Cardiomagnyl pills coated 75mg N100
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Active ingredients
Acetylsalicylic acid + Magnesium hydroxide
Release form
Pills
Composition
Active ingredient: Acetylsalicylic acid (Acetylsalicylic acid), Magnesium hydroxide (Magnesium hydroxide). Concentration of the active substance (mg): Acetylsalicylic acid - 75 mg, Magnesium hydroxide - 15.2 mg
Pharmacological effect
NSAIDs, antiplatelet agent. The basis of the mechanism of action of acetylsalicylic acid is irreversible inhibition of the COX-1 enzyme, as a result of which synthesis of thromboxane A2 is blocked and platelet aggregation is inhibited. Acetylsalicylic acid is also believed to have other mechanisms for suppressing platelet aggregation, which expands its field of application in various vascular diseases. Acetylsalicylic acid also has anti-inflammatory, analgesic and antipyretic effects. Magnesium hydroxide, which is part of Cardiomagnyl, protects the gastrointestinal mucosa from exposure to acetylsalicylic acid.
Pharmacokinetics
Absorption After receiving the drug inside acetylsalicylic acid is absorbed from the gastrointestinal tract almost completely. The bioavailability of acetylsalicylic acid is about 70%, but this value is characterized by significant individual variability due to systemic hydrolysis in the mucous membranes of the gastrointestinal tract and in the liver with the formation of salicylic acid under the action of enzymes. The bioavailability of salicylic acid is 80-100%. Metabolism and elimination of T1 / 2 acetylsalicylic acid is about 15 minutes, because with the participation of enzymes, it is rapidly hydrolyzed to salicylic acid in the intestine, liver, and blood plasma. T1 / 2 salicylic acid - about 3 hours, but when taking acetylsalicylic acid in high doses (> 3 g), this figure can increase significantly as a result of saturation of enzyme systems. Magnium hydroxide (in the doses used) does not affect the bioavailability of acetylsalicylic acid.
Indications
Primary prevention of cardiovascular diseases such as thrombosis and acute heart failure with risk factors (for example, diabetes mellitus, hyperlipidemia, arterial hypertension, obesity, smoking, old age). Prevention of recurrent myocardial infarction and thrombosis of blood vessels.Prevention of thromboembolism after surgical interventions on the vessels (coronary artery bypass surgery, percutaneous transluminal coronary angioplasty). Unstable angina.
Contraindications
Hypersensitivity to ASA, drug auxiliaries and other NSAIDs, hemorrhage in the brain; bleeding tendency (vitamin K deficiency, thrombocytopenia, hemorrhagic diathesis); bronchial asthma induced by salicylates and NSAIDs; erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase); gastrointestinal bleeding; severe renal failure (creatinine clearance less than 10 ml / min.); pregnancy; lactation period; glucose-6-phosphate dehydrogenase deficiency; simultaneous administration with methotrexate (more than 15 mg per week); children's age up to 18 years.
Precautionary measures
Do not exceed the recommended dose. With caution, you should prescribe the drug for gout, hyperuricemia, history of ulcerative lesions of the gastrointestinal tract or bleeding from the gastrointestinal tract, with renal and / or liver failure, bronchial asthma, hay fever, nasal polyposis, allergic conditions, in the II trimester of pregnancy .
Use during pregnancy and lactation
The use of high doses of salicylates in the first trimester of pregnancy is associated with an increased incidence of fetal developmental defects. In the second trimester of pregnancy, salicylates can only be prescribed with a rigorous assessment of risk and benefit. In the third trimester of pregnancy, salicylates at a high dose (> 300 mg / day) cause inhibition of labor, premature closure of the ductus arteriosus in the fetus, increased bleeding in the mother and fetus, and administration directly to the birth can cause intracranial hemorrhages, especially in premature babies. The appointment of salicylates in the third trimester of pregnancy is contraindicated. The available clinical data are not sufficient to establish the possibility or impossibility of using the drug during the breastfeeding period. Before prescribing acetylsalicylic acid during breastfeeding, the potential benefit of drug therapy should be assessed with respect to the potential risk to infants.
Dosage and administration
Tablets are swallowed whole with water. If desired, the tablet can be broken in half, chewed or pre-rub.
Side effects
Urticaria, angioedema, anaphylactic reactions, nausea, heartburn, vomiting, pain in the abdomen, ulcers of the mucous membrane of the stomach and duodenum, gastrointestinal bleeding, increased activity of “liver” enzymes, stomatitis, esophagitis, erosive lesions of the upper parts of the organism; intestinal tract, strictures, colitis, irritable bowel syndrome, bronchospasm, increased bleeding, anemia, hypoprothrombinemia, thrombocytopenia, neutropenia, aplastic anemia, eosinophilia, agranulocytosis, head servation, headache, insomnia, somnolence, tinnitus, intracerebral hemorrhage.
Overdose
Symptoms of an overdose of moderate severity: nausea, vomiting, tinnitus, hearing loss, dizziness, confusion Soznaniya.lechenie: gastric lavage should designate activated carbon, symptomatic terapiyu.Simptomy severe overdose: fever, hyperventilation, ketosis, respiratory alkalosis, coma, cardiovascular and respiratory failure, severe hypoglycemia. Treatment: immediate hospitalization in specialized departments for emergency treatment - gastric lavage, o acid-base balance, alkaline and forced alkaline diuresis, hemodialysis, saline injection, activated carbon, symptomatic therapy. When conducting alkaline diuresis, it is necessary to achieve pH values between 7.5 and 8. Forced alkali diuresis should be carried out when the concentration of salicylates in the plasma is more than 500 mg / l (3.6 mmol / l) in adults and 300 mg / l (2.2 mmol / l) in children.
Interaction with other drugs
With simultaneous use of acetylsalicylic acid increases the effect of the following drugs: - methotrexate (by reducing renal clearance and displacing it from the connection with proteins); - heparin and indirect anticoagulants (due to dysfunction of platelets and displacing indirect anticoagulants from the connection with proteins) - thrombolytic and antiplatelet and anticoagulant drugs (ticlopidine); digoxin (due toreducing its renal excretion); - hypoglycemic agents for oral administration (sulfonylurea derivatives) and insulin (due to the hypoglycemic properties of acetylsalicylic acid itself in high doses and displacing sulfonylurea derivatives from the bond with plasma proteins); - valproic acid (due to ousting it from the bond with proteins). Simultaneous use of acetylsalicylic acid with ibuprofen leads to a decrease in the cardioprotective effects of acetylsalicylic acid. An additive effect is observed while taking ac Ethyl salicylic acid with ethanol (alcohol). Acetylsalicylic acid weakens the effect of uricosuric drugs (benzbromarone) due to competitive tubular elimination of uric acid. Increasing the elimination of salicylates, systemic GCS weakens their action.
special instructions
Cardiomagnyl should be taken after prescribing by a doctor. Acetylsalicylic acid can provoke bronchospasm, as well as cause attacks of asthma and other hypersensitivity reactions. Risk factors are a history of asthma, hay fever, nasal polyposis, chronic respiratory diseases, and allergic reactions (such as skin reactions, itching, urticaria) to other drugs. Acetylsalicylic acid can cause bleeding of varying severity during and after surgical interventions. A few days before the planned surgical intervention, the risk of bleeding should be assessed compared with the risk of ischemic complications in patients, taking low doses of acetylsalicylic acid. If the risk of bleeding is significant, the use of acetylsalicylic acid should be temporarily stopped. The combination of acetylsalicylic acid with anticoagulants, thrombolytics and antiplatelet medications is accompanied by an increased risk of bleeding. With the use of acetylsalicylic acid in low doses, it can trigger the development of gout in susceptible people. The combination of acetylsalicylic acid with methotrexate is accompanied by an increased incidence of adverse events. effects from the blood-forming organs. Acceptance of acetylsalicylic acid in high doses has a hypoglycemic effect, which must be borne in mind when prescribing it to patients with diabetes,receiving hypoglycemic agents for ingestion and insulin. With the combined use of systemic corticosteroids and salicylates, remember that the concentration of salicylates in the blood is reduced during treatment, and overturning of systemic corticosteroids can cause an overdose of salicylates. The combination of acetylsalicylic acid and ibuprofen is not recommended in patients with increased risk cardiovascular diseases: with simultaneous use with ibuprofen there is a decrease in the antiplatelet effect of acetylsalicylic acid in doses up to 300 mg, which leads to a decrease in the cardioprotective effects of acetylsalicylic acid. Exceeding the dose of acetylsalicylic acid over the recommended therapeutic doses is associated with the risk of gastrointestinal bleeding. With prolonged use of acetylsalicylic acid in low doses as an antiaggregant therapy, caution is needed in elderly patients because of the risk of developing gastrointestinal bleeding.When taking acetylsalicylic acid with ethanol at the same time, the risk of damage to the mucous membrane is increased CT and lengthening of bleeding time. Effect on the ability to drive vehicles and control mechanisms During the period of treatment with acetylsalicylic acid drugs, patients should be careful when driving and occupying potentially dangerous activities that require increased concentration and psychomotor reactions.