Analgesic and antipyretic. Inhibits prostaglandin synthesis, which prevents the stimulation of pain receptors by bradykinin and other substances. Irreversible platelet antiaggregant effect.
Therapeutic indications and Oral Dosage.:
-Pain (headache, dental, menstrual), fever: >16 years: 500 mg/4-6 h, or 500 mg-1 g followed by 500 mg/4 h; max. 4 g/day.
- Platelet antiaggregant (prophylaxis of: MI or reinfarction in patients with unstable angina or history of MI, occlusion of aortocoronary bypass, thrombophlebitis, phlebothrombosis and arterial thrombosis, postoperative thromboembolism in patients with biological vascular prostheses or arteriovenous shunts; treatment of TIA in men with transient cerebral ischemia to reduce risk of stroke): 100-300 mg/day.
CONTRAINDICATIONS
active, chronic or recurrent gastroduodenal ulcer; recurrent gastric discomfort, history of gastric bleeding or perforation after NSAID treatment; asthma; hypersensitivity to salicylates, NSAIDs or tartrazine; coagulation disorders; severe renal or hepatic impairment; nasal polyps associated with asthma induced or exacerbated by ASA; under 16 years (risk of Reye’s syndrome); 3rd trimester of pregnancy at doses > 100 mg/day.
PRECAUTIONS
Habitual alcohol intake (risk of gastric bleeding), G6PD deficiency, urticaria, rhinitis, hypertension, elderly. Do not take before (1 week) or after dental extraction or surgery, or in case of gout, metrorrhagia or menorrhagia. Risk of bleeding, ulceration and perforation of the upper digestive tract. Avoid combining with drugs that increase bleeding risk. Do not use systematically as a preventive for vaccination discomfort. Avoid concomitant use with heparin + thrombocytopenia. Use the lowest effective dose. If pain persists >5 days, fever >3 days, worsens or other symptoms appear, evaluate clinical situation. Hepatic insufficiency
Contraindicated in severe hepatic impairment. Renal insufficiency Contraindicated in severe renal impairment. Interactions Increases risk of ulcers and gastrointestinal bleeding with: other NSAIDs, corticosteroids. Increases bleeding risk with: SSRIs, oral anticoagulants (heparin, warfarin), thrombolytics, platelet antiaggregants, alcohol. Risk of acute renal failure with: diuretics, ACE inhibitors. Reduces effect of: ACE inhibitors, ARBs, antihypertensive β-blockers, interferon alpha, uricosurics (probenecid, sulfinpyrazone). Plasma levels increased with uricosurics. Increases effect of: insulin, sulfonylureas. Increases its toxicity with: cimetidine, ranitidine, zidovudine. Increases nephrotoxicity of: cyclosporine. Increases ototoxicity of: vancomycin. Increases plasma levels of: lithium, digoxin, barbiturates, zidovudine, valproic acid, phenytoin, methotrexate (do not combine with high-dose methotrexate; at low doses monitor blood count and renal function). Renal excretion increased by antacids. Lab: in blood: increase of glucose, paracetamol and total proteins; reduction of ALT, albumin, alkaline phosphatase, cholesterol, CPK, LDH and total proteins. In urine: reduction of 5-hydroxyindoleacetic acid, 4-hydroxy-3-methoxymandelic acid, total estrogens and glucose.
Pregnancy Cat D. Risk of miscarriages and cardiac malformations and gastroschisis. 1st and 2nd trimester use only in strict cases at low dose.
Contraindicated in the 3rd trimester as it contributes to maternal and neonatal bleeding and premature closure of the ductus arteriosus
Lactation: Acetylsalicylic acid is excreted through breast milk, therefore its use is not recommended during breastfeeding due to the risk of adverse effects in the infant.
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