Acetylsalicylic acid ASK-Cardio tablet p about intestinal 100 mg x30

ASA tablets po enteric soluble 75 mg No. 10x5

Name

ASA tablet, coated, vol. 75 mg in container pack No. 10x5

Description

Round, biconvex, red, film-coated tablets.

Main active ingredient

Acetylsalicylic acid

Release form

Enteric-coated tablets

Dosage

75 mg

pharmachologic effect

Acetylsalicylic acid inhibits platelet aggregation and also has antipyretic, analgesic and anti-inflammatory effects. Aggregation is inhibited even after using the drug in low doses, the effect persists for several days after taking a single dose. It is believed that acetylsalicylic acid has other mechanisms for suppressing platelet aggregation, which expands the scope of its use in various vascular diseases. Enteric-coated tablets are a pharmaceutical form that does not disintegrate in the stomach, thereby reducing the risk of direct contact of acetylsalicylic acid with the gastric mucosa and its damage. The disintegration of the tablet and the release of the active substance occurs only in the duodenum.

Indications for use

Unstable angina - as part of standard therapy. Acute myocardial infarction - as part of standard therapy. Prevention of recurrent myocardial infarction. Prevention of repeated transient ischemic attack (TIA) and repeated cerebral infarction. Prevention of thrombosis after surgery and invasive vascular interventions (for example, after coronary artery bypass grafting (CABG) or primary percutaneous coronary intervention (PCI)). Prevention of cardiovascular diseases in patients at high risk is possible only as prescribed by a doctor, if the benefit of therapy outweighs the risk of adverse events, in particular bleeding, and it is possible to diagnose hidden bleeding. Note: acetylsalicylic acid in a single dose of 75-150 mg is not intended for the treatment of pain.

Directions for use and doses

• Unstable angina: 75-150 mg once a day.
• Acute myocardial infarction: 75-150 mg once a day.
• Prevention of recurrent myocardial infarction: 300 mg once a day.
• Prevention of repeated transient ischemic attack (TIA) and repeated cerebral infarction: 75-150 mg 1 time per day.
• Prevention of thrombosis after surgery and invasive vascular interventions (for example, after coronary artery bypass grafting (CABG) or primary percutaneous coronary intervention (PCI)): 75-150 mg 1 time per day.

Antiplatelet therapy with acetylsalicylic acid is recommended to begin 24 hours after CABG or PCI surgery.

• Prevention of cardiovascular diseases in patients at high risk (possible only as prescribed by a doctor, if the benefits of therapy outweigh the risk of adverse events): 75 mg 1 time per day.

It is recommended to take acetylsalicylic acid once a day, before meals, with plenty of liquid. In case of acute myocardial infarction, it is recommended to chew the first tablet and drink plenty of water. Acetylsalicylic acid 75 mg (150 mg) is intended for long-term use. The duration of therapy is determined by the doctor.

Use during pregnancy and lactation

Pregnancy Inhibition of prostaglandin synthesis may adversely affect pregnancy and/or embryonic/fetal development. Data from epidemiological studies indicate an increased risk of miscarriage, as well as the development of heart defects and gastroschisis after the use of prostaglandin synthesis inhibitors in early pregnancy. The risk is expected to increase with increasing dose and duration of therapy. Experience in pregnant women using acetylsalicylic acid in daily doses of 50 to 150 mg in the second and third trimesters showed no evidence of decreased uterine tone, increased bleeding, or premature closure of the ductus arteriosus. There are no data on the effect of daily doses of acetylsalicylic acid in the range of 150 and 300 mg during pregnancy. In the first and second trimesters of pregnancy, acetylsalicylic acid can be taken in a daily dose of less than 300 mg, in short courses, only as prescribed by a doctor, after a careful assessment of the benefit-risk ratio for the mother and fetus. In the third trimester of pregnancy, salicylates in high doses (more than 300 mg/day; we are talking about usual doses of acetylsalicylic acid from 500 mg as an anesthetic) can 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. In the third trimester of pregnancy, acetylsalicylic acid can be taken in a daily dose of less than 150 mg, in short courses, only as prescribed by a doctor, after a careful assessment of the benefit/risk ratio for the mother and fetus. Taking acetylsalicylic acid in a daily dosage of more than 150 mg in the third semester is contraindicated. Breastfeeding Acetylsalicylic acid and its metabolites pass into breast milk in small quantities. Interruption of breastfeeding is usually not required if a daily dose of up to 150 mg is used. When using the drug for a long time or when it is prescribed at a daily dose of more than 150 mg per day, breastfeeding should be stopped.

Impact on the ability to drive vehicles and operate machinery

Taking the drug ASA does not affect the ability to drive a car and/or moving machinery.

Precautionary measures

Caution should be exercised;

• For gout, hyperuricemia, because acetylsalicylic acid in low doses reduces the excretion of uric acid; It should be borne in mind that acetylsalicylic acid in low doses can provoke the development of gout in predisposed patients (those with reduced excretion of uric acid).
• If there is a history of ulcerative lesions of the gastrointestinal tract or gastrointestinal bleeding.
• If liver function is impaired (below class B on the Child-Pugh scale).
• In case of impaired renal function (creatinine clearance more than 30 ml/min), as well as in cases of circulatory disorders resulting from atherosclerosis of the renal arteries, congestive heart failure, hypovolemia, extensive surgery, sepsis, cases of massive bleeding, since in all of these cases acetylsalicylic acid can increase risk of developing acute renal failure and renal dysfunction.
• For bronchial asthma, chronic respiratory diseases, hay fever, nasal polyposis, drug allergies, including NSAIDs (analgesics, anti-inflammatory, antirheumatic drugs).
• In case of proposed surgical intervention (including minor ones, for example, tooth extraction), since acetylsalicylic acid may cause a tendency to develop bleeding for several days after taking the drug.
• For patients who have acute glucose-6-phosphate dehydrogenase (G6PD) deficiency, acetylsalicylic acid may cause hemolysis or hemolytic anemia. Factors that may increase the risk of hemolysis include, for example, high dose, fever or acute infections.
• When used in combination with the following drugs: with methotrexate at a dose of less than 15 mg per week; with anticoagulant, thrombolytic or other antiplatelet agents; with NSAIDs and salicylic acid derivatives in large doses; with digoxin; with hypoglycemic agents for oral administration (sulfonylurea derivatives) and insulin; with valproic acid; with alcohol (alcoholic drinks in particular); with selective serotonin reuptake inhibitors; with ibuprofen (see section “Interaction with other drugs”).

Exceeding the dose of acetylsalicylic acid is associated with the risk of gastrointestinal bleeding. Overdose is especially dangerous in elderly patients. In severe forms of glucose-6-phosphate dehydrogenase deficiency, acetylsalicylic acid can cause hemolysis and hemolytic anemia. Factors that may increase the risk of hemolysis include fever, acute infections, and high doses of the drug. At low doses, acetylsalicylic acid reduces the excretion of uric acid, which can cause attacks of gout in patients predisposed to this disease. Medicines containing acetylsalicylic acid should not be prescribed to children and adolescents for the treatment of viral infections, with or without fever, without consulting a doctor. Some viral illnesses, especially influenza A, influenza B and chickenpox, carry the risk of developing Reye's syndrome, a very rare but life-threatening disease that requires emergency medical attention. This risk may increase with concomitant use of acetylsalicylic acid, however, a cause-and-effect relationship has not been established. A sign of Reye's syndrome can be persistent vomiting in the above diseases. Considering the above, children under 16 years of age are contraindicated in using the drug without appropriate indications (Kawasaki disease).

Interaction with other drugs

When used simultaneously, acetylsalicylic acid enhances the effect of the drugs listed below, therefore, if it is necessary to simultaneously prescribe the drug ASA with the listed drugs, the need to reduce the dose of these drugs should be considered:

• Methotrexate by reducing renal clearance and displacing it from protein binding; the combination of acetylsalicylic acid with methotrexate is accompanied by an increased incidence of side effects from the hematopoietic organs; the use of the drug together with methotrexate is contraindicated if the dose of the latter exceeds 15 mg per week (see section “Contraindications”) and can be used with caution when the dose of methotrexate is less than 15 mg per week.
• Heparin and indirect anticoagulants due to disruption of platelet function and displacement of indirect anticoagulants from protein binding.
• When used simultaneously with anticoagulants, thrombolytic and antiplatelet agents (ticlopidine), there is an increased risk of bleeding as a result of the synergism of the main therapeutic effects of the drugs used.
• When used simultaneously with drugs that have anticoagulant, thrombolytic or antiplatelet effects, an increased damaging effect on the mucous membrane of the gastrointestinal tract is observed.
• Selective serotonin reuptake inhibitors, which may lead to an increased risk of bleeding from the upper gastrointestinal tract (synergism with acetylsalicylic acid).
• Digoxin due to a decrease in its renal excretion, which can lead to an overdose.
• 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 communication with blood plasma proteins. This must be kept in mind when prescribing the drug ASA to patients with diabetes mellitus receiving the listed drugs.
• When used simultaneously with valproic acid, its toxicity increases due to displacement from binding with blood plasma proteins.
• NSAIDs and salicylic acid derivatives in high doses (increased risk of ulcerogenic effect and bleeding from the gastrointestinal tract as a result of synergistic action).
• Ethanol (alcoholic drinks) - increased risk of damage to the mucous membrane of the gastrointestinal tract and prolongation of bleeding time as a result of the mutual enhancement of the effects of acetylsalicylic acid and ethanol.

The simultaneous administration of acetylsalicylic acid in high doses may weaken the effect of the drugs listed below. If it is necessary to simultaneously prescribe the drug ASA with the listed drugs, you should consider the need to adjust the dose of the drugs listed below:

• Any diuretics (when used together with acetylsalicylic acid in high doses, a decrease in glomerular filtration rate is observed as a result of a decrease in the synthesis of prostaglandins in the kidneys).
• Angiotensin-converting enzyme (ACE) inhibitors (a dose-dependent decrease in glomerular filtration rate (GFR) is noted as a result of inhibition of prostaglandins that have a vasodilatory effect, respectively, weakening of the hypotensive effect. The clinical significance of the decrease in GFR is noted with a daily dose of acetylsalicylic acid more than 160 mg. In addition, there is a decrease in the positive cardioprotective effect of ACE inhibitors prescribed to patients for the treatment of chronic heart failure. This effect is also manifested when used in conjunction with acetylsalicylic acid in high doses).
• Medicines with uricosuric action - benzbromarone, probenecid (reduced uricosuric effect due to competitive suppression of renal tubular excretion of uric acid).

When used simultaneously with ibuprofen, antagonism is observed in relation to irreversible platelet inhibition caused by the action of acetylsalicylic acid, which leads to a decrease in the cardioprotective effects of acetylsalicylic acid. Therefore, the combination of the drug ASA with ibuprofen is not recommended in patients with an increased risk of cardiovascular disease. When used simultaneously with systemic glucocorticosteroids (GCS) (with the exception of hydrocortisone or other GCS used for replacement therapy of Addison's disease), there is an increase in the elimination of salicylates and, accordingly, a weakening of their effect. When using GCS and salicylates in combination, it should be remembered that during treatment the level of salicylates in the blood is reduced, and after discontinuation of GCS, an overdose of salicylates is possible.

Contraindications

Hypersensitivity to acetylsalicylic acid, excipients in the composition of the drug. Bronchial asthma induced by salicylates and other NSAIDs. Erosive and ulcerative lesions of the gastrointestinal tract (in the acute stage). Gastrointestinal bleeding. Hemorrhagic diathesis. Combined use with methotrexate at a dose of 15 mg per week or more. Pregnancy (III trimester) with a daily dose of more than 150 mg. Severe renal failure (creatinine clearance (CC) less than 30 ml/min). Severe liver failure (class B and higher on the Child-Pugh scale). Chronic heart failure of functional class III-IV according to the NYHA classification.

Compound

Each tablet contains: active substance: acetylsalicylic acid - 75 mg or 150 mg; excipients: modified corn starch, stearic acid, microcrystalline cellulose. shell composition: Aquarius Prefered® (hypromellose, copovidone plasdon, polyethylene glycol, polydextrose, titanium dioxide, caprylic/capric acid triglyceride, yellow iron oxide E 172), Acrylic-IZ® (copolymer of methacrylic acid and ethyl acrylate, talc, ponceau 4 R E 124 , triethyl citrate, titanium dioxide, anhydrous colloidal silicon dioxide, sodium bicarbonate, sodium lauryl sulfate, sunset yellow E 110, indigo carmine E 132).

Overdose

Salicylate intoxication (develops when taking acetylsalicylic acid at a dose of more than 100 mg/kg/day for more than 2 days) can result from prolonged use of toxic doses of the drug as part of improper therapeutic use of the drug (chronic intoxication) or a single accidental or intentional use toxic dose of a drug in an adult or child (acute intoxication). Symptoms of chronic intoxication with salicylic acid derivatives are nonspecific and are often difficult to diagnose. Mild intoxication usually develops only after repeated use of large doses of the drug and is manifested by dizziness, tinnitus, hearing loss, increased sweating, nausea and vomiting, headache and confusion. These symptoms disappear after reducing the dose of the drug. Tinnitus may appear when the concentration of acetylsalicylic acid in the blood plasma is from 150 to 300 mcg/ml. More severe symptoms appear when the concentration of acetylsalicylic acid in the blood plasma is above 300 mcg/ml. The main manifestation of acute intoxication is a severe disturbance of the acid-base state, the manifestations of which may vary depending on the age of the patient and the severity of intoxication. In children, the most typical development is metabolic acidosis. Treatment of intoxication is carried out in accordance with accepted standards and depends on the severity of intoxication and the clinical picture and should be aimed mainly at accelerating the elimination of the drug and restoring the water-electrolyte balance and acid-base state. Symptoms of overdose are mild to moderate: dizziness, tinnitus, hearing loss, increased sweating, nausea, vomiting, headache, confusion, profuse sweating, tachypnea, hyperventilation, respiratory alkalosis. Treatment: gastric lavage, repeated intake of activated carbon, forced alkaline diuresis, restoration of water-electrolyte balance and acid-base state. Symptoms of moderate to severe overdose:

• respiratory alkalosis with compensatory metabolic acidosis;
• hyperpyrexia (extremely high body temperature);
• respiratory disorders: hyperventilation, non-cardiogenic pulmonary edema, respiratory depression, asphyxia;
• disorders of the cardiovascular system: cardiac arrhythmias, arterial hypotension, cardiac depression;
• disturbances of water and electrolyte balance: dehydration, impaired renal function from oliguria up to the development of renal failure, characterized by hypokalemia, hypernatremia, hyponatremia;
• impaired glucose metabolism: hyperglycemia, hypoglycemia (especially in children), ketoacidosis;
• tinnitus, deafness;
• gastrointestinal bleeding;
• hematological disorders: from inhibition of platelet aggregation to coagulopathy, prolongation of prothrombin time, hypoprothrombinemia;
• neurological disorders: toxic encephalopathy and depression of central nervous system function (drowsiness, confusion, coma, convulsions).

Treatment: immediate hospitalization in specialized departments for emergency treatment - gastric lavage, repeated intake of activated charcoal, forced alkaline diuresis, hemodialysis, restoration of water-electrolyte balance and acid-base status, symptomatic therapy.

Side effect

To assess the frequency of side effects, the World Health Organization classification is used: very often (> 1/10), often (> 1/100, 1/1000, 1/10000,

Storage conditions

Store in a place protected from moisture and light at a temperature not exceeding 25 °C. Keep out of the reach of children.

Buy ASK tablet, coated, vol. 75 mg in container pack No. 10x5 in the pharmacy

Price for ASA tablet, coated, about 75 mg in container pack No. 10x5

Instructions for use for ASA tablet, coated, 75 mg, in container pack No. 10x5

Acetylsalicylic acid ASK-Cardio

Trade name: ASA-cardio International name: Acetylsalicylic acid Pharmacological group: NSAID (non-steroidal anti-inflammatory drug) Pharmacological group for ATC: B01AC06. Acetylsalicylic acid Pharmacodynamics: NSAIDs have anti-inflammatory, analgesic and antipyretic effects associated with indiscriminate inhibition of the activity of COX1 and COX2, which regulate the synthesis of Pg. As a result, Pg is not formed, which ensures the formation of edema and hyperalgesia. A decrease in Pg content (mainly E1) in the thermoregulation center leads to a decrease in body temperature due to dilation of skin vessels and increased sweating. The analgesic effect is due to both central and peripheral effects. Reduces platelet aggregation, adhesion and thrombus formation by suppressing the synthesis of thromboxane A2 in platelets. The antiplatelet effect persists for 7 days after a single dose (more pronounced in men than in women). Reduces mortality and the risk of developing myocardial infarction in unstable angina. Effective in the primary prevention of cardiovascular diseases, especially myocardial infarction in men over 40 years of age, and in the secondary prevention of myocardial infarction. In a daily dose of 6 g or more, it suppresses prothrombin synthesis in the liver and increases prothrombin time. Increases fibrinolytic activity of plasma and reduces the concentration of vitamin K-dependent coagulation factors (II, VII, IX, X). Increases the incidence of hemorrhagic complications during surgical interventions and increases the risk of bleeding during anticoagulant therapy. Stimulates the excretion of uric acid (impairs its reabsorption in the renal tubules), but in high doses. Blockade of COX1 in the gastric mucosa leads to inhibition of gastroprotective Pg, which can cause ulceration of the mucous membrane and subsequent bleeding. Dosage forms containing buffer substances, enteric coating, as well as special “effervescent” forms of tablets have a lesser irritating effect on the gastrointestinal mucosa.

Pharmacokinetics: When taken orally, absorption is complete. During absorption, it undergoes systemic elimination in the intestinal wall and in the liver (deacetylated). The absorbed part is quickly hydrolyzed by plasma cholinesterases and albuminesterase, so T1/2 is no more than 15-20 minutes. It circulates in the body (75-90% in connection with albumin) and is distributed in tissues in the form of salicylic acid anion. TCmax - 2 hours (for dosage forms with buffer properties - 35-40 minutes). Serum concentrations of salicylates are highly variable. In newborns, salicylates can displace bilirubin from its binding to albumin and contribute to the development of bilirubin encephalopathy. Salicylates easily penetrate many tissues and body fluids, incl. in CSF, peritoneal and synovial fluid. Penetration into the joint cavity accelerates in the presence of hyperemia and edema and slows down in the proliferative phase of inflammation. Salicylates are found in small quantities in nervous tissue, traces in bile, sweat, and feces. When acidosis occurs, most of the salicylate is converted into non-ionized acid, which penetrates well into tissues, incl. into the brain. It quickly passes through the placenta and is excreted in small quantities in breast milk. Salicylic acid is metabolized primarily in the liver to form 4 metabolites found in many tissues and urine. It is excreted primarily by active secretion in the renal tubules in the form of salicylic acid itself (60%) and its metabolites. The excretion of unchanged salicylate depends on the pH of the urine (with alkalinization of the urine, the ionization of salicylates increases, their reabsorption worsens and excretion increases significantly). The rate of elimination depends on the dose: when taking small doses, T1/2 is 2-3 hours, with increasing doses it can increase to 15-30 hours. In newborns, the elimination of salicylates is much slower than in adults.

Indications for use: Feverish syndrome in infectious and inflammatory diseases. Mild or moderate pain syndrome (of various origins): headache (including those associated with alcohol withdrawal syndrome), migraine, toothache, neuralgia, lumbago, radicular syndrome, myalgia, arthralgia, algomenorrhea.

Contraindications: Hypersensitivity to ASA (including other NSAIDs), erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase), gastrointestinal bleeding, hemorrhagic diathesis, bronchial asthma induced by taking salicylates and other NSAIDs, a combination of bronchial asthma , recurrent polyposis of the nose and paranasal sinuses and intolerance to ASA, simultaneous use of methotrexate at a dose of 15 mg/week or more, pregnancy (I and III trimester), lactation period, childhood (up to 15 years - when used as an antipyretic).

With caution: Gout, hyperuricemia, gastric and duodenal ulcers or gastrointestinal bleeding (history), renal/liver failure, bronchial asthma, COPD, hay fever, nasal polyposis, drug allergies, simultaneous use of methotrexate in a dose of less than 15 mg/week, concomitant therapy with anticoagulants, pregnancy (II trimester).

Dosage regimen: Inside. Tablets containing ASA in doses over 325 mg (400-500 mg) are designed for use as an analgesic and anti-inflammatory drug. Orally, for fever and pain in adults - 0.5-1 g/day (up to 3 g), divided into 3 doses. The duration of treatment should not exceed 2 weeks. Effervescent tablets are dissolved in 100-200 ml of water and taken orally, after meals, a single dose is 0.25-1 g, taken 3-4 times a day.

Side effects: Nausea, decreased appetite, gastralgia, diarrhea, allergic reactions (skin rash, angioedema, bronchospasm), impaired liver and/or kidney function, thrombocytopenia, anemia, leukopenia, Reye's syndrome (encephalopathy and acute fatty liver with rapid development liver failure). With long-term use - dizziness, headache, vomiting, erosive and ulcerative lesions of the gastrointestinal tract, hypocoagulation, bleeding (including in the gastrointestinal tract), visual impairment, decreased hearing acuity, tinnitus, bronchospasm, interstitial nephritis, prerenal azotemia with hypercreatininemia and hypercalcemia, papillary necrosis, acute renal failure, nephrotic syndrome, aseptic meningitis, increased symptoms of CHF, edema, increased activity of “liver” transaminases.

Overdose: Symptoms (single dose less than 150 mg/kg - acute poisoning is considered mild, 150-300 mg/kg - moderate, more than 300 mg/kg - severe): salicylic syndrome (nausea, vomiting, tinnitus, blurred vision, dizziness , severe headache, general malaise, fever - a poor prognostic sign in adults). Severe poisoning - hyperventilation of the lungs of central origin, respiratory alkalosis, metabolic acidosis, confusion, drowsiness, collapse, convulsions, anuria, bleeding. Initially, central hyperventilation of the lungs leads to respiratory alkalosis - shortness of breath, suffocation, cyanosis, cold sticky sweat; with increasing intoxication, respiratory paralysis and uncoupling of oxidative phosphorylation increase, causing respiratory acidosis. In chronic overdose, the concentration determined in plasma does not correlate well with the severity of intoxication. The greatest risk of developing chronic intoxication is observed in elderly people when taking more than 100 mg/kg/day for several days. In children and elderly patients, the initial signs of salicylicism are not always noticeable, so it is advisable to periodically determine the content of salicylates in the blood: a concentration above 70 mg% indicates moderate or severe poisoning, above 100 mg% - extremely severe, prognostically unfavorable. For moderate to severe poisoning, hospitalization is required. Treatment: provocation of vomiting, administration of activated carbon and laxatives, constant monitoring of CBS and electrolyte balance, depending on the metabolic state - administration of sodium bicarbonate, sodium citrate solution or sodium lactate. Increasing reserve alkalinity enhances the excretion of ASA due to alkalinization of urine. Alkalinization of urine is indicated when the concentration of salicylates is above 40 mg% and is provided by intravenous infusion of sodium bicarbonate (88 mEq in 1 liter of 5% dextrose solution, at a rate of 10-15 ml/h/kg), restoration of BCC and induction of diuresis is achieved by administration of sodium bicarbonate in the same doses and dilution, which is repeated 2-3 times. Caution should be exercised in elderly patients in whom intensive fluid infusion may lead to pulmonary edema. The use of acetazolamide to alkalize urine is not recommended (it can cause acidosis and increase the toxic effect of salicylates). Hemodialysis is indicated when salicylate concentrations are more than 100-130 mg%, in patients with chronic poisoning - 40 mg% or lower if indicated (refractory acidosis, progressive deterioration, severe central nervous system damage, pulmonary edema and renal failure). For pulmonary edema - mechanical ventilation with an oxygen-enriched mixture.

Interaction: Increases the toxicity of methotrexate, reducing its renal clearance, valproic acid, enhances the effects of other NSAIDs, narcotic analgesics, oral hypoglycemic drugs, heparin, indirect anticoagulants, thrombolytics and antiplatelet agents, sulfonamides (including co-trimoxazole), T3, reduces the effect of uricosuric drugs (benzbromarone, sulfinpyrazone), antihypertensive drugs, diuretics (spironolactone, furosemide). GCS, ethanol and ethanol-containing drugs increase the damaging effect on the gastrointestinal mucosa and increase the risk of gastrointestinal bleeding. Increases the concentration of digoxin, barbiturates, Li+ salts in plasma. Antacids containing Mg2+ and/or Al3+ slow down and impair the absorption of ASA. Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

Special instructions: The duration of treatment (without consulting a doctor) should not exceed 5 days when prescribed as an analgesic drug and more than 3 days as an antipyretic. Currently, the use of ASA as an anti-inflammatory drug in a daily dose of 5-8 g is limited due to the high likelihood of developing side effects from the gastrointestinal tract (NSAID gastropathy). According to indications, rheumatism, rheumatoid arthritis, infectious-allergic myocarditis, pericarditis, rheumatic chorea are not currently used. Before surgery, to reduce bleeding during surgery and in the postoperative period, you should stop taking salicylates 5-7 days in advance and notify the doctor. During long-term therapy, it is necessary to conduct a complete blood count and stool examination for occult blood. Children should not be prescribed drugs containing ASA, since in the case of a viral infection they can increase the risk of Reye's syndrome. Symptoms of Reye's syndrome are prolonged vomiting, acute encephalopathy, and liver enlargement. Prescribing tablets after meals, thoroughly crushing them, using tablets with buffer additives or coated with a special enteric coating, as well as the simultaneous use of drugs that neutralize the acidity of gastric juice, reduce the irritant effect on the gastrointestinal tract. It has a teratogenic effect, when used in the first trimester it leads to the development of cleft palate, in the third trimester it causes inhibition of labor (inhibition of Pg synthesis), premature closure of the ductus arteriosus in the fetus, hyperplasia of the pulmonary vessels and hypertension in the “lesser” circulation. It is excreted in breast milk, which increases the risk of bleeding in the baby due to impaired platelet function. ASA, even in small doses, reduces the excretion of uric acid from the body, which can cause the development of an acute attack of gout in predisposed patients. During the treatment period, you should refrain from taking ethanol.