|The name of the preparation||Character; dose; package||Manufacturer||Price 100%||Price after refund||In which pharmacy?|
|Acard 150 mg||gastrointestinal tablets; 150 mg; 30 tabl.||Polfa Warsaw||11.15||Check|
|Acard 150 mg||gastrointestinal tablets; 150 mg; 60 tables||Polfa Warsaw||19.43||Check|
Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.
A preparation that inhibits platelet aggregation.
The active substance is a non-steroidal anti-inflammatory drug (NSAID) Acetylsalicylic acid . Like other NSAIDs , it has anti-inflammatory, analgesic, antipyretic and platelet aggregation inhibitors. The basis of the mechanism of action of acetylsalicylic acid is the inhibition of cyclooxygenases (both COX-1 and COX-2), enzymes involved in the synthesis of prostaglandins and thromboxane from lipids of cell membranes. Prostaglandins play a significant role in the development of inflammation, and thromboxane stimulates platelet aggregation and vasoconstriction (which may contribute to the formation of clots and congestion). Inhibition of increased prostaglandin synthesis underlies the analgesic and anti-inflammatory effects of acetylsalicylic acid, and the inhibition of thromboxane synthesis at the base of its antiaggregatory action.
Acetylsalicylic acid, used in low doses (usually 75-150 mg daily), inhibits platelet COX-1 activity. This leads to suppression of thromboxane synthesis, reduction of platelet aggregation ability and inhibition of vasodilator-dependent vasoconstriction. COX-1 activity is inhibited by acetylsalicylic acid irreversibly and persists throughout the life of the platelet, i.e. about 9 days. Analgesic and anti-inflammatory effects, dependent on inhibition of COX-2 induced inflammation, require higher doses of acetylsalicylic acid (usually 2-6 g per day).
The rate of absorption of acetylsalicylic acid from the gastrointestinal tract depends on the pharmaceutical form used. Acetylsalicylic acid found in enteric coated tablets is absorbed more slowly than from tablets disintegrating in the stomach. The release of the active substance from coated tablets takes place only in the small intestine, which contributes to the protection of the gastric mucosa against the irritating effect of acetylsalicylic acid.
The preparation is indicated in ischemic heart disease and in clinical situations where it is advisable to inhibit platelet aggregation:
• prevention of myocardial infarction in people at high risk
• a recent heart attack or suspicion
• unstable coronary heart disease
• secondary prevention in people after a heart attack
• state after coronary artery bypass grafts, coronary angioplasty
• prevention of seizures of transient cerebral ischemia (TIA) and ischemic stroke in patients with TIA
• in people with TIA after having had ischemic stroke
• obliterative peripheral atherosclerosis
• prevention of coronary thrombosis in people with multiple risk factors
• prevention of venous thrombosis and pulmonary embolism in long-term immobilized persons (eg after major surgery), in addition to other methods of prophylaxis.
Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients or other salicylates.
It is contraindicated if you have ever had asthma attacks (so-called Aspirin -induced asthma) after taking salicylates or non-steroidal anti-inflammatory drugs (eg Ibuprofen , Ketoprofen , Naproxen ).
The use of the preparation is contraindicated in people:
• with an increased risk of bleeding (haemorrhagic diathesis)
• with active peptic ulcer of the stomach and / or duodenum
• with severe liver or kidney failure
• with severe heart failure
• taking Methotrexate in doses of 15 mg in a week or more in parallel
• patients with gout
• deficient in Glucose -6-phosphate dehydrogenase
• in women in the third trimester of pregnancy
• in children and adolescents up to 16 years of age in the course of viral infections (eg influenza, chickenpox), due to the risk of Reye's syndrome, a severe condition leading to liver and brain damage that may be life-threatening.
Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Caution should be exercised if acetylsalicylic acid is used in people:
• with hypersensitivity to non-steroidal anti-inflammatory or anti-rheumatic drugs or to any other allergens
• using anticoagulants in parallel
• using ibuprofen in parallel due to the risk of reduction of acetylsalicylic acid used to inhibit platelet aggregation
• with impaired liver or kidney function
• with peptic ulcer or bleeding from the gastrointestinal tract (risk of ulcer recurrence and Gastrointestinal bleeding ).
If you suspect or have been diagnosed with any of the above conditions, consult a physician before using the preparation.
In patients with hypersensitivity to NSAIDs or other allergens, only the physician may decide to use acetylsalicylic acid after considering whether the expected benefits are greater than the possible risks.
Using acetylsalicylic acid may result in an asthma attack and bronchospasm that causes difficulty in breathing or other hypersensitivity reactions. Increased risk includes patients with bronchial asthma, chronic respiratory diseases, patients with rhinitis or nasal polyps, and people with allergic reactions to any allergens (eg skin reactions, pruritus, urticaria).
People with an increased bleeding tendency (patients with haemophilia, patients with vitamin K deficiency) and those taking anticoagulants (eg Warfarin or other coumarin derivatives or Heparin ) should consult a physician before using the product. The doctor, after considering the ratio of expected benefits to risk, will decide whether it is advisable to use the preparation.
The preparation may cause prolongation of bleeding time, including during or after surgery (this also applies to minor surgical procedures, eg tooth extraction). Usually, after prior consultation with a doctor, the preparation should be discontinued prior to surgery. Acetylsalicylic acid should not be taken within 5 days preceding the planned surgery, especially in the case of ophthalmology or otologic surgery.
Additional information about the other ingredients of the preparation:
• the preparation contains less than 23 mg sodium per dose, which means that the preparation is considered "sodium-free".
Does this preparation affect the ability to drive vehicles?
There was no effect of the preparation on the ability to drive vehicles and operate equipment / machines.
The preparation is in the form of gastro-resistant tablets. It is intended for oral use. Use the preparation as recommended. Do not exceed the recommended doses, because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts about the use of the preparation, consult your doctor.
Usually 150 mg a day.
Fresh myocardial infarction or suspicion: 300 mg once, biting it thoroughly to speed up absorption.
The preparation is intended for oral use. The tablets should be taken after a meal, swallowed whole (do not break, do not chew).The enteric-coated tablet has a coating that prevents the tablet from disintegrating in the stomach, which reduces the irritating effect of acetylsalicylic acid on the mucous membrane of the stomach.
Warning! In case of a recent myocardial infarction or suspicion, the preparation may be used when acetylsalicylic acid in uncoated tablets is not available. In this case, the enteral tablets of the preparation should be thoroughly broken up to speed up the absorption of the active substance.
During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, consult a physician before using the product.
The use of the preparation is contraindicated in women in the third trimester of pregnancy.
The preparation should not be used in the first and second trimester of pregnancy, unless the doctor considers it absolutely necessary. The use of the preparation in the first and second trimester of pregnancy and in women planning pregnancy is allowed only on the order of a physician, if he considers the use necessary after considering whether the expected benefits to the mother outweigh the possible risk to the fetus (only short-term use of small doses). Only a doctor can assess the benefit / risk ratio in your case.
Do not use the product during breastfeeding, due to the risk of Reye's syndrome in a child or platelet dysfunction.
Tell your doctor about all medicines you have recently taken, including those that are over the counter.
The following interactions are largely related to the use of acetylsalicylic acid at painkillers (1-3 g / day). The incidence of low-dose acetylsalicylic acid interactions is not well understood.
Concomitant use of acetylsalicylic acid and methotrexate at doses of 15 mg per week or more is contra-indicated (possible increase in methotrexate concentration and increased bone marrow toxicity, sometimes severe intoxication leading to death).
If you are taking any of the medicines listed below, consult your doctor before using the product, as you may need to change your dose or stop taking your medicine. Take particular care if you are using:
• methotrexate at doses lower than 15 mg per week (possible increase in methotrexate concentration and increased bone marrow toxicity, if a physician recommends using acetylsalicylic acid in parallel, blood counts should be monitored once a week during the first weeks of treatment; renal and elderly patients require regular medical examinations and supervision)
• ibuprofen (possible reduction of acetylsalicylic acid at low doses to inhibit platelet aggregation)
• anticoagulants such as warfarin, heparin (possible increased anticoagulant action and prolonged bleeding time and increased risk of hemorrhage, anticoagulation is not recommended during the period of taking the preparation, however, if the doctor recommends their parallel use, the bleeding time should be monitored)
• thrombolytic drugs and platelet aggregation inhibitors such as ticlopidine, Clopidogrel (possible worsening of their effect, prolonged bleeding time and increased risk of haemorrhage)
• selective serotonin reuptake inhibitors (increased risk of gastrointestinal bleeding)
• other non-steroidal anti-inflammatory drugs (increased risk of side effects, especially gastrointestinal bleeding and kidney damage)
• medicines that increase urinary uric acid excretion, eg benzbromarone, probenecid (acetylsalicylic acid weakens the effect of uricosuric agents, in patients with reduced uric acid excretion the preparation may cause gout attack)
• Digoxin or lithium (risk of increased digoxin or lithium concentration in the blood, monitoring of digoxin or lithium in the blood plasma is recommended, especially when initiating or ending acetylsalicylic acid therapy)
• antidiabetic agents, e.g.insulin, sulphonylurea derivatives (their severity, risk of hypoglycaemia)
• diuretics (possible reduction of their diuretic and antihypertensive effect, risk of acute renal failure - hydration is recommended and monitoring of renal function at the beginning of treatment, possible increase in the toxicity of Furosemide to the hearing organ)
• antihypertensive agents, including ACE inhibitors, angiotensin antagonists, and beta blockers (possible reduction of antihypertensive effect, risk of acute renal failure)
• corticosteroid s used generally (use with acetylsalicylic acid increases the risk of ulceration and gastrointestinal bleeding)
• valproic acid (possible potentiation of valproic acid toxicity and aggravation of platelet aggregation inhibition)
• ciclosporin or tacrolimus (increased risk of damaging kidneys, kidney function should be monitored).
Alcohol consumption increases the risk of gastrointestinal adverse reactions, including ulceration and gastrointestinal bleeding.
Like all medicines, also Acard 150 mg can cause side effects, although they will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
The most common are gastrointestinal side effects that include: nausea, vomiting, indigestion, abdominal pain. Rare: gastritis, gastrointestinal bleeding (including tarry stools, bloody vomiting) and gastric and / or duodenal ulcer, sometimes with bleeding and perforation, increased liver enzymes, transient liver dysfunction, hypoglycaemia. Possible: headache and dizziness, tinnitus, kidney problems, prolonged bleeding time and increased risk of bleeding (perioperative hemorrhage, haemorrhage, nosebleeds, genital tract bleeding, bleeding from the gums, gastrointestinal haemorrhage, cerebral hemorrhage, especially in people with uncontrolled hypertension and / or taking haemostatic agents in parallel). In some cases, haemorrhage can be life-threatening; they can also lead to acute or chronic anemia (also as a result of latent microcortes from the gastrointestinal tract) with appropriate symptoms, such as weakness, paleness, and reduced blood supply to organs and tissues. Hypersensitivity reactions (rash, urticaria, pruritus) and Anaphylactic reactions may occur, including life threatening anaphylactic shock, angioneurotic edema (swelling of the face, larynx, tongue, throat that may impede breathing), bronchospasm, asthma attack and severe skin reactions.
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