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NSAIDs. It has anti-inflammatory, analgesic and antipyretic effects, as well as inhibits platelet aggregation. The mechanism of action is associated with inhibition of the activity of COX - the main enzyme in the metabolism of arachidonic acid, which is a precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever. The decrease in the content of prostaglandins (mainly E1) in the center of thermoregulation leads to a decrease in body temperature due to the expansion of blood vessels of the skin and an increase in sweating. The analgesic effect is due to both central and peripheral effects. Reduces aggregation, platelet adhesion and thrombus formation by suppressing the synthesis of thromboxane A2 in platelets.
Reduces mortality and the risk of myocardial infarction with unstable angina. Effective in the primary prevention of diseases of the cardiovascular system and in the secondary prevention of myocardial infarction. At a daily dose of 6 g or more, it suppresses the synthesis of prothrombin in the liver and increases the prothrombin time. Increases plasma fibrinolytic activity and reduces the concentration of vitamin K-dependent coagulation factors (II, VII, IX, X). It increases hemorrhagic complications during surgical interventions, increases the risk of bleeding during therapy with anticoagulants. Stimulates the excretion of uric acid (violates its reabsorption in the renal tubules), but in high doses. COX-1 blockade in the gastric mucosa leads to inhibition of gastroprotective prostaglandins, which may lead to ulceration of the mucous membrane and subsequent bleeding.
Rheumatism, rheumatoid arthritis, infectious-allergic myocarditis; fever in infectious and inflammatory diseases; pain syndrome of weak and medium intensity of various genesis (including neuralgia, myalgia, headache); prevention of thrombosis and embolism; primary and secondary prevention of myocardial infarction; prevention of cerebral circulatory disorders by ischemic type.
In clinical immunology and allergology: in gradually increasing doses for prolonged "aspirin" desensitization and the formation of stable tolerance to NSAIDs in patients with "aspirin" asthma and the "aspirin triad".
1 tablet contains:
active substance: acetylsalicylic acid 500 mg.
Excipients: potato starch, stearic acid, citric acid, talc.
Acetylsalicylic acid is marketed under different brands and generic names, and comes in different dosage forms:
|Brand name||Manufacturer||Country||Dosage form|
|Thrombo ASS||G.L.Farma GmbH||Austria||pills|
|Aspirin||Bayer Pharma AG||Germany||effervescent pills|
|Upsarin UPSA||UPSA SAS||France||effervescent pills|
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infrequently: hypersensitivity reactions;
very rarely: anaphylactic shock, anaphylactic / anaphylactoid reactions.
Nervous system disorders
Violations of the heart and blood vessels
infrequently: tachycardia, arterial hypotension;
very rarely: bleeding *;
frequency unknown: when taking acetylcysteine, cases of collapse are described.
seldom: shortness of breath, bronchospasm (mainly in patients with bronchial hyperreactivity against the background of bronchial asthma).
Disorders of the gastrointestinal tract
infrequently: abdominal pain, nausea, vomiting, diarrhea, stomatitis;
frequency unknown: heartburn.
Violations of the skin and subcutaneous tissue
infrequently: urticaria, rash, rash, angioedema, pruritus;
very rarely: Stevens-Johnson syndrome, Lyell's syndrome (see section "Special Instructions").
Disturbances from an organ of hearing and labyrinth disturbances
infrequently: ringing in the ears.
frequency unknown: swelling of the face.
* Single reports of bleeding development with acetylcysteine, sometimes with hypersensitivity reactions. Decrease in platelet aggregation during the use of acetylcysteine was confirmed in some studies, the clinical significance of this phenomenon has not yet been clarified.
A history of gastric ulcer or duodenal ulcer, bronchial asthma, obstructive bronchitis, liver and / or kidney failure, histamine intolerance (long-term use should be avoided, as acetylcysteine affects the histamine metabolism, which can lead to symptoms of its intolerance, such as headache, vasomotor rhinitis, pruritus), esophageal varicose veins, adrenal gland diseases, arterial hypertension.
With simultaneous use of acetylcysteine with antitussive drugs due to the suppression of the cough reflex, sputum in the bronchi may be stagnant. Before prescribing such a combination therapy, a thorough assessment of the patient’s condition is necessary.
Current reports that acetylcysteine inactivates antibacterial drugs such as tetracyclines (with the exception of doxycycline), aminoglycosides, cephalosporins, penicillins (ampicillin), and antifungal drugs (amphotericin B) are exclusively related to in vitro studies (pharmaceutical incompatibility). However, antimicrobials for oral administration and drug ACC® Active should be used at intervals of at least 2 hours (not applicable to cefixime and loracarbef).
Simultaneous use with acetylcysteine can lead to increased vasodilator and antiplatelet effects of nitroglycerin. If the combined use of nitroglycerin and acetylcysteine is required, the patient’s condition should be monitored for potential development of arterial hypotension (sometimes severe, headache can manifest).
The simultaneous use of acetylcysteine and carbamazepine can be expressed in reducing the concentration of carbamazepine to the subtherapeutic level.
The simultaneous use of Activated charcoal can reduce the effect of acetylcysteine.
Acetylcysteine eliminates the toxic effects of paracetamol.
Patients with bronchial asthma and obstructive bronchitis, acetylcysteine should be administered with caution under systemic control of bronchial patency. If the patient is not able to effectively cough, it is necessary to drain or aspirate the secret.
When using acetylcysteine, very rarely there have been reported cases of severe allergic reactions, such as Stevens-Johnson syndrome and Lyell's syndrome.In the event of changes in the skin and mucous membranes should immediately consult a doctor, the drug should be stopped.
Do not take the drug immediately before bedtime (it is recommended to take the drug before 18.00).
Impact on laboratory data. Acetylcysteine can influence the results of colorimetric determination of plasma salicylate concentrations. In urine analysis, acetylcysteine can influence the results of the determination of ketone bodies.
Influence on ability to steer vehicles, mechanisms
Acetylcysteine does not affect the ability to drive and operate machinery.
Cases of toxic overdose while taking acetylcysteine inside are not described. Acetylcysteine, when taken in doses up to 500 mg / kg / day, did not cause overdose symptoms. Healthy volunteers received acetylcysteine at a dose of 11.6 g per day for 3 months without developing any serious adverse reactions.
Symptoms: Gastrointestinal symptoms such as nausea, vomiting and diarrhea may occur.
Treatment: symptomatic therapy if necessary.
- Brand name: ACC
- Active ingredient: Acetylcysteine
- Manufacturer: Sandoz
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