Cardiomagnil, 75 mg+15, 2 mg 100 pcs

Cardiomagnesin is an antiaggregative.

Pharmacodynamics

The mechanism of action of acetylsalicylic acid (ASA) is based on irreversible inhibition of COX-1, resulting in blocking the synthesis of thromboxane A2 and suppressing platelet aggregation. It is believed that ASA has other mechanisms to inhibit platelet aggregation, which expands the field of its use in various vascular diseases. ASA also has anti-inflammatory, analgesic and antipyretic effects.

Magnesium hydroxide, a component of Cardiomagnil®, protects the gastrointestinal mucosa from the effects of ASA.

Pharmacokinetics

ASK is almost completely absorbed from the GI tract. T1/2 of ASK is about 15 minutes, because with the participation of enzymes ASK is rapidly hydrolyzed into salicylic acid (SA) in the intestine, liver and blood plasma. T1/2SC is about 3 hours, but it can be significantly increased with simultaneous administration of large doses of ASA (more than 3 g) as a result of enzyme system saturation.

The bioavailability of ASK is about 70%, but this value varies considerably because ASK undergoes presystemic hydrolysis (gastrointestinal mucosa, liver) into SC under the action of enzymes. The bioavailability of SC is 80-100%.

The doses of magnesium hydroxide used do not affect the bioavailability of acetylsalicylic acid.

Indications

Angina

• prevention of recurrent myocardial infarction and blood vessel thrombosis
• Primary prevention of cardiovascular diseases such as thrombosis and acute heart failure in the presence of risk factors (eg diabetes, hyperlipidemia, hypertension, obesity, smoking, old age);
• unstable angina;
• prevention of thromboembolism after vascular surgery (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty).

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Active ingredient

Acetylsalicylic acid, Magnesium hydroxide

Composition

1 tabletacetylsalicylic acid75 mg

magnesium hydroxide15.2 mg

Supplementary substances:

Corn starch-9.5 mg,

Microcrystalline cellulose-12.5 mg,

magnesium stearate – 150 µg,

potato starch – 2.0 mg.

The composition of the shell:

Hypromellose (methylhydroxypropylcellulose 15) – 460 µg,

propylene glycol – 90 µg,

talc – 280 µg.

How to take, the dosage

The tablet should be swallowed whole with water. If desired, the tablet may be broken in half, chewed, or previously crushed.

For primary prevention of cardiovascular disease, such as thrombosis and acute heart failure in the presence of risk factors (e.g., diabetes, hyperlipidemia, arterial hypertension, obesity, smoking, advanced age), 1 tablet is indicated. Cardiomagnanil, containing acetylsalicylic acid in a dose of 150 mg in the first day, then 1 tablet. Cardiomagnol containing acetylsalicylic acid in a dose of 75 mg once daily.

In order to prevent recurrent myocardial infarction and blood vessel thrombosis, 1 tablet of Cardiomagnacil containing acetylcylcalic acid is prescribed. Cardiomagnil containing acetylsalicylic acid in a dose of 75-150 mg once daily.

For prevention of thromboembolism after vascular surgery (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty), 1 tablet is prescribed. Cardiomagnanil containing acetylsalicylic acid at a dose of 75-150 mg once daily.

In unstable angina, 1 tablet of Cardiomagnacil containing acetylsolic acid is prescribed. Cardiomagnil containing acetylsalicylic acid in a dose of 75-150 mg once daily.

Interaction

When used concomitantly ASA increases the effect of the following drugs:

• methotrexate – by reducing renal clearance and displacing it from protein binding;
• heparin and indirect anticoagulants – due to disruption of platelet function and displacement of indirect anticoagulants from protein binding;
• thrombolytic and antiplatelet agents (ticlopidine);
• Hypoglycemic agents (insulin and sulfonylurea derivatives) – due to the hypoglycemic properties of ASA itself at high doses and displacing sulfonylurea derivatives from protein binding;
• valproic acid – due to its displacement from protein binding.

Additive effect is observed when concomitant administration of ASA with ethanol (alcohol).

ASA attenuates the effect of uricosuric agents (benzbromaron) due to competitive tubular elimination of uric acid.

Asc increases the elimination of salicylates, systemic GCS attenuates their effects.

The antacids and colestiramine reduce absorption of the drug.

Special Instructions

The drug Cardiomagnil should be taken after a doctor’s prescription.

Acetylsalicylic acid may provoke bronchospasm, and also 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 (e.g., skin reactions, itching, urticaria) to other medications.

Acetylsalicylic acid may cause bleeding of varying severity during and after surgical interventions.

A few days before the planned surgical intervention, the risk of bleeding compared to the risk of ischemic complications in patients taking low-dose acetylsalicylic acid should be assessed. If the risk of bleeding is significant, acetylsalicylic acid should be temporarily discontinued.

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

Low doses of acetylsalicylic acid may provoke development of gout in predisposed individuals (those with decreased uric acid excretion).

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

High doses of acetylsalicylic acid have hypoglycemic effects, which should be kept in mind when prescribing it for patients with diabetes who are on oral hypoglycemic agents and insulin.

When using systemic GCS and salicylates in combination, we should remember that during treatment, the concentration of salicylates in blood is decreased, and after withdrawal of systemic GCS, an overdose of salicylates is possible.

The combination of acetylsalicylic acid with ibuprofen is not recommended in patients with increased cardiovascular risk: concomitant use with ibuprofen has decreased antiplatelet effects of acetylsalicylic acid at doses up to 300 mg, which reduces 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.

Long-term use of acetylsalicylic acid at low doses as antiplatelet therapy requires caution in elderly patients due to the risk of gastrointestinal bleeding.

The concomitant administration of acetylsalicylic acid with ethanol increases the risk of gastrointestinal mucosal damage and prolongs bleeding time.

Impact on driving and operating machinery

Patients should be careful during treatment with acetylsalicylic acid when driving vehicles and engaging in potentially dangerous activities that require increased concentration and quick psychomotor reactions.

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Contraindications

• cerebral hemorrhage;
• sensitivity to bleeding (vitamin K deficiency, thrombocytopenia, hemorrhagic diathesis);
• bronchial asthma, induced by taking salicylates and NSAIDs;
• gastrointestinal erosive disease (acute phase);
• gastrointestinal bleeding;
• severe renal failure (CK< 10 ml/min);
• Glucose-6-phosphate dehydrogenase deficiency;
• I and III trimesters of pregnancy;
• period of lactation (breastfeeding);
• children and adolescents under 18 years of age;
• high sensitivity to acetylsalicylic acid, excipients of the drug and other NSAIDs.

With caution. The drug should be prescribed in case of gout, hyperuricaemia, a history of gastrointestinal ulcers or bleeding, renal and/or hepatic insufficiency, bronchial asthma, hay fever, nasal polyposis, allergic conditions, in the 2nd trimester of pregnancy.

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Side effects

The frequency of adverse reactions listed below was determined accordingly as follows: very common (≥1/10); common (> 1/100,1/1000,1/10,000,

Allergic reactions: common – urticaria, Quincke’s edema; sometimes – anaphylactic reactions.

Digestive system disorders: very often – heartburn; often – nausea, vomiting; sometimes – abdominal pain, gastric and duodenal mucosa ulcers, gastrointestinal bleeding; rarely – perforation of gastric or duodenal ulcers, increased liver enzyme activity; very rarely – stomatitis, esophagitis, upper GI erosive lesions, strictures, colitis, irritable bowel syndrome.

Respiratory system disorders: often – bronchospasm.

Hematopoietic system: very common – increased bleeding, rarely – anemia, very rare – hypoprothrombinemia, thrombocytopenia, neutropenia, aplastic anemia, eosinophilia, agranulocytosis.

CNS disorders: sometimes – dizziness, somnolence; often – headache, insomnia; rarely – tinnitus, intracerebral hemorrhage.

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Overdose

Symptoms of moderate overdose: nausea, vomiting, tinnitus, hearing impairment, dizziness, confusion.

Treatment: the stomach should be flushed, activated charcoal should be prescribed, symptomatic therapy should be carried out.

Serious overdose symptoms: fever, hyperventilation, ketoacidosis, respiratory alkalosis, coma, cardiovascular and respiratory failure, severe hypoglycemia.

Treatment: immediate hospitalization in specialized departments for emergency therapy – gastric lavage, determination of acid-base balance, alkaline and forced alkaline diuresis, hemodialysis, administration of saline solutions, activated carbon, symptomatic therapy.

In alkaline diuresis, pH values between 7.5 and 8 should be achieved. Forced alkaline diuresis should be performed when the plasma concentration of salicylates is more than 500 mg/l (3.6 mmol/L) in adults and 300 mg/l (2.2 mmol/L) in children.

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Similarities

Trombital, Trombital Forte, Fazostabil