|The name of the preparation||Character; dose; package||Manufacturer||Price 100%||Price after refund||In which pharmacy?|
|Acard 300 mg||tablets; 300 mg; 1 tabl||Polfa Warsaw||4.74|
|Acard 300 mg||tablets; 300 mg; 10 tables||Polfa Warsaw||3.56|
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 indication for the use of the preparation is a recent myocardial infarction or suspicion.
Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the product if you are allergic (you are hypersensitive) to any of the ingredients.
The use of the preparation is contraindicated if there is hypersensitivity to other NSAIDs, with symptoms such as bronchospasm, rhinitis and shock.
The use of the preparation is contraindicated in people:
• with active peptic ulcer of the stomach and / or duodenum, inflammation or bleeding from the gastrointestinal tract or other organs and systems (eg, bleeding in the central nervous system)
• with severe liver or kidney failure
• with severe heart failure
• with blood coagulation disorders (eg hemophilia, thrombocytopenia)
• taking Methotrexate in doses of 15 mg in a week or more in parallel
• in women in the third trimester of pregnancy
• in children and adolescents up to 16 years of age in the course of viral infections (e.g.flu, chickenpox), because of the risk of Reye's syndrome, a severe condition leading to liver and brain damage that could 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.
The use of acetylsalicylic acid may cause an asthma attack and bronchospasm that causes difficulty in breathing or other hypersensitivity reactions (urticaria, angioneurotic edema , shock). Increased risk includes patients with bronchial asthma, chronic respiratory diseases, chronic urticaria, patients with rhinitis or nasal polyps, and people with allergic reactions to any allergens (eg skin reactions, pruritus, urticaria).
Acetylsalicylic acid can rarely cause severe skin reactions, sometimes leading to death, such as Stevens and Johnson syndrome or toxic epidermal necrolysis. In the event of the first symptoms of skin lesions (rash, mucosal lesions) or any symptoms of hypersensitivity, the preparation should be discontinued immediately and a physician should be consulted.
The warnings given below largely concern the use of Aspirin in painkillers (1-3 g / day) and the occurrence of these risks is unlikely after the acute use of acetylsalicylic acid in case of a recent or suspected acute myocardial infarction.
Caution should be exercised if acetylsalicylic acid is used in people:
• deficient in Glucose -6-phosphate dehydrogenase
• taking oral antidiabetics (sulphonylurea), due to the risk of increased hypoglycaemic effect
• taking medicines used to treat gout
• with impaired renal function or chronic renal failure
• with systemic lupus erythematosus and liver failure (liver function should be monitored, risk of salicylate toxicity increased)
• using anticoagulants, thrombolytics, platelet aggregation inhibitors in parallel, including other non-steroidal anti-inflammatory drugs, serotonin reuptake inhibitors and other drugs affecting haemostasis, due to the increased risk of bleeding
• taking methotrexate at doses lower than 15 mg per week (possible increase in methotrexate concentration and increased bone marrow toxicity)
• with bleeding from the genital tract, with extensive monthly bleeding, women with intrauterine devices
• with hypertension and heart failure
• history of peptic ulceration or Gastrointestinal bleeding (risk of peptic ulcer recurrence and gastrointestinal bleeding), as well as people taking medications that increase the risk of peptic ulceration and gastrointestinal bleeding, such as: oral corticosteroid s, selective serotonin reuptake inhibitors or deferasirox.
If you suspect or have been diagnosed with any of the above conditions, consult a physician before using the preparation.
Acetylsalicylic acid, even when used in small doses, inhibits the excretion of uric acid. In patients with reduced uric acid excretion, the preparation may cause gout attack.
In the elderly, there is an increased risk of side effects such as gastrointestinal bleeding or perforation that can lead to death. Patients in this age group require particularly careful monitoring.
The use of acetylsalicylic acid may cause fertility problems in women by affecting ovulation.
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 tablets 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.
Fresh myocardial infarction or suspicion: 150-300 mg once, usually 300 mg.
The tablet should be thoroughly broken up to speed up the absorption and then to drink with water.You can also dissolve the tablet in 0.5 glasses of water and drink the solution.
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).
The use of uricosuric agents, eg benzbromarone, probenecid, sulfinpyrazone (acetylsalicylic acid, which is used concomitantly with uricosuric agents), should be avoided in parallel, and in patients with reduced uric acid excretion, gout may occur.
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)
• 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 angiotensin converting enzyme inhibitors, angiotensin antagonists, Calcium antagonists, and beta blockers (possible reduction of antihypertensive effect, risk of acute renal failure)
• acetazolamide (carbonic anhydrase inhibitor, weak diuretic used sometimes in the treatment of e.g. glaucoma, may have toxic effects on the peripheral nervous system and severe acidosis)
• 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 nonsteroidal anti-inflammatory drugs (increased risk of side effects, especially gastrointestinal bleeding and kidney damage, parallel use of these drugs and acetylsalicylic acid is not recommended)
• valproic acid (possible potentiation of valproic acid toxicity and aggravation of platelet aggregation inhibition)
• corticosteroids used generally (use with acetylsalicylic acid increases the risk of ulceration and gastrointestinal bleeding)
• antidiabetic agents, e.g.insulin, sulphonylurea derivatives (their severity, risk of hypoglycaemia)
• 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)
• ciclosporin or tacrolimus (increased risk of damaging kidneys, kidney function should be monitored).
• Ibuprofen (possible reduction of the effect of acetylsalicylic acid at low doses to inhibit platelet aggregation).
Alcohol consumption increases the risk of gastrointestinal adverse reactions, including ulceration and gastrointestinal bleeding.
Like all medicines, also Acard 300 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, such as like Stevens and Johnson syndrome or toxic epidermal necrolysis.
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