Cardiomagnyl way. Cardiomagnyl - instructions for use. Analogues and manufacturers: cheap Russian substitutes

INN: Acetylsalicylic acid

Manufacturer: Takeda GmbH, Oranienburg

Anatomical-therapeutic-chemical classification: Acetylsalicylic acid

Registration number in the Republic of Kazakhstan: No. RK-LS-5 No. 020821

Registration period: 19.09.2014 - 19.09.2019

Instruction

Tradename

Cardiomagnyl

International non-proprietary name

Acetylsalicylic acid

Dosage form

Film-coated tablets 75 mg

Film-coated tablets 150 mg

Cleaving

One film-coated tablet contains

active substance: acetylsalicylic acid 75 mg or 150 mg

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

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

Description

White, heart-shaped, film-coated tablets (for a dosage of 75 mg)

White, oval-shaped, film-coated tablets with crack risk (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 under the action of esterases. The bioavailability of salicylic acid is 80-100%.

After oral administration, non-ionized ASA is absorbed in the stomach and intestines. Absorption decreases with 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. The peak serum concentration of ASA is reached 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 of body weight. When plasma concentrations increase, saturated protein binding occurs, leading to an increase in the volume of distribution. Salicylates are extensively bound to plasma proteins and rapidly distributed throughout the body. Salicylates are also found in breast milk and can cross the placental barrier.

Metabolism ASA is hydrolyzed to the active metabolite salicylate in the intestinal wall. After absorption, ASA is rapidly converted to salicylic acid, but in the first 20 minutes after ingestion, ASA is the dominant form. breeding Salicylate is mainly eliminated through hepatic metabolism. Therefore, plasma salicylate concentrations 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 in the urine unchanged. The excreted amount depends on the dose and on the pH of the urine. Approximately 30% of the dose is excreted in alkaline urine and 2% in acidic urine.

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

Pharmacodynamics

ASA is an analgesic, anti-inflammatory, and antipyretic 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 cyclooxygenase enzyme.

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

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

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

Indications for use

Tablets 75 mg

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

prevention of recurrent myocardial infarction and thrombosis of blood vessels

Tablets 150 mg

acute and chronic ischemic heart disease

Dosage and administration

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 onset of the first symptoms.

Prevention of recurrent thrombosis

150 mg as initial dose followed by 75 mg daily.

Patients over 50

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

Tablets 150 mg

150 mg daily

In case of impaired liver or kidney function dose adjustment may be necessary. The drug is not prescribed for severe violations of the liver or kidneys.

Side effects

Adverse 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)

Highly often:

prolonged bleeding time

inhibition of platelet aggregation

heartburn, acid reflux, abdominal pain

Often:

hemorrhagic diathesis

headache

bronchospastic effect in patients with asthma

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

insomnia

Infrequently:

occult bleeding

vertigo (dizziness), drowsiness

tinnitus

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

  allergic reactions - urticaria, angioedema (angioneurotic edema often develops in patients with allergies)

  anaphylactic reactions

Rarely:

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

kidney dysfunction

hypoglycemia

hemorrhagic vasculitis

Rarely:

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

stomatitis, esophagitis, ulceration in the lower gastrointestinal tract, stenosis, colitis, exacerbations of inflammatory bowel disease

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, to non-steroidal anti-inflammatory drugs (NSAIDs), or to 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 the age of 16

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: reduced clearance of methotrexate.

Effect: methotrexate toxicity (leukopenia, thrombocytopenia, anemia,

nephrotoxicity, ulceration of the mucous membranes).

ACE inhibitors

Possible mechanism: inhibition of prostaglandin synthesis.

Effect: decrease in the effectiveness of ACE inhibitors.

Acetazolamide

Possible mechanism: Elevated acetazolamide concentrations may

lead to diffusion of salicylates from the blood plasma into the surrounding tissues.

Effect: acetazolamide-induced toxicity (fatigue, lethargy, drowsiness, confusion, hyperchloremic metabolic

acidosis) and toxicity caused by salicylates (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.

The concomitant use of the following drugs requires caution

Clopidogrel, ticlopidine

The combination of clopidogrel and ASA has a synergistic effect, therefore 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). Effect: increased risk of bleeding.

Absiximab, tirofiban, eptifibatide

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

Heparin Possible mechanism: Reduces thrombin production, resulting in 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 lead to a synergistic effect with increased inhibition of platelet activity and, as a result, an increased risk of hemorrhagic diathesis. NSAIDs and COX-2 inhibitors (celecoxib)

Possible mechanism: additive gastrointestinal irritation. Effect: increased risk of gastrointestinal bleeding. Ibuprofen At the same time, the use of ibuprofen inhibits irreversible platelet aggregation caused by ASA. Treatment with ibuprofen in patients at increased risk for cardiovascular disease may limit the cardioprotective effect of ASA.

Patients taking ASA once a day for the prevention of cardiovascular disease, and those who take ibuprofen from time to time, 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: prolonged bleeding time.

Spironolactone Possible mechanism: Modified renin effect. Effect: Decreased effectiveness of spironolactone. Selective serotonin reuptake inhibitors(SSRI) 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 (depression of the central nervous system, problems of the gastrointestinal tract).

The combination may require dose adjustment of valproate. Corticosteroids Possible mechanism: additive irritation of the gastrointestinal tract and increased renal clearance or metabolism of salicylates. Effect: increased risk of gastrointestinal ulcers and sub-therapeutic salicylate plasma concentrations.

Antidiabetic drugs

Possible mechanism: additive hypoglycemic effect. Effect: hypoglycemia

Antacids Possible mechanism: increased renal clearance and reduced renal absorption (due to increased urinary pH).

Effect: reduction of the effect of ASA.

Varicella vaccine

Mechanism: unknown.

Effect: increased risk of developing Reye's syndrome.

Ginkgo biloba

Possible mechanism: Gingko 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 an increased risk of adverse 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 violation of liver function

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

ASA can lead to increased bleeding during and after surgical interventions such as tooth extractions.

Fertility The use of ASA may reduce fertility, and therefore should not be used in women who wish to become pregnant. If ASA treatment 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 use in obstetrics requiring special supervision.

High doses (more than 100 mg / day)

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

Third trimester: the appointment of ASA over a dose of 100 mg per day can cause the fetus:

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

Renal dysfunction with the consequent 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 reduced platelet aggregation

Suppression of the contractile activity of the uterus, which can lead to late labor or an increase in the duration of labor.

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

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

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

Overdose

Dangerous dose for adults: 300 mg/kg.

Symptoms: as a rule, chronic mild 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 chronic overdose or drug abusers, elderly patients or children.

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

If bleeding is suspected, prothrombin time and/or international normalized ratio (INR) should be monitored. The water-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 clearance of salicylate and restores acid-base and water-salt balance.

Modern cardiology is designed to solve a wide range of problems, one of which is the prevention of cardiovascular diseases and complications.

It was the shift in emphasis from symptomatic treatment towards preventive preventive measures in a number of leading countries of the world that made it possible to significantly reduce the level of lethal outcomes of diseases caused by coronary causes.

Cardiologists and therapists have set the task of finding an inexpensive, sufficiently effective drug that can solve the problems of the cardiological spectrum without any side effects and does not cause pharmacological dependence in the patient.

About the drug

Some statistics: mortality due to various diseases of the heart and blood vessels is huge: seventeen million inhabitants of the planet annually. This cause of death is one third of all other causes of death on our planet. As many as seven million earthlings die every year from ischemia, and a stroke takes the lives of nearly six million more.

Antiplatelets today are represented by four main groups, separated on the basis of an evidence base that takes into account the results of treatment and adverse effects of medications.

1. The first category includes drugs that are not recommended for the practical treatment of cardio diseases and do not have advantages over acetylsalicylic acid, moreover, they represent a potential hazard. For example, Sulfinpyrazone or Dipyridamole.
2. The second group contains preparations of modern cardiotherapy in its antiplatelet manifestation. First of all, it is Aspirin as a cyclooxygenase inhibitor.
3. The third category includes thienopyridines, such as Plavix or Tiklin
4. To the fourth group - blockers for intravenous use, such as Abciximab.

The search for effective pharmacological preparations for solving the problems of the cardiological spectrum led scientists in the now distant 1971 to use acetylsalicylic acid (ASA) as an antiplatelet drug that has proven its effectiveness.

Back in 1994, an international group of leading cardiologists published a meta-analysis of one hundred and forty-five RCTs (randomized trials, that is, those in which participants are randomly divided into groups, and in one the substance to be studied is used, and in the second - placebo or a standard drug) concerning the effect of acetylsalicylic acid on the human body.

The analysis reliably showed a reduction in the risk of recurrent diseases in those who had an ischemic stroke or myocardial infarction, as well as those subject to other cardiovascular pathologies, but taking drugs based on ASA.

The results of this analysis were confirmed in subsequent studies based on the dynamics of the diseases of 145,000 patients.

What drugs have become the most relevant today in the treatment and prevention of diseases of the cardiovascular system?

Among the huge variety of medicines designed to get in the way of thrombosis, support the work of the heart and blood vessels, you can safely find a place for Cardiomagnyl - a medicine whose main working substance is acetylsalicylic acid, which reduces the formation of blood clots.

The name of this medicine in Latin is Cardiomagnyl. Cardiomagnyl code according to ATC - classification of drugs - B01AC06. In addition to Cardiomagnyl, this group includes drugs that affect hematopoietic functions.

Pharmacological group

The antiaggregant Cardiomagnyl is referred to as antipyretics - analgesics. This drug is an analgesic non-steroidal anti-inflammatory and antirheumatic drug (NSAID) that does not contain narcotic substances or precursors.

According to the International Classification of Diseases of the Tenth Revision (ICD-10), Cardiomagnyl is nosologically correlated with such widespread diseases as:

pharmachologic effect

Let's pay attention to the specifics of the action of the drug in the body:

1. Cardiomagnyl provides blocking of the COX-1 enzyme, which indirectly relieves pain and inhibits inflammation.
2. Protects the mucous membrane of the gastrointestinal tract.

Pharmacokinetics of Cardiomagnyl

Absorption of the drug is almost one hundred percent. It should be understood that the proportion of this drug that directly reaches the bloodstream is quite variable. This is due to presystemic hydrolysis occurring in the mucosa and the formation of salicylic acid associated with this.

The bioavailability of these acids for the body is different: within 70% for ASA, and in the range from 80 to 100% for salicylic acid.

When ingested Cardiomagnyl first, within fifteen minutes, ASA begins to act. At the end of this time, acetylsalicylic acid undergoes hydrolysis, turning into salicylic acid. But the time during which the latter operates is already more significant: about three hours.

It is extremely important for understanding the features of treatment with Cardiomagnyl as an antiplatelet that the ASA molecule acts as an antithrombotic, but the anti-inflammatory properties of the drug are provided by the product of its metabolism - salicylic acid.

How and in what doses to take Cardiomagnyl

The method of taking Cardiomagnyl is quite traditional for solid dosage forms: orally, with a small amount of water. Mostly at night, because due to a more pronounced thickening of the blood at this time, it is at night and in the morning that heart attacks and separation of blood clots are most frequent.

And given that Cardiomagnyl still has some irritating effect on the stomach, patients are unambiguously recommended to take Cardiomagnyl after meals.

A little about the medicinal doses of Cardiomagnyl. They, of course, are different in solving different medical problems. For example, for primary prevention of the possibility of thrombosis or acute heart failure complicated by concomitant diseases, the scheme is as follows: once a day, one tablet of the drug containing 150 mg of ASA. The dosage is soon reduced to once a day, 75 mg of the drug.

Also, taking 75 mg of the drug daily, they prevent the recurrence of a heart attack or thrombosis.

Post-surgical thromboembolism, as well as unstable angina, is usually prevented by prescribing a daily dose of Cardiomagnyl to the patient for oral administration from 75 to 150 mg.

Naturally, the question arises about the course of treatment with Cardiomagnyl. It takes a long time: from a month-long course of taking the drug, the course can stretch for many years.

So to the question: “How long can Cardiomagnyl be taken without a break?” the answer is to the very end of life.

Are there any complications or side effects when taking Cardiomagnyl?

As for any drug, the statement is true for Cardiomagnyl: "Everything is a poison and everything is a medicine." In our case, allergies most often manifest themselves up to anaphylactic reactions, including Quincke's edema and urticaria.

But the digestive system more often than usual reacts to the components of Cardiomagnyl with heartburn, less often with nausea and vomiting, and sometimes with the occurrence of ulcers of the mucous membrane of the stomach or duodenum. It is extremely rare for PVA to respond to this remedy with colitis, strictures, stomatitis, or erosive lesions.

Occasionally, after taking the drug, liver enzymes increase their activity.

The respiratory system most often reacts to Cardiomagnyl's acetylsalicylic acid by the occurrence of bronchospasm.

The drug complicates the work of the body in hematopoiesis with possible increased bleeding and, much less often, with anemia, agranulocytosis, hypoprothrombinemia, neutropenia or thrombocytopenia.

The central nervous system often reacts to the intervention of ASA, which is part of Cardiomagnyl, with dizziness, drowsiness, headache, up to a stroke.

What should be paid special attention to

Just like other drugs, Cardiomagnyl is taken only after the appointment of this drug by a cardiologist.

You need to be extremely careful if you have a history of asthma, allergies to medications and chronic respiratory diseases.

When planning a surgical intervention, one cannot ignore the fact that the combination of Cardiomagnyl with antiplatelet and thrombolytic substances dramatically increases the chances of unwanted bleeding. Based on the foregoing, when taking low doses of the drug, a weighted assessment of the possible development of internal bleeding and their comparison with the risk of ischemia is necessary.

The possibility of developing gout in patients with reduced excretion of uric acid remains relevant if they take Cardiomagnyl in low doses.

How does Cardiomagnyl interact with drugs?

Cardiomagnyl acts as a kind of enhancer of the following drugs:

Synergistically summarizes the effect of each of the drugs when combined with alcohol. Cardiomagnyl inhibits the effect on the body of uricosuric drugs (primarily Benzbromarone).

Glucocorticosteroid drugs significantly weaken the effect of ASA Cardiomagnyl on the body. Antiacid drugs reduce the absorption of Cadiomagnyl.

The use in conjunction with Methotrex also causes negative effects in hematopoiesis. When using Cardiomagnyl simultaneously with glucocorticosteroids, the possibility of a sharp increase in the content of salicylates in the blood after the abolition of these drugs is taken into account.

The complex use of Cardiomagnyl with Ibuprofen increases the chances of diseases of the cardiovascular system.

Features of working with mechanisms while taking Cardiomagnyl

Taking Cardiomagnyl somewhat inhibits the work of the central and peripheral nervous systems, therefore, work related to the need for prolonged increased concentration is not recommended for patients during this period.

Exceeding the dose of the drug and its manifestations

Cardiomagnyl is able to cause quite severe conditions, which are a direct consequence of an overdose when taken. Such conditions manifest themselves as dizziness, vomiting, confusion.

In more serious cases, exceeding the recommended dose may cause hyperventilation, ketoacidosis, coma, and cardiovascular failure.

Shelf life and storage conditions

With proper storage, the drug is suitable for use for five years.

Requirements for the place of storage of Cardiomagnyl are quite standard: original packaging, storage temperature not exceeding 25 ° C is optimal. The impact on the preparation of moisture should be excluded, the protection of Cardiomagnyl from light and children's attention should be maintained.

The composition of Cardiomagnyl and the form of its release

Cardiomagnyl is available in two different forms, differing in the dosage of the drug. The tablets stylized as "hearts" contain 75 mg of Cardiomagnyl. Round, more familiar to the consumer, tablets are dosed at 50 mg of the drug. Both options are packaged in bottles made of dark medical glass.

It is indisputable that, at its core, Cardiomagnyl contains acetylsalicylic acid.

The second most important component is magnesium hydroxide, the presence of which in the preparation reduces the risk of a negative effect of acetylsalicylic acid on the mucous membranes.

In addition to these two components, Cardiomagnyl contains excipients such as hypromellose, magnesium stearate, and cellulose.

Analogues of Cardiomagnyl

So, Acecardol. Let's try to figure out what is better to take: Acecardol or, in fact, Cardiomagnyl? The choice, as always, is up to the attending physician, because Acecardol is more aggressive to the gastrointestinal tract, but ... it is several times cheaper than Cardiomagnyl, which, when choosing, significantly tips the scales in his favor.

Cardiac. This drug is less preferable than Cardiomagnyl, since, like the previous drug, it is more aggressive to the gastrointestinal mucosa.

Lopirel. This drug is prescribed for heart rhythm failures, so it is more specific than Cardiomagnyl. And yet, besides, Lopirel, which is produced in Malta, costs ten times more than Cardiomagnyl.

Comparing the Russian Cardiomagnyl and the German Fazostabil, we can conclude that the latter is practically similar to the domestic drug in terms of the spectrum of effects on the body.

There are also inexpensive Russian analogues of Cardiomagnyl on the medicine market. The names of these medicines are Aspicor and Aspinat-cardio.

Aspicor can practically eliminate the associated risk of damage to the gastric mucosa, because it is absorbed by the small intestine. Aspinat-cardio perfectly prevents circulatory disorders of the brain.

The above drugs contain acetylsalicylic acid. However, there are also “aspirin-free” analogues.

So, get acquainted: Ticlid, the active substance of which enters - ticlopidine. The drug is superior to acetylsalicylic analogues in terms of therapeutic effect on the body and is more selective.

Trental. The basis of the drug is pentoxifylline, which, among other things, tones the respiratory muscles.

Clopidogrel contains clopidogrel bisulfate. This drug, in conjunction with ASA, catalyzes the antiplatelet effect of the drug on the body.

What is the cost of Cardiomagnyl?

It would be useful to point out that the acquisition of Cardiomagnyl does not require a prescription.

Prices for Cardiomagnyl will differ depending on the dosage of tablets and their number in the package. So, 30 tablets cost from 100 to 150 rubles, and a package of 100 tablets with the same dose of 75 mg costs from 180 to 270 rubles.

A package of 100 higher doses can be purchased at a price of 185 to 290 rubles.

Those who suffer from acute heart failure or are predisposed to vein thrombosis take Cardiomagnyl. This is a fairly serious drug that requires a doctor's prescription. Read the instructions before buying Cardiomagnyl, because the medicine also has contraindications for use.

Indications for the use of Cardiomagnyl

The drug can be prescribed for:

• hypertension;
• diabetes mellitus;
• increased lipid levels;
• elderly people who suffer from unstable angina;
• after vascular surgery;
• after a heart attack.

Even smokers are at risk and may receive such a doctor's prescription.

It is Cardiomagnyl, whose contraindications and side effects are quite wide, nevertheless, helps to stabilize the patient's condition, because it contains aspirin, which is coated with a special shell of magnesium hydroxide. Magnesium hydroxide protects the stomach from acid attack and helps prevent ulcers or gastritis.

When is medical supervision needed?

However, the acid is not as harmless as it seems. Although it thins the blood, relieves inflammation and even fever, it can give a lot of side effects.

Not only heartburn, but vomiting, nausea, and colic in the abdomen can disturb the patient who is prescribed the drug. Gastric and duodenal ulcers may occur. And someone who already has an ulcer can open stomach bleeding. To this we can add irritable bowel syndrome, and even stomatitis, because the susceptibility to the constant intake of aspirin is different for everyone.

Side effects from Cardiomagnyl can lead to:

• Quincke's edema;
• hives.

Carefully monitor your well-being and try to immediately consult a doctor if problems arise.

Also, sometimes the drug has a negative effect on the central nervous system. Appears:

• drowsiness or, conversely, insomnia;
• dizziness;
• headache.

Therefore, older people need to take the drug with caution so as not to aggravate their condition even more. Constant monitoring of well-being is necessary, and you should not exceed the dosage prescribed by your doctor.

Bronchospasm may occur, and on the part of the circulatory system, side effects of Cardiomagnyl will be bleeding, up to anemia, and other changes that only a doctor can identify. Therefore, taking such a drug is necessary under the constant supervision of a doctor and with the control of blood tests.

When should you not take Cardiomagnyl?

Cardiomagnyl has the following contraindications for use:

• hemorrhages and bleeding of the gastrointestinal tract in history;
• tendency to bleeding and hemophilia;
• erosion and ulcers of the stomach, as well as intestines;
• pregnancy and breastfeeding;
• age up to 18 years;
• susceptibility to acetylsalicylic acid and its intolerance.

In addition, the drug is carefully taken in renal failure. When buying Cardiomagnyl in tablets, it is better to read the contraindications right away, because although the drug is inexpensive, it may not be suitable if there are problems listed above.

Please note that you should not take it for prevention, be sure to consult with specialists. You can always find out what indications and contraindications Cardiomagnyl has from the annotation, so do not be lazy to read the instructions before buying.

Any drug not only heals, but can also give side effects, so do not be afraid to take it if prescribed by a doctor. He usually relies on the anamnesis and prescribes the drug strictly according to the specifics of the disease. Most importantly, do not forget to tell your doctor about side effects after taking the medicine, if they suddenly appear. In this case, or if you have contraindications to taking Cardiomagnyl, the doctor will select another drug.

Due to the high prevalence of cardiovascular diseases, the use of Cardiomagnyl is in some cases vital. The drug helps the heart pump blood, it affects the viscosity index and prevents the formation of platelets.

Cardiomagnyl is indicated as primary prevention in cases of the presence of certain negative factors, which include obesity and diabetes, smoking and high blood pressure, as well as old age, etc. The drug is prescribed for angina pectoris, with resistive heart attacks and thromboembolic manifestations: in all cases in which vascular surgery was performed.

Release form

The industry produces the drug in the form of heart-shaped tablets, which indicate the purpose of the drug. They are placed in brown glass bottles of 30 or 100 pieces. The main substances of the drug are:

• acetylsalicylic acid (aspirin);
• magnesium hydroxide;
• starch;
• talc;
• magnesium.

Pharmacological effects and pharmacokinetics

Acetylsalicylic acid (ASA), which is part of Cardiomagnyl, has various mechanisms to counteract platelet aggregation, including inhibition of the COX-1 enzyme. In addition, this substance is an anesthetic, relieving inflammation and antipyretic. Acid can have a negative effect on the gastrointestinal mucosa; to level it, magnesium hydroxide is added to the composition of Cardiomagnyl.

Important!

The pharmacokinetics of the drug is completely safe for the human body.

Absorption and absorption from the gastrointestinal tract occurs very quickly and almost in full. T1 / 2 ASA is 15 minutes, as a result of hydrolysis, it turns into 100 percent bioavailable salicylic acid. The process occurs in the blood plasma, gastrointestinal tract and liver.

T1 / 2 salicylic acid with small doses of Cardiomagnyl is approximately 3 hours. If the enzyme systems are saturated, the value of the indicator increases significantly.

Instructions: how to take Cardiomagnyl

It is possible to prevent the recurrence of thrombi and CCC of various types by prescribing daily 150 mg at the initial treatment stage, after a while, reducing the dose to 75.

Appointment of Cardiomagnyl Forte with the optimal dosage

Cardiomagnyl Forte tablets are prescribed at a dosage of 1 tablet / day. those with IBS. This is the initial rate, which is subsequently reduced.

How to drink?

Medicine tablets should be taken with a glass of clean water or other liquid. They are usually swallowed whole, in some situations, crushed or divided in half before use. You can just chew.

Time of day to take Cardiomagnyl

In the manufacturer's instructions, you will not find the answer to the question: the medicine should be taken in the morning, in the evening or at night. The doctor should offer a variant of recommendations. Most often, the doctor's advice tends to the evening regimen of taking the medicine. Many factors indicate that an hour after the evening meal is the best time to use a blood thinner.

Duration of use

If the severity of cardiovascular disease is high, the use of the drug is prescribed for a permanent regimen. Termination can only be affected by the presence of certain contraindications. The patient and the doctor treating the patient should monitor the rate of blood pressure and hemocoagulation. Their values ​​in dynamics will help determine the duration of the medication.

Let's try to take a test and find out what condition your heart is in.

Did either of your parents have a heart attack before age 60?

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Do you smoke and/or drink alcohol more than once a month?

Squat down for 60 seconds. Is your heart rate above 100 beats per minute?

Do you experience chest pain and/or shortness of breath during intense physical exertion or nervous stress?

Do you eat more than 4 times a week fatty pork, butter, sugary soda, sausages?

Your heart

you have a healthy heart

At this stage, your heart is healthy. But it is important to remember that it is necessary to maintain a healthy lifestyle and undergo regular examinations with your family doctor (at least 1 time per year). Learn about the tests and diagnostics you need to keep your heart healthy.

You are at risk of developing heart disease

Perhaps already now you have shortness of breath, palpitations, chronic fatigue and lethargy. This may be the first symptom of starting heart problems. Read about how to recognize the first symptoms and correctly diagnose the disease.

You don't have a healthy heart

Most likely, you already know that you have heart rhythm problems. Further, the situation will only get worse. You need to undergo a comprehensive examination and start treatment. You can see in detail about the dangers and consequences of different types of heart disease

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Dosing regimen

With various forms of coronary artery disease, doctors usually prescribe a daily dose of Cardiomagnyl at the start of 150 mg. If maintenance treatment is required, the dosage is halved. In acute myocardial infarction and with significant angina problems, the daily dosage can be tripled to 450 mg. Contacting a doctor and taking Cardiomagnyl should be carried out with the appearance of the first symptoms.

Contraindications for taking the drug

In some cases, a blood-thinning drug is contraindicated for use. This is observed when hemorrhage in the brain and other situations with prolonged blood loss, including those caused by a lack of vitamin K in the body, diseases of hemorrhagic diathesis and thrombocytopenia. It is undesirable to use Cardiomagnyl in patients with bronchial asthma. In the presence of an exacerbation of the erosive and ulcerative problem and the manifestation of bleeding in the gastrointestinal tract, the drug should be excluded at least for a while.

The physician should not prescribe Cardiomagnyl if the patient has a deficiency of glucose-6-phosphate dehydrogenase and in cases of pronounced CC<10 мл/мин kidney failure. Do not take the medicine at the same time as methotrexate. You also need to remember that Cardiomagnyl and alcohol are incompatible.

There are restrictions on admission for pregnant women, the use of this drug in the I and III trimesters should be excluded. During the period of feeding a child with milk, it is also undesirable for women to use Cardiomagnyl. Children and adolescents under 18 years of age this medicine should not be prescribed. The drug is contraindicated in anyone who has hypersensitivity to various components and acetylsalicylic acid.

There may be adverse effects in patients with allergies, gout, nasal polyposis, not only in the 1st and 3rd, but also in the 2nd trimester of pregnancy. In all cases, a doctor's consultation is required. In modern conditions, it can be obtained online.

What is the danger of using the drug during pregnancy and breastfeeding?

If sacylates enter the body of a pregnant woman in the first trimester in significant doses, there is an increase in problems with the development of the fetus. If this happens in the third trimester, labor activity is inhibited. Before the set time, the arterial duct of the embryo closes, a dosage of more than 300 mg / day provokes bleeding. The phenomenon is observed in both mother and fetus. Especially dangerous are large doses of the drug, used close to childbirth. They can provoke intracranial hemorrhages.

Adverse reactions of the body

Adverse reactions in most cases are manifested in the form of allergies. Most often, patients complain of urticaria or Quincke's edema. In some cases, anaphylactic reactions are possible. Side effects that occur in the digestive system include:

Formation of blood clots in blood vessels

• heartburn (more often than other manifestations);
• vomiting and nausea;
• pain with exacerbation of inflammation of the gastric mucosa and 12 duodenal ulcer;
• bleeding in the gastrointestinal tract;
• increasing the activity of liver enzymes;
• colitis and stomatitis;
• strictures;
• esophagitis, etc.

Sometimes the intestines are irritated, erosive disorders in the gastrointestinal tract are observed. In the respiratory system, spasmodic manifestations may occur in relation to the bronchi. In the hematopoietic system, failures are possible in the form of increased bleeding. This side effect is seen quite often. Anemia is less common. Even more rare side effects are:

• manifestation of agranulocytosis;
• bouts of neutropenia;
• The patient has eosinophilia.

Through the reception of Cardiomagnyl, in adverse cases, a negative effect on the nervous system can be exerted, which can manifest itself in the form of headache, tinnitus, drowsiness and dizziness. The most unpleasant side effect should be considered intracerebral hemorrhage.

How does the drug interact with other drugs

Cardiomagnyl increases the healing potential of anticoagulants, methotrexate, drugs with hypoglycemic properties, acetazolamide, etc. At the same time, its use negatively affects the effectiveness of ACE inhibitors.

Absorption of Cardiomagnyl components is adversely affected by antacids and cholestyramine. It is not advisable to combine NSAIDs with Cardiomagnyl. Cardiomagnyl in combination with Probenecid is problematic, as there is a weakening of the therapeutic effect of both drugs.

There is also no magnesium hydroxide in Tromboass, the negative effects are minimized by the presence of a special intestinal-soluble protective shell in the drug. Tromboass and Fazostabil, according to doctors and patients, have fewer side effects.

Aspirin Cardio, manufactured by Bayer AG, unlike Cardiomagnyl, also has a shell that dissolves in the intestinal tract.

Special studies have helped to establish: Cardiomagnyl is more effective than all enteric analogues and affects the suppression of platelet aggregation.

How it is dispensed in a pharmacy, storage rules

The drug and analogues are dispensed by pharmacies without a prescription. It is important to control the expiration date. It is equal to three years. The purchased product must be stored at temperatures up to 25 degrees, avoiding direct sunlight on the bottle.

One tablet contains

Active ingredients:
Acetylsalicylic acid - 75 mg / 150 mg
Magnesium hydroxide - 15.2 mg / 30.39 mg

Excipients:
Corn starch - 9.5 mg / 19.0 mg
Cellulose microcrystalline - 12.5 mg / 25.0 mg
Magnesium stearate - 150 mcg / 305 mcg
Potato starch - 2.0 mg / 4.0 mg

Shell
Hypromellose (Methylhydroxypropylcellulose 15) 460mcg/1.2mg
Propylene glycol - 90 mcg / 240 mcg
Talc - 280 mcg / 720 mcg

Description

Film-coated tablets containing 75 mg/15.2 mg of acetylsalicylic acid and magnesium hydroxide, respectively: film-coated tablets, white in the form of a stylized "heart".

Film-coated tablets containing 150 mg/30.39 mg of acetylsalicylic acid and magnesium hydroxide, respectively: film-coated tablets, white, oval-shaped, scored on one side.

Pharmacological properties

Pharmacotherapeutic group: Antiplatelet agent

ATH CODE: B01AC30

Pharmacodynamics

The mechanism of action of acetylsalicylic acid (ASA) is based on irreversible inhibition of cyclooxygenase (COX-1), as a result of which the synthesis of thromboxane A2 is blocked and platelet aggregation is suppressed. It is believed that ASA also has other mechanisms for suppressing platelet aggregation, which expands the scope of its application in various vascular diseases. ASA also has anti-inflammatory, analgesic, antipyretic effects. Magnesium hydroxide, which is part of Cardiomagnyl, protects the mucous membrane of the gastrointestinal tract from the effects of acetylsalicylic acid.

Pharmacokinetics

ASA is almost completely absorbed from the gastrointestinal tract. The half-life of ASA is about 15 minutes, because. with the participation of ASA enzymes, it is rapidly hydrolyzed into salicylic acid (SA) in the intestine, liver and blood plasma. The half-life of SC is about 3 hours, but it can significantly increase with the simultaneous administration of large doses of ASA (more than 3.0 g) as a result of saturation of the enzyme systems.

The bioavailability of ASA is about 70%, but this value fluctuates to a large extent, since ASA undergoes first-time hydrolysis (mucosa of the gastrointestinal tract, liver) into SA 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 for use

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

Prevention of recurrent myocardial infarction and thrombosis of blood vessels.

Prevention of thromboembolism after surgical interventions on the vessels (coronary bypass grafting, percutaneous transluminal coronary angioplasty).

Unstable angina.

Contraindications

Hypersensitivity to ASA, excipients of the drug and other NSAIDs, cerebral hemorrhage; bleeding tendency (vitamin K deficiency, thrombocytopenia, hemorrhagic diathesis); bronchial asthma induced by the intake of salicylates and NSAIDs; erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase); gastrointestinal bleeding; severe renal failure (creatinine clearance less than 10 ml / min.); pregnancy (I and III trimesters); lactation period; deficiency of glucose-6-phosphate dehydrogenase; simultaneous reception with methotrexate (more than 15 mg per week); children's age up to 18 years.

Carefully

With gout, hyperuricemia, a history of ulcerative lesions of the gastrointestinal tract or gastrointestinal bleeding, renal and / or liver failure, bronchial asthma, hay fever, nasal polyposis, allergic conditions, in the II trimester of pregnancy.

Use during pregnancy and during breastfeeding

The use of high doses of salicylates in the first 3 months of pregnancy is associated with an increased incidence of fetal defects. In the second trimester of pregnancy, salicylates can only be prescribed taking into account a strict assessment of risk and benefit.

In the last trimester of pregnancy, salicylates at a high dose (more than 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 delivery can cause intracranial hemorrhage, especially in premature babies.

The appointment of salicylates in the last trimester of pregnancy is contraindicated.

Available clinical data are not enough to establish the possibility or impossibility of using the drug during breastfeeding. Before prescribing acetylsalicylic acid during breastfeeding, the potential benefit of drug therapy should be assessed against the potential risk to infants.

Dosage and administration

The tablets are swallowed whole with a glass of water. If desired, the tablet can be broken in half, chewed or pre-pounded.

Primary prevention of cardiovascular diseases such as thrombosis and acute heart failure in the presence of risk factors (eg, diabetes mellitus, hyperlipidaemia, arterial hypertension, obesity, smoking, older age)
1 tablet of Cardiomagnyl containing ASA at a dose of 150 mg on the first day, then 1 tablet of Cardiomagnyl containing ASA at a dose of 75 mg 1 time per day.

Prevention of recurrent myocardial infarction and thrombosis of blood vessels

Prevention of thromboembolism after surgical interventions on the vessels (coronary bypass grafting, percutaneous transluminal coronary angioplasty)
1 tablet of Cardiomagnyl containing ASA at a dose of 75-150 mg 1 time per day.

Unstable angina
1 tablet of Cardiomagnyl containing ASA at a dose of 75-150 mg 1 time per day.

Side effect

The frequency of the adverse reactions listed below was determined according to the following:

• very often ≥ 1/10;
• often > 1/100,<1/10;
• sometimes > 1/1000,<1/100;
• rarely > 1/10 000,<1/1000;
• rarely< 1/10 000, включая отдельные сообщения.

Allergic reactions: urticaria (often), Quincke's edema (often).

The immune system: anaphylactic reactions (sometimes).

Gastrointestinal tract: nausea (often), heartburn (very common), vomiting (often), pain in the abdomen, ulcers of the mucous membrane of the stomach and duodenum (sometimes), including perforated (rarely), gastrointestinal bleeding (sometimes), increased liver enzyme activity (rare), stomatitis (very rare), esophagitis (very rare), erosive lesions of the upper gastrointestinal tract (very rare), strictures (very rare), colitis (very rare), exacerbation of intestinal irritation ( rarely).

Respiratory system: bronchospasm (often)

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

Central nervous system: dizziness (sometimes), headache (often), insomnia (often), drowsiness (sometimes), tinnitus, intracerebral hemorrhage (rare).

Overdose

Symptoms of an overdose of moderate severity

nausea, vomiting, tinnitus, hearing loss, dizziness, confusion.

Treatment: wash the stomach, take activated charcoal. Treatment is symptomatic.

Symptoms of a severe overdose

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 solutions, activated charcoal, symptomatic therapy. When performing alkaline diuresis, a pH value between 7.5 and 8 should be achieved. Forced alkaline diuresis should be performed when the plasma salicylate concentration is more than 500 mg/l (3.6 mmol/l) in adults and 300 mg/l (2, 2 mmol/l) in children.

Interaction with other drugs (see also section "Special Instructions")

With the simultaneous use of ASA, it enhances the effect of the following drugs:

• methotrexate by reducing renal clearance and displacing it from its association with proteins
• heparin and indirect anticoagulants due to impaired platelet function and displacement of indirect anticoagulants from protein binding
• thrombolytic and antiplatelet and anticoagulant drugs (ticlopidine)
• digoxin due to decreased renal excretion
• hypoglycemic agents for oral administration (sulfonylurea derivatives) and insulin due to the hypoglycemic properties of ASA itself in high doses and the displacement of sulfonylurea derivatives from association with blood plasma proteins
• valproic acid by displacing it from its association with proteins

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

An additive effect is observed while taking ASA with ethanol (alcohol).

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

By enhancing the elimination of salicylates, systemic glucocorticosteroids (GCS) weaken their effect.

Antacids and cholestyramine reduce the absorption of the drug.

special instructions

The drug should be used after a doctor's prescription.

ASA can provoke bronchospasm, as well as cause asthma attacks and other hypersensitivity reactions. Risk factors are a history of bronchial asthma, hay fever, nasal polyposis, chronic respiratory disease, and allergic reactions to other drugs (eg, skin reactions, itching, urticaria).

ASA can cause bleeding of varying severity during and after surgery. A few days before the planned surgical intervention, the risk of bleeding should be assessed in comparison with the risk of ischemic complications in patients taking low doses of ASA. If the risk of bleeding is significant, ASA should be temporarily discontinued.

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

ASA in low doses can provoke the development of gout in predisposed patients (having reduced excretion of uric acid).

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

High doses of ASA have a hypoglycemic effect, which must be borne in mind when prescribing it to patients with diabetes mellitus receiving oral hypoglycemic agents and insulin.

With the combined use of systemic glucocorticosteroids (GCS) and salicylates, it should be remembered that during treatment, the concentration of salicylates in the blood is reduced, and after the abolition of systemic glucocorticosteroids (GCS), an overdose of salicylates is possible.

The combination of ASA with ibuprofen is not recommended in patients with an increased risk of cardiovascular diseases: with simultaneous use with ibuprofen, a decrease in the antiplatelet effect of ASA at doses up to 300 mg is noted, which leads to a decrease in the cardioprotective effects of ASA.

With long-term use of low doses of ASA as aggregant therapy, care must be taken in elderly patients due to the risk of gastrointestinal bleeding.

With the simultaneous use of ASA with alcohol, the risk of damage to the mucous membrane of the gastrointestinal tract and prolongation of bleeding time is increased.

Influence on the ability to drive vehicles and moving mechanisms.
During the period of treatment with ASA drugs, care must be taken when driving vehicles and engaging in potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.

Release form