Indications & Dose:
Cardiovascular disease (secondary prevention) l
Adult: 75 mg daily
Management of unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI) | Management of ST-segment elevation myocardial infarction (STEMI)
Adult: 300 mg, chewed or dispersed in water
Suspected transient ischaemic attack l
Adult: 300 mg once daily until diagnosis established
Transient ischaemic attack (long-term treatment in combination with dipyridamole) | Ischaemic stroke not associated with atrial fibrillation (in combination with dipyridamole if clopidogrel contra-indicated or not tolerated) Ischaemic stroke not associated with atrial fibrillation (used alone if clopidogrel and dipyridamole contra-indicated or not tolerated)
Adult: 75 mg once daily
Acute ischaemic stroke
Adult: 300 mg once daily for 14 days, to be initiated 24 hours after thrombolysis or as soon as possible within 48 hours of symptom onset in patients not receiving thrombolysis
Atrial fibrillation following a disabling ischaemic stroke(before being considered for anticoagulant treatment)
Adult: 300 mg once daily for 14 days
Following disabling ischaemic stroke in patients receiving anticoagulation for a prosthetic heart valve and who are at significant risk of haemorrhagic transformation
Adult: 300 mg once daily, anticoagulant treatment stopped for 7 days and to be substituted with aspirin
Following coronary by-pass surgery l
Adult: 75–300 mg daily
Mild to moderate pain
Pyrexia
Adult: 300–900 mg every 4–6 hours as required;maximum 4 g per day
Adult: 450–900 mg every 4 hours; maximum 3.6 g per day.
Contraindications:
Hypersensitivity to salicylates, NSAIDs, or tartrazine GI bleeding; hemophilia; hemorrhagic states
Side Effects:
CNS: Confusion, dizziness, drowsiness, headache
EENT: Dimness of vision, reversible hearing loss, tinnitus
GI: Acute reversible hepatotoxicity, anorexia, cholestasis, diarrhea, dyspepsia, epigastric discomfort, GI bleeding, heartburn, increased transaminase levels, nausea
HEMS: Decreased plasma iron concentration, hyperuricemia (low dose), hyperuricosuria (high dose), leukopenia, prolonged bleeding time, shortened erythrocyte survival time, thrombocytopenia
METAB: Hypoglycemia, hypokalemia, hyponatremia
RESP: Hyperpnea, wheezing
SKIN: Angioedema, bruising, hives, rash, urticaria
MISC: Fever, thirst
Cautions:
Precautions:
Anemia, asthma, nasal polyps, nasal allergies, hepatic disease, renal disease, Hodgkin’s disease, pre/postoperatively, children or teenagers with flu-like symptoms (may be associated with the development of Reye’s syndrome), gout, history of coagulation defects, bleeding disorders
PREGNANCY; ( if full doses used in 3rd trimester); use in pregnancy should generally be avoided; in pregnancies at risk for the development of pregnancy inducedhypertension and preeclampsia, and in fetuses with- intrauterine growth retardation, low dose aspirin (40-150 mg/day) may be beneficial; excreted into breast milk in low concentrations
Interaction:
Drugs
ACE inhibitors: Reduced anti hypertensive effect
Acetazolamide: Increased concentrations of acetazolamide, possibly leading to CNS toxicity
Antacids: Decreased serum salicylate concentrations; high dog salicylates only
Corticosteroids: Increased incidence and/or severity of GI ulceration; enhanced salicylate excretion
Diltiazem: Enhanced antiplatelet effect of aspirin
Ethanol: Enhanced aspirin induced GI mucosal damage and aspirin induced prolongation of bleeding time
Griseofulvin: Reduced serum salicylate level
Intrauterine contraceptive device: May reduce contraceptive effectiveness
Methotrexate: Increased serum methotrexate concentrations and enhanced methotrexate toxicity
Oral anticoagulants: Increased risk of bleeding by inhibiting platelet function and possibly by producing gastric erosions
Probenecid: Salicylates inhibit the uricosuric activity of probenecid
Sulfinpyrazone: Salicylates inhibit the uricosuric activity of sulfinpyrazone
Sulfonylurea: Enhanced hypoglycemic response to sulfonylurea
Warfarin: Enhanced hypoprothrombinemic effect of warfarin
Zarfirlukast: Increased plasma concentrations of zarfirlukast
Warnings:
Adverse Effects:
Lactations:
Special Precautions:
Counselling:
Side Effects Or Adverse Reactions:
Patient And Carer Advice:
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