Ацетилсалициловая кислота Реневал Таблетки, 10 шт, 500 мг, в пленочной оболочке

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Ацетилсалициловая кислота ингибирует агрегацию тромбоцитов блокируя синтез тромбоксана А\u003csub\u003e2\u003c/sub\u003e."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"При приеме внутрь абсорбция полная. Во время абсорбции подвергается пресистемной элиминации в стенке кишечника и в печени (деацетилируется). Абсорбированная часть быстро гидролизуется неспецифическими холинэстеразами плазмы и альбуминэстеразой поэтому период полувыведения - не более 15-20 мин."}},{"type":"paragraph","data":{"text":"В организме циркулирует (на 75-90 % в связи с альбумином) и распределяется в тканях в виде аниона салициловой кислоты."}},{"type":"paragraph","data":{"text":"Время достижения максимальной концентрации - 2 ч. Сывороточная концентрация салицилатов весьма вариабельна. Салицилаты легко проникают во многие ткани и жидкости организма в т.ч. в спинномозговую перитонеальную и синовиальную жидкости. Проник­новение в полость сустава ускоряется при наличии гиперемии и отека и замедляется в пролиферативной фазе воспаления. В небольших количествах салицилаты обнаруживают­ся в нервной ткани следы - в желчи поте фекалиях. При возникновении ацидоза большая часть салициловой кислоты превращается в неионизированную кислоту хорошо прони­кающую в ткани в т.ч. в мозг. Быстро проходит через плаценту в небольших количествах выводится с грудным молоком."}},{"type":"paragraph","data":{"text":"Метаболизируется преимущественно в печени. Метаболитами ацетилсалициловой и сали­циловой кислот являются глицинконъюгант салициловой кислоты гентизиновая кислота и ее глицинконъюгант. Выводится преимущественно путем активной секреции в каналь­цах почек в виде салициловой кислоты (60 %) и в виде метаболитов. Выведение салици­ловой кислоты зависит от pH мочи (при подщелачивании мочи возрастает ионизирование салицилатов ухудшается их реабсорбция и значительно увеличивается выведение). Ско­рость выведения зависит от дозы: при приеме небольших доз период полувыведения - 2-3 ч с увеличением дозы может возрастать до 15-30 ч."}}]},{"id":1,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Лечение умеренного или слабовыраженного болевого синдрома: головной боли (в том числе при абстинентном синдроме) зубной боли боли в горле боли в спине и мышцах боли в суставах боли при менструации."}},{"type":"paragraph","data":{"text":"Повышенная температура тела при \"простудных\" и других инфекционно-воспалительных заболеваниях (у взрослых и детей старше 15 лет)."}}]},{"id":2,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"- Повышенная чувствительность к ацетилсалициловой кислоте и другим НПВП или дру­гим компонентам препарата;"}},{"type":"paragraph","data":{"text":"- эрозивно-язвенные поражения желудочно-кишечного тракта (ЖКТ) (в фазе обострения);"}},{"type":"paragraph","data":{"text":"- желудочно-кишечное кровотечение;"}},{"type":"paragraph","data":{"text":"- геморрагические диатезы;"}},{"type":"paragraph","data":{"text":"- сочетанное применение метотрексата в дозе 15 мг в неделю и более;"}},{"type":"paragraph","data":{"text":"- полное или неполное сочетание бронхиальной астмы рецидивирующего полипоза носа и околоносовых пазух и непереносимости ацетилсалициловой кислоты;"}},{"type":"paragraph","data":{"text":"- бронхиальная астма индуцированная приемом салицилатов и других НПВП;"}},{"type":"paragraph","data":{"text":"- беременность (I и III триместр) период грудного вскармливания;"}},{"type":"paragraph","data":{"text":"- детский возраст (до 15 лет - при применении в качестве жаропонижающего средства)."}},{"type":"paragraph","data":{"text":"Препарат не назначают детям до 15 лет с острыми респираторными заболеваниями вы­званными вирусными инфекциями из-за риска развития синдрома Рейе (энцефалопатия и острая жировая дистрофия печени с острым развитием печеночной недостаточности)."}}]},{"id":14,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"При сопутствующей терапии антикоагулянтами подагре язвенной болезни желудка и/или двенадцатиперстной кишки (в анамнезе) включая хроническое или рецидивирующее течение язвенной болезни или эпизоды желудочно-кишечных кро­вотечений; при почечной и/или печеночной недостаточности дефиците глюкозо-6-фосфатдегидрогеназы; гиперурикемии бронхиальной астме хронической обструктивной болезни легких сенной лихорадке полипозе носа лекарственной аллергии одновремен­ном приеме метотрексата в дозе менее 15 мг/нед. беременности (II триместр)."}}]},{"id":3,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При беременности применение препарата противопоказано."}},{"type":"paragraph","data":{"text":"При необходимости применения препарата в период лактации грудное вскармливание следует прекратить."}}]},{"id":15,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь взрослым и детям старше 12 лет: разовая доза составляет 250-500 мг максималь­ная разовая доза - 10 г (2 таблетки по 500 мг) максимальная суточная доза 30 г (6 табле­ток по 500 мг) разовую дозу при необходимости можно принимать 3-4 раза в сутки с ин­тервалом не менее 4 часов."}},{"type":"paragraph","data":{"text":"Детям (в качестве обезболивающего средства) в возрасте от 6 до 12 лет за исключением острых респираторных заболеваний вызванных вирусными инфекциями из-за риска раз­вития синдрома Рейе (энцефалопатия и острая жировая дистрофия печени с острым разви­тием печеночной недостаточности) разовая доза составляет 250 мг на прием принимать до 3 раз в сутки."}},{"type":"paragraph","data":{"text":"Способ применения: препарат следует принимать после еды запивая водой молоком или щелочной минеральной водой."}},{"type":"paragraph","data":{"text":"Частота и время приема: разовую дозу при необходимости можно принимать 3-4 раза в сутки с интервалом не менее 4 часов. Регулярное соблюдение режима приема препарата позволяет избежать резкого повышения температуры и уменьшить интенсивность болево­го синдрома."}},{"type":"paragraph","data":{"text":"Длительность лечения (без консультации с врачом) не должна превышать 7 дней при на­значении в качестве обезболивающего средства и более 3 дней - в качестве жаропони­жающего средства."}}]},{"id":4,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны желудочно-кишечного тракта: снижение аппетита боли в животе изжога тошнота рвота явные (рвота с кровью дегтеобразный стул) или скрытые признаки желу­дочно-кишечного кровотечения которые могут приводить к железодефицитной анемии эрозивно-язвенные поражения (в том числе с перфорацией) желудочно-кишечного тракта единичные случаи - нарушения функции печени (повышение печеночных трансаминаз) диарея."}},{"type":"paragraph","data":{"text":"Со стороны центральной нервной системы: головокружение шум в ушах (обычно яв­ляются признаками передозировки); при длительном применении - головная боль нару­шение зрения снижение остроты слуха асептический менингит."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: при длительном применении - усиление симптомов хронической сердечной недостаточности."}},{"type":"paragraph","data":{"text":"Со стороны системы кроветворения: повышение риска кровотечения что является следствием влияния ацетилсалициловой кислоты на агрегацию тромбоцитов тромбоцитопения анемия лейкопения."}},{"type":"paragraph","data":{"text":"Со стороны выделительной системы: нарушение функции почек; при длительном при­менении - интерстициальный нефрит преренальная азотемия с повышением содержания креатинина в крови и гиперкальциемией папиллярный некроз острая почечная недоста­точность нефротический синдром отеки."}},{"type":"paragraph","data":{"text":"Аллергические реакции: кожная сыпь анафилактические реакции бронхоспазм отек Квинке."}},{"type":"paragraph","data":{"text":"Синдром Рейе (энцефалопатия и острая жировая дистрофия печени с быстрым развитием печеночной недостаточности)."}},{"type":"paragraph","data":{"text":"При появлении подобных симптомов рекомендуется прекратить прием препарата и не­медленно обратиться к лечащему врачу."}}]},{"id":16,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы"}},{"type":"paragraph","data":{"text":"Передозировка средней степени тяжести: тошнота рвота шум в ушах нарушение слуха головная боль головокружение и спутанность сознания. Эти симптомы проходят при снижении дозы или отмене препарата."}},{"type":"paragraph","data":{"text":"Тяжелая передозировка: лихорадка гипервентиляция кетоацидоз респираторный алка­лоз метаболический ацидоз кома кардиогенный шок дыхательная недостаточность вы­раженная гипогликемия."}},{"type":"paragraph","data":{"text":"При хронической передозировке концентрация определяемая в плазме плохо коррелиру­ет со степенью тяжести интоксикации. Наибольший риск развития хронической интокси­кации отмечается у лиц пожилого возраста при приеме в течение нескольких суток более 100 мг/кг/сут. У детей и пациентов пожилого возраста начальные признаки салицилизма не всегда заметны поэтому целесообразно периодически определять концентрацию салицилатов в крови: концентрация выше 70 мг % свидетельствует об умеренном или тяжелом отравлении; выше 100 мг % - о крайне тяжелом прогностически неблагоприятном. При отравлении средней и тяжелой степени тяжести необходима госпитализация."}},{"type":"paragraph","data":{"text":"Лечение: госпитализация желудочный лаваж прием активированного угля мониторинг кислотно-щелочного баланса защелачивание мочи для того чтобы получить pH мочи ме­жду 75-8 (форсированный щелочной диурез считается достигнутым если концентрация салицилата в плазме крови составляет более 500 мг/л (36 ммоль/л) у взрослых или 300 мг/л (22 ммоль/л) у детей) гемодиализ возмещение потери жидкости симптоматиче­ская терапия. Следует соблюдать осторожность у пожилых больных у которых интенсив­ная инфузия жидкости может привести к отеку легких. Не рекомендуется применение ацетазоламида для ощелачивания мочи (может вызвать ацидоз и усилить токсическое дей­ствие салицилатов). Гемодиализ показан при концентрации салицилатов более 100-130 мг % у больных с хроническим отравлением - 40 мг % и ниже при наличии показаний (рефрактерный ацидоз прогрессирующее ухудшение состояния тяжелое поражение центральной нервной системы отек легких и почечная недостаточность)."}},{"type":"paragraph","data":{"text":"При отеке легких - искусственная вентиляция легких смесью обогащенной кислородом."}}]},{"id":17,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Совместное применение:"}},{"type":"paragraph","data":{"text":"- с метотрексатом в дозе 15 мг в неделю или более является противопоказанием: повыша­ется гемолитическая цитотоксичность метотрексата (снижается почечный клиренс метот­рексата и метотрексат замещается салицилатами в связи с белками плазмы крови);"}},{"type":"paragraph","data":{"text":"- с антикоагулянтами например гепарином: повышается риск кровотечения вследствие нарушения функции тромбоцитов повреждения слизистой оболочки желудочно-кишечного тракта вытеснения антикоагулянтов (непрямых) из связи с белками плазмы крови;"}},{"type":"paragraph","data":{"text":"- с другими нестероидными противовоспалительными препаратами: в результате синерги­ческого взаимодействия повышается риск возникновения язв и кровотечений из желудка и двенадцатиперстной кишки;"}},{"type":"paragraph","data":{"text":"- с урикозурическими лекарственными средствами например бензбромароном: снижает урикозурический эффект;"}},{"type":"paragraph","data":{"text":"- с дигоксином: концентрация дигоксина повышается вследствие снижения почечной эк­скреции;"}},{"type":"paragraph","data":{"text":"- с гипогликемическими препаратами: повышается гипогликемическое действие гипогли­кемических препаратов вследствие гипогликемического действия ацетилсалициловой ки­слоты;"}},{"type":"paragraph","data":{"text":"- с препаратами группы тромболитиков: усиливается фибринолитический эффект послед­них и риск возникновения кровотечений повышается;"}},{"type":"paragraph","data":{"text":"- с глюкокортикостероидами исключая гидрокортизон используемый в качестве замести­тельной терапии при болезни Аддисона: при применении глюкокортикостероидов снижа­ется концентрация салицилатов в крови за счет повышения выведения последних;"}},{"type":"paragraph","data":{"text":"- с ингибиторами ангиотензинпревращающего фермента: снижается гломерулярная фильтрация за счет ингибирования синтеза простагландинов и как следствие снижается антигипертензивный эффект;"}},{"type":"paragraph","data":{"text":"- с вальпроевой кислотой: повышается токсичность вальпроевой кислоты;"}},{"type":"paragraph","data":{"text":"- с глюкокортикостероидами этанолом (алкогольные напитки) и этанолсодержащими ле­карственными средствами: возрастает риск повреждающего действия на слизистую обо­лочку желудочно-кишечного тракта повышается риск развития желудочно-кишечных кровотечений;"}},{"type":"paragraph","data":{"text":"- усиливает эффекты наркотических анальгетиков непрямых антикоагулянтов и антиагрегантов сульфаниламидов (в том числе ко-тримоксазола - усиливает их активность и ток­сичность) трийодтиронина (усиливает активность и повышается риск развития побочных эффектов последнего);"}},{"type":"paragraph","data":{"text":"- снижает эффект гипотензивных лекарственных средств диуретиков (спиронолактон фуросемид);"}},{"type":"paragraph","data":{"text":"- повышает концентрацию барбитуратов солей лития в плазме;"}},{"type":"paragraph","data":{"text":"- антациды содержащие магний и/или алюминий замедляют и ухудшают всасывание аце­тилсалициловой кислоты;"}},{"type":"paragraph","data":{"text":"- миелотоксичные лекарственные средства усиливают проявления гематотоксичности препарата."}}]},{"id":5,"name":"Особые указания","slug":"","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота может вызывать бронхоспазм приступ бронхиальной астмы или другие реакции повышенной чувствительности. Факторами риска являются наличие бронхиальной астмы полипов носа лихорадки хронических бронхо-легочных заболева­ний случаев аллергии в анамнезе (аллергические риниты высыпания на коже)."}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота может повышать склонность к кровоточивости что связано с ее ингибирующим влиянием на агрегацию тромбоцитов. Это следует учитывать при необ­ходимости хирургических вмешательств включая такие небольшие вмешательства как удаление зуба. Перед хирургическим вмешательством для уменьшения кровоточивости в ходе операции и в послеоперационном периоде следует отменить прием препарата за 5-7 дней и поставить в известность врача."}},{"type":"paragraph","data":{"text":"Детям нельзя назначать препараты содержащие ацетилсалициловую кислоту поскольку в случае вирусной инфекции повышается риск возникновения синдрома Рейе. Симптомами синдрома Рейе являются продолжительная рвота острая энцефалопатия увеличение пе­чени."}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота уменьшает выведение мочевой кислоты из организма что может стать причиной острого приступа подагры у предрасположенных пациентов."}},{"type":"paragraph","data":{"text":"Не выявлено влияния приема препарата на управление автотранспортным средством и другими механизмами которое может повлиять на способность управлять транспортными средствами и др."}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота обладает тератогенным влиянием; при применении в I триме­стре приводит к развитию расщепления верхнего неба; в III триместре вызывает торможе­ние родовой деятельности (ингибирование синтеза простагландинов) преждевременное закрытие артериального протока у плода гиперплазию легочных сосудов и гипертензию в малом круге кровообращения. Выделяется с грудным молоком что повышает риск воз­никновения кровотечений у ребенка вследствие нарушения функции тромбоцитов."}},{"type":"paragraph","data":{"text":"В период лечения следует воздержаться от приема этанола."}}]},{"id":18,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Нет сведений."}}]},{"id":19,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки по 500 мг."}}]},{"id":6,"name":"Условия хранения","slug":"storage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В сухом месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":7,"name":"Срок годности","slug":"expiry_date","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"4 года."}},{"type":"paragraph","data":{"text":"Не использовать по истечении срока годности указанного на упаковке."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Без рецепта"}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"АО \"Производственная фармацевтическая компания Обновление\" (АО \"ПФК Обновление\"), г. Новосибирск, ул. Станционная, д.80, Россия"}}]},{"id":22,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"АО \"ПФК Обновление\""}}]}],"source":{"title":"ЭркаФарм","url":"https://erkapharm.com"}},"description_toggle":false,"short_description":"Препарат оказывает обезболивающее жаропонижающее противовоспалительное дейст­вие что обусловлено ингибированием циклооксигеназ участвующих в синтезе простагландинов. Ацетилсалициловая кислота ингибирует агрегацию тромбоцитов блокируя синтез тромбоксана А2. При приеме внутрь абсорбция полная. Во время абсорбции подвергается пресистемной элиминации в стенке кишечника и в печени (деацетилируется). Абсорбированная часть быстро гидролизуется неспецифическими холинэстеразами плазмы и альбуминэстеразой поэтому период полувыведения - не более 15-20 мин. В организме циркулирует (на 75-90 % в связи с альбумином) и распределяется в тканях в виде аниона салициловой кислоты. Время достижения максимальной концентрации - 2 ч. Сывороточная концентрация салицилатов весьма вариабельна. Салицилаты легко проникают во многие ткани и жидкости организма в т.ч. в спинномозговую перитонеальную и синовиальную жидкости. Проник­новение в полость сустава ускоряется при наличии гиперемии и отека и замедляется в пролиферативной фазе воспаления. В небольших количествах салицилаты обнаруживают­ся в нервной ткани следы - в желчи поте фекалиях. При возникновении ацидоза большая часть салициловой кислоты превращается в неионизированную кислоту хорошо прони­кающую в ткани в т.ч. в мозг. Быстро проходит через плаценту в небольших количествах выводится с грудным молоком. Метаболизируется преимущественно в печени. Метаболитами ацетилсалициловой и сали­циловой кислот являются глицинконъюгант салициловой кислоты гентизиновая кислота и ее глицинконъюгант. Выводится преимущественно путем активной секреции в каналь­цах почек в виде салициловой кислоты (60 %) и в виде метаболитов. 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