Kombi-ask

General characteristics. Structure:

Active agents: acetylsalicylic acid of 75 mg; magnesium hydroxide of 15,2 mg

Other ingredients: sodium of a kroskarmelloz, cellulose microcrystallic, коповидон, talc, silicon dioxide colloid anhydrous, magnesium stearate, opadry II White.

Active agents: acetylsalicylic acid of 150 mg; magnesium hydroxide of 30,39 mg

Other ingredients: sodium of a kroskarmelloz, cellulose microcrystallic, коповидон, talc, silicon dioxide colloid anhydrous, magnesium stearate, opadry II White.

Covering for drawing a cover of Opadry II White: polyethyleneglycol, polyvinyl alcohol, talc, titanium E171 dioxide.

Pharmacological properties:

Pharmacodynamics. Acetylsalicylic acid is analgezivny, anti-inflammatory, febrifugal and antiagregantny drug.
The main pharmacological effect — inhibition of formation of prostaglandins and thromboxanes. The analgesic effect is additional effect which is caused by TsOG enzyme inhibition. Antiinflammatory action is connected with the reduced blood-groove caused by synthesis inhibition prostaglandina2.
Acetylsalicylic acid it is irreversible inhibits synthesis of G/H prostaglandins. Its influence on prostaglandins lasts longer, than the time spent of acetylsalicylic acid in an organism. Influence of acetylsalicylic acid on biosynthesis of thromboxane in thrombocytes and for bleeding continues a long time after the treatment termination. It is terminated only after emergence of new thrombocytes in a blood plasma.
Magnesium hydroxide has antiacid effect and protects a mucous membrane of a digestive tract from the irritating influence of acetylsalicylic acid.

Pharmacokinetics. Absorption. After intake acetylsalicylic acid is quickly soaked up in a GIT. Speed of absorption decreases with meal and patients with attacks have migraines, raises — at patients with an achlorhydria. Cmax in a blood plasma is reached in 0,5–2 h.
At oral administration magnesium in small amounts is slowly absorbed from a small intestine.
Distribution. Linkng of acetylsalicylic acid with proteins of a blood plasma makes 80–90%. Distribution volume for adults makes 170 ml/kg of body weight. Salicylates strongly contact proteins of a blood plasma and quickly spread on an organism. Salicylates get into breast milk and can get through a placental barrier. Magnesium spreads with proteins in the connected look (? 25–30%). A small amount gets into breast milk. Magnesium can get through a placental barrier.
Metabolism. Acetylsalicylic acid is hydrolyzed to an active metabolite — salicylate in a stomach wall. After absorption acetylsalicylic acid quickly turns into salicylic acid, but within the first 20 min. after intake is dominating in a blood plasma.
Removal. Salicylate is removed mainly due to hepatic metabolism. T? makes 2–3 h. At a high dose of acetylsalicylic acid T? increases to 15–30 h. Salicylate is also removed in not changed view with urine. The removed volume depends on the level of a dose and pH of urine. About 30% of a dose are removed with urine if urine reaction alkaline, only 2% — if acid. A small amount of magnesium is removed with urine, but a bo'lshy part reabsorbirutsya and removed with a stake.

Indications to use:

- acute (unstable stenocardia, acute myocardial infarction) and chronic ischemic heart disease;
- prevention of a repeated thrombogenesis;
- primary prevention of thromboses, cardiovascular diseases, such as an acute coronary syndrome at patients who have factors of development of cardiovascular diseases: AG, a hypercholesterolemia, a diabetes mellitus, obesity (a body weight index <30), the hereditary anamnesis (a myocardial infarction at patients aged up to 55 years).

Route of administration and doses:

Acute and chronic ischemic heart disease. The recommended initial dose — 150 mg of 1 times a day. A maintenance dose — 75 mg of 1 times a day.
Acute myocardial infarction. Unstable stenocardia. The recommended dose makes 150–450 mg, apply as soon as possible after emergence of symptoms.
Prevention of a repeated thrombogenesis. The recommended initial dose — 150 mg of 1 times a day. A maintenance dose — 75 mg of 1 times a day.
Primary prevention of thromboses, cardiovascular diseases, such as acute coronary syndrome, patients with existence of factors have a development of cardiovascular diseases. The recommended preventive dose — 75 mg of 1 times a day.
The doctor defines a course of treatment individually depending on indications and disease severity.
Swallow of tablets entirely, washing down with water.

Features of use:

It is necessary to avoid the prolonged combined use of acetylsalicylic acid with other NPVP as the risk of emergence of by-effects increases. At patients of advanced age at prolonged use of drug the risk of developing of gastrointestinal bleedings can increase.
In case of the planned surgical intervention it is recommended to stop administration of drug for several days.
It is necessary to use with care drug at patients with asthma and allergic reactions, dyspepsia, the known damages of the mucous membrane of a stomach broken by function of a liver or kidneys. At use of acetylsalicylic acid in low doses removal of uric acid can decrease.
Use during pregnancy or feeding by a breast. The decision on use of drug in the I-II trimester of pregnancy and feeding has to be accepted by a breast after careful assessment of a ratio advantage/risk, in the lowest doses (to 100 mg/days) and under careful observation.
It is contraindicated to use drug in the III trimester of pregnancy.
Children. Drug is not appointed to children.
Ability to influence speed of response at control of vehicles or other mechanisms. Does not influence.

Side effects:

Undesirable effects on the frequency of emergence classify by such categories: very often (? 1/10), it is frequent (? 1/100, <1/10), infrequently (? 1/1000, <1/100), it is rare (? 1/10 000, <1/1000); very seldom (<1/10 000, including isolated cases).
From system of blood: very often — the increased bleeding, inhibition of aggregation of thrombocytes; infrequently — the concealed hemorrhage; seldom — anemia in case of long therapy; very seldom — a prothrombinopenia (high doses), thrombocytopenia, a neutropenia, aplastic anemia, an eosinophilia, an agranulocytosis.
From immune system: infrequently — anaphylactic reactions, allergic rhinitis.
From endocrine system: seldom — a hypoglycemia.
From a nervous system: often — a headache, sleeplessness; infrequently — dizziness (вертиго), drowsiness; seldom — intratserebralny hemorrhage.
From sense bodys: infrequently — a ring in ears; seldom — a dozozavisimy reversible hearing loss and deafness.
From respiratory system: often — a bronchospasm (at patients with asthma).
From a GIT: very often — heartburn, a reflux; often — erosive damages of an upper part of a digestive tract, nausea, dyspepsia, vomiting, diarrhea; infrequently — ulcers of an upper part of a GIT, including vomiting with blood and a tar-like chair; seldom — gastrointestinal bleedings, perforation; very seldom — stomatitis, an esophagitis, toxic defeat with ulcers of a lower part of a GIT, a stricture, colitis, an aggravation of an irritable colon.
From a liver: seldom — increase in level of transaminases and ShchF of serum; very seldom — a dozozavisimy reversible acute hepatitis of average degree.
From skin: often — urticaria, rash of various character, a Quincke's edema, a purpura, a hemorrhagic vasculitis, a multiformny erythema, Stephens's syndrome — Johnson, a Lyell's disease.

Interaction with other medicines:

At the combined use acetylsalicylic acid strengthens action of hypoglycemic means, anticoagulants (warfarin, фенпрокумон, klopidogret, heparin sodium), acetazoleamide, a methotrexate. Effect of furosemide, Spironolactonum, APF inhibitors oppresses. It is not recommended to apply at the same time with other NPVP. Antacids can reduce drug absorption. Clinical value of this interaction of acetylsalicylic acid and magnesium minimum at the expense of a small amount of magnesium which is a part of drug. Use with probenetsidy weakens effect of both drugs.

Contraindications:

Hypersensitivity to drug components, other salicylates. Stomach ulcer in an aggravation phase; tendency to bleedings (deficit of vitamin K, thrombocytopenia, hemophilia); liver failure of heavy degree, heavy renal failures (level of glomerular filtering <10 ml/min.); the expressed heart failure; asthma, a Quincke's edema caused by use of salicylates or NPVP in the anamnesis. III trimester of pregnancy. Children's age.

Overdose:

Dangerous dose for adults — 150 mg/kg of body weight.
Symptoms of poisoning of average degree (result of prolonged use of high doses): dizziness, a ring in ears, deafness, a vazodilatation, perspiration, nausea, vomiting, a headache, consciousness opacification.
Symptoms of serious and acute poisoning (owing to overdose): hyperventilation of lungs, heat, concern, ketosis, alkaloidal alkalosis and metabolic acidosis.
In case of a serious poisoning oppression of TsNS can lead to a coma, a cardiovascular collapse and an apnoea.
Acute poisoning with acetylsalicylic acid (> 300 mg/kg of body weight) often causes an acute liver failure, and the dose more than 500 mg/kg can be lethal.
Treatment: gastric lavage and reception of absorbent carbon.
It is necessary to recover balance of liquid and electrolytes to avoid acidosis, a hyper pyrexia, a hyperpotassemia and dehydration. Effective methods of removal of salicylate from a blood plasma are the alkaline diuresis, a hemodialysis or hemoperfusion.

Storage conditions:

In original packaging at a temperature not above 25 °C.

Issue conditions:

Without recipe

Packaging:

Tab. п / captivity. cover, No. 20, No. 100

Tab. п / captivity. cover, No. 20, No. 100.