Cardiomagnyl

Use during pregnancy and breastfeeding

The use of salicylates in high doses in the first trimester of pregnancy is associated with an increased incidence of fetal defects.
In the second trimester of pregnancy, salicylates can be prescribed only taking into account a strict assessment of risks and benefits. In the third trimester of pregnancy, salicylates in high doses (>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 immediately before birth can cause intracranial hemorrhages, especially in premature infants. The administration of salicylates in the first and third trimesters of pregnancy is contraindicated. The available clinical data are insufficient to establish the possibility or impossibility of using the drug during breastfeeding. Before prescribing acetylsalicylic acid during breastfeeding, the potential benefits of drug therapy should be assessed against the potential risk for infants.

Use for liver dysfunction

In case of liver failure, it should be used with caution.

Use for renal impairment

The drug is contraindicated in severe renal failure (creatinine clearance less than 10 ml/min); in case of renal failure should be used with caution.

Use in children

Contraindicated in children and adolescents under 18 years of age.

special instructions

You should take the drug Cardiomagnyl after a doctor’s prescription.

Acetylsalicylic acid can provoke bronchospasm, as well as cause attacks of bronchial asthma and other hypersensitivity reactions. Risk factors include a history of bronchial asthma, hay fever, nasal polyposis, chronic respiratory diseases, and allergic reactions (for example, skin reactions, itching, urticaria) to other drugs.

Acetylsalicylic acid can cause bleeding of varying severity during and after surgery.

Several days before planned surgery, 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, acetylsalicylic acid should be temporarily discontinued.

The combination of acetylsalicylic acid with anticoagulants, thrombolytics and antiplatelet drugs is accompanied by an increased risk of bleeding.

Taking acetylsalicylic acid in low doses can trigger the development of gout in predisposed individuals (those with reduced excretion of uric acid).

The combination of acetylsalicylic acid with methotrexate is accompanied by an increased incidence of side effects from the hematopoietic organs.

Taking acetylsalicylic acid in high doses has a hypoglycemic effect, which must be kept in mind when prescribing it to patients with diabetes mellitus receiving oral hypoglycemic agents and insulin.

When using systemic corticosteroids and salicylates in combination, it should be remembered that during treatment the concentration of salicylates in the blood is reduced, and after discontinuation of systemic corticosteroids, an overdose of salicylates is possible.

The combination of acetylsalicylic acid with ibuprofen is not recommended in patients with an increased risk of cardiovascular diseases: when used simultaneously with ibuprofen, a decrease in the antiplatelet effect of acetylsalicylic acid in doses of up to 300 mg is observed, which leads to a decrease in the cardioprotective effects of acetylsalicylic acid.

Exceeding the dose of acetylsalicylic acid beyond the recommended therapeutic doses is associated with the risk of gastrointestinal bleeding.

With long-term use of acetylsalicylic acid in low doses as antiplatelet therapy, caution is required in elderly patients due to the risk of gastrointestinal bleeding.

When taking acetylsalicylic acid with ethanol at the same time, there is an increased risk of damage to the gastrointestinal mucosa and prolongation of bleeding time.

Impact on the ability to drive vehicles and operate machinery

During treatment with acetylsalicylic acid, patients should be careful when driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Arterial hypertension – lifelong medication use?

Perhaps the majority of patients seen by a cardiologist are patients with high blood pressure - arterial hypertension (AH). Some of them had their blood pressure rise for the first time due to a stressful situation, some have been taking medications for a long time, but, as a rule, few have a complete understanding of their disease, and most importantly, how to live with it correctly and effectively treat it .

In a healthy person, blood pressure changes throughout the day depending on the level of stress (physical, mental, etc.), but in general these fluctuations do not exceed the so-called physiological norm, which supports the normal functioning of the body. For an adult, blood pressure is considered normal no higher than 140/90 mmHg. Art. And in some cases, for example, in the presence of diabetes mellitus, kidney disease, the pressure should be even lower at the level of 130/80 - 120/70 mm Hg. Art., which helps prevent the progression of these diseases and the development of complications. The state of the nervous system, heart and blood vessels plays an important role in maintaining blood pressure within optimal limits. With hypertension, the heart works overload, pumping an additional volume of blood. Over time, this leads to increased resistance from the vessels, which narrow under conditions of constant overload. The walls of the arteries thicken and harden, losing their elasticity. With the long-term existence of hypertension, the load on the vessels becomes unbearable, which can lead to degenerative changes in their wall, with the development of narrowing or pathological expansion, and even rupture of the vessel can occur. If this complication occurs in a vital organ (heart, brain), then it can result in myocardial infarction or cerebral hemorrhage (stroke) . But, despite this danger, the insidiousness of hypertension is that it can be completely asymptomatic for a long time.

The diagnosis of hypertension is usually not made after a single blood pressure measurement, unless the readings are too high, for example, over 170-180/105-110 mm Hg. Art. Typically, a series of measurements are taken over a period of time to completely eliminate random fluctuations and inaccuracies. It is also necessary to take into account the circumstances during which blood pressure measurements are taken. As a rule, blood pressure increases under stress, after drinking strong coffee or smoking a cigarette.

About 1/3 of the adult population has a persistent increase in blood pressure above 140/90 millimeters of mercury. 2/3 of those who suffer from hypertension do not know about their disease, and those who know often do not give it due importance (especially if the numbers are not so high, about 160/100 mm Hg), until headaches, heart pain, shortness of breath, arrhythmia, and swelling will not occur.

An interesting fact is that in a doctor’s office, when measuring blood pressure, the readings can be higher than at rest at home. This effect is called "white coat hypertension" and is caused by the patient's fear of the disease or the doctor. In addition to measuring blood pressure, the doctor usually checks for changes in other organs, especially if the pressure readings are at high levels.

If the blood pressure in an adult does not exceed 140/90 mm. rt. Art., then re-measurement is usually carried out no earlier than a year later. In patients whose blood pressure is between 140/90 and 160/100, repeated measurements are taken after a short period of time to confirm the diagnosis.

A high diastolic (bottom) pressure, such as 110 or 115 mmHg, indicates the need for immediate treatment.

Hypertension is one of the most common diseases. In developed countries, 10% of the adult population and about 60% of people over 65 years of age have high blood pressure. Unfortunately, no more than 30% of these people know about their illness, regularly receive therapy and follow the doctor’s recommendations. Unlike a number of diseases that you can “get over,” hypertension, as a rule, is a chronic, lifelong condition.

Arterial hypertension is most often primary in nature and is a symptom of hypertension. Less commonly, high blood pressure is secondary and is a sign of diseases of various organs (kidneys, blood vessels, etc.). Each of these diseases requires special treatment, which is why any increase in blood pressure requires consultation with a cardiologist.

In older people, a special type of hypertension sometimes occurs, so-called “isolated systolic hypertension.” In this case, systolic pressure readings are equal to or exceeding 140 mmHg, and diastolic pressure readings remain below 90 mmHg. This type of hypertension is a dangerous risk factor for the development of strokes and heart failure. Often, patients seek help only when the diastolic pressure, in their opinion, becomes too low - 50-60 mm Hg. Art. Sometimes this can be a sign of heart disease, but more often it is associated with age-related changes in the vascular wall, and it is very important to find drugs that will reduce the gap between systolic and diastolic pressure numbers, which in turn reduces the risk of stroke and heart failure .

In cases where routine and dietary measures do not allow adequate control of blood pressure, additional (and not instead) medications are prescribed. Today their list is quite impressive. Often, when a patient seeks help with complaints of high blood pressure despite taking prescribed medications, you can see that the medications were chosen correctly and are suitable for the patient for long-term use, but their dosages are inadequate. In cardiology, there is the concept of an effective dose - that is, one at which one can count on the manifestation of the desired effect. And if you take the same drug in halves or fours, and not just 2, but once a day, and often not even every day, then there is no need to talk about any hypotensive, much less therapeutic, effect of the drug. When prescribing one or more drugs, the cardiologist takes into account the level of blood pressure, the severity of hypertension, the individual daily blood pressure profile, the main risk factors or causes of arterial hypertension, the severity of target organ damage, the presence of concomitant diseases, and the interaction of drugs with each other and with other medications taken. , the possibility of developing side effects. Therefore, it is absolutely unacceptable for a patient to change doctor’s prescriptions, drug doses, frequency of administration, or discontinue one or another drug on their own. If, when taking a prescribed combination of antihypertensive drugs, the patient notices the occurrence of any side effects, the pressure does not decrease or, on the contrary, decreases excessively, it is necessary to discuss this with the attending physician, who, having understood the reasons, will adjust your prescriptions.

The role of the patient in the treatment of arterial hypertension cannot be underestimated. The effectiveness of treatment measures largely depends on how ready he is, in accordance with the doctor’s recommendations, to actively and consistently fight and, if possible, eliminate his risk factors. Dealing with risk factors means stopping smoking, limiting alcohol consumption, regularly taking recommended medications and monitoring their effect on blood pressure by recording measurements in a special diary.

Effective control of blood pressure should be considered if, as a result of lifestyle modifications, elimination of risk factors and bad habits, or taking antihypertensive drugs, it is possible to maintain blood pressure levels below 140/90 mmHg. Art., and for patients with diabetes mellitus, if possible, below 130/80 mmHg. Art. Achieving a target blood pressure level helps reduce the relative risk of developing fatal and non-fatal conditions/diseases, compared with patients who are not treated or are taking ineffective combinations. Each patient with hypertension needs to reduce excess weight, lead an active lifestyle, stop smoking, limit alcohol consumption (10 - 20 g for women, 20 - 30 for men in terms of pure ethanol), regularly take recommended medications and monitor their effect on blood pressure, enter blood pressure measurement data and other information necessary for the doctor in a special blood pressure self-monitoring diary.

If blood pressure exceed the specified level, then you should discuss with your doctor the possible reasons for the lack of effectiveness of the treatment. Among them:

in blood pressure has not been identified
Failure to comply with lifestyle modification recommendations
Irregular use of antihypertensive drugs
Inadequate antihypertensive therapy

As practice shows, if the patient trusts his doctor, with competent interaction between the doctor and the patient, in most cases it is possible to control this terrible disease.

What if you are already taking 3 or more medications and your blood pressure has not stabilized at your target level? This form of hypertension is classified as resistant.

Resistant hypertension is a condition in which blood pressure remains above target despite taking a combination of three or more antihypertensive drugs. Uncontrolled hypertension is not synonymous with resistant hypertension. Uncontrolled hypertension is caused by insufficient secondary control of blood pressure due to non-compliance with treatment regimen or true resistance to therapy. The criterion for refractory arterial hypertension is a decrease in systolic blood pressure by less than 15% and diastolic blood pressure by less than 10% from the initial level against the background of rational therapy using adequate doses of three or more antihypertensive drugs.

The lack of adequate blood pressure in more than 2/3 of patients is due to non-compliance with the treatment regimen - pseudo-refractoriness. Another most common and easily eliminated cause of this phenomenon is excessive consumption of table salt. Reasons that are much more difficult to cope with include obesity, alcohol abuse, the use of certain medications, breathing disorders and stopping during sleep, and kidney disease.

The following factors are associated with an increased risk of developing resistant hypertension: older age, high initial blood pressure, obesity, excessive consumption of table salt, chronic kidney disease, diabetes mellitus, left ventricular hypertrophy, female gender. The cause of true refractoriness in hypertension is volume overload associated with inadequate use of diuretics.

What's the solution?

Usually, in the case of resistant (refractory) hypertension, doctors continue to increase the doses of drugs taken by the patient to the maximum tolerated or add sequentially a fourth, fifth, and sometimes a sixth drug from other groups. Patients react to this differently. Many people stop trusting the doctor, some refuse to take medications altogether, because they do not notice any difference between their blood pressure while taking handfuls of medications and without them.

Of course, this decision is fundamentally wrong. In order to avoid progressive target organ damage and serious complications in the future, it is necessary to continue taking medications even if it is not possible to achieve the target blood pressure level. But no one will deny that the use of a multicomponent combination of drugs significantly increases the risk of side effects and unpredictable drug interactions.

What can modern medicine offer in this case? It turns out there is a way out.

Soon in our clinic we will be able to offer a non-surgical method for correcting blood pressure by denervation of the renal arteries. A new procedure, catheter-based renal denervation of the renal arteries, helps control high blood pressure by destroying some of the nerve fibers located in the wall of the renal arteries.

As often happens, the idea of denervation is not new, it is a well-forgotten old thing. Surgeons have long known that excision of the sympathetic nerve fibers responsible for maintaining blood pressure resulted in a decrease in blood pressure. But the procedure could not be used to treat hypertension, since it was accompanied by high operative mortality and long-term complications such as severe hypotension when moving to a vertical position, up to loss of consciousness, dysfunction of the intestines and pelvic organs. But this happens because the sympathetic stimulation of the kidneys and other organs is completely turned off, which leads to an imbalance of nervous regulation. Since the sympathetic nerve fibers innervating the kidney pass directly into the wall of the main renal artery and are adjacent to it, using catheter radiofrequency ablation (RFA) targeted destruction of fibers in the renal arteries will not lead to disruption of the innervation of the abdominal organs and lower extremities. In addition, by destroying only a small part of the nerve endings in the renal arteries, the kidneys are not deprived of nervous regulation. THE CAUSE OF RESISTANT HYPERTENSION IS EXCESSIVE SYMPATHETIC ACTIVITY OF THE KIDNEYS. And catheter RFA allows you to eliminate this excess activity. HYPERTENSION BECOME CONTROLLED.

The introduction of this procedure into our practice is based on a study published in the famous journal Lancet, which showed the safety and effectiveness of the technique, which allows us to achieve a lasting reduction in blood pressure up to 30 mm. rt. Art. from the initial level.

For this treatment, a radiofrequency catheter from Ardian is used, which is inserted through a puncture in the femoral artery. Next, the catheter is passed under X-ray control into the renal artery. Through the tip of the catheter, radiofrequency energy is dosed around the circumference at 4-5 points of the renal arteries. The procedure takes about 40 minutes, after which the catheter is removed. The patient's hospital stay is 24 hours. The condition for the procedure is normal kidney function. But the most striking thing about the procedure is that over time, the therapeutic effect not only does not decrease, but, on the contrary, the blood pressure of the majority gradually and steadily normalizes.

Currently, renal denervation is used only in patients with resistant hypertension. This should lead to approximately a 50% reduction in hypertension-related complications and mortality. This does not mean that medications are no longer needed. Patients will still likely need to take high blood pressure medications, but the number of medications needed to keep blood pressure at target levels will be significantly reduced.

What are the side effects of RFA of the renal arteries?

To date, no serious complications of catheter-based renal denervation have been reported worldwide. The procedure was accompanied by moderate abdominal pain, which was relieved by intravenous analgesics and sedatives. Only one patient had damage to the renal artery by the catheter before RFA, which was corrected by implantation of a stent. The most common complication in a small number of patients was pain and swelling in the groin area. No deterioration in renal function was noted.

Who needs renal denervation?

Denervation of the renal arteries

Cost: 250,000 rub.
Duration: 20-30 minutes
Hospitalization: 1 day in hospital

More details

This intervention is indicated for patients with resistant hypertension, i.e. with a persistent increase in systolic (upper) blood pressure higher than 160 mm Hg. Art., despite the use of 3 or more antihypertensive drugs, including a diuretic. This is especially indicated if the combination of drugs is poorly tolerated or if there are side effects. In this case, patients must be preliminarily examined, and possible secondary causes of arterial hypertension (for example, diseases of the adrenal glands) must be reliably excluded. At the preliminary stage, it is necessary to conduct a computed tomography scan of the renal arteries to clarify the anatomical features of the vessels.

If you have high blood pressure , contact the cardiologists of our center. They will definitely help you.

Cardiomagnyl in the prevention and treatment of cardiovascular diseases

About the article

67984

Regular issues of "RMZh" No. 5 dated March 18, 2006 p. 400

Category: General articles

Author: Teplova N.V. 1 1 Federal State Autonomous Educational Institution of Russian National Research Medical University named after. N.I. Pirogov Ministry of Health of Russia, Moscow, Russia

For quotation:

Teplova N.V. Cardiomagnyl in the prevention and treatment of cardiovascular diseases. RMJ. 2006;5:400.

Today, acetylsalicylic acid is the “gold standard” in the prevention and treatment of diseases of the cardiovascular system. Acetylsalicylic acid is the most widely used and perhaps the most fully studied drug in the world. A quarter of a century ago, despite the absence at that time of clear evidence of the effectiveness of antiplatelet agents, it became the rule to prescribe acetylsalicylic acid to almost any patient suffering from coronary heart disease or who had suffered a myocardial infarction or ischemic cerebrovascular accident. Subsequently, antiplatelet therapy was convincingly confirmed in almost all multicenter studies performed according to the standards of “evidence-based medicine.” According to these studies, it was found that antiplatelet agents are effective in both men and women, in various age groups, and in persons suffering from arterial hypertension and diabetes mellitus.

However, despite more than a century that has passed since the discovery of acetylsalicylic acid, the horizons of its therapeutic potential and mechanism of action are still expanding. Acetylsalicylic acid, as the “gold standard”, was not chosen by chance: it is easy to dose, inexpensive, relatively safe, side effects as a result of long-term clinical use are well known and predictable. The main mechanism of action of acetylsalicylic acid is associated with irreversible blockade of cyclooxygenase-1. It is present both in platelets and in the vascular wall. Acetylsalicylic acid inhibits the synthesis of thromboxane A2, which is formed in platelets and ensures platelet aggregation with vasoconstriction. In addition, acetylsalicylic acid leads anucleated platelets to the ability to aggregate throughout their life, which is 7–10 days. Other antiplatelet drugs do not have such a long-lasting effect. Despite the fact that about 10% of the total platelet pool is renewed daily, after a single dose of acetylsalicylic acid, it takes 5–7 days for at least half of the platelets to restore their normal function. Currently, a huge number of studies have been conducted around the world on the use of antiplatelet agents in cardiovascular diseases. In 2002, the largest meta-analysis of randomized clinical trials on the benefits of antiplatelet agents in patients at high risk of developing vascular diseases (Antithrombotic Trialists Collaboration) was published. The meta-analysis included the results of 287 studies, which included 135,000 patients at high risk of developing vascular diseases. The results of this meta-analysis indicate that the administration of antiplatelet agents to these categories of patients can reduce the risk of developing non-fatal myocardial infarction + non-fatal stroke + other vascular diseases by at least one quarter. In recent years, from the standpoint of evidence-based medicine, the benefits of acetylsalicylic acid have been identified for a wide variety of categories of patients, although the range of indications for its use is still expanding. The main groups of patients in whom the administration of acetylsalicylic acid can reduce mortality and the incidence of serious, including fatal, cardiovascular complications (myocardial infarction, stroke, thromboembolism) are: – patients with acute myocardial infarction. The effectiveness of acetylsalicylic acid in the acute stage of myocardial infarction in combination with thrombolytics reaches 42%. Moreover, if combination therapy is started in the first 6 hours after the onset of a heart attack, mortality rates are reduced by more than 50%. In addition, acetylsalicylic acid is the drug of choice for pericarditis, one of the complications of myocardial infarction (ACC/AHA Guidelines, 1996); – patients with unstable angina. Acetylsalicylic acid is a first-line drug in the treatment of patients with unstable angina, as it reduces the incidence of cardiovascular death and myocardial infarction. The administration of acetylsalicylic acid to this category of patients is accompanied by a highly significant reduction in the risk of developing cardiovascular complications by 46% (antithrombotic Trialists Collaboration meta-analysis). – patients with a history of myocardial infarction. The results of the Antithrombotic Trialists Collaboration meta-analysis indicate a reduction in the risk of cardiovascular events (myocardial infarction + stroke + cardiovascular mortality) during treatment with acetylsalicylic acid; – patients with silent myocardial ischemia. Acetylsalicylic acid is also effective for silent myocardial ischemia, as well as for the symptomatic version of coronary heart disease; – patients after surgery on the coronary arteries. Surgical treatments are inevitably associated with endothelial damage and subsequent platelet activation. Acetylsalicylic acid suppresses platelet activation, preventing the development of early stent stenosis or restenosis of the coronary vessels (Antiplatelets Trialists Collaboration 11, 1994); – patients with a history of stroke and/or transient ischemic attacks. According to international multicenter controlled studies, acetylsalicylic acid is the most effective drug for the secondary prevention of ischemic cerebrovascular accidents (ESPS - 2); – patients with acute stroke. Currently, the results of two large studies have been obtained: one of them is open - International stroke trial, daily dose of acetylsalicylic acid 300 mg, the other placebo-controlled - Chinese acute stroke trial, daily dose of acetylsalicylic acid 160 mg. The results of a meta-analysis indicate that the use of acetylsalicylic acid prevents nine serious cardiovascular complications for every thousand patients treated; – patients with atrial fibrillation. The latest guidelines issued by the National Stroke Association in the USA recommend the use of acetylsalicylic acid as primary prevention of stroke in patients over 65 years of age with atrial fibrillation and the absence of other risk factors. For patients aged 65 to 75 years with atrial fibrillation, acetylsalicylic acid is considered as an alternative to warfarin in the absence of other risk factors; – patients after heart valve surgery. In a study by Turpie et al., 1993, acetylsalicylic acid reduced the risk of embolism or death from complications by 77% in patients undergoing mitral valve replacement; – patients with peripheral arterial diseases. Acetylsalicylic acid helps prevent venous thrombosis and pulmonary embolism. In 2000, the largest clinical study on the prevention of venous thrombosis was published: “Pulmonary Embolism Prevention” (PEP-study), which convincingly proved a decrease in the development of pulmonary embolisms and the incidence of symptomatic deep vein thrombosis; – patients with diabetes mellitus. The American Diabetes Association (ADA) recommends the administration of acetylsalicylic acid to all patients with type 2 diabetes mellitus for the purpose of secondary prevention of coronary artery disease in the absence of contraindications. The administration of acetylsalicylic acid for the purpose of primary prevention of coronary artery disease is indicated for patients with type 2 diabetes mellitus over the age of 30 years who have a high risk of its occurrence (a family history of coronary artery disease, smoking, arterial hypertension, obesity, dyslipidemia); – patients with arterial hypertension. Currently, indications for the use of acetylsalicylic acid in patients with arterial hypertension are being considered. According to the HOT study, additional use of acetylsalicylic acid reduced the incidence of cardiovascular events by 15%, and the incidence of myocardial infarction by 36%. One of the most important issues in the use of acetylsalicylic acid remains the question of the size of its dosages. Thus, according to a meta-analysis of the Antithrombotic Trialists Collaboration, the reduction in the risk of cardiovascular complications during the use of acetylsalicylic acid in high doses of 500–1500 mg was 19%, in medium doses of 160–325 mg – 26%, and in low doses 75– 150 mg – 32%. At the same time, low doses are more preferable for long-term therapy due to a lesser ulcerogenic effect. Therefore, the currently recommended daily dose of acetylsalicylic acid is from 75 to 150 mg per day. Despite the positive effects associated with the use of acetylsalicylic acid, its use in clinical practice is limited due to side effects. In addition to the risk of bleeding, as well as a history of peptic ulcer disease, the main clinical problem of prescribing acetylsalicylic acid remains frequent side effects from the gastrointestinal tract (dyspeptic symptoms and an increase in the frequency of erosive and ulcerative lesions of the stomach and duodenum). The occurrence of erosive and ulcerative lesions of the stomach while taking acetylsalicylic acid in doses used in cardiology is a well-known fact. The use of enteric-soluble forms of acetylsalicylic acid has long been considered the only solution to this problem. However, when analyzing the results of a number of studies, some authors noted the formation of erosions and gastric ulcers even when using enteric-coated acetylsalicylic acid tablets. To date, new dosage forms of acetylsalicylic acid have been created, offering new ways to protect the gastrointestinal tract. One of the most effective is the drug Cardiomagnyl (Nycomed, Denmark) - a combination of acetylsalicylic acid (in the most effective and safe doses - 75 and 150 mg) with a non-absorbable antacid - magnesium hydroxide. Non-absorbable antacids are the most commonly used drugs in the treatment of stomach diseases, including peptic ulcers. Their positive effect is associated with the adsorption of hydrochloric acid; in addition, they reduce the proteolytic activity of gastric juice (through the adsorption of pepsin), have enveloping properties, bind bile acids and lysolecithin, which have a negative effect on the gastric mucosa. However, the most important thing for the prevention of aspirin-induced complications is data on the cytoprotective effect of antacids. In experimental and clinical settings, antacids can prevent the occurrence of damage to the gastric mucosa. It has been established that the cytoprotective effect of antacids is associated with an increase in the level of prostaglandins in the stomach wall (since a decrease in prostaglandins in the stomach wall is the main mechanism of ulcer formation when using acetylsalicylic acid), increased secretion of bicarbonates and an increase in glycoproteins of gastric mucus. Magnesium hydroxide, which is part of Cardiomagnyl, is the fastest-acting antacid. This is the most important point, since acetylsalicylic acid is quickly absorbed from the stomach: significant concentrations in the blood plasma are achieved within 15–20 minutes. At the same time, the results of a number of studies have proven that magnesium hydroxide does not affect the absorption of acetylsalicylic acid. It is well known that the most common side effect of acetylsalicylic acid on the gastrointestinal tract is dyspepsia (according to some authors, in 50 percent or more of cases), and esophagogastroduodenoscopy does not reveal erosive, ulcerative and inflammatory changes. This symptom complex is the most common reason for patients refusing to take acetylsalicylic acid. The combination of acetylsalicylic acid with magnesium hydroxide (Cardiomagnyl) can dramatically reduce the incidence of dyspepsia and increase patient adherence to treatment. Consequently, the use of the drug Cardiomagnyl in clinical practice, which also has an excellent price/effectiveness ratio, can increase the tolerability of acetylsalicylic acid in many patients with diseases of the cardiovascular system. Thus, the prescription of Cardiomagnyl is especially indicated: - in the acute stage of myocardial infarction, - patients with post-infarction cardiosclerosis, - in the presence of atrial fibrillation, - with stable and unstable angina, - with coronary revascularization, - in the acute stage of stroke, - patients with strokes in history and transient ischemic attacks, - after transplantation of artificial valves, - in the presence of deep vein thrombosis, - in patients with occlusive diseases of the peripheral arteries. The results of the ongoing clinical studies will provide new food for thought, but in practice it is necessary to use the rules of “medicine of evidence” and not doubtful facts. Therefore, when choosing a drug for the treatment of patients with cardiovascular diseases, from the point of view of effectiveness and safety, preference should currently be given to new dosage forms of acetylsalicylic acid, and, first of all, to compounds of acetylsalicylic acid with magnesium hydroxide (Cardiomagnyl). Literature 1. Ostroumova O.D. Possibilities of using Cardiomagnyl in patients with diabetes mellitus. // Rus. Honey. Magazine. – 2004.– vol. 12, no. 5. – pp. 34–37. 2. Collaborative meta–analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients (Antiplatelet Trialists Collaboration).– BMJ 2002; 324:71–86. 3. European Stroke Initiative – Recommendation for stroke management, 2003. 4. Ischemic Cerebrovascular Disease. // H. Adams, V. Hachinski. J. Norris/ – Oxford University press, 2001. – 575 p. 5. Stroce prevention by the practitioner./ Ed. J. Bogousslavsky. – Cerebrovascular Diseases, 1999/ – 9. –S 4. – 70 p.

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CARDIOMAGNIL (tablets)

companies.
But the medicine that I used was made in Russia in Yaroslavl at Takeda Pharmaceuticals LLC: And Cardiomagnyl also comes with different dosages of aspirin in one tablet: either 75 mg or 150 mg. I bought something with a lower dosage:

The shelf life of this medicine, which is sold in pharmacies without a prescription, is quite long. The production date and expiration date are printed on the top of the box:

Inside the box there is a bottle of tablets:

The tablets themselves are made in the shape of hearts:

I usually took one tablet a day and put them in the pill box, which is in the photo above. So I always remembered whether I took a pill today or not.

So, after taking Cardiomagnyl tablets for six months, I discovered that my blood had thinned, and this is the main task of Cardiomagnyl - to thin the blood so that blood clots do not form in the vessels, to such a state that bleeding from any scratch or wound it lasted a long time on my skin and there was no way to stop it. I immediately realized that I had to stop taking these pills. And now I understand that since I taught myself to drink a lot of water during the day (the first thing I do in the morning is drink two glasses of water), my blood is not thick anyway.

I also realized that drinking more fluid is the most effective and cheapest way to keep your blood in normal condition. So, now I don’t take Cardiomagnyl and I hope I won’t take it in the future.

Of course, dear readers, it is up to you to decide whether you should take Cardiomagnyl tablets in an attempt to avoid heart attacks and strokes. But still, if you are a healthy and young person, then I do not recommend using them. Any medicine is not harmless to human health. “Cardiomagnyl” is no exception. For many diseases, for example, asthma or constant high blood pressure, it should not be taken. It is also not recommended to take such pills for men under 40 years of age, and for women under 50 years of age. In addition, aspirin (read “Cardiomagnyl”) cannot be taken simultaneously with many medications. Therefore, if you are already planning to drink Cardiomagnyl, then stop taking other medications or take them only after consulting a doctor.

Cardiomagnyl also has side effects, including stomach bleeding. So, dear readers, think a hundred times before you start drinking this remedy. But you need to drink it for a long time, because it is a medicine with a cumulative effect.

And “Cardiomagnyl” has cheaper, but no less effective analogues, for example, “Aspirin Cardio” and “Thrombo-ASS”. These tablets are also coated, that is, they do not harm the stomach as much as regular aspirin without a shell.

I will give the drug “Cardiomagnyl” a low rating, because, firstly, I do not consider it such a necessary remedy, and secondly, I think that its cost is greatly overpriced. And of course, I, dear readers, do not advise you to use it, at least without consulting not just a doctor, but a cardiologist.