The basis of the mechanism of action of primobolan depot bayer primobolan depot bayer is irreversible COX inhibition, resulting in blocked synthesis of thromboxane A2 and primobolan depot bayer platelet aggregation is inhibited. It is believed that ASA has other mechanisms of inhibition of platelet aggregation, which expands the scope of its application in various vascular diseases. ASA also has anti-inflammatory, Analgesic, antipyretic effect.After oral primobolan primobolan enanthate depot bayer acid is absorbed in the upper small intestine. Maximum plasma concentration is observed after an average of 3 hours after ingestion of the drug. primobolan depot bayer acid is partially metabolized in the liver with the formation of less active metabolites. Excreted by the kidneys as unchanged or as metabolites; the half-life of aspirin is about 15 minutes for metabolites – about 3 hours.
Prevention of acute myocardial infarction in the presence of risk factors (eg, diabetes mellitus, hyperlipidemia, hypertension, obesity, smoking, old age), and recurrent myocardial infarction.
Prevention of stroke (including patients with transient ischemic attack).
Prevention of thromboembolism after surgery and invasive procedures on vessels (eg, coronary artery bypass grafting, carotid endarterectomy, arterio-venous bypass, angioplasty, carotid arteries).
Prevention of deep vein thrombosis and pulmonary artery and its branches (for example, after prolonged immobilization resulting from surgical large)
Hypersensitivity to ASA to excipients of the drug and other NSAIDs.
Erosive-ulcerative lesions, gastro – intestinal bleeding, hemorrhagic diathesis, bronchial asthma induced by intake of salicylates and NSAIDs, the triad Fernand-Vidal, (a combination of asthma, recurrent nasal polyposis, and paranasal sinuses and intolerances ASA), the combined use with methotrexate 15 mg per week or more pregnancy (I and III trimester) and lactation age of 18 years.
Use with caution
a history of: ulcerative lesions of the gastrointestinal tract or gastrointestinal bleeding, kidney and liver failure, asthma, chronic respiratory disease, hay fever, nasal polyposis, allergic reactions to other drugs,
in II trimester of pregnancy; in combination with methotrexate at a dose less than 15 mg per week,
vitamin K deficiency, and glucose-6-phosphate dehydrogenase.
The use of high doses of salicylates in the first 3 months of pregnancy is associated with an increased rate of fetal defects (cleft palate, heart defects). In the II trimester of pregnancy salicylates can be assigned only on the basis of strict risk assessment and benefit.
In the last trimester of pregnancy salicylates in high doses (more than 300 mg / day) cause inhibition of labor, premature closure of the ductus arteriosus in the fetus, increased bleeding in the mother and the fetus, and the appointment just before birth may cause intracranial hemorrhage, especially in preterm detey.Naznachenie salicylates in the last trimester of pregnancy is contraindicated.
Use in lactation
Salicylates and their metabolites in small amounts into breast milk. Accidental intake of salicylates during lactation is not accompanied by the development of adverse reactions in children and does not require stopping breastfeeding. However, long-term use of the drug or to appoint him to a high dose of breast-feeding should be discontinued immediately.
Dosing and Administration
The tablets should be taken orally before meals, drinking plenty of fluids. The drug is intended for long-term use. The duration of therapy is determined by the attending physician.
Prophylaxis in cases of suspected acute myocardial infarction: 100 – 200 mg / day or 300 mg every other day (first tablet must be chewed for rapid absorption).
Preventing the first time there is an acute myocardial infarction in the presence of risk factors: 100 mg / day or 300 mg every other day.
Prophylaxis of recurrent myocardial infarction. Unstable angina. Prevention of stroke and transient ischemic attack. Prevention of thromboembolic complications of surgery or invasive investigations: 100 – 300 mg / day.
Prevention of deep vein thrombosis and pulmonary embolism and its branches: 100 – 200 mg / day or 300 mg every other day.
Allergic reactions: urticaria, angioedema.
Immune system: anaphylactic reactions.
Gastrointestinal tract: nausea, heartburn, vomiting, pain in the abdomen, the gastric mucosa and duodenal ulcers, including perforation, gastrointestinal bleeding, increased activity of “liver” enzymes.
Respiratory system: bronchospasm
Hematopoietic system: increased bleeding, anemia (rare).
Central nervous system: dizziness, tinnitus
Symptoms of an overdose of moderate severity: nausea, vomiting, tinnitus, hearing loss, dizziness, confusion.
Treatment: reduction in dose.
Symptoms of severe overdose: fever, hyperventilation, ketosis, respiratory alkalosis, coma, cardiovascular and respiratory insufficiency, severe hypoglycemia.
Treatment: immediate hospitalization in specialized departments for emergency treatment of gastric lavage, determination of the acid-alkaline balance, alkaline and forced alkaline diuresis, dialysis, administration of solutions, activated carbon, symptomatic therapy. When conducting alkali diuresis necessary to achieve pH values between 7.5 and 8. Forced diuresis alkali should be performed when the salicylate concentration in plasma is greater than 500 mg / l (3.6 mmol / L) in adults and 300 mg / L (2, 2 mmol / l) in children.
. Interaction with other drugs With simultaneous use of ASA enhances the effect of the following medicines:
- methotrexate by reducing renal clearance and displacement of its association with proteins;
- heparin and indirect anticoagulants due to dysfunction of platelets and displacing anticoagulants from binding with proteins;
- thrombolytic and antiplatelet agents (ticlopidine);
- digoxin due to the reduction of its renal excretion;
- hypoglycemic agents (sulfonylureas and insulin) hypoglycemic properties by itself in high doses of ASA and sulfonylurea derivatives of displacement due to proteins
- valproic acid due to displacement from its association with proteins;
- An additive effect is observed while taking ASA with alcohol;
- ASA reduces the effect of uricosuric agents (benzbromaron) due to competitive tubular elimination of uric acid;
- Leveraging the elimination of salicylates, systemic glucocorticosteroids (GCS) weaken their effect.
The drug should be used when prescribing physician. ASA may provoke bronchospasm and induce asthma attacks or other hypersensitivity reactions. Risk factors are the presence of a history of asthma, hay fever, nasal polyposis, chronic respiratory diseases and allergic reactions to other drugs (eg, skin reactions, pruritus, urticaria). ASA can cause bleeding of varying severity during and after surgery. The combination of ASA with anticoagulant, thrombolytic and antiplatelet drugs is accompanied by an increased risk of bleeding. ASA in low doses can trigger the development of gout in susceptible individuals (with a reduced excretion of uric acid). The combination of ASA with methotrexate is accompanied by an increased incidence of side effects of hematopoiesis.
High doses of ASA have a hypoglycemic effect, it must be borne in mind when assigning his patients with diabetes receiving hypoglycemic drugs. When combined with the appointment of the SCS and salicylates should be remembered that during treatment the level of salicylate in the blood is reduced, and after the abolition of GCS possible overdose of salicylates.
We do not recommend the combination of ASA with ibuprofen, because the latter worsens Atsekardola beneficial effect on life expectancy. Increasing the dose of ASA carries a risk of gastrointestinal bleeding. Overdose is especially dangerous in elderly patients. With the combination of ASA with alcohol increased the risk of damage to the mucous membrane of the gastrointestinal tract and prolongation of bleeding time.