Cardiomagnil: instructions for using the medicine, structure, Contraindications

Active material: Acetylsalicylic acid, magnesium hydroxide
When ATH: B01AC30
CCF: NSAIDs. Antiplatelet
ICD-10 codes (testimony): I20.0, I21, i26, I74, I82
When CSF: 01.12.11.06.01
Manufacturer: NYCOMED DENMARK ApS (Denmark)

Cardiomagnil: dosage form, composition and packaging

◊ Pills, Film-coated white, in the form of stylized heart.

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

30 PC. – vials of dark glass.
100 PC. – vials of dark glass.

◊ Pills, Film-coated white, oval, with Valium on one side.

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

30 PC. – vials of dark glass.
100 PC. – vials of dark glass.

Cardiomagnil: pharmachologic effect

NSAIDs, antiplatelet drug. The mechanism of action of aspirin is irreversible inhibition of the enzyme cyclooxygenase (Splendor-1), whereby blocked synthesis of thromboxane A₂ and podavlyaetsya aggregation trombotsitov. Think, that acetylsalicylic acid has other mechanisms of suppression of platelet aggregation, that expands the scope of its application in various vascular diseases. Aspirin also has anti-inflammatory, analgesic and antipyretic activity.

Magnesium hydroxide, part of the cardiomagnyl, protect the gastrointestinal mucosa against acetylsalicylic acid.

Cardiomagnil: pharmacokinetics

After oral administration, acetylsalicylic acid is absorbed from the gastrointestinal tract is almost completely.

T_1/2 acetylsalicylic acid is about 15 m, tk. the participation of enzymes, it is rapidly hydrolyzed to salicylic acid in the intestine, liver and blood plasma. T_1/2 salicylic acid – about 3 no, but when taking aspirin at high doses (>3 g) this figure could increase significantly as a result of saturation of the enzyme systems.

Bioavailability of acetylsalicylic acid is about 70%, but this figure is characterized by considerable individual variability due to first-pass hydrolysis in the gastrointestinal mucosa and liver to form under the action of salicylic acid esterase. Bioavailability of salicylic acid 80-100%.

Magnesium hydroxide (at the dosages) It does not affect the bioavailability of acetylsalicylic acid.

Cardiomagnil: testimony

- Primary prevention of cardiovascular disease, such as thrombosis and acute heart failure in the presence of risk factors (eg, diabetes, hyperlipidemia, arterial hypertension, obesity, smoking, advanced age);

- Prevention of recurrent myocardial infarction and thrombosis of blood vessels;

- Prevention of thromboembolism after surgery on blood vessels (coronary artery bypass grafting, chreskozhnaя translюminalьnaя koronarnaя angioplasty);

- unstable angina.

Cardiomagnil: dosing regimen

The tablets should be swallowed whole, drinking water. If you wish, you can break the tablet in half, chew or pre-grind.

To primary prevention of cardiovascular diseases, such as thrombosis and acute heart failure in the presence of risk factors (eg, diabetes, hyperlipidemia, arterial hypertension, obesity, smoking, advanced age) appoint 1 tab. Kardiomagnila, containing acetylsalicylic acid dose 150 mg on the first day, then 1 tab. Kardiomagnila, containing acetylsalicylic acid dose 75 mg 1 time / day.

To prevention of recurrent myocardial infarction and thrombosis of blood vessels appoint 1 tab. Kardiomagnila, containing acetylsalicylic acid dose 75-150 mg 1 time / day.

To prevention of thromboembolism after surgery on blood vessels (coronary artery bypass grafting, chreskozhnaя translюminalьnaя koronarnaя angioplasty) appoint 1 tab. Kardiomagnila, containing acetylsalicylic acid dose 75-150 mg 1 time / day.

At unstable angina appoint 1 tab. Kardiomagnila, containing acetylsalicylic acid dose 75-150 mg 1 time / day.

Cardiomagnil: side effects

The frequency of adverse reactions, below, determined according to the following: very common ≥1 / 10; often > 1/100, <1/10; sometimes > 1/1000, <1/100; rarely> 1/10 000, <1/1000; rarely < 1/10 000, including isolated reports.

Allergic reactions: often – hives, angioedema; sometimes – anaphylactic reactions.

From the digestive system: Often – heartburn; often – nausea, vomiting; sometimes – pain in the abdomen, ulcers of the mucous membrane of the stomach and duodenum, gastrointestinal bleeding; rarely – ulcer perforation of the stomach or duodenum, increase in liver enzymes; rarely – stomatitis, esophagitis, erosive lesions of the upper gastrointestinal tract, stricture, colitis, Irritable Bowel Syndrome.

The respiratory system: often – bronchospasm.

From the hematopoietic system: Often – increased bleeding; rarely – anemia; rarely – gipoprotrombinemii, thrombocytopenia, neutropenia, aplasticheskaya anemia, eozinofilija, agranulocytosis.

CNS: sometimes – dizziness, drowsiness; often – headache, insomnia; rarely – noise in ears, intracerebral hemorrhage.

Cardiomagnil: Contraindications

- Bleeding in the brain;

- Bleeding tendency (Vitamin K deficiency, thrombocytopenia, gyemorragichyeskii diatyez);

- Bronchial asthma, induced intake of salicylates, and NSAIDs;

- Erosive and ulcerative lesions of the gastrointestinal tract (exacerbation);

- Gastro-intestinal bleeding;

- Severe renal insufficiency (CC<10 ml / min);

- Deficiency of glucose-6-fosfatdegidrogenazы;

- Concomitant use of methotrexate (>15 mg per week);

- I and III trimesters of pregnancy;

- Lactation (breast-feeding);

- Childhood and adolescence up 18 years;

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

FROM caution should be prescribed for gout, hyperuricemia, a history of ulcers or gastrointestinal bleeding from the gastrointestinal tract, in renal and / or hepatic insufficiency, asthma, hay fever, nasal polyposis, allergic conditions, in the II trimester of pregnancy.

Cardiomagnil: Pregnancy and lactation

The use of salicylates in high doses in the I trimester of pregnancy is associated with increased incidence of fetal malformations. During II trimester salicylates may be administered only on the basis of strict risk assessment and benefit. In the III trimester salicylates high dose (>300 mg / day) cause inhibition of labor, premature closure of the ductus arteriosus in the fetus, increased bleeding in the mother and fetus, and the appointment just before birth may cause intracranial hemorrhage, particularly premature infants. Appointment of salicylates in I and III trimesters of pregnancy is contraindicated.

Salicylates and their metabolites in small amounts are excreted in breast milk. Accidental intake of salicylates during lactation is not accompanied by the development of adverse reactions in the child and does not require stopping breastfeeding. However, long-term use of the drug, or the appointment of his high-dose breast-feeding should be stopped immediately.

Cardiomagnil: Special instructions

Take the drug should Cardiomagnyl only on prescription.

Aspirin may provoke bronchospasm, and also cause asthma attacks and other hypersensitivity reactions. Risk factors include the presence of a history of bronchial asthma, hay fever, nasal polyposis, chronic diseases of the respiratory system, and allergic reactions (skin rash, itch, hives) other drugs.

Aspirin can cause bleeding of varying severity during and after surgery.

The combination of aspirin with anticoagulants, thrombolytic and antiplatelet agents associated with an increased risk of bleeding.

Acetylsalicylic acid in low doses can trigger the development of gout in susceptible individuals (having reduced excretion of uric acid).

The combination of aspirin with methotrexate is accompanied by an increased incidence of side effects of hematopoiesis.

Acetylsalicylic acid in high doses has a hypoglycemic effect, it must be borne in mind when assigning it to patients with diabetes, receiving hypoglycemic agents.

When combined with the appointment of corticosteroids and salicylates should remember, that during the treatment the level in the blood decreased salicylates, and after the abolition of GCS possible overdose of salicylates.

Not recommended a combination of acetylsalicylic acid and ibuprofen, since the latter impairs beneficial effect of aspirin on survival.

Exceeding the dose of aspirin is associated with a risk of gastrointestinal bleeding.

Overdose is especially dangerous in the elderly.

With the combination of aspirin with alcohol increased the risk of damaging the gastrointestinal mucosa and prolonged bleeding.

Effects on ability to drive vehicles and management mechanisms

There was no any effect on the ability of patients cardiomagnyl to drive vehicles and operate machinery.

Cardiomagnil: overdose

Overdose symptoms of moderate severity: nausea, vomiting, noise in ears, amblyacousia, dizziness, confusion.

Treatment: should wash out the stomach, assign activated carbon, symptomatic therapy.

Overdose symptoms severe: fever, hyperventilation, Ketoacidosis, respiratory alkalosis, coma, cardiovascular and respiratory failure, severe hypoglycemia.

Treatment: immediate hospitalization in a specialized department for emergency treatment – gastric lavage, Determination of acid-base balance, alkaline and forced alkaline diuresis, hemodialysis, introduction of salt solutions, Activated carbon, simptomaticheskaya therapy. During the alkaline diuresis is necessary to achieve a pH between 7.5 and 8. Forced alkaline diuresis should be, when the concentration of salicylate in plasma is greater than 500 mg / l (3.6 mmol / l) adults and 300 mg / l (2.2 mmol / l) children.

Cardiomagnil: drug interaction

With simultaneous application of acetylsalicylic acid increases the effects of these drugs: methotrexate (by reducing renal clearance and ousting him from association with proteins), heparin and indirect anticoagulants (due to dysfunction of platelets, and the displacement of anticoagulants due to proteins), thrombolytic and antiplatelet agents (ticlopidine), digoksina (due to the decrease in its renal excretion), hypoglycemic agents: insulin and sulfonylureas (due hypoglycemic properties of the acetylsalicylic acid in high doses and displacement of sulfonylurea derivatives association with proteins), valproic acid (due to displacement of its association with proteins).

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

Aspirin reduces the effect of uricosuric agents (ʙenzʙromarona) due to competitive tubular excretion of uric acid.

Leveraging the elimination of salicylates, systemic corticosteroids weaken their action.

Antacids and cholestyramine while applying reduce the absorption of the drug Cardiomagnyl.

Cardiomagnil: terms of dispensing from pharmacies

The drug is resolved to application as an agent Valium holidays.

Cardiomagnil: terms and conditions of storage

The drug should be stored in a dry, protected from light and away from children at a temperature no higher than 25 ° C. Shelf life – 5 years.