Ascard-75 (Acetylsalicylic acid)

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Ascard is enteric coated Acetylsalicylic acid (Aspirin) available in tablet form in 75mg, 150mg and 300mg strengths. The enteric coated Ascard is designed to resist disintegration in the stomach, but o dissolve in a better neutral-to-alkaline environment of the duodenum.

Special enteric coating helps to protect the stomach from injury which may result from ingestion of plain, buffered or highly buffered aspirin, and the patients still gets the same serum salicylate levels and anti-platelet activity as with other form of aspirin.

ASCARD

Pharmacokinetics

The bioavailability of enteric coated aspirin has been demonstrated in a number of salicylate excretion studies. The studies show levels of salicylate (and metabolites) in urine excreted over 48 hours the enteric coated aspirin do no differ statistically from plain i.e. non enteric-coated aspirin

Plasma studies, in which enteric coated aspirin has been compared with plain aspirin in steady state studies over eight days, also demonstrated that enteric coated aspirin provides plasma salicylate levels not satisfactory different from plain aspirin.

Dissolution of the enteric coating occurs at a neutral-to-basic pH and is therefore dependent on gastric emptying into the duodenum. With continued dosing, appropriate plasma levels are maintained

Pharmacodynamics

Ascard inhibits he first step in the coagulation of blood – aggregation of platelets. The beneficial effects of Ascard (Aspirin) in the thromboembolic disease are thought to be due to the inhibitor platelets thromboxane A2 synthesis. Thromboxane A2 is powerful inducer of platelets aggregation and is formed via the action of enzyme cyclo-oxygenase, it acts on surface receptors carried by platelets and activates phospholipase C causing the formation of inositol triphosphate. This causes a rise in tracellular calcium ions (ca++) which triggers aggregation of platelets.

Ascard (Aspirin) prevents thromboxane A2 formation by inhibiting the enzyme cyclo-oxygenase.

Indications

  • Angina pectoris
  • Myocardial infarction
  • Transient ischemic attack
  • Prophylactic use of Ascard is also recommended to avoid the chances of thromboembolic disorder

Ascard is also indicated:

Conditions requiring chronic or long term aspirin therapy for pain and or inflammation e.g. rheumatoid arthritis, juvenile arthritis, systemic lupus erythematous, osteoarthritis (degenerative joint disease), ankylosing spondylitis, psoriatic arthritis, Reiter’s syndrome and fibrositis. ASCARD is also used for the relief of pain and inflammation in rheumatic fever.

Dosage and administration

Angina pectoris/ myocardial infarction: the recommended dosage indicated for anti-platelet function is 75mg daily or as directed by the physician

  • Study in 333 USA physicians with ‘unstable angina’ indicated that low dose aspirin reduces the risk for 1st myocardial infarction. (Manson JE, et al. Aspirin in prevention of angina pectoris in randomized trial of USA physicians 1990)
  • Patients with silent ischemia may benefit from low dose aspirin. Aspirin can be used as initial management to stop thrombosis progression and increase coronary blood flow (Redker PM et al, low dose aspirin therapy for chronic stable angina: randomized, placebo control clinical trial)
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  • Single dose of 40 to 80 mg and 50 mg respectively are capable of inhibiting platelet aggregation without having a significant or long lasting effect on vascular prostacyclin ( Robert et al (lancet 1986, 1, 1153))

Transient ischemic attack

For analgesic or anti-inflammatory indication the dosage can be increased or modified according to the clinical situation of the individual patient under a physician’s directions.

Safety

The safety of enteric coated aspirin has been demonstrated in a number of endoscopic studies comparing it with plain aspirin as well as plain buffered and arthritis-strengths buffered preparations. All aspirin forms were given at a dose of 3900-4000mg per day for 14 days. The normal healthy volunteers participating in these studies were gastroscoped before and after the medication and 14 days drug free periods followed active drug. Compared to all the other preparation, there was significantly less gastric and duodenal damage during the course of the enteric coated aspirin

Warning

Children and teenagers should not use this medicine for chicken pox or flu symptoms, before a doctor is consulted about Reye’s syndrome, a rare but serious illness. If pain persists for more than 10 days or if redness is present or in arthritic or rheumatic conditions affecting children under 12 years consult a physician immediately. Discontinue use if dizziness, ringing in ears or impaired hearing occurs. If you experience persistent or unexplained stomach upset, consult your physician. As with any medicine, in case of pregnancy and lactation the drug should be taken under medical advice.

Adverse reaction

Gastrointestinal reactions

Stomach pain (14%, 4.4%); heartburn (11.9%); nausea or vomiting (7.6%, 2.1%); hospitalization for gastrointestinal disorder patients had increased rates of gross gastrointestinal bleeding. In the AMIS and other trials, plain aspirin-treated patients had increased rates of gross gastrointestinal bleeding. Symptoms and signs of gastrointestinal irritation were not significantly increased in subjects treated for unstable angina with buffered aspirin in solution.

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