"Aspecard" preparation: instructions for use, analogues, reviews

Acetylsalicylic acid (ASA) refers to drugs with antipyretic, anti-inflammatory and antiplatelet effect. In medical practice it has been used for more than 125 years, therefore it is one of the most studied medicinal substances. Moreover, ASA is now issued in the form of a cardioform to reduce the risk of coronary artery thrombosis, which prevents the development of myocardial infarction. A typical example is the preparation "Aspekard", which contains acetylsalicylic acid in a dosage optimal for the antiplatelet effect.

Information about the form of release and the manufacturer

The manufacturer of the medicine is the Ukrainian company "Stirolbiopharm". Accordingly, the production technology used, the drug is available in the form of a gastrointestinal form in a dose of 100 mg in one tablet. Methods of packaging tablets:

• Cardboard package 120 tablets (10 blisters for 12 tab.);
• Polymer container of 100 tablets.

The tablet "Aspekard" contains 100 mg ASA, microcrystalline cellulose, croscarmellose sodium, colloidal silicon dioxide, stearic acid.

Recommendations for the appointment

The preparation "Aspecard" uses a rather narrow, although the instruction to it contains recommendations for the treatment of a variety of diseases, including rheumatic pathologies. The manufacturer recommends the use of "Aspekard" and as an antipyretic or analgesic. In fact, in a given dosage of acetylsalicylic acid, the drug can be effectively used only as a drug that prevents platelet aggregation.

Indications for the use of "Aspecard"

About the "Aspecard" preparation instructions for use, expert reviews and clinical studies give a lot of information on antiplatelet therapy. It is shown in the following situations:

• With acute coronary syndrome (at the stage of acute myocardial infarction with elevation, depression or intact location of the ST segment, with unstable angina);
• With ONMIK (ischemic stroke or transient ischemic attack);
• In the case of proven ischemic heart disease as a means of preventing ACS and ONMC;
• In the prevention of repeated episodes of ACS and ONMC;
• In the presence of varicose veins of the lower extremities;
• As a prophylactic agent, preventing thrombosis of shunts after CABG;
• With arterial hypertension in case of high cardiovascular risk.

High cardiovascular risk is a cumulative concept, including the presence of target organ damage in hypertension and related diseases: diabetes, coronary heart disease, central nervous system.

Features of dosing regimes recommended by the manufacturer

The "Aspekard" preparation does not have the manufacturer's instructions for the treatment. It does not contain information on the taking of the remedy in various clinical situations, beginning with the prevention of atherothrombosis in IHD and CWC, and ending with acute circulatory disorders of the brain and heart. This omission is considered negligent and unprofessional attitude to the production of drugs and accompanying information materials. This also creates the prerequisites for the publication of a mass of articles in which the recommended dosages diverge.

Dosing regimens based on international recommendations

Based on international recommendations developed by the European Community of Cardiology (ESC) and the American Heart Association (AHA) and adapted by the Ministry of Health, the regimens for the use of acetylsalicylic acid are:

• At the acute care stage in acute coronary syndrome, it is required to give the patient 3 tablets "Aspekard 100". Instructions for use are ignored, and a single dose is 300 mg;
• In chronic cardiac ischemia (IHD), one tablet of 100 mg after dinner is prescribed for a regular appointment;
• With hypertension of patients with an already high risk of cardiovascular complications, as well as with venous varicose disease of the lower extremities, 100 mg (1 tablet) in the evening after dinner are also taken.

The ESC and AHA instructions do not foresee other ways of prescribing Aspecard. It is also important to note that the standard dose of "Aspecard" is 100 mg ASA. To prevent the above diseases, in accordance with the instructions ESC and AHA, a dose of 75 mg is applied. However, 100 mg is given to patients after CABG in order to prevent thrombosis of the shunt. In other cases it is recommended to use 75 mg, that is the amount of ASA that has a sufficient antiplatelet effect and has a minimum risk of gastrotoxicity.

Also, the manufacturer does not give important information about the withdrawal of the drug. According to statistics, a sudden discontinuation of reception is the cause of 10.2% of acute cardiovascular complications. And they meet about 10.6 days after the abolition of ASA. This period is average and reflects the time during which the entire population of platelets with functioning cyclooxygenase is restored. As a result, the possibility of formation of thrombi is restored again. Therefore, the drug should be taken continuously, and when complications arise from the gastrointestinal tract, another antiaggregant should be prescribed instead of "Aspecard".

Contraindications for the use of Aspecard

The safety of all pharmacological drugs is relative, as they have side effects. In doing so, they cause some contraindications. In particular:

• With violations of blood clotting (hemorrhagic diathesis, haemophilia A and B);
• With violations of the stomach (erosions, acute gastric ulcers and 12 duodenal ulcers);
• With pregnancy in the first trimester and during lactation;
• With severe renal or hepatic insufficiency;
• At an allergic reaction to salicylates;
• In children under the age of 18;
• In the presence of bronchial asthma;
• In the treatment of methotrexate.

These contraindications are absolute, although some of them are temporary: lactation, pregnancy, erosion and gastrointestinal ulcers, children's age. Moreover, there is also a group of conditions, the presence of which requires constant monitoring by the doctor. This is the simultaneous use of antiplatelet agents with anticoagulants, as well as the treatment of patients after coronary artery bypass grafting. If the kidney function is impaired, the application instructions applied to the Aspecard preparation require a reduction in dosage or a complete gradual withdrawal of the medication.

Joint Effects of Aspekard

Acetylsalicylic acid has a number of effects that enhance or inhibit the action of a number of drugs. In particular:

• ASA enhances the effect of any antiplatelet and anticoagulant;
• ASA enhances the antipyretic and analgesic effect of NSAIDs, enhances the anti-rheumatic effect of "Meloxicam";
• When combined with cytostatics increases their gastro-toxicity;
• When taken with alcohol, the risk of complications of an ulcer or bleeding increases;
• Glucocorticoids increase gastro-toxicity of "Aspecard";
• ASA when combined with diuretics weakens the diuretic effect of Furosemide, Torasemide, and Spironolactone.
• "Aspecard" weakens the effect of uricosuric drugs: Probenecid, Etamid, Sulfinpyrazona;
• Absorbable antacid preparations significantly reduce the absorption of Aspekard.

The likelihood of an overdose and its symptoms

Regarding the "Aspecard" preparation, the instruction, testimonials and application statistics confirm a sufficiently high level of safety in admission according to indications and with the exception of contraindications. This means that the prescribed dose of 100 mg of the drug is safe enough, although it is necessary to control your health. And due to the presence of a contingent of patients with suicidal tendencies, as well as the risk that the ASK tablet will take a child, the details of the probability of overdose and its symptoms are necessary.

At an easy degree of poisoning with salicylates, provoked by the use of Aspecard, not according to the recommendations of the doctor, the symptoms are the following: dizziness, pain in the region of the pit of the stomach, in the peripodal region, sometimes lower back pain, especially in patients with kidney disease. When an overdose is also observed shivering, vomiting, sometimes with bloody veins. The first aid is the artificial inducing of vomiting: copious cold drink, reception of activated carbon and enterosorbents, delivery of the patient to a hospital.

It is important that the instructions for use do not indicate the toxic doses of Aspecard. They are different for different weight and age of the patient. For example, in an adult, symptoms of an overdose of ASA of mild degree occur with a single intake of about 5-7 grams of acid. In children, 1.5 grams of a single dose is sufficient for an overdose. Significant overdose occurs when adults use 7-9 grams, and children 2-2.5 grams of ASA.

This degree of drug overdose manifests itself with the above disorders with the involvement of cognitive functions. Loses attention, noise begins in the ears, thinking becomes confused, speech is indistinct. Vomiting happens often, the patient quickly loses fluid with vomiting, breathing becomes quicker, there is an acute retention of urine, the body temperature rises. It is impossible to help the patient in this situation: delivery to the intensive care unit for infusion therapy with sodium bicarbonate, lactate is required .

Features of therapeutic action "Aspecard"

The instructions for use applied to the preparation "Aspekard" contain an indication of taking one tablet per day (100 mg / day). This dose of ASA is sufficient to inhibit platelet cyclooxygenase. The result is inhibition of the synthesis of thromboxane A2, which completely inhibits the ability of platelets to aggregate. This excludes the possibility of thrombosis, which is the cause of myocardial or cerebral infarction.

To provide antithrombotic effect, acetylsalicylic acid should be absorbed into the blood. However, some of it works in the stomach, also inhibiting cyclooxygenase-1 and its isoforms in the mucous membrane of the organ. The result of this mechanism is a side effect - a decrease in the protective abilities of the mucous-carbonate barrier. This increases the risk of developing erosions and stomach ulcers, provokes gastrointestinal bleeding. Intestinal forms are also capable of causing bleeding, but the incidence of such a side effect is extremely low.

Application in pregnancy and lactation

The opinion of specialists, based on the evaluation of statistics and a number of experiments, allows us to have a clear idea of the use of Aspecard during pregnancy. In particular, in the first trimester its use is prohibited. In the 2nd and 3rd trimester, use is permitted, however, after evaluating its therapeutic benefit and comparing the risks of admission. In the vast majority of clinical situations, the appointment of ASA is unreasonable, although other NSAIDs are also capable of increasing the risk of miscarriage.

During lactation, the drug "Aspecard", its analogs, generics, as well as all medicines with acetylsalicylic acid in the composition is prohibited. The reason for this is the ingestion of the drug into breast milk. With it, it penetrates the child's body. And his danger lies in the high risk of developing Ray's syndrome - extremely severe hepatic encephalopathy, which causes cerebral edema and the death of a child. For similar reasons, it is prohibited to prescribe the drug before the age of 16-18.

Characteristics of feedback from specialists and patients

Characterizing the drug "Aspecard" reviews of patients in many cases are biased. They positively estimate the price of the medicine, since it is almost the lowest among analogues. However, reviews related to practical use are less indicative because it is impossible to assess the degree of reduction in the risk of vascular thrombosis. In terms of side effects noted by patients, the drug is characterized as sufficiently safe.

The opinions of specialists are unambiguous: firstly, the medicine effectively reduces the risks of thrombosis, and secondly, the adherence of patients to antiplatelet therapy is higher because of the low price of the Aspocard preparation. Analogues for the class of antiplatelet agents are much higher. Domestic intestinal soluble drug "Acecaradol" is more expensive by 50%, whereas the cost of imported drugs is 7-10 times higher. But, based on fewer side effects of enteric-soluble drugs, as well as on economic conclusions, priority should preferably be given to "Acecaradol". The cost of a monthly treatment is about 20 rubles.

Objective deficiency of the cardiopreparation "Aspekard"

The instruction for use applied to the preparation "Aspekard 100" says that the medicine is produced in tablets. They dissolve in the stomach and create a high concentration. Providing a local gastrotoxic effect, the drug loses on safety to other drugs, namely, enteric-soluble. The risk of gastric bleeding when using the latter is significantly less.

Examples of safer drugs are the following: "Acecardol", "Polokard", "Cardiomagnolo", "Aspirin Cardio". Moreover, said agents also contain magnesium hydroxide capable of protecting the mucous membranes from damage by acetylsalicylic acid. Nevertheless, the drug "Aspekard" can be used to prevent thrombosis, albeit with limitations. But patients with erosion of the mucous membrane, ulcers of the duodenum or stomach, including chronic ones, are recommended to take enteric-soluble cardio forms of acetylsalicylic acid.

The branch application of the cardiopreparation "Aspecard"

Most of the available instructions for use indicate the presence of anti-inflammatory and antipyretic properties of the drug "Aspekard 100". In fact, the therapeutic effects of the drug in a 5-fold single dose - 500 mg. The dosage of 100 mg is exclusively cardiac, and its effects are not sufficient to effectively reduce the temperature in infectious diseases.

The cardioform of the drug, released in a dose of 100 mg, is suitable for anesthesia and relief of fever only with a single intake of 5 tablets. In this case, the predominance of selectivity to cyclooxygenase 1 causes a number of adverse reactions. Therefore, as an antipyretic tablet "Aspecard", of course, are suitable. However, at the moment there are a number of safer drugs of the series showing greater selectivity to cyclooxygenase 2. They also have fewer side effects associated with impaired proliferation of the gastrointestinal epithelium.

Safe class analogues of the drug "Aspecard"

A similar trend is observed in the treatment of rheumatic diseases. Moreover, the instructions for use applied to the Aspecard preparation contain information about their treatment. But the recommended dose is about 5-8 grams per day.

In such an amount, acetylsalicylic acid exhibits an incomparably stronger gastrotoxic effect than when taking medications such as Meloxicam, Celecoxib, Roferoxib, and others. And as an antipyretic agent, the most valuable class analogue is Ibuprofen.