Thrombopol
Thrombopol: 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: Trombopol
ATX code: N02BA01
Active ingredient: Acetylsalicylic acid (Acetylsalicylic acid)
Manufacturer: Polpharma (Poland)
Description and photo update: 2018-24-10
Prices in pharmacies: from 28 rubles.
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Thrombopol is a drug with antiplatelet, analgesic, anti-inflammatory and antipyretic effects.
Release form and composition
The dosage form of Trombopol is enteric-coated tablets: pink, biconvex, round (in blisters of 10 pcs., In a cardboard box of 3, 5 or 6 blisters; in blisters of 25 pcs., In a cardboard box of 2 blisters).
Composition of 1 tablet:
- active substance: acetylsalicylic acid - 75 or 150 mg;
- auxiliary components: corn starch, sodium carboxymethyl starch, microcrystalline cellulose;
- shell: hypromellose, Acryl-Eyes [mixture for coating tablets; composition - sodium lauryl sulfate, sodium bicarbonate, methacrylic acid copolymer (type C), talc, triethyl citrate, titanium dioxide, colloidal silicon dioxide, crimson dye (Ponso 4R)].
Pharmacological properties
Pharmacodynamics
Thrombopol is one of the NSAIDs (non-steroidal anti-inflammatory drugs), antiplatelet agents.
The basis of the mechanism of action of acetylsalicylic acid - irreversible inhibition of COX-1 (COX), which leads to a blockade of the synthesis of thromboxane A 2 and platelet aggregation inhibition.
The antiplatelet effect occurs even after the use of small doses of the drug, the duration of its action after a single dose is 7 days. Acetylsalicylic acid can be used to treat and prevent the following diseases / conditions: myocardial infarction, complications of varicose veins, ischemic heart disease.
In addition, the substance has analgesic, anti-inflammatory and antipyretic effects.
Due to the enteric coating of tablets, acetylsalicylic acid is released in the more alkaline environment of the duodenum, which helps to reduce its irritating effect on the gastric mucosa.
Pharmacokinetics
The absorption of acetylsalicylic acid from Trombopol begins 3-4 hours after taking the drug (this confirms the effective blocking of the dissolution of tablets in the stomach). C max (maximum concentration of a substance) in plasma averages 6.72 and 12.7 μg / ml (for tablets 75 and 150 mg, respectively), the time to reach it is approximately 2-3 hours. The absorption of the drug is slowed down by the presence of food in the gastrointestinal tract.
AUC (area under the concentration-time curve) is 56.42 and 108.08 μg × h / ml (for tablets 75 and 150 mg, respectively).
Acetylsalicylic acid largely and quickly penetrates the body fluids and most tissues. The degree of its binding to blood plasma proteins is determined by the concentration.
The relative distribution is approximately 0.15-0.2 l / kg, it increases simultaneously with an increase in the serum concentration of Thrombopol in the blood.
Unlike other salicylates, non-hydrolyzed acetylsalicylic acid does not accumulate in the blood serum against the background of repeated administration of the drug.
Acetylsalicylic acid is partially metabolized during absorption. This process occurs under the influence of enzymes mainly in the liver. In this case, the following metabolites are formed (found in urine and many tissues): phenyl salicylate, glucuronide salicylate and salicyluric acid.
T 1/2 (half-life) of acetylsalicylic acid from blood plasma is in the range from 15 to 20 minutes.
Only 1% of the ingested dose is excreted as non-hydrolyzed acetylsalicylic acid by the kidneys, the rest as salicylates and their metabolites.
In the absence of impaired renal function, 80-100% of a single dose is excreted within 24-72 hours by the kidneys.
The metabolic process in women is slower (due to the lower activity of enzymes in the blood serum).
In patients with renal insufficiency, as well as in pregnant women and newborns, salicylates can displace bilirubin from association with albumin, which contributes to the appearance of bilirubin encephalopathy.
Indications for use
- unstable angina;
- acute myocardial infarction (prevention of primary myocardial infarction in the presence of risk factors, in particular, in diabetes mellitus, hyperlipidemia, arterial hypertension, obesity, smoking, in old age, as well as prevention of repeated myocardial infarction);
- stroke (prevention, including patients with transient cerebrovascular accident);
- transient disorders of cerebral circulation (prevention);
- thromboembolism (prevention in the postoperative period and after invasive interventions on the vessels, in particular, coronary artery bypass grafting, carotid endarterectomy, carotid artery angioplasty, arteriovenous bypass grafting);
- deep vein thrombosis and thromboembolism of the pulmonary artery and its branches (prevention, including in patients after extensive surgery during prolonged immobilization).
Contraindications
Absolute:
- exacerbation of erosive and ulcerative lesions of the gastrointestinal tract;
- a combination of bronchial asthma, recurrent sinus / nasal polyposis and acetylsalicylic acid intolerance;
- hemorrhagic diathesis;
- gastrointestinal bleeding;
- simultaneous use with methotrexate at a dose of 15 mg per week or more;
- bronchial asthma induced by the intake of salicylates and NSAIDs;
- I and III trimesters of pregnancy, as well as the period of breastfeeding;
- age up to 18 years;
- individual intolerance to any component of the drug, as well as other NSAIDs.
Relative (Thrombopol is prescribed under medical supervision):
- polyposis of the nose;
- gout;
- chronic respiratory diseases;
- hyperuricemia;
- renal / hepatic impairment;
- aggravated history of gastric and duodenal ulcers or gastrointestinal bleeding;
- bronchial asthma;
- hay fever;
- drug allergy;
- simultaneous use with anticoagulants;
- simultaneous use with methotrexate at a dose of up to 15 mg per week;
- II trimester of pregnancy.
Instructions for the use of Thrombopol: method and dosage
Thrombopol is taken orally with a small amount of water, without chewing, regardless of the meal.
The duration of use is determined by the doctor. A long course is shown.
The recommended dosage regimen for Trombopol is 75 or 150 mg per day.
Side effects
- digestive system: increased activity of liver enzymes, nausea, vomiting, diarrhea, heartburn, abdominal pain, ulcers of the mucous membrane of the stomach and duodenum, including perforated, gastrointestinal bleeding;
- central nervous system: tinnitus, dizziness;
- respiratory system: bronchospasm;
- allergic reactions: Quincke's edema, urticaria;
- hematopoietic system: increased bleeding; rarely - anemia.
Overdose
The first symptoms of an overdose are manifested in the form of nausea, vomiting, tinnitus and rapid breathing, in addition, the following disorders may develop: visual impairment, hearing loss, motor agitation, headaches, drowsiness, hyperthermia, convulsions. With severe intoxication, violations of the water-electrolyte and acid-base balance (dehydration and metabolic acidosis) may appear.
Symptoms of mild / moderate intoxication occur after the use of 150-300 mg / kg of acetylsalicylic acid. Severe overdose develops at a dose of 300-500 mg / kg. Doses greater than 500 mg / kg are potentially fatal.
There is no specific antidote for Thrombopol. As a therapy in order to reduce the absorption of the drug, the following measures are shown: induce vomiting and rinse the stomach. These measures are effective within 3-4 hours after taking the drug; in cases of taking an excessive dose, this period is extended to 10 hours. In order to reduce the absorption of the substance, it is necessary to take an aqueous suspension of activated carbon (adult dose - 50-100 g, children dose - 30-60 g), while monitoring the water-electrolyte balance should be established (if necessary, it should be replenished in a timely manner).
In the treatment of acidosis and to accelerate the excretion of acetylsalicylic acid by the kidneys, intravenous sodium bicarbonate is indicated, the pH should be maintained in the range of 7–7.5.
In cases of very severe intoxication, hemodialysis or peritoneal dialysis is indicated.
Because of the likelihood of respiratory acidosis, drugs that depress the central nervous system (for example, barbiturates) are prohibited. In the presence of breathing disorders, it is necessary to ensure airway patency and oxygen access. If necessary, perform intratracheal intubation and provide mechanical ventilation.
special instructions
Acetylsalicylic acid can cause the development of bronchospasm, as well as lead to attacks of bronchial asthma and other hypersensitivity reactions. Main risk factors: aggravated history of bronchial asthma, hay fever, nasal polyposis, chronic respiratory diseases, allergic reactions to other drugs (for example, skin reactions, itching, urticaria).
The use of acetylsalicylic acid can cause varying degrees of severity of bleeding during / after surgery. In this regard, therapy should be discontinued 5-7 days before the proposed operation.
The risk of bleeding increases with the combined use of Thrombopol with anticoagulants, platelet aggregation inhibitors and thrombolytic drugs.
Low doses of acetylsalicylic acid in cases of a predisposition (reduced excretion of uric acid) can cause gout.
When Thrombopol is combined with methotrexate, the incidence of adverse reactions from the hematopoietic organs increases.
High doses of acetylsalicylic acid produce a hypoglycemic effect, which should be taken into account in patients with diabetes mellitus who are receiving drugs with hypoglycemic action.
With the combined appointment of glucocorticosteroids with Thrombopol, a decrease in its concentration in the blood is observed, and after the withdrawal of glucocorticosteroids, an overdose of salicylates is possible.
Simultaneous use with ibuprofen is not recommended, since it reduces the effectiveness of acetylsalicylic acid.
The combination of acetylsalicylic acid and ethanol increases the likelihood of damage to the gastrointestinal mucosa and lengthening the bleeding time.
Overdose is especially dangerous in elderly patients. Due to the fact that patients over the age of 65 may have a decrease in renal function, this group of patients should be prescribed Trombopol in reduced doses.
Application during pregnancy and lactation
- I and III trimesters of pregnancy: the drug is contraindicated; the use of Thrombopol in the first trimester leads to splitting of the upper palate and heart defects, in the third trimester - to inhibition of labor, premature closure of the ductus arteriosus in the fetus, increased bleeding in the mother / fetus; the appointment of salicylates just before childbirth can cause intracranial hemorrhage, especially in premature babies;
- II trimester of pregnancy: Thrombopol can be used only after a careful assessment of the benefit / risk ratio;
- lactation period: the drug is contraindicated.
Pediatric use
Patients under the age of 18 are not prescribed therapy.
With impaired renal function
Renal failure: Thrombopol can be used under medical supervision.
For violations of liver function
According to the instructions, Thrombopol for liver failure can be used under medical supervision.
Use in the elderly
Elderly patients Thrombopol should be prescribed with caution in reduced doses.
Drug interactions
Drugs, the effect of which is enhanced when combined with Thrombopol:
- methotrexate: associated with a decrease in renal clearance and its displacement from the connection with proteins; the combination is contraindicated or requires caution (when used in doses above or up to 15 mg per week, respectively);
- heparin and indirect anticoagulants: associated with impaired platelet function and displacement of indirect anticoagulants from protein binding;
- thrombolytic drugs and platelet aggregation inhibitors (ticlopidine);
- digoxin: associated with a decrease in its renal excretion;
- hypoglycemic agents (insulin and sulfonylurea derivatives): associated with the hypoglycemic properties of acetylsalicylic acid itself in high doses and the displacement of sulfonylurea derivatives from the bond with proteins;
- valproic acid: associated with the displacement of its association with proteins;
- NSAIDs;
- sulfonamides (including co-trimoxazole);
- barbiturates;
- lithium salts.
Drugs, the effect of which decreases when used in combination with Thrombopol:
- sulfinpyrazone, probenecid, benzbromarone and other anti-gout drugs that increase the excretion of uric acid: associated with competitive tubular elimination of uric acid;
- antihypertensive agents, including angiotensin-converting enzyme inhibitors;
- aldosterone antagonists (in particular spironolactone);
- loop diuretics (in particular furosemide).
Other possible interactions:
- alcohol: additive effect;
- glucocorticosteroids for systemic use: weakening of the action of Thrombopol.
Analogs
Trombopol's analogs are: Thrombo ACC, Trombogard 100, Upsarin UPSA, Sanovask, Acetylsalicylic acid, Taspir, ASK-cardio, Aspirin, Aspinat, Aspikor, CardiASK.
Terms and conditions of storage
Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about Trombopol
According to reviews, Thrombopol is an effective drug. In some cases, it is noted that taking the drug can lead to the development of side effects, in particular from the digestive system.
The price of Thrombopol in pharmacies
The approximate price for Trombopol is 40–51 rubles. (30 tablets of 75 mg) or 49–57 rubles. (30 tablets, 150 mg each).
Thrombopol: prices in online pharmacies
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Drug name Price Pharmacy |
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Thrombopol 75 mg enteric-coated tablets 30 pcs. 28 RUB 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!
