How long does cardiomagnyl last? Cardiomagnyl: instructions for use, analogues and reviews, prices in Russian pharmacies. Qualitative and quantitative composition

Dosage form

Film-coated tablets 75 mg

Film-coated tablets 150 mg

Composition

One film-coated tablet contains

active ingredient: acetylsalicylic acid 75 mg or 150 mg

excipients: magnesium hydroxide, corn starch, microcrystalline cellulose (E460), potato starch, magnesium stearate (E470b)

film shell composition: hypromellose (methylhydroxypropylcellulose 15), macrogol (propylene glycol), talc.

Description

White tablets in the shape of a stylized “heart”, film-coated (for a dosage of 75 mg)

White, oval, film-coated tablets with a break mark (for a dosage of 150 mg)

Pharmacotherapeutic group

Anticoagulants. Platelet aggregation inhibitors excluding heparin. Acetylsalicylic acid

ATX code B01AC06

Pharmacological properties

Pharmacokinetics

Suction
Acetylsalicylic acid (ASA) is rapidly absorbed from the gastrointestinal tract. The bioavailability of ASA is about 70%, but this value is characterized by significant individual variability due to presystemic hydrolysis in the mucous membranes of the gastrointestinal tract and in the liver with the formation of salicylic acid esterases. The bioavailability of salicylic acid is 80-100%.

After oral administration, non-ionized ASA is absorbed in the stomach and intestines. Absorption is reduced by food intake and in patients suffering from migraine attacks. The rate of absorption is increased in patients suffering from achlorhydria or in patients taking polysorbates or antacids. Peak serum concentrations of ASA are achieved within half an hour, and for salicylic acid within 1-2 hours.

Distribution
80% - 90% of ASA binds to plasma proteins. The volume of distribution in adults reaches 170 ml/kg body weight. When plasma concentrations increase, saturated protein binding occurs, resulting in an increase in volume of distribution. Salicylates are widely bound by plasma proteins and are rapidly distributed throughout the body. Salicylates are also found in breast milk and can cross the placental barrier.

Metabolism
ASA is hydrolyzed into the active metabolite salicylate in the intestinal wall. After absorption, ASA is quickly converted into salicylic acid, but in the first 20 minutes after ingestion, ASA is the dominant form.
Removal
Salicylate is primarily eliminated through hepatic metabolism. Therefore, plasma concentrations of salicylate increase disproportionately with dose. At a dose of ASA 325 mg, the plasma half-life for salicylate is 2-3 hours. At high doses of ASA, the half-life increases to 15-30 hours. Salicylate is also excreted unchanged in the urine. The amount excreted depends on the dose and the pH of the urine. Approximately 30% of the dose is excreted in alkaline urine and 2% in acidic urine.

Renal excretion includes glomerular filtration, active renal tubular secretion, and passive tubular reabsorption.

Pharmacodynamics

ASA is an analgesic, anti-inflammatory and antipyretic agent that also prevents platelet aggregation. This increases bleeding time.

The pharmacological effect of ASA is to inhibit the production of prostaglandins and thromboxanes.

The analgesic effect is a peripheral effect caused by inhibition of the enzyme cyclooxygenase.

The anti-inflammatory effect is associated with blood perfusion and is due to inhibition of prostaglandin E2 synthesis.

ASA irreversibly acetylates and inhibits the enzyme prostaglandin G/H synthase and therefore the effect on platelets is longer lasting than the presence of ASA itself in the body. The effect of ASA on thromboxane biosynthesis in platelets and on bleeding time persists for many days even after treatment has stopped. The effect only stops when new platelets are found in the plasma.

In addition, salicylate (the active metabolite) has an anti-inflammatory effect, an effect on breathing, on the acid-base balance and on the stomach. Salicylates stimulate respiration primarily through direct action on the medulla oblongata. They have an indirect effect on the gastric mucosa due to their inhibition of vasodilatory and cytoprotective prostaglandins and, in addition, cause a predisposition to ulcers.

Indications for use

Tablets 75 mg

Primary prevention of cardiovascular diseases such as thrombosis and acute coronary syndrome in people over 50 years of age with one or more of the following that may be risk factors for cardiovascular disease: hypertension, hypercholesterolemia, diabetes mellitus, obesity (BMI > 30 ) and family history of myocardial infarction before age 55 in at least one parent or sibling

Prevention of recurrent myocardial infarction and blood vessel thrombosis

Tablets 150 mg

Acute and chronic ischemic heart disease

Directions for use and doses

When taken orally, the tablets may be chewed or suspended in water to ensure rapid absorption.

Tablets 75 mg

Acute and chronic ischemic heart disease

Acute myocardial infarction/unstable angina

150 - 450 mg as soon as possible after the first symptoms appear.

Prevention of recurrent thrombosis

150 mg as an initial dose, followed by 75 mg daily.

Patients over 50 years of age

Primary prevention, if there is a particular risk of developing cardiovascular disease: 75 mg daily.

Tablets 150 mg

150 mg daily

If liver or kidney function is impaired, dose adjustment may be necessary. The drug is not prescribed for severe liver or kidney dysfunction.

Side effects

Adverse side reactions are distributed in the following order, taking into account the frequency of occurrence: very often (≥1/10); often (≥1/100 to<1/10); не часто (≥1/1,000 до <1/100); редко (≥1/10,000 до <1/1,000); очень редко (<1/10,000)

Often:

Prolonged bleeding time

Inhibition of platelet aggregation

Heartburn, acid reflux, abdominal pain

Hemorrhagic diathesis

Headache

Bronchospastic effect in patients with asthma

Erythema and erosions in the upper gastrointestinal tract, nausea, dyspepsia, vomiting, diarrhea

Insomnia

Hidden bleeding

Vertigo (dizziness), drowsiness

Tinnitus

Ulcers and bleeding in the upper gastrointestinal tract, vomiting blood, melena (black stools)

Allergic reactions - urticaria, angioedema (angioedema often develops in patients with allergies)

Anaphylactic reactions

Increased values of transaminases and alkaline phosphatase

Anemia (with long-term treatment), hemolysis (in the presence of congenital deficiency of glucose-6-phosphate dehydrogenase)

Intracerebral bleeding

Dose-dependent reversible hearing loss and deafness

Severe gastrointestinal bleeding in the upper gastrointestinal tract, perforation

Renal dysfunction

Hypoglycemia

Hemorrhagic vasculitis

Very rarely:

Hypoprothrombinemia (at high doses), thrombocytopenia, neutropenia, eosinophilia, agranulocytosis, aplastic anemia

Stomatitis, esophagitis, formation of ulcers in the lower part of the gastrointestinal tract, stenosis, colitis, exacerbations of inflammatory bowel diseases

Purpura, erythema, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome)

Dose-dependent reversible toxic hepatitis associated with various viral diseases (influenza A and B, chicken pox).

Maybe:

Reye's syndrome

Contraindications

Known or suspected hypersensitivity to salicylates, non-steroidal anti-inflammatory drugs (NSAIDs) or any of the excipients

Hemorrhagic diathesis (vitamin K deficiency, thrombocytopenia, hemophilia)

Peptic ulcer in the active stage

Severe renal impairment (GFR)<0,2 мл / с (10 мл / мин))

Severe liver dysfunction

Severe cardiac dysfunction

Children under 16 years of age

Exceeding the dose of more than 100 mg per day in the third trimester in pregnant women

Drug interactions

The concomitant use of the following drugs should be avoided:

Methotrexate

Possible mechanism: decreased clearance of methotrexate.

Effect: methotrexate toxicity (leukopenia, thrombocytopenia, anemia, nephrotoxicity, ulceration of the mucous membranes).

ACE inhibitors

Possible mechanism: inhibition of prostaglandin synthesis.

Effect: decreased effectiveness of ACE inhibitors.

Acetazolamide

Possible mechanism: Increased concentrations of acetazolamide may result in diffusion of salicylates from the blood plasma into surrounding tissues.

Effect: Acetazolamide-induced toxicity (fatigue, lethargy, drowsiness, confusion, hyperchloremic metabolic acidosis) and salicylate-induced toxicity (vomiting, tachycardia, hyperpnea, confusion).

Probenecid, sulfinpyrazone

Possible mechanism: probenecid and high doses of salicylates (> 500 mg) mutually block the effect of both drugs, affecting the excretion of uric acid.

Effect: decreased excretion of uric acid.

Concomitant use of the following drugs requires caution

Clopidogrel, ticlopidine

The combination of clopidogrel and ASA has a synergistic effect, so an increased risk of bleeding is associated with this combination. Caution is required when prescribing this combination.

Anticoagulants: warfarin, phenprocoumon

Possible mechanism: reduce thrombin production, which leads to an indirect decrease in platelet activity (vitamin K antagonist).

Absiximab, tirofiban, eptifibatide

Possible mechanism: inhibit glycoprotein IIb/IIIa receptors on platelets.
Effect: increased risk of bleeding.

Heparin
Possible mechanism: Reduces thrombin production, which leads to an indirect decrease in platelet activity.

Effect: increased risk of bleeding.

If two or more of the above agents are used together with ASA, this may result in a synergistic effect with increased inhibition of platelet activity and, as a result, an increased risk of bleeding diathesis.
NSAIDs and COX-2 inhibitors (celecoxib)

Possible mechanism: additive gastrointestinal irritation.

Ibuprofen
Simultaneously, the use of ibuprofen inhibits irreversible platelet aggregation caused by ASA. Treatment with ibuprofen in patients at increased risk of cardiovascular disease may limit the cardioprotective effect of ASA.

Patients taking ASA once daily for cardiovascular disease prevention and those taking ibuprofen occasionally should take ASA at least 2 hours before taking ibuprofen.

Furosemide
Possible mechanism: inhibition of proximal tubular excretion of furosemide.

Effect: the diuretic effect of furosemide is reduced.

Quinidine
Possible mechanism: additive effect on platelets.
Effect: extended bleeding time.

Spironolactone
Possible mechanism: modified renin effect.
Effect: decreased effectiveness of spironolactone.
Selective serotonin reuptake inhibitors (SSRIs)
Possible mechanism: additive irritation of the gastrointestinal tract.
Effect: increased risk of gastrointestinal bleeding.
Valproate
Possible mechanism: ASA alters the binding and metabolism of valproate.
Effect: valproate toxicity (central nervous system depression, gastrointestinal problems).

The combination may require a dose adjustment of valproate.
Corticosteroids
Possible mechanism: additive GI irritation and increased renal clearance or metabolism of salicylates.
Effect: increased risk of gastrointestinal ulcers and subtherapeutic plasma concentrations of salicylate.

Antidiabetic drugs

Possible mechanism: additive hypoglycemic effect.
Effect: hypoglycemia

Antacids
Possible mechanism: increased renal clearance and decreased renal absorption (due to increased urine pH).

Effect: reduced effect of ASA.

Chickenpox vaccine

Mechanism: unknown.

Effect: increased risk of developing Reye's syndrome.

Ginkgo biloba

Possible mechanism: Ginkgo biloba inhibits platelet aggregation.
Effect: increased risk of bleeding.

special instructions

Long-term use of Cardiomagnyl in combination with other NSAIDs should be avoided due to the increased risk of unwanted effects (see section Drug Interactions).

Magnesium hydroxide, which is part of the drug, is an antacid that neutralizes hydrochloric acid, has an enveloping property, binds lysolecithin and bile acids, which have an adverse effect on the gastric mucosa.

Long-term use should be avoided in elderly patients with pain, inflammation, fever and rheumatic disease due to the risk of gastrointestinal bleeding. Low doses of ASA should be used with caution in elderly patients for the treatment of acute or chronic coronary heart disease and stroke, as well as for the prevention of stroke and coronary heart disease due to the risk of gastrointestinal bleeding.

ASA can cause bronchospasm and cause asthma attacks or other allergic reactions.

The drug should be used with caution in the following conditions:

A history of gastrointestinal ulcers, including chronic and recurrent peptic ulcers or gastrointestinal bleeding

In patients with impaired renal or circulatory function

In case of liver dysfunction

In patients suffering from severe glucose 6 phosphate dehydrogenase (G6PD) deficiency, ASA can induce the development of hemolysis or hemolytic anemia.

ASA can lead to increased bleeding during and after surgery, such as tooth extraction.

Fertility
The use of ASA can reduce fertility, and therefore should not be used in women wishing to become pregnant. If treatment with ASA is necessary, treatment should be as short as possible and the dose should be as low as possible. The effect on fertility is reversible.

Pregnancy and lactation

Low doses (up to 100 mg/day)

Clinical studies show that dosages up to 100 mg/day are safe for obstetric use that requires special supervision.

High doses (more than 100 mg/day)

First and second trimester: Prostaglandin synthesis inhibitors can only be used if there are strict indications, and the dose should be as low as possible and the duration of treatment as short as possible.

Third trimester: administration of ASA above a dose of 100 mg per day can cause in the fetus:

Cardiopulmonary toxicity (with premature closure of the Batal duct and pulmonary hypertension)

Renal dysfunction with the consistent development of renal failure and a decrease in amniotic fluid;

in mother and fetus at the end of pregnancy:

Increased bleeding time as a consequence of possible decreased platelet aggregation

Suppression of uterine contractility, which can lead to late labor or increased labor duration.

In connection with the above, the use of ASA above a dose of more than 100 mg per day is contraindicated in the third trimester in pregnant women.

Due to the lack of experience with use during lactation, before prescribing ASA during breastfeeding, the potential benefits of drug therapy should be assessed against the potential risk for infants.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms
Cardiomagnyl does not affect or only slightly affects the ability to drive a vehicle or work with moving machinery.

Overdose

Dangerous dose for adults: 300 mg/kg.

Symptoms: As a rule, mild chronic salicylate poisoning occurs only after long-term use of high doses and is manifested by: fever, tachypnea, tinnitus, respiratory alkalosis, metabolic acidosis, lethargy, mild dehydration, nausea and vomiting.
Intoxication tends to be more severe in patients with chronic overdose or drug abuse, as well as in elderly patients or children.

Treatment: gastric lavage; if there is a suspicion that more than 120 mg/kg was taken, activated charcoal is necessary. Serum salicylate should be measured at least every 2 hours after ingestion until salicylate levels begin to steadily decline and acid-base balance improves.

If bleeding is suspected, prothrombin time and/or international normalized ratio (INR) should be monitored.
The water and electrolyte balance must be restored. Alkaline diuresis and hemodialysis are effective ways to remove salicylates from plasma. Hemodialysis should be considered in cases of severe intoxication, as it rapidly increases salicylate clearance and restores acid-base and water-salt balance.

Release form and packaging

30 or 100 tablets in brown glass bottles, sealed with a white screw cap (made of polyethylene) with a built-in removable capsule with silica gel and a ring that ensures first opening control. The bottle, along with instructions for use in the state and Russian languages, is placed in a cardboard pack.

Takeda GmbH, Oranienburg, Germany

Cardiomagnyl is an anti-inflammatory, antiplatelet drug. Instructions for use recommend taking 75 mg tablets, the enhanced form of Forte 150 mg for the prevention of recurrent myocardial infarction, vascular thrombosis, cardiovascular diseases, and the prevention of thromboembolism after vascular surgery.

Release form and composition

Issued:

Cardiomagnyl tablets 75 mg po.
Tablets Cardiomagnyl Forte 150 mg po.

Tablets 75/15.2 mg are produced in the shape of a stylized “heart”, their color is white. Forte tablets are oval-shaped, white, with a score line on one side.

Cardiomagnyl contains 75 mg of acetylsalicylic acid and 15.2 mg of magnesium hydroxide; Forte contains active substances in a ratio of 150/30.39 mg, respectively.

Auxiliary components: magnesium hydroxide and stearate, corn and potato starch, MCC, talc, methyloxypropylcellulose 15, macrogol.

Pharmacological properties

The mechanism of action of acetylsalicylic acid is based on the ability of this substance to suppress platelet aggregation (sticking together), and therefore prevent the formation of blood clots. In addition, acetylsalicylic acid has analgesic, anti-inflammatory and antipyretic effects.

Magnesium hydroxide, which is part of the drug Cardiomagnyl, prevents the aggressive effects of acetylsalicylic acid on the mucous membrane of the gastrointestinal tract. Instructions for use (price, reviews, analogues of tablets will be discussed below in the article) informs that magnesium hydroxide does not affect the high bioavailability of acetylsalicylic acid, reaching 70%.

The half-life of acetylsalicylic acid is only 15 minutes, due to the fact that under the influence of enzymes this substance is quite quickly converted into salicylic acid, the bioavailability of which ranges from 80% to 100%, depending on the individual characteristics of the patient. The half-life of salicylic acid reaches three hours.

What does Cardiomagnyl help with?

Indications for use of the drug include:

unstable 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 (for example, diabetes mellitus, hyperlipidemia, hypertension, obesity, smoking, old age);
prevention of thromboembolism after vascular surgery (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty).

Instructions for use

Cardiomagnyl tablets are swallowed whole and washed down with water (if necessary, the tablet can be crushed).

To prevent primary cardiovascular diseases, one tablet containing 150 mg of aspirin is prescribed on the first day, after which a tablet containing 75 mg of aspirin is taken once a day. To prevent vascular thrombosis and recurrent infarction, one tablet is prescribed, containing 75-150 mg of acetylsalicylic acid - once a day.

According to the instructions, to prevent thromboembolism after vascular surgery, one tablet containing 75-150 mg of acetylsalicylic acid is prescribed once a day. Good reviews about Cardiomagnyl, used for unstable angina, one tablet containing 75-150 mg of aspirin once a day.

Contraindications

1st and 3rd trimesters of pregnancy;
lactation period (breastfeeding);
children and adolescents up to 18 years of age;
tendency to bleeding (vitamin K deficiency, thrombocytopenia, hemorrhagic diathesis);
hypersensitivity to acetylsalicylic acid, NSAID excipients of the drug Cardiomagnyl, from which the tablets can cause side effects;
erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
gastrointestinal bleeding;
bronchial asthma induced by taking salicylates and NSAIDs;
simultaneous use with methotrexate (>15 mg per week);
deficiency of glucose-6-phosphate dehydrogenase;
bleeding in the brain;
severe renal failure (CK<10 мл/мин).

Side effects

gastrointestinal bleeding;
Quincke's edema;
stomatitis;
esophagitis;
perforation of a gastric or duodenal ulcer;
bronchospasm;
anaphylactic reactions;
anemia;
heartburn;
strictures;
nausea, vomiting;
drowsiness, insomnia;
hives;
colitis;
headache;
pain in the abdominal area;
dizziness;
ulcers of the mucous membrane of the stomach and duodenum;
noise in ears;
increased bleeding;
hypoprothrombinemia, thrombocytopenia, neutropenia, eosinophilia, agranulocytosis.

Children, pregnancy and breastfeeding

The use of Cardiomagnyl in high doses in the 1st trimester of pregnancy is associated with an increased incidence of fetal developmental defects.

In the 2nd trimester of pregnancy, salicylates should only be prescribed based on a strict assessment of risks and benefits.

In the 3rd trimester of pregnancy, salicylates in high doses (>300 mg per day) cause inhibition of labor, premature closure of the ductus arteriosus in the fetus, increased bleeding in the mother and fetus, and administration immediately before birth can cause intracranial hemorrhages, especially in premature infants. The administration of salicylates in the 1st and 3rd trimesters of pregnancy is contraindicated.

However, with long-term use of the drug or when it is prescribed in a high dose, breastfeeding should be stopped immediately.

The drug is contraindicated for children under 18 years of age.

special instructions

Long-term combined use of the drug with NSAIDs increases the risk of adverse reactions. In elderly people, long-term use of Cardiomagnyl increases the likelihood of developing gastrointestinal bleeding.

The drug is used with caution in allergy sufferers, patients with bronchial asthma, kidney/liver dysfunction, existing lesions of the gastric mucosa, and dyspepsia.

Drug interactions

With simultaneous use, acetylsalicylic acid enhances the effect of the following drugs: methotrexate, heparin and indirect anticoagulants, thrombolytic and antiplatelet drugs (ticlopidine), digoxin, hypoglycemic agents: insulin and sulfonylurea derivatives, valproic acid.

Analogs of the drug Cardiomagnyl

Structural analogs of the active substance are not produced.

For replacement, drugs containing acetylsalicylic acid may be prescribed:

Coplavix.
Godasal.
Agrenok.

Vacation conditions and price

The average price of Cardiomagnyl (table 75 mg, No. 30) in Moscow is 100 rubles. In Kyiv you can buy medicine (75 mg tablet, No. 30) for 52 hryvnia, in Kazakhstan - for 540 tenge. In Minsk, pharmacies offer Cardiomagnyl for 4-5 bel. rubles Dispensed from pharmacies with a prescription.

Post Views: 365

Cardiomagnyl is a combined antiplatelet drug used primarily not for therapeutic purposes, but for prophylactic purposes to prevent cardiovascular diseases associated with circulatory failure due to deterioration of the rheological characteristics of the blood. This is not the first cardiological drug from the European-famous pharmaceutical holding Nycomed (the same Concor is well known in Russia), but it is definitely one of the best-selling. The drug contains two pharmacologically active substances: acetylsalicylic acid and magnesium hydroxide. A lot has been written about acetylsalicylic acid today: its mechanism of action is based on the irreversible suppression of the activity of the enzyme cyclooxygenase-1, which, in turn, inhibits the synthesis of thromboxane A2 (a mediator that activates platelet aggregation). Meanwhile, pharmacologists attribute to acetylsalicylic acid other properties aimed at suppressing platelet aggregation, which makes it a universal remedy for various cardiovascular diseases. In addition to this, acetylsalicylic acid has analgesic, antipyretic and anti-inflammatory effects. Magnesium hydroxide is included in the composition of cardiomagnyl to protect the mucous membrane of the digestive tract from the effects of acetylsalicylic acid. At the same time, the doses of magnesium hydroxide used do not reduce its bioavailability.

Despite the over-the-counter procedure for dispensing cardiomagnyl, its use must be coordinated with a doctor, because otherwise, you can provoke the development of a number of undesirable side effects associated with the pharmacological action of the drug. We can say that these negative reactions are a continuation of the advantages of acetylsalicylic acid: for example, while taking the drug, bleeding of varying degrees of intensity may occur, and if the patient is taking anticoagulants or thrombolytics at the same time, then the risk of bleeding becomes even higher. You should not combine taking Cardiomagnyl with alcohol: the drug itself can negatively affect the mucous membrane of the gastrointestinal tract, and strong drinks can significantly increase its risk of damage.

Cardiomagnyl tablets should be taken whole, but if the patient has problems swallowing, the tablet can be chewed or broken. When preventing thrombosis and acute coronary insufficiency in the presence of aggravating factors such as hypertension, overweight, diabetes, smoking, old age, it is recommended to take 150 mg of cardiomagnyl on the first day, and then 75 mg daily. To prevent heart attacks, the same dosages of cardiomagnyl are used.

Pharmacology

NSAID, antiplatelet agent. The mechanism of action of acetylsalicylic acid is based on irreversible inhibition of the COX-1 enzyme, as a result of which the synthesis of thromboxane A 2 is blocked and platelet aggregation is suppressed. It is believed that acetylsalicylic acid has other mechanisms for suppressing platelet aggregation, which expands the scope of its use in various vascular diseases. Acetylsalicylic acid also has anti-inflammatory, analgesic and antipyretic effects.

Magnesium hydroxide, which is part of Cardiomagnyl, protects the gastrointestinal mucosa from the effects of acetylsalicylic acid.

Pharmacokinetics

Suction

After taking the drug orally, acetylsalicylic acid is absorbed from the gastrointestinal tract almost completely.

The bioavailability of acetylsalicylic acid is about 70%, but this value is characterized by significant individual variability due to presystemic hydrolysis in the mucous membranes of the gastrointestinal tract and in the liver with the formation of salicylic acid under the action of enzymes. The bioavailability of salicylic acid is 80-100%.

Metabolism and excretion

T 1/2 of acetylsalicylic acid is about 15 minutes, because with the participation of enzymes, it is quickly hydrolyzed into salicylic acid in the intestines, liver and blood plasma. T1/2 of salicylic acid is about 3 hours, but when taking acetylsalicylic acid in high doses (>3 g), this figure can increase significantly as a result of saturation of enzyme systems.

Magnesium hydroxide (in the doses used) does not affect the bioavailability of acetylsalicylic acid.

Release form

White film-coated tablets in the shape of a stylized “heart”.

Excipients: corn starch - 9.5 mg, microcrystalline cellulose - 12.5 mg, magnesium stearate - 150 mcg, potato starch - 2.0 mg.

Shell composition: hypromellose (methylhydroxypropylcellulose 15) - 460 mcg, propylene glycol - 90 mcg, talc - 280 mcg.

30 pcs. - brown glass bottles (1) - cardboard packs.
100 pieces. - brown glass bottles (1) - cardboard packs.

Dosage

The tablets should be swallowed whole with water. If desired, the tablet can be broken in half, chewed or pre-grown.

For the primary prevention of cardiovascular diseases, such as thrombosis and acute heart failure in the presence of risk factors (for example, diabetes mellitus, hyperlipidemia, arterial hypertension, obesity, smoking, old age), 1 tablet is prescribed. Cardiomagnyl containing acetylsalicylic acid in a dose of 150 mg on the first day, then 1 tablet. Cardiomagnyl containing acetylsalicylic acid in a dose of 75 mg 1 time / day.

To prevent recurrent myocardial infarction and thrombosis of blood vessels, 1 tablet is prescribed. Cardiomagnyl containing acetylsalicylic acid in a dose of 75-150 mg 1 time / day.

To prevent thromboembolism after vascular surgery (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty), 1 tablet is prescribed. Cardiomagnyl containing acetylsalicylic acid in a dose of 75-150 mg 1 time / day.

For unstable angina, 1 tablet is prescribed. Cardiomagnyl containing acetylsalicylic acid in a dose of 75-150 mg 1 time / day.

Overdose

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

Treatment: rinse the stomach, prescribe activated charcoal, and carry out symptomatic therapy.

Symptoms of severe overdose: fever, hyperventilation, ketoacidosis, respiratory alkalosis, coma, cardiovascular and respiratory failure, severe hypoglycemia.

Treatment: immediate hospitalization in specialized departments for emergency treatment - gastric lavage, determination of acid-base balance, alkaline and forced alkaline diuresis, hemodialysis, administration of saline solutions, activated charcoal, symptomatic therapy. When carrying out alkaline diuresis, it is necessary to achieve pH values between 7.5 and 8. Forced alkaline diuresis should be carried out when the concentration of salicylates in plasma is more than 500 mg/l (3.6 mmol/l) in adults and 300 mg/l (2.2 mmol/l) in children.

Interaction

When used simultaneously, acetylsalicylic acid enhances 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 binding with proteins);

Thrombolytic and antiplatelet and anticoagulant drugs (ticlopidine);

Digoxin (due to a decrease in its renal excretion);

Hypoglycemic agents for oral administration (sulfonylurea derivatives) and insulin (due to the hypoglycemic properties of acetylsalicylic acid itself in high doses and displacing sulfonylurea derivatives from association with plasma proteins);

Valproic acid (by displacing it from bonds with proteins).

The simultaneous use of acetylsalicylic acid with ibuprofen leads to a decrease in the cardioprotective effects of acetylsalicylic acid.

An additive effect is observed when acetylsalicylic acid is taken simultaneously with ethanol (alcohol).

Acetylsalicylic acid weakens the effect of uricosuric drugs (benzbromarone) due to competitive tubular elimination of uric acid.

By enhancing the elimination of salicylates, systemic corticosteroids weaken their effect.

Antacids and cholestyramine, when used simultaneously, reduce the absorption of the drug Cardiomagnyl.

Side effects

The frequency of the adverse reactions listed below was determined according to the following: very often (≥1/10); often (> 1/100,<1/10); иногда (> 1/1000, <1/100); редко (> 1/10 000, <1/1000); очень редко (< 1/10 000, включая отдельные сообщения).

Allergic reactions: often - urticaria, Quincke's edema; sometimes - anaphylactic reactions.

From the digestive system: very often - heartburn; often - nausea, vomiting; sometimes - pain in the abdomen, ulcers of the mucous membrane of the stomach and duodenum, gastrointestinal bleeding; rarely - perforation of a stomach or duodenal ulcer, increased activity of liver enzymes; very rarely - stomatitis, esophagitis, erosive lesions of the upper gastrointestinal tract, strictures, colitis, irritable bowel syndrome.

From the respiratory system: often - bronchospasm.

From the hematopoietic system: very often - increased bleeding; rarely - anemia; very rarely - hypoprothrombinemia, thrombocytopenia, neutropenia, aplastic anemia, eosinophilia, agranulocytosis.

From the side of the central nervous system: sometimes - dizziness, drowsiness; often - headache, insomnia; rarely - tinnitus, intracerebral hemorrhage.

Indications

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

Contraindications

bleeding in the brain;
tendency to bleeding (vitamin K deficiency, thrombocytopenia, hemorrhagic diathesis);
bronchial asthma induced by taking salicylates and NSAIDs;
erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);
gastrointestinal bleeding;
severe renal failure (CK<10 мл/мин);
deficiency of glucose-6-phosphate dehydrogenase;
simultaneous use with methotrexate (>15 mg per week);
I and III trimesters of pregnancy;
lactation period (breastfeeding);
children and adolescents up to 18 years of age;
hypersensitivity to acetylsalicylic acid, excipients of the drug and other NSAIDs.

The drug should be prescribed with caution in case of gout, hyperuricemia, a history of ulcerative lesions of the gastrointestinal tract or bleeding from the gastrointestinal tract, renal and/or liver failure, bronchial asthma, hay fever, nasal polyposis, allergic conditions, and in the second trimester of pregnancy.

Features of application

Use during pregnancy and breastfeeding

The use of salicylates in high doses in the first trimester of pregnancy is associated with an increased incidence of fetal defects. In the second trimester of pregnancy, salicylates can be prescribed only taking into account a strict assessment of risks and benefits. In the third trimester of pregnancy, salicylates in high doses (>300 mg/day) cause inhibition of labor, premature closure of the ductus arteriosus in the fetus, increased bleeding in the mother and fetus, and administration immediately before birth can cause intracranial hemorrhages, especially in premature infants. The administration of salicylates in the first and third trimesters of pregnancy is contraindicated.

The available clinical data are insufficient to establish the possibility or impossibility of using the drug during breastfeeding. Before prescribing acetylsalicylic acid during breastfeeding, the potential benefits of drug therapy should be assessed against the potential risk for infants.

Use for liver dysfunction

In case of liver failure, it should be used with caution.

Use for renal impairment

The drug is contraindicated in severe renal failure (creatinine clearance less than 10 ml/min); in case of renal failure should be used with caution.

Use in children

Contraindicated in children and adolescents under 18 years of age.

special instructions

You should take the drug Cardiomagnyl after a doctor’s prescription.

Acetylsalicylic acid can provoke bronchospasm, as well as 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 (for example, skin reactions, itching, urticaria) to other drugs.

Acetylsalicylic acid can cause bleeding of varying severity during and after surgery.

Several days before planned surgery, the risk of bleeding should be assessed compared with the risk of ischemic complications in patients taking low doses of acetylsalicylic acid. If the risk of bleeding is significant, acetylsalicylic acid should be temporarily discontinued.

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

Taking acetylsalicylic acid in low doses can trigger the development of gout in predisposed individuals (those with reduced excretion of uric acid).

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

Taking acetylsalicylic acid in high doses has a hypoglycemic effect, which must be kept in mind when prescribing it to patients with diabetes mellitus receiving oral hypoglycemic agents and insulin.

When using systemic corticosteroids and salicylates in combination, it should be remembered that during treatment the concentration of salicylates in the blood is reduced, and after discontinuation of systemic corticosteroids, an overdose of salicylates is possible.

The combination of acetylsalicylic acid with ibuprofen is not recommended in patients with an increased risk of cardiovascular diseases: when used simultaneously with ibuprofen, a decrease in the antiplatelet effect of acetylsalicylic acid in doses of up to 300 mg is observed, which leads to a decrease in 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.

With long-term use of acetylsalicylic acid in low doses as antiplatelet therapy, caution is required in elderly patients due to the risk of gastrointestinal bleeding.

When taking acetylsalicylic acid with ethanol at the same time, there is an increased risk of damage to the gastrointestinal mucosa and prolongation of bleeding time.

Impact on the ability to drive vehicles and operate machinery

During treatment with acetylsalicylic acid, patients should be careful when driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Update: October 2018

Cardiomagnyl is an anti-inflammatory drug (non-steroidal), an antiplatelet agent, which is used to prevent the development of thrombosis and acute heart failure in patients with certain cardiovascular diseases or risk factors that increase the complications of these diseases.

The anti-inflammatory effects of the drug are associated with irreversible inhibition of cyclooxygenase-1 by acetylation and blocking the formation of thromboxane A2. All this leads to the suppression of aggregation of blood platelet cells, and therefore the prevention of thrombosis.

Pharmgroup: NSAIDs, antiplatelet agents.

Composition, physical and chemical properties, price

Available in the form of white oral tablets, in a specific heart-shaped form. Covered with a film shell.

Composition of cardiomagnyl per 1 tablet:

Main substance: acetylsalicylic acid - 75 mg, magnesium hydroxide - 15.2 mg. The “forte” form of the drug contains a 2-fold higher dose of active ingredients: acetylsalicylic acid – 150 mg, magnesium hydroxide – 30.39 mg.
Excipients: magnesium stearate, corn and potato starch, microcrystalline cellulose.
Shell composition: hypromellose, propylene glycol, talc.

Available in brown glass bottles of 30 and 100 tablets. Price:

75 mg No. 100 – 200-250 rub.,
150 mg No. 100 – 300-400 rub.

pharmachologic effect

Cardiomagnyl is characterized by a pronounced antiplatelet effect. The well-known acetylsalicylic acid, which is part of the drug, in large doses (500 mg - the average therapeutic dose for an adult) has a pronounced anti-inflammatory effect, eliminates pain, inflammation and fever. In small doses, it prevents platelet aggregation, the formation of blood clots, and also has a mild anti-inflammatory effect:

irreversibly inhibits cyclooxygenase-1, which is involved in the formation of prostaglandins that trigger an inflammatory response in the body;
inhibits the synthesis of thromboxane A2 in platelets, thus preventing their aggregation (sticking together).

To achieve these effects, the drug should be used for a long time, in recommended doses.

Magnesium hydroxide has a protective effect on the gastrointestinal mucosa and protects it from the action of acetylsalicylic acid.

Pharmacokinetics

Acetylsalicylic acid (ASA) is completely absorbed from the gastrointestinal tract. The hydrolysis reaction to salicylic acid is carried out using hepatic esterases in the liver, as well as in the blood plasma and intestines. The half-life of ASA is about 15 minutes, and salicylic acid is about 3 hours. Additional intake of ASA (above 3 g) can lengthen the half-life of the metabolite (salicylic acid) due to the absolute saturation of enzyme systems.

The bioavailability of salicylic acid is 80-100%, i.e. is high. The bioavailability of ASA varies at around 70%, but may be altered by presystemic hydrolysis in the gastric wall, as well as in the intestine and liver. It is very important that magnesium hydroxide does not in any way affect the bioavailability of ASA.

Indications

Indications for the use of cardiomagnyl are as follows:

Primary prevention of heart and vascular diseases - thrombosis and acute heart failure against the background of risk factors: diabetes mellitus, arterial hypertension, hyperlipidemia, obesity, smoking, old age;
Prevention of recurrent myocardial infarction and blood vessel thrombosis;
Prevention of thromboembolism after vascular operations: coronary artery bypass grafting, coronary angioplasty (transluminal);
Angina pectoris is unstable.

Contraindications

The instructions for use of cardiomagnyl indicate the following restrictions on use:

Hemorrhage in brain tissue;
Tendency to bleeding due to vitamin K deficiency, hemorrhagic diathesis, thrombocytopenia;
Erosive and ulcerative pathologies of the gastrointestinal tract in the acute phase;
Gastrointestinal bleeding;
Bronchial asthma induced by treatment with salicylates and NSAIDs;
Severe kidney dysfunction (KD)<10 мл/мин);
Deficiency of the enzyme glucose-6-phosphate dehydrogenase;
Concomitant treatment with methotrexate at a dose of more than 5 mg per week;
1st, 3rd trimesters of pregnancy;
Lactation;
Children under 18 years of age;
Hypersensitivity to ASA, additional substances in the drug and other NSAIDs.

Contraindications for cardiomagnyl should never be ignored - negative reactions from the body are serious and even life-threatening.

special instructions

The drug is prescribed with caution and under the supervision of a doctor in the following cases:

hyperuricemia;
history of ulcerative lesions of the gastrointestinal tract or bleeding from the gastrointestinal tract;
gout;
renal or liver failure;
bronchial asthma;
hay fever;
allergic conditions;
nasal polyposis;
2nd trimester of pregnancy.

It should be remembered that acetylsalicylic acid can cause bronchospasm, attacks of bronchial asthma and other hypersensitivity reactions.

Also, the active substance can cause bleeding during and after operations. Therefore, before surgery, the attending physician should assess the risk of bleeding compared with the risk of ischemic complications in patients being treated with cardiomagnyl, and based on this, decide whether to discontinue the drug or continue taking it. It should also be remembered that acetylsalicylic acid in combination with thrombolytics, anticoagulants and antiplatelet drugs is also characterized by an increased risk of bleeding.

Treatment with the drug may provoke the development of gout in patients with a predisposition to the disease (with reduced excretion of uric acid).

In combination with methotrexate (even in low doses), there is an increased incidence of side effects from the hematopoietic system.

High doses of ASA have a hypoglycemic effect, so patients with diabetes mellitus treated with hypoglycemic drugs internally and receiving insulin should be careful during treatment.

Unauthorized excess of the drug dose directly increases the risk of bleeding from the gastrointestinal tract.

During long-term treatment with the drug, caution should be exercised in elderly patients - the risk of developing gastrointestinal bleeding in this age group is always higher.

During treatment, you should not drink alcohol, as this also increases the risk of damage to the gastrointestinal mucosa, and if bleeding develops, its duration increases.

Dosage

The tablets must be swallowed whole with water. If swallowing is difficult, you can break the tablet in half or crush it into powder.

Primary prevention of CVS: thrombosis, acute heart failure against the background of the risk factors listed above, on the first day a “Forte” tablet of 150 mg (or 2 of 72 mg) is prescribed per single dose, and then switched to a dose of 75 mg once a day (regular cardiomagnyl tablet );
Prevention of recurrent myocardial infarction and thrombosis: 1 tablet 75 or 150 mg once a day. The dose is selected individually;
Prevention of thromboembolism after vascular surgery: 1 tablet 75 or 150 mg once a day. The dose is selected individually;
Unstable angina: also 1 tablet 75 or 150 mg once a day. The dose is selected individually.

Overdose

An overdose of the drug can be moderate to severe.

The clinical picture of a moderate overdose: vomiting, nausea, hearing impairment, tinnitus, confusion and dizziness. Treatment includes gastric lavage, taking an adequate dose of activated carbon and other drugs for symptomatic therapy, depending on the clinic.

The clinical picture of a moderate overdose: hyperventilation, fever, respiratory alkalosis, ketoacidosis, coma, respiratory and cardiovascular failure, severe hypoglycemia. Treatment necessarily involves immediate hospitalization for emergency treatment in the intensive care unit and includes: administration of alkaline solutions, gastric lavage, forced and alkaline diuresis (so that the blood pH becomes 7.5-8), hemodialysis and the use of other drugs for symptomatic therapy.

Side effects

Side effects of cardiomagnyl can be observed in different systems:

Allergic phenomena: urticaria often occurs, a little less often - Quincke's edema, and anaphylactic-type reactions up to shock can rarely develop.
From the gastrointestinal tract: very often patients note heartburn, nausea and vomiting often occur. Pain in the abdomen is sometimes observed, ulcers may develop on the mucous membrane of the stomach and duodenum, as well as bleeding from the gastrointestinal tract. Quite rarely, but still there are cases of perforation of a stomach or duodenal ulcer, and increased liver enzymes. In the rarest cases, stomatitis, erosive changes in the upper gastrointestinal tract, esophagitis, colitis, strictures, and irritable bowel syndrome are possible.
From the respiratory system bronchospasm often develops.
From the hematopoietic organs: increased bleeding is observed very often; rarely - anemia. Hypoprothrombinemia, neutropenia, thrombocytopenia, aplastic anemia, eosinophilia, and agranulocytosis develop very rarely.
From the side of the central nervous system: dizziness, drowsiness are observed in some cases. Patients often report headaches and sleep disturbances in the form of insomnia. Rarely there is tinnitus and very rarely intracerebral hemorrhage.

Drug interactions

Cardiomagnyl enhances the effect of the following drugs when treated simultaneously:

methotrexate - by reducing renal clearance and displacing it from protein binding;
indirect anticoagulants and heparin- by changing platelet function and displacing anticoagulants from binding with proteins;
thrombolytic and antiplatelet drugs, for example, ticlopidine;
hypoglycemic agents oral and insulin by a similar mechanism;
digoxin, causing a decrease in its renal excretion;
valproic acid, displacing it from its connection with proteins.

In combination with ibuprofen, the cardioprotective effects of acetylsalicylic acid are reduced.

When taking cardiomagnyl with drugs containing ethanol, the effect of both drugs is enhanced.

The effect of uricosuric drugs while taking cardiomagnyl is reduced due to tubular competitive elimination of uric acid.

By enhancing the elimination of salicylate drugs, systemic corticosteroids weaken their effects.

When treated simultaneously with antacids and cholestyramine, the absorption of acetylsalicylic acid is reduced.

Thromboass or cardiomagnyl?

Which is better: thromboass or cardiomagnyl? This question is asked by many patients. Let's try to figure it out.

One of the most significant advantages for the patient is the lower price of the drug Thromboass: a package of 100 tablets at a dosage of 100 mg will cost 120-180 rubles. However, cardiomagnyl tablets also belong to the group of affordable medications, and given the fact that you need to take it once a day, they will not hit your wallet hard.

Medicines are interchangeable: they have almost the same indications, contraindications and side effects. The active ingredient is the same - acetylsalicylic acid, only in different dosages. Thus, cardiomagnyl contains 100 or 150 mg of ASA, and thromboass - 50 or 100 mg. It has been proven that small doses of ASA have an antiplatelet effect, so in this regard both drugs will be effective.

The drug cardiomagnyl contains a second active component - magnesium hydroxide, which protects the gastrointestinal mucosa from the negative effects of ASA. Thromboass does not contain such a component, but has a special shell that does not dissolve in the stomach under the influence of hydrochloric acid and is absorbed already in the duodenum. However, not all patients, for health reasons or other reasons, are able to swallow the tablet whole, and when chewed, the protective properties of the coating are already lost. In addition, even if the tablet is swallowed whole, ASA does not act only on the gastric mucosa, while it is already absorbed in the duodenum, while many patients have combined ulcerative lesions of both the stomach and duodenum.

NSAID, antiplatelet agent.
Drug: CARDIOMAGNIL
Active substance of the drug: acetylsalicylic acid, magnesium hydroxide
ATX coding: B01AC30
KFG: NSAIDs. Antiplatelet agent
Registration number: P No. 013875/01
Registration date: 12/25/07
Owner reg. cert.: NYCOMED DANMARK ApS (Denmark)

Release form Cardiomagnyl, drug packaging and composition.

White film-coated tablets in the shape of a stylized heart.

1 tab.
acetylsalicylic acid
75 mg
magnesium hydroxide
15.2 mg

White, oval, film-coated tablets with a score line on one side.

1 tab.
acetylsalicylic acid
150 mg
magnesium hydroxide
30.39 mg

Excipients: corn starch, microcrystalline cellulose, magnesium stearate, potato starch, hypromellose (methylhydroxypropylcellulose 15), macrogol (propylene glycol), talc.

30 pcs. - dark glass bottles.
100 pieces. - dark glass bottles.

The description of the drug is based on the officially approved instructions for use.

Pharmacological action Cardiomagnyl

NSAID, antiplatelet agent. The mechanism of action of acetylsalicylic acid is based on the irreversible inhibition of the enzyme cyclooxygenase (COX-1), as a result of which the synthesis of thromboxane A2 is blocked and platelet aggregation is suppressed. It is believed that acetylsalicylic acid has other mechanisms for suppressing platelet aggregation, which expands the scope of its use in various vascular diseases. Acetylsalicylic acid also has anti-inflammatory, analgesic and antipyretic effects.

Magnesium hydroxide, which is part of Cardiomagnyl, protects the gastrointestinal mucosa from the effects of acetylsalicylic acid.

Pharmacokinetics of the drug.

After taking the drug orally, acetylsalicylic acid is absorbed from the gastrointestinal tract almost completely.

T1/2 of acetylsalicylic acid is about 15 minutes, because with the participation of enzymes, it is quickly hydrolyzed into salicylic acid in the intestines, liver and blood plasma. T1/2 of salicylic acid is about 3 hours, but when taking acetylsalicylic acid in high doses (>3 g), this figure can increase significantly as a result of saturation of enzyme systems.

The bioavailability of acetylsalicylic acid is about 70%, but this value is characterized by significant individual variability due to presystemic hydrolysis in the mucous membranes of the gastrointestinal tract and in the liver with the formation of salicylic acid esterases. The bioavailability of salicylic acid is 80-100%.

Magnesium hydroxide (in the doses used) does not affect the bioavailability of acetylsalicylic acid.

Indications for use:

Primary prevention of cardiovascular diseases such as thrombosis and acute heart failure in the presence of risk factors (for example, diabetes mellitus, hyperlipidemia, hypertension, obesity, smoking, old age);

Prevention of recurrent myocardial infarction and blood vessel thrombosis;

Prevention of thromboembolism after vascular surgery (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty);

Unstable angina.

Dosage and method of administration of the drug.

The tablets should be swallowed whole with water. If desired, the tablet can be broken in half, chewed or pre-grown.

For the primary prevention of cardiovascular diseases, such as thrombosis and acute heart failure in the presence of risk factors (for example, diabetes mellitus, hyperlipidemia, arterial hypertension, obesity, smoking, old age), 1 tablet is prescribed. Cardiomagnyl containing acetisalicylic acid in a dose of 150 mg on the first day, then 1 tablet. Cardiomagnyl containing acetisalicylic acid in a dose of 75 mg 1 time / day.

To prevent recurrent myocardial infarction and thrombosis of blood vessels, 1 tablet is prescribed. Cardiomagnyl containing acetisalicylic acid in a dose of 75-150 mg 1 time / day.

To prevent thromboembolism after vascular surgery (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty), 1 tablet is prescribed. Cardiomagnyl containing acetisalicylic acid in a dose of 75-150 mg 1 time / day.

For unstable angina, 1 tablet is prescribed. Cardiomagnyl containing acetisalicylic acid in a dose of 75-150 mg 1 time / day.

Side effects of Cardiomagnyl:

The frequency of the adverse reactions listed below was determined according to the following: very often 1/10; often > 1/100,<1/10; иногда > 1/1000, <1/100; редко> 1/10 000, <1/1000; очень редко < 1/10 000, включая отдельные сообщения.

Allergic reactions: often - urticaria, Quincke's edema; sometimes - anaphylactic reactions.

From the respiratory system: often - bronchospasm.

From the hematopoietic system: very often - increased bleeding; rarely - anemia; very rarely - hypoprothrombinemia, thrombocytopenia, neutropenia, aplastic anemia, eosinophilia, agranulocytosis.

From the side of the central nervous system: sometimes - dizziness, drowsiness; often - headache, insomnia; rarely - tinnitus, intracerebral hemorrhage.

Contraindications to the drug:

Bleeding in the brain;

Tendency to bleeding (vitamin K deficiency, thrombocytopenia, hemorrhagic diathesis);

Bronchial asthma induced by taking salicylates and NSAIDs;

Erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase);

Gastrointestinal bleeding;

Severe renal failure (CR<10 мл/мин);

Glucose-6-phosphate dehydrogenase deficiency;

Concomitant use with methotrexate (>15 mg per week);

I and III trimesters of pregnancy;

Lactation period (breastfeeding);

Children and adolescents up to 18 years of age;

Hypersensitivity to acetylsalicylic acid, excipients of the drug and other NSAIDs.

Use during pregnancy and lactation.

Salicylates and their metabolites are excreted in small quantities into breast milk. Accidental intake of salicylates during lactation is not accompanied by the development of adverse reactions in the child and does not require cessation of breastfeeding. However, with long-term use of the drug or when it is prescribed in a high dose, breastfeeding should be stopped immediately.

Special instructions for the use of Cardiomagnyl.

Cardiomagnyl should be taken only as prescribed by a doctor.

Acetylsalicylic acid can provoke bronchospasm, as well as cause attacks of bronchial asthma and other hypersensitivity reactions. Risk factors include a history of bronchial asthma, hay fever, nasal polyposis, chronic diseases of the respiratory system, as well as allergic reactions (skin rash, itching, urticaria) to other drugs.

Acetylsalicylic acid can cause bleeding of varying severity during and after surgery.

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

Taking acetylsalicylic acid in low doses can trigger the development of gout in predisposed individuals (those with reduced excretion of uric acid).

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

Taking acetylsalicylic acid in high doses has a hypoglycemic effect, which must be kept in mind when prescribing it to patients with diabetes mellitus receiving hypoglycemic agents.

When concomitantly prescribing GCS and salicylates, it should be remembered that during treatment the level of salicylates in the blood is reduced, and after discontinuation of GCS, an overdose of salicylates is possible.

Exceeding the dose of acetylsalicylic acid is associated with the risk of gastrointestinal bleeding.

Overdose is especially dangerous in elderly patients.

When acetylsalicylic acid is combined with alcohol, there is an increased risk of damage to the gastrointestinal mucosa and prolongation of bleeding time.

Impact on the ability to drive vehicles and operate machinery

No effect of Cardiomagnyl on the ability of patients to drive vehicles or operate machinery was detected.

Drug overdose:

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

Treatment: rinse the stomach, prescribe activated charcoal, and carry out symptomatic therapy.

Symptoms of severe overdose: fever, hyperventilation, ketoacidosis, respiratory alkalosis, coma, cardiovascular and respiratory failure, severe hypoglycemia.

Treatment: immediate hospitalization in specialized departments for emergency treatment - gastric lavage, determination of acid-base balance, alkaline and forced alkaline diuresis, hemodialysis, administration of saline solutions, activated carbon, symptomatic therapy. When carrying out alkaline diuresis, it is necessary to achieve pH values between 7.5 and 8. Forced alkaline diuresis should be carried out when the concentration of salicylates in plasma is more than 500 mg/l (3.6 mmol/l) in adults and 300 mg/l (2.2 mmol/l) in children.

Interaction of Cardiomagnyl with other drugs.

With simultaneous use, acetylsalicylic acid enhances the effect of the following drugs: methotrexate (by reducing renal clearance and displacing it from protein binding), heparin and indirect anticoagulants (by disrupting platelet function and displacing indirect anticoagulants from protein binding), thrombolytic and antiplatelet agents drugs (ticlopidine), digoxin (due to a decrease in its renal excretion), hypoglycemic agents: insulin and sulfonylurea derivatives (due to the hypoglycemic properties of acetylsalicylic acid itself in high doses and displacement of sulfonylurea derivatives from binding with proteins), valproic acid (due to its displacement from connections with proteins).

An additive effect is observed when acetylsalicylic acid is taken simultaneously with ethanol (alcohol).

Acetylsalicylic acid weakens the effect of uricosuric drugs (benzbromarone) due to competitive tubular elimination of uric acid.

By enhancing the elimination of salicylates, systemic corticosteroids weaken their effect.

Antacids and cholestyramine, when used simultaneously, reduce the absorption of the drug Cardiomagnyl.

Terms of sale in pharmacies.

The drug is approved for use as a means of OTC.

Terms of storage conditions for the drug Cardiomagnyl.

The drug should be stored in a dry place, protected from light and out of reach of children, at a temperature not exceeding 25°C. Shelf life: 5 years.