НПВП, антиагрегант. В основе механизма антиагрегантного дейс... Инструкция
Показания к применению
Профилактика острого инфаркта миокарда при наличии факторов риска (например сахарный диабет, гиперлипидемия, артериальная гипертензия, ожирение, курение, пожилой возраст) и повторного инфаркта миокарда. нестабильная стенокардия, профилактика инсульта (в т.ч. у пациентов с преходящим нарушением мозгового кровообращения). профилактика тромбоэмболии после ...
НПВП, антиагрегант. В основе механизма антиагрегантного действия ацетилсалициловой кислоты (АСК) лежит необратимая инактивация ЦОГ-1, в результате чего блокируется синтез тромбоксана A2 и подавляется агрегация тромбоцитов. Считается, что АСК имеет и другие механизмы подавления агрегации тромбоцитов, что расширяет область ее применения при различных сосудистых заболеваниях. В высоких дозах АСК также оказывает противовоспалительное, жаропонижающее и анальгезирующее действие. Антиагрегантный эффект развивается даже после применения препарата в малых дозах и сохраняется в течение 7 сут после однократного приема.
Показания к применению
Профилактика острого инфаркта миокарда при наличии факторов риска (например сахарный диабет, гиперлипидемия, артериальная гипертензия, ожирение, курение, пожилой возраст) и повторного инфаркта миокарда. нестабильная стенокардия, профилактика инсульта (в т.ч. у пациентов с преходящим нарушением мозгового кровообращения). профилактика тромбоэмболии после операций и инвазивных вмешательств на сосудах (аорто-коронарное шунтирование, эндартерэктомия сонных артерий, артерио-венозное шунтирование, ангиопластика сонных артерий), профилактика тромбоза глубоких вен и тромбоэмболии легочной артерии и ее ветвей (например при длительной иммобилизации в результате большого хирургического вмешательства).
Противопоказания
Гиперчувствительность к ацетилсалициловой кислоте, вспомогательным веществам и другим НПВС. эрозивно-язвенные поражения ЖКТ, желудочно-кишечное кровотечение. бронхиальная астма, индуцированная приемом салицилатов и НПВС, триада Фернана-Видаля (сочетание бронхиальной астмы, рецидивирующего полипоза носа и околоносовых пазух и непереносимости ацетилсалициловой кислоты). геморрагический диатез. печеночная/почечная недостаточность. беременность (I и III триместр) и период лактации. С осторожностью: при подагре, гиперурикемии, наличии в анамнезе: язвенных поражений ЖКТ, желудочно-кишечных кровотечений, почечной и печеночной недостаточности, бронхиальной астмы, хронических заболеваний органов дыхания, сенной лихорадки, полипоза носа, аллергических реакций на другие препараты. во II триместре беременности, в сочетании с метотрексатом в дозе менее 15 мг в неделю, при дефиците витамина К и глюкозо-6-фосфатдегидрогеназы. Не рекомендуется назначать пациентам моложе 18 лет из-за отсутствия клинических данных.
Применение при беременности и в период грудного вскармливания
Применение салицилатов в высоких дозах в I триместре беременности ассоциируется с повышенной частотой дефектов развития плода (расщепление верхнего неба, пороки сердца). Назначение салицилатов в I триместре беременности противопоказано. Во II триместре беременности салицилаты можно назначать только после тщательной оценки риска для плода и пользы для матери, предпочтительно в дозах не выше 150 мг/сут и в течение непродолжительного времени. В III триместре беременности салицилаты в высокой дозе (более 300 мг/сут) вызывают ослабление родовой деятельности, преждевременное закрытие артериального протока у плода, повышенную кровоточивость у матери и плода, а назначение непосредственно перед родами может вызвать внутричерепные кровоизлияния, особенно у недоношенных детей. Назначение салицилатов в III триместре беременности противопоказано. Салицилаты и их метаболиты в небольших количествах выделяются с грудным молоком. Случайный прием салицилатов в период лактации не сопровождается развитием побочных реакций у ребенка и не требует прекращения грудного вскармливания. Однако при длительном применении препарата или назначении его в высокой дозе кормление грудью следует немедленно прекратить.
Способ применения и дозы
Внутрь, перед едой, запивая большим количеством воды. Длительность терапии определяет врач. Профилактика при подозрении на острый инфаркт миокарда - по 100–200 мг/сут или 300 мг через день (первую таблетку необходимо разжевать для более быстрого всасывания.) Профилактика впервые возникшего острого инфаркта миокарда при наличии факторов риска - по 100 мг/сут или 300 мг через день. Профилактика повторного инфаркта миокарда . нестабильная стенокардия, профилактика инсульта и преходящего нарушения мозгового кровообращения . профилактика тромбоэмболических осложнений после хирургических операций или инвазивных исследований - по 100–300 мг/сут. Профилактика тромбоза глубоких вен и тромбоэмболии легочной артерии и ее ветвей - по 100–200 мг/сут или 300 мг через день.
Побочное действие
Аллергические реакции крапивница, отек Квинке. Со стороны пищеварительного тракта: тошнота, изжога, рвота, болевые ощущения в области живота, язвы слизистой оболочки желудка и двенадцатиперстной кишки, в том числе перфоративные, желудочно-кишечные кровотечения, повышение активности «печеночных» ферментов. Со стороны дыхательной системы бронхоспазм. Со стороны иммунной системы анафилактические реакции. Со стороны системы кроветворения анемия (редко), повышенная кровоточивость. Со стороны центральной нервной системы головокружение, шум в ушах.
Особые указания
Аллергические реакции крапивница, отек Квинке. Со стороны пищеварительного тракта: тошнота, изжога, рвота, болевые ощущения в области живота, язвы слизистой оболочки желудка и двенадцатиперстной кишки, в том числе перфоративные, желудочно-кишечные кровотечения, повышение активности «печеночных» ферментов. Со стороны дыхательной системы бронхоспазм. Со стороны иммунной системы анафилактические реакции. Со стороны системы кроветворения анемия (редко), повышенная кровоточивость. Со стороны центральной нервной системы головокружение, шум в ушах.
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