in blood pressure, heart rhythm disturbances;
- on the part of the water-electrolyte balance: dehydration of the body, impaired renal function (from oliguria to renal failure), accompanied by hypernatremia, hypokalemia, hyponatremia;
- violation of glucose metabolism: hypoglycemia (especially in children), hyperglycemia, ketoacidosis;
- hematological disorders: hypoprothrombinemia, prolongation of prothrombin time, from inhibition of platelet aggregation to coagulopathy;
- on the part of the organ of hearing: tinnitus, deafness;
- others: gastrointestinal bleeding, hyperpyrexia, respiratory alkalosis with compensatory metabolic acidosis, hyperventilation, respiratory depression, noncardiogenic pulmonary edema, asphyxia.
With moderate and severe poisoning, urgent hospitalization and emergency therapy are required. First of all, gastric lavage is performed, repeated intake of activated carbon is prescribed. Further, forced alkaline diuresis and hemodialysis are carried out, as well as measures that contribute to the restoration of the acid-base state and water-electrolyte balance. Further treatment is symptomatic.
special instructions
SANOVASK can only be used as directed by a doctor. It is forbidden to independently increase the daily dose.
In high doses, the drug has a hypoglycemic effect. This should be taken into account when treating patients with diabetes mellitus if they are receiving insulin or hypoglycemic agents that are derivatives of sulfonylureas.
In low doses, the drug can cause the development of gout in patients with decreased uric acid excretion.
The suppressing platelet aggregation action of SANOVASK lasts for several days after the last dose, which is why the risk of bleeding increases during surgery and in the postoperative period. When a serious operation is planned, during which it is necessary to absolutely exclude the risk of bleeding, it is recommended to stop taking an antiplatelet agent on the eve of the intervention.
While taking SANOVASK, hypersensitivity reactions may develop, including bronchospasm and attacks of bronchial asthma. The likelihood of their occurrence increases if the patient has predisposing factors: a history of bronchial asthma, nasal polyposis, hay fever, chronic respiratory diseases, drug allergies.
Drinking alcoholic beverages during treatment increases the risk of damage to the gastrointestinal mucosa and an increase in bleeding time.
The combination of SANOVASK and ibuprofen should be avoided in patients at increased risk of cardiovascular diseases, since ibuprofen reduces the cardioprotective effect of ASA.
With the simultaneous use of methotrexate increases the frequency of adverse reactions from the hematopoietic organs.
Co-administration of thrombolytics, anticoagulants or other antiplatelet agents is associated with an increased risk of bleeding.
When taking glucocorticosteroids (GCS) in the blood, the level of salicylates decreases, and after their cancellation, it rises sharply, which is fraught with an overdose.
Influence on the ability to drive vehicles and complex mechanisms
During the period of taking SANOVASK due to possible dizziness, patients should be careful when engaging in potentially hazardous activities that require an increased reaction rate and attention.
Application during pregnancy and lactation
In the first trimester, large doses of salicylates increase the incidence of fetal defects. Cleavage of the upper palate and heart defects are more common. In the third trimester, high doses of ASA can inhibit labor, cause increased bleeding in the mother and the fetus, and premature closure of the ductus arteriosus in the fetus. If the drug is taken immediately before childbirth, intracranial hemorrhage is possible in a child, especially a premature baby. In this regard, SANOVASK is contraindicated in the I and III trimesters.
In the second trimester, there were no serious malformations, however, the drug is allowed to be used only if the benefit to the woman is clearly higher than the risk to the fetus. The daily dose of SANOVASK should not exceed 150 mg, the treatment is carried out as short as possible.
ASA and its metabolites pass into breast milk. A one-time intake of a small dose of the drug does not cause side effects in the child, and therefore does not require the termination of feeding. However, if the dose is high, the feeding should be stopped immediately. If long-term treatment is required, the woman is advised to transfer the baby to artificial feeding.
Pediatric use
Children and adolescents under 18 years of age are an absolute contraindication to taking SANOVASK.
With impaired renal function
Taking an antiplatelet agent is contraindicated in severe renal failure (CC <30 ml / min).
SANOVASK should be used with extreme caution in patients with mild to moderate renal impairment (CC ≥ 30 ml / min).
For violations of liver function
An antiplatelet agent is contraindicated in severe hepatic impairment (Child-Pugh grades B and C).
SANOVASK should be used with extreme caution in patients with mild hepatic impairment (Child-Pugh class A).
Use in the elderly
There are no dosage recommendations for the elderly. However, it should be borne in mind that in patients of this category, an overdose is of particular danger, therefore, the doctor's prescriptions should be carefully followed.
Drug interactions
ASA enhances the effect of the following drugs (if necessary, combined use should reduce their doses):
- methotrexate: its renal clearance decreases and it is displaced from the connection with proteins;
- selective serotonin reuptake inhibitors: there is a synergistic effect with ASA, which is accompanied by the risk of bleeding from the upper gastrointestinal tract;
- valproic acid: is displaced from the connection with blood plasma proteins, which is accompanied by an increase in its toxicity;
- digoxin: its renal excretion decreases, which is fraught with overdose;
- ethanol: there is a mutual enhancement of the effects of ethanol and ASA, this significantly increases the risk of damage to the gastrointestinal mucosa and lengthening of bleeding time;
- insulin, oral hypoglycemic agents (sulfonylurea derivatives): in high doses, ASA itself has hypoglycemic properties, in addition, displaces sulfonylurea derivatives from the connection with plasma proteins;
- anticoagulants, thrombolytics, other antiplatelet agents: when combined with ASA, synergism of the main therapeutic effects is observed, the damaging effect on the gastrointestinal mucosa increases, the risk of bleeding increases;
- ibuprofen: antagonism is observed with respect to irreversible inhibition of platelets under the action of ASA, which reduces the cardioprotective effects of SANOVASK;
- NSAIDs and salicylic acid derivatives in high doses: there is a synergistic effect, as a result of which the risk of bleeding from the gastrointestinal tract and the development of an ulcerogenic effect increases.
In high doses, ASA can weaken the effect of the following drugs (when used together, an increase in their dose may be required):
- diuretics: due to a decrease in the synthesis of prostaglandins in the kidneys, the rate of their glomerular filtration decreases;
- drugs with uricosuric action (probenecid, benzbromarone): there is a competitive suppression of renal tubular excretion of uric acid, which leads to a decrease in the uricosuric effect;
- angiotensin-converting enzyme (ACE) inhibitors: due to inhibition of prostaglandins, the glomerular filtration rate decreases (with a dose of ASA more than 160 mg / day), as a result, the hypotensive effect decreases. Also, their positive cardioprotective effect decreases in patients receiving ACE inhibitors for chronic heart failure.
Systemic corticosteroids (with the exception of hydrocortisone, prescribed for substitution therapy for Addison's disease) increase the excretion of salicylates, as a result of which the effect of SANOVASK is weakened.
Analogs
SANOVASK analogs are Agrenox, ASK-cardio, Aducyl, Acetylcardio-LekT, Aspirin Cardio, Brilinta, Acetylsalicylic acid Cardio, Ventavis, Detromb, Deplatt-75, Ilomedin, Zilt, Cardiomagnyl, Clapitlopax, Kardogrell Coplavix, Lopirel, Lirta, Monafram, Plavix, Pidogrel, Plogrel, Trombital, Trombo ASS, Phazostabil, Effient, Fluder.
Terms and conditions of storage
Store in a dry, dark place, out of reach of children, at a temperature not exceeding 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about SANOVASK
There are no reviews directly about SANOVASK on specialized medical sites and forums. However, there are many reviews about its active ingredient and other antiplatelet agents, which contain acetylsalicylic acid as an active ingredient.
ASA is a medicinal substance with thoroughly studied mechanisms of action and safety, tested in clinical practice. The World Health Organization has included acetylsalicylic acid in the list of essential drugs. It is used to relieve pain, reduce elevated body temperature and eliminate the inflammatory process, as well as to prevent vascular complications.
Medicines containing ASA are medicines with proven effectiveness.
Price for SANOVASK in pharmacies
Approximate prices for SANOVASK in the form of enteric film-coated tablets are:
- dosage of 50 mg: 32–42 rubles. per pack of 30 pcs. and 67–74 rubles. per pack of 60 pcs.;
- dosage of 75 mg: 33–43 rubles. per pack of 30 pcs. and 71-79 rubles. per pack of 60 pcs.;
- dosage of 100 mg: 35–45 rubles. per pack of 30 pcs. and 75-79 rubles. per pack of 60 pcs.
SANOVASK: prices in online pharmacies
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Drug name Price Pharmacy |
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Sanovask 75 mg enteric film-coated tablets 30 pcs. RUB 16 Buy |
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Sanovask 50 mg enteric film-coated tablets 30 pcs. RUB 20 Buy |
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Sanovask 100 mg enteric film-coated tablets 30 pcs. RUB 20 Buy |
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Sanovask 50 mg enteric film-coated tablets 60 pcs. RUB 30 Buy |
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Sanovask 75 mg enteric film-coated tablets 60 pcs. RUB 30 Buy |
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Sanovask 100 mg enteric film-coated tablets 60 pcs. RUB 50 Buy |
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Sanovask tablets p.p. intestinal. 100mg 60 pcs. RUB 72 Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, 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!
