1 tablet contains 75 mg acetylsalicylic acid;
auxiliary substances: corn starch, magnesium hydroxide cellulose microcrystalline magnesium stearate potato starch; methyl hydroxyethyl cellulose; propylene glycol; talc.
Basic physico-chemical properties: film-coated tablets, white in the form of a stylized "heart".
Antithrombotic agents. The thrombocyte aggregation inhibitors, excluding heparin.
Code ATH V01A S06.
Acetylsalicylic acid is an analgesic, anti-inflammatory and antipyretic and antiplatelet agent. Antiplatelet properties increase the bleeding time.
The main pharmacological effect - inhibiting the formation of prostaglandins and thromboxane. Analgesic effect is an additional effect that is caused by inhibition of the enzyme cyclooxygenase. The anti-inflammatory effect is associated with reduced blood flow caused by inhibition of PGE2 synthesis.
Acetylsalicylic acid irreversibly inhibits the synthesis of prostaglandins G/H, its effect on platelets lasts longer than acetylsalicylic acid is in the body. The effect of acetylsalicylic acid on the biosynthesis of thromboxane in platelets and bleeding time lasts for a long time after the termination of treatment. The action stops only after the appearance of new platelets in blood plasma.
Salicylic acid (an active metabolite of acetylsalicylic acid) has an anti-inflammatory effect, as well as has an impact on respiratory processes, the state of acid-base balance and gastric mucosa. Salicylates stimulate respiration, mainly by exercising a direct effect on the bone marrow. Salicylates exercise an indirect effect on the gastric mucosa by inhibiting its vasodilator and cytoprotective prostaglandins and increase the risk of ulcers.
Absorption. After ingestion, acetylsalicylic acid is rapidly absorbed from the digestive tract. After taking the absorption of non-ionized form of acetylsalicylic acid occurs in the stomach and intestines. The rate of absorption decreases with food intake and in patients with migraine attacks, increases - in patients with ahlorgidrii or in patients taking polysorbates or antacids. The maximum concentration in plasma is reached after 1-2 hours.
Distribution. Binding of acetylsalicylic acid with blood plasma proteins is 80-90%. The volume of distribution for adults is 170 ml/kg body weight. When the concentration in the blood plasma increases, the saturation of the active centers of proteins occurs, which leads to an increase in the volume of distribution. Salicylates are extensively bound to blood plasma proteins and rapidly spread throughout the body. Salicylates penetrate into breast milk and can cross the placental barrier.
Metabolism. Acetylsalicylic acid is hydrolyzed to an active metabolite - salicylic acid in the stomach wall. After absorption, acetylsalicylic acid is rapidly converted into salicylic acid, but during the first 20 minutes after ingestion is dominant in blood plasma.
Conclusion. Salicylic acid is metabolized in the liver. Thus, the equilibrium concentration of salicylic acid in blood plasma increases disproportionately ingested dose. At a dose of 325 mg of acetylsalicylic acid withdrawal occurs with the participation of kinetics of the first-order reaction. The half-life period is 2-3 hours. With a high dose of acetylsalicylic acid, the half-life period increases to 15-30 hours. Salicylic acid is also excreted in unchanged form with the urine. The amount of salicylic acid is derived depends on the level of urine dose and pH. Approximately 30% salicylic acid is excreted in the urine if the urine reaction is alkaline, only 2% - if acidic. Kidney excretion is due to glomerular filtration processes, active secretion of renal tubules and passive tubular reabsorption.
Acute and chronic ischemic heart disease.
Prevention of re-thrombosis.
Primary prevention of thrombosis, cardiovascular diseases, such as acute coronary syndrome in patients older than 50 years, in which there are risk factors for cardiovascular diseases: hypertension, hypercholesterolemia, diabetes mellitus, obesity (body mass index>30), family history (myocardial infarction in patients under the age of 55 years at least one parent or brother or sister).
Hypersensitivity to acetylsalicylic acid, other salicylates or to any component of the drug.
Asthma caused by ingestion of salicylates or substances with a similar action, especially NSAIDs in history.
Acute peptic ulcers.
Severe renal failure.
Hepatic insufficiency of severe degree.
Severe heart failure.
Combination with methotrexate in a dosage of 15 mg/week or more (see "Interaction with other medicinal products and other forms of interaction" ).
Interaction with other medicinal products and other forms of interaction
Contraindications for concurrent use.
Methotrexate. The use of acetylsalicylic acid and methotrexate at doses of 15 mg/week or more increases hematologic toxicity of methotrexate (decreased renal clearance of methotrexate by anti-inflammatory agents and displacement by salicylates of methotrexate from the blood plasma).
The ACE inhibitors. ACE inhibitors in combination with high doses of acetylsalicylic acid cause a decrease in filtration in glomerules due to inhibition of the vasodilator effect of prostaglandins and a decrease in the antihypertensive effect.
Acetazolamide. Perhaps an increase in the concentration of acetazolamide can lead to the penetration of salicylates from blood plasma into the tissue and cause toxicity of acetazolamide (fatigue, lethargy, drowsiness, confusion, hyperchloremic metabolic acidosis) and toxicity of salicylates (vomiting, tachycardia, hyperpnoea, confusion).
Probenecid, sulfinpirazon. When using probenecide and high doses of salicylates (>500 mg), each other's metabolism is suppressed and excretion of uric acid may decrease.
Combinations that should be used with caution.
Methotrexate. When using acetylsalicylic acid and methotrexate at doses less than 15 mg/week increased hematological toxicity of methotrexate (reduced renal clearance of methotrexate anti-inflammatory agents and displacement of methotrexate salicylates due to plasma proteins).
Clopidogrel, ticlopidine. The combined use of clopidogrel and acetylsalicylic acid has a synergistic effect. This combined use is carried out with caution, as it increases the risk of bleeding.
Anticoagulants (warfarin, phenprocoumon). It is possible to reduce the production of thrombin, resulting in an indirect effect on the reduction of platelet activity (vitamin K antagonist) and increases the risk of bleeding.
Abciximab, tirofiban, eptifibatid. Inhibition of glycoprotein IIb/IIIa receptors on platelets is possible, which leads to increased risk of bleeding.
Heparin. It is possible to reduce the production of thrombin, resulting in an indirect effect on the reduction of platelet activity, which leads to an increased risk of bleeding.
If two or more of the above substances are used together with acetylsalicylic acid, it can lead to the synergistic effect of increased inhibition of platelet activity and, as a result, increased hemorrhagic diathesis.
NSAIDs and COX-2 inhibitors (celecoxib). Combined use increases the risk of gastrointestinal disorders, can lead to gastrointestinal bleeding.
Ibuprofen. Simultaneous use of ibuprofen inhibits irreversible platelet aggregation caused by the action of acetylsalicylic acid. Treatment with ibuprofen in patients with an increased risk of exposure to the cardiovascular system may limit the cardioprotective effect of acetylsalicylic acid.
Patients who take acetylsalicylic acid 1 time per day for the prevention of cardiovascular disease and occasionally take ibuprofen should take acetylsalicylic acid at least 2 hours before taking ibuprofen.
Furosemide. Inhibition of proximal Kanal elimination of furosemide is possible, which leads to a decrease in the diuretic effect of furosemide.
Quinidine. Possible additive effect on platelets, which leads to an increase in the duration of bleeding.
Spironolactone. Possible modified the effect of renin, which reduces the effectiveness of spironolactone.
Selective serotonin reuptake inhibitors. Combined use increases the risk of gastrointestinal disorders, can lead to gastrointestinal bleeding.
Valproate. While the use of valproate acetylsalicylic acid expels it due to plasma proteins, increasing the toxicity of the latter (depression of the Central nervous system, gastrointestinal tract).
Systemic glucocorticosteroids (excluding hydrocortisone, which is used for substitution therapy for Addison's disease) reduce the level of salicylates in the blood and increase the risk of overdose after treatment.
Antidiabetic drugs. The simultaneous use of acetylsalicylic acid and antidiabetic drugs increases the risk of hypoglycemia.
Antacids. It is possible to increase the renal clearance and reduce renal absorption (due to an increase in the pH of urine), which leads to a decrease in the effect of acetylsalicylic acid.
Chicken pox vaccine. The combined use increases the risk of Reye's syndrome.
Ginkgo biloba. Joint the use of gingko biloba prevents platelet aggregation, which leads to increased risk of bleeding.
Digoxin. When used simultaneously with digoxin, the concentration of the latter in the blood plasma increases due to a decrease in renal excretion.
Alcohol causes damage to the mucous membrane of the gastrointestinal tract and prolongs the bleeding time due to the synergy of acetylsalicylic acid and alcohol.
The drug Cardiomagnyl is used with caution in the following situations:
hypersensitivity to analgesic, anti-inflammatory, Antirheumatic agents, as well as in the presence of allergies to other substances;
ulcers of the gastrointestinal tract, including chronic and recurrent peptic ulcer disease or gastrointestinal bleeding history
the simultaneous use of anticoagulants;
in patients with impaired renal function or patients with impaired cardiovascular circulation (eg, vascular pathology of the kidney, congestive heart failure, hypovolemia, major surgery, sepsis or severe bleeding), since acetylsalicylic acid can also increase the risk of renal dysfunction and acute renal failure ;
patients with severe deficiency of glucose-6-phosphate dehydrogenase acetylsalicylic acid may induce hemolysis or hemolytic anemia. Especially in the presence of factors that may increase the risk of hemolysis, such as high doses of the drug, fever or acute infectious process,
impaired liver function.
Ibuprofen can reduce the inhibitory effect of acetylsalicylic acid on platelet aggregation. In the case of the drug Cardiomagnyl before taking ibuprofen as analgesic the patient should consult a doctor.
Acetylsalicylic acid may influence the development of bronchospasm or asthma attack or other hypersensitivity reactions. Risk factors include asthma in the anamnesis, hay fever, nasal polyposis or chronic respiratory disease, allergic reactions (e.g. skin reactions, itching, urticaria) to other substances in the anamnesis.
Through the inhibitory effect of acetylsalicylic acid on platelet aggregation which persists for several days after ingestion, the use of drugs containing acetylsalicylic acid, may increase the likelihood/gain of bleeding during surgical operations (including minor surgical intervention such as tooth extraction).
When using small doses of acetylsalicylic acid may decrease the excretion of uric acid. This can lead to a gout attack in predisposed patients.
Do not use drugs containing acetylsalicylic acid, children and adolescents with acute respiratory viral infection (SARS), which is accompanied or is not accompanied by an increase in body temperature, without consulting a doctor. In some viral diseases, particularly with influenza A, influenza b, and varicella, there is a risk of Reye's syndrome, which is a very rare but life-threatening disease that requires urgent medical intervention. The risk may be increased if acetylsalicylic acid is used as a concomitant drug, but the cause-effect relationship in this case is not proven. If these conditions are accompanied by constant vomiting, it may be a manifestation of Reye's syndrome.
Application during pregnancy and lactation
Inhibition of prostaglandin synthesis may negatively affect pregnancy and/or embryonal/foetal development. The available data from epidemiological studies indicate the risk of miscarriage and fetal malformations after the use of inhibitors of prostaglandin synthesis during early pregnancy. The risk increases depending on the increase in dose and duration of therapy. According to available data, the link between taking acetylsalicylic acid and an increased risk of miscarriage has not been confirmed.
Available epidemiological data on the occurrence of malformations is not consistent, however, an increased risk of gastroschisis cannot be excluded in the application of acetylsalicylic acid. The results of a prospective study of the effect in early pregnancy (1-4 month) with the participation of about 14,800 couples woman-child do not indicate any connection with an increased risk of malformation.
Animal studies indicate reproductive toxicity.
During the I and II trimester of pregnancy preparations containing acetylsalicylic acid should not be prescribed without a clear clinical need. In women who may be expected to be pregnant or during the I and II trimester of pregnancy, the dose of drugs containing acetylsalicylic acid should be as low as possible, and the duration of treatment can be shorter.
In the III trimester of pregnancy, all inhibitors of prostaglandin synthesis can affect the fetus in the following way:
cardiopulmonary toxicity (with premature closure of the ductus arteriosus and pulmonary hypertension)
the impairment of renal function with subsequent development of renal failure with oligogidroamniona;
the woman and child in late pregnancy inhibitors of prostaglandin synthesis can be affected in the following way:
the possibility of prolonging the bleeding time, antiplatelet effect, which can occur even after very low doses;
inhibition of uterine contractions, which may lead to a delay or increase in the duration of labor.
Despite this, aspirin is contraindicated in third trimester of pregnancy.
Salicylates and their metabolites penetrate into breast milk in small amounts.
Since no harmful effects of the drug on the baby have been found after taking by women during lactation, it is generally not necessary to interrupt breastfeeding. However, in cases of regular use or when the use of high doses breast-feeding must stop in the early stages.
The ability to influence the reaction rate when driving motor transport or operating other mechanisms
Method of application and doses
Acute and chronic ischemic heart disease.
The recommended initial dose of 150 mg per day. Maintenance dose-75 mg per day.
Acute myocardial infarction. Unstable angina.
The recommended dose is 150-450 mg, apply as soon as possible after the onset of symptoms.
Prevention of re-thrombosis.
The recommended initial dose of 150 mg per day. Maintenance dose-75 mg per day.
Primary prevention of thrombosis, cardiovascular diseases,such as acute coronary syndrome in patients who have factors of cardiovascular disease.
The recommended prophylactic dose is 75 mg per day.
The tablets are swallowed whole, if necessary, with water. To ensure rapid absorption, the tablet can be chewed or dissolved in water.
Impaired liver function. The drug is not used in patients with severe hepatic impairment. Dose correction may be required in patients with impaired liver function.
The impairment of renal function. The drug is not used for the treatment of patients with severe renal insufficiency (glomerular filtration level <0.2 ml/s (10 ml/min)). Dose correction may be required in patients with impaired renal function.
According to the testimony (see Section " Method of application and dosage ") drug Cardiomagnyl not apply to children.
The use of acetylsalicylic acid to children under the age of 15 can cause severe side effects (including Reye's syndrome, one sign of which is the constant vomiting).
Dangerous dose . Adults 300 mg/kg of body weight.
Chronic poisoning with salicylates may be latent, as its symptoms and symptoms are non-specific. Moderate chronic intoxication caused by salicylates or salicylism occurs, usually only after repeated taking high doses.
Symptoms of chronic poisoning average degree (the result of prolonged use of high doses) dizziness, deafness, sweating, fever, rapid breathing, tinnitus, respiratory alkalosis, metabolic acidosis, lethargy, mild dehydration, headache, confusion, nausea and vomiting.
Acute intoxication is evidenced by a marked change in the acid-base balance, which may vary depending on the age and severity of intoxication. Most often, its manifestation in children is metabolic acidosis. The severity of the condition cannot be evaluated on the basis of the concentration of salicylates in the blood plasma. Absorption of acetylsalicylic acid can be slowed down due to delayed gastric release, the formation of concrements in the stomach or in the case of taking the drug in the form of tablets coated with an intestinal-soluble membrane.
Symptoms of severe and acute poisoning (due to overdose): hypoglycemia (mainly in children), encephalopathy, coma, hypotension, pulmonary edema, convulsions, coagulopathy, cerebral edema, cardiac arrhythmias.
A more pronounced toxic effect is observed in patients with chronic overdose or drug abuse, as well as in elderly patients or children.
Treatment. In case of acute overdose, gastric lavage and the intake of activated charcoal are necessary. If you suspect the use of doses greater than 120 mg/kg of body weight, to apply the activated carbon again.
The level of salicylate in serum should be measured at least every 2:00 after taking the dose, until the salicylate level is consistently reduced and restored acid-alkaline balance.
Prothrombin time and/or mnis (international normalized index) should be checked, particularly if there is a suspicion of bleeding.
It is necessary to restore the balance of liquid and electrolytes. Alkaline diuresis and hemodialysis are effective methods for removing salicylate from blood plasma. Hemodialysis should be used in case of severe intoxication, so how this method significantly accelerates the removal of salicylates and restores acid-base and water-salt balances.
Through the complex pathophysiological effects of salicylate poisoning manifestations and symptoms/test results may include:
Manifestations and sentimentality analysistravestis events
Intoxication of mild or moderate gastric Lavage, repeated administration of activated charcoal, forced alkaline diuresis
Tachypnea, hyperventilation, respiratory alkylsalicylate, alkalinebatteries electrolyte and acid-base balance
Hyperhidrosis (increased sweating)
Moderate or severe intoxication gastric Lavage, repeated administration of activated charcoal, forced alkaline diuresis, hemodialysis in severe cases
Respiratory alkalosis with compensatory metabolic azidotimidine, aldoifosfamide electrolyte and acid-base balance
hyperpyrexia Restoration of electrolyte and acid-base balance
Respiratory: hyperventilation, noncardiogenic pulmonary edema, respiratory failure, asphyxia
Cardiovascular: dysarrhythmias, hypotension, cardiovascular insufficiency example, changes in blood pressure, ECG
Loss of fluid and electrolytes dehydration, oliguria, renal nedostatochnosti, hypokalemia, hypernatremia, hyponatremia, changes in spaceconstrained electrolyte and acid-base balance
Violation of glucose metabolism, ketoatsidoticheskaya, hypoglycemia (especially in children). Increased levels of ketone bodies
Ringing in the ears, deafness
Gastro-intestinal: bleeding in the digestive tract
Hematologic: inhibition of platelet coagulopathies, prolongation of the PT, hypoprothrombinemia
Neurologic: toxic encephalopathy and CNS depression with manifestations such as lethargy, confusion, coma and seizures
The above information about adverse reactions is based on spontaneous postmarketing reports of adverse reactions in the application of all dosage forms and acetylsalicylic acid (including oral administration for a short and long course of treatment). Despite this, the classification of adverse reactions by frequency categories CIOMS III was not carried out.
Gastrointestinal disorders: frequent signs and symptoms of dyspepsia, epigastric pain and abdominal pain in some cases, inflammation of the gastrointestinal tract, erosive-ulcerative lesions of the gastrointestinal tract, which can in rare cases cause gastrointestinal hemorrhages and perforations of relevant laboratory parameters and clinical manifestations.
Due to the antiplatelet action on platelets, acetylsalicylic acid may be associated with risk of bleeding, a prolonged bleeding time. There were bleeding such as Perioperative hemorrhage, hematomas, bleeding from the genitourinary system, nasal bleeding, bleeding from the gums; rarely or very rarely - severe bleeding, such as gastrointestinal hemorrhages, cerebral hemorrhages (especially in patients with uncontrolled hypertension and/or the simultaneous use of antihemostatic agents), which in some cases could potentially endanger lives.
Hemorrhage can lead to acute and chronic posthemorrhagic anemia/iron deficiency anemia (due to the so-called hidden microcrustacea) with the relevant and laboratory manifestations of clinical symptoms such as asthenia, skin pallor, hypoperfusion.
Hemolysis and hemolytic anemia were observed in patients with severe forms of glucose-6-phosphate dehydrogenase insufficiency.
Renal impairment and acute renal failure were reported.
Hypersensitivity reactions with appropriate laboratory and clinical manifestations including asthmatic condition, mild to moderate skin reactions, as well as those from the respiratory tract, gastrointestinal tract and cardiovascular system, including symptoms such as rash, urticaria, edema, itching, rhinitis, nasal congestion, cardiovascular insufficiency and very rarely severe reactions, including anaphylactic shock.
Very rarely reported transient liver failure with increased levels of transaminases and alkaline phosphatase of blood serum.
There was dizziness and ringing in the ears, which may indicate an overdose.
Store at a temperature not exceeding 25 ° C. Keep out of reach of children!
30 or 100 tablets in a bottle; 1 bottle in a cardboard box.
Category home away from home
Without a prescription - 30 tablets. On prescription-100 tablets.
Takeda GmbH, the place of production Oranienburg/Takeda GmbH Betriebsst?tte Oranienburg.
Manufacturer's location and address of the place of business
Lansstrasse 70-98, 16515 Oranienburg, Germany/Lehnitzstrasse 70-98, 16515 Oranienburg, Germany.
CARDIOLINE DROPS 50ML
Cardioline is a cardiac drug that protects the cardiovascular system, has a marked antioxidant effect. These drops are combined, since they include an extract from several medicinal plants, which include:
Grass mountain flower spring.
Liquid a brownish tint with a sweet odor. Released in a bottle of 50 ml.
Effect on the body, indications
When taking the drug improves metabolism in the liver and myocardium, suspended lipid oxidation. Antioxidant enzymes become more active, which has a positive effect on cellular energy balance. Drops have a sedative effect, which contributes to a better state of health during exercise, increases efficiency.
The drug is used for:
Neurosis of the heart.
Intake and dosage
Welcome Cardioline orally 20-30 drops two to three times every 24 hours. For better absorption of active substances-30 minutes before or 60 minutes after meals. The drops are suitable for dilution in liquid in the proportion of 1: 3-5
The duration of therapy is determined by the patient's condition, it is individually determined by the doctor. The average course is 2-4 months.