Тромбитал Форте Таблетки, банка, 100 шт, 150+30,39 мг+мг, для приема внутрь, для взрослых, в пленочной оболочке

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"}},{"type":"paragraph","data":{"text":"Магния гидроксид,\nвходящий в состав препарата Тромбитал Форте, защищает слизистую оболочку\nжелудочно-кишечного тракта от воздействия ацетилсалициловой кислоты."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eФармакокинетика\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\nАцетилсалициловая кислота всасывается из желудочно-кишечного тракта практически\nполностью. Период полувыведения ацетилсалициловой кислоты составляет около "}},{"type":"paragraph","data":{"text":"\n15 минут, т.к. при участии ферментов ацетилсалициловая кислота быстро\nгидролизуется в салициловую кислоту в кишечнике, печени и плазме крови. Период\nполувыведения салициловой кислоты составляет около 3 часов, но он может\nзначительно увеличиваться при одновременном введении больших доз\nацетилсалициловой кислоты (более 3,0 г) в результате насыщения ферментных\nсистем."}},{"type":"paragraph","data":{"text":"Биодоступность\nацетилсалициловой кислоты составляет 70%, но эта величина в значительной\nстепени колеблется, поскольку ацетилсалициловая кислота подвергается\nпресистемному гидролизу (слизистая желудочно-кишечного тракта, печень) в\nсалициловую кислоту под действием ферментов. Биодоступность салициловой кислоты\nсоставляет 80-100%."}},{"type":"paragraph","data":{"text":"Используемые дозы магния\nгидроксида не влияют на биодоступность ацетилсалициловой кислоты."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Нестабильная стенокардия и стабильная стенокардия."}},{"type":"paragraph","data":{"text":"Профилактика повторного инфаркта миокарда."}},{"type":"paragraph","data":{"text":"Профилактика повторной транзиторной ишемической атаки (ТИА) и повторного\nишемического инсульта у пациентов, ранее перенесших нарушение мозгового\nкровообращения."}},{"type":"paragraph","data":{"text":"Профилактика тромботических осложнений после операций и инвазивных\nвмешательств на сосудах (таких, как аортокоронарное шунтирование,\nэндартерэктомия сонных артерий, артериовенозное шунтирование, ангиопластика и\nстентирование коронарных артерий, ангиопластика сонных артерий)."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к ацетилсалициловой кислоте, вспомогательным веществам препарата и другим нестероидным противовоспалительным препаратам (НПВП); кровоизлияние в головной мозг; склонность к кровотечению (недостаточность витамина К, тромбоцитопения, геморрагический диатез); эрозивно-язвенное поражение желудочно-кишечного тракта (в фазе обострения); желудочно-кишечное кровотечение; бронхиальная астма, индуцированная приемом салицилатов и других НПВП; сочетание бронхиальной астмы, рецидивирующего полипоза носа и околоносовых пазух с непереносимостью ацетилсалициловой кислоты; одновременный прием метотрексата в дозе 15 мг в неделю и более; беременность (I и III триместры); период лактации; дефицит глюкозо-6-фосфатдегидрогеназы; тяжелая почечная недостаточность (клиренс креатинина (КК) менее 30 мл/мин); тяжелая печеночная недостаточность (класс В и С по шкале Чайлд-Пью); хроническая сердечная недостаточность III и IV функционального класса по классификации NYHA; детский возраст до 18 лет. "}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"При подагре,\nгиперурикемии, так как ацетилсалициловая кислота в малых дозах снижает\nэкскрецию мочевой кислоты. При наличии в анамнезе язвенных поражений\nжелудочно-кишечного тракта или желудочно-кишечных кровотечений. При печеночной\nнедостаточности (класс А по шкале Чайлд-Пью). При почечной недостаточности (КК\nболее 30 мл/мин). При бронхиальной астме, хронических заболеваниях органов\nдыхания, сенной лихорадке, полипозе носа, аллергических состояниях, лекарственной\nаллергии. При сахарном диабете. У пациентов пожилого возраста. Во II триместре\nбеременности. При предполагаемом хирургическом вмешательстве (включая\nнезначительные, например, экстракция зуба), т.к. ацетилсалициловая кислота\nможет вызывать склонность к развитию кровотечений в течение нескольких дней\nпосле приема препарата. При одновременном приеме со следующими лекарственными\nсредствами (см. раздел «Взаимодействие с другими лекарственными средствами»)."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Препарат принимают внутрь, один раз в день, запивая водой. Таблетку можно\nпроглотить целиком, разжевать или предварительно растереть.                                          "}},{"type":"paragraph","data":{"text":"В 1 таблетке Тромбитал Форте содержится 150 мг ацетилсалициловой кислоты.\nПри необходимости, по решению врача, возможно снижение суточной дозы\nацетилсалициловой кислоты до 75 мг (см. раздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"Нестабильная стенокардия и стабильная\nстенокардия: по 1 таблетке 1 раз в сутки. "}},{"type":"paragraph","data":{"text":"Профилактика повторного инфаркта миокарда:\u003cb\u003e \u003c/b\u003eпо 1 таблетке 1 раз в\nсутки. При необходимости, в случае назначения врачом схемы приема\nацетилсалициловой кислоты в дозе 150 мг в первые сутки, затем в дозе 75 мг 1\nраз в сутки, следует в первые сутки принять 1 таблетку препарата  Тромбитал Форте, содержащую 150 мг\nацетилсалициловой кислоты, затем принимать по 1 таблетке препарата Тромбитал,\nсодержащей 75 мг ацетилсалициловой кислоты, 1 раз в сутки (см. Раздел «Особые\nуказания»).  "}},{"type":"paragraph","data":{"text":"Профилактика повторной транзиторной ишемической атаки (ТИА) и повторного\nишемического инсульта у пациентов, ранее перенесших нарушение мозгового\nкровообращения:\u003cb\u003e \u003c/b\u003eпо 1 таблетке 1 раз в сутки.  "}},{"type":"paragraph","data":{"text":"Профилактика тромботических осложнений после операций и инвазивных вмешательств   на \nсосудах  (таких,  как аортокоронарное шунтирование, эндартерэктомия\nсонных артерий, артериовенозное шунтирование, ангиопластика и стентирование\nкоронарных артерий, ангиопластика сонных артерий):\u003cb\u003e \u003c/b\u003eпо 1 таблетке 1 раз в\nсутки.  "}},{"type":"paragraph","data":{"text":"\u003ci\u003eОсобые группы пациентов\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eПациенты с нарушением функции почек\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Препарат Тромбитал Форте противопоказан пациентам с тяжелым нарушением функции почек. Следует с\nосторожностью применять препарат Тромбитал Форте у пациентов с нарушением функции почек, поскольку ацетилсалициловая\nкислота может повышать риск развития почечной недостаточности и острой почечной\nнедостаточности (см. раздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПациенты с нарушением функции печени\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Препарат Тромбитал Форте противопоказан пациентам с тяжелым нарушением функции печени. Следует с\nосторожностью применять препарат Тромбитал Форте у пациентов с нарушением функции печени."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДети\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Безопасность и эффективность применения\nпрепаратов ацетилсалициловой кислоты + [магния гидроксида] у детей в возрасте\nдо 18 лет не установлена. Данные отсутствуют."}},{"type":"paragraph","data":{"text":"Применение препарата Тромбитал Форте у пациентов младше 18 лет противопоказано."}},{"type":"paragraph","data":{"text":"Препарат предназначен для длительного применения.\nДлительность лечения и доза препарата Тромбитал Форте определяется врачом."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПрименяйте препарат\nтолько согласно тем показаниям, тому способу применения и в тех дозах, которые\nуказаны в инструкции.\u003c/i\u003e\u003c/b\u003e"}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Перечисленные ниже\nнежелательные явления распределены по частоте возникновения в соответствии со\nследующей градацией: очень часто (с частотой более 1/10), часто "}},{"type":"paragraph","data":{"text":"\n(с частотой не менее 1/100, но менее 1/10), нечасто (с частотой не менее\n1/1000, но менее 1/100), редко (с частотой не менее 1/10000, но менее 1/1000),\nочень редко (с частотой менее 1/10000), включая отдельные сообщения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны крови и лимфатической системы\u003c/i\u003e:\u003cb\u003e \u003c/b\u003eочень часто – повышенная кровоточивость\n(гематомы, носовые кровотечения, кровоточивость десен, кровотечения из\nмочеполовых путей); редко\u003cb\u003e \u003c/b\u003e–\nанемия; очень редко – гипопротромбинемия, тромбоцитопения, нейтропения,\nапластическая анемия, эозинофилия, агранулоцитоз; неизвестная частота –\nлейкопения. Имеются сообщения о серьезных случаях кровотечений, к которым\nотносятся желудочно-кишечные кровотечения и кровоизлияния в мозг (особенно у\nпациентов с артериальной гипертензией, не достигших целевых цифр артериального\nдавления и/или получающих сопутствующую терапию антикоагулянтными средствами),\nкоторые в отдельных случаях могут носить угрожающий жизни характер.\nКровотечения могут приводить к развитию острой или хронической\nпостгеморрагической/железодефицитной анемии (например, вследствие скрытого\nкровотечения) с соответствующими клинико-лабораторными признаками и симптомами\n(астения, бледность, гипоперфузия). Имеются сообщения о случаях гемолиза и\nгемолитической анемии у пациентов с тяжелыми формами дефицита\nглюкозо-6-фосфатдегидрогеназы."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции\u003c/i\u003e: часто – крапивница, отек\nКвинке; нечасто –\u003cb\u003e \u003c/b\u003eанафилактические\nреакции, включая ангионевротический отек; неизвестная частота – кожная сыпь,\nкожный зуд, ринит, отек слизистой оболочки носа, кардио-респираторный\nдистресс-синдром, а также тяжелые реакции, включая анафилактический шок."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы\u003c/i\u003e:\u003cb\u003e \u003c/b\u003eчасто – головная боль,\nбессонница; нечасто – головокружение, сонливость; редко – шум в ушах,\nвнутримозговое кровоизлияние; неизвестная частота – снижение слуха, что может\nбыть признаком передозировки препарата (см. раздел «Передозировка»)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны дыхательной системы, органов грудной\nклетки и средостения\u003c/i\u003e:\u003cb\u003e \u003c/b\u003eчасто\n–\u003cb\u003e \u003c/b\u003eбронхоспазм. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны желудочно-кишечного тракта\u003c/i\u003e\u003cb\u003e: \u003c/b\u003eочень часто – изжога; часто – тошнота,\nрвота; нечасто – болевые ощущения в области живота, язвы слизистой оболочки\nжелудка и двенадцатиперстной кишки, в том числе перфоративные (редко),\nжелудочно-кишечные кровотечения; редко – повышение активности\n\"печеночных\" ферментов; очень редко – стоматит, эзофагит, эрозивные\nпоражения верхних отделов желудочно-кишечного тракта, стриктуры,  синдром раздраженного кишечника, колит;\nнеизвестная частота – снижение аппетита, диарея."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны мочевыделительной системы: \u003c/i\u003eнеизвестная частота –\nнарушение функции почек и острая почечная недостаточность."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eЕсли у Вас отмечаются побочные эффекты,\nуказанные в инструкции, или они усугубляются, или Вы заметили любые другие\nпобочные эффекты, не указанные в инструкции, сообщите об этом врачу.\u003c/i\u003e\u003c/b\u003e"}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Может возникнуть после однократного приема\nбольшой дозы или при длительном употреблении препарата. Если однократная доза\nацетилсалициловой кислоты меньше 150 мг/кг, острое отравление считают легким,\n150-300 мг/кг – средней степени тяжести, и при употреблении более высоких доз –\nтяжелым. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы передозировки от легкой до средней степени тяжести:\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\nголовокружение, шум в ушах, ухудшение слуха, нарушение зрения, повышенное\nпотоотделение, тошнота, рвота, головная боль, спутанность сознания, тахипноэ,\nгипервентиляция, респираторный алкалоз. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение: \u003c/i\u003eпровокация рвоты, многократный прием\nактивированного угля, форсированный щелочной диурез, восстановление\nводно-электролитного баланса и кислотно-основного состояния. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы передозировки от средней до тяжелой степени:\u003c/i\u003e "}},{"type":"paragraph","data":{"text":"·      \nреспираторный алкалоз с компенсаторным\nметаболическим ацидозом;"}},{"type":"paragraph","data":{"text":"·      \nгиперпирексия (крайне высокая температура\nтела);"}},{"type":"paragraph","data":{"text":"·      \nнарушения дыхания: гипервентиляция,\nнекардиогенный отек легких, угнетение дыхания, асфиксия;"}},{"type":"paragraph","data":{"text":"·      \nнарушения со стороны сердечно-сосудистой\nсистемы: нарушения ритма сердца, снижение артериального давления, угнетение\nсердечной деятельности, коллапс;"}},{"type":"paragraph","data":{"text":"·      \nнарушения водно-электролитного баланса:\nдегидратация, нарушение функции почек от олигурии вплоть до развития почечной\nнедостаточности, характеризующейся гипокалиемией, гипернатриемией,\nгипонатриемией;"}},{"type":"paragraph","data":{"text":"·      \nнарушение метаболизма глюкозы:\nгипергликемия, гипогликемия (особенно у детей), кетоацидоз;"}},{"type":"paragraph","data":{"text":"·      \nшум в ушах, глухота;"}},{"type":"paragraph","data":{"text":"·      \nжелудочно-кишечные кровотечения;"}},{"type":"paragraph","data":{"text":"·      \nгематологические нарушения: от\nингибирования агрегации тромбоцитов до коагулопатии, удлинение протромбинового\nвремени, гипопротромбинемия;"}},{"type":"paragraph","data":{"text":"·      \nневрологические нарушения: токсическая\nэнцефалопатия и угнетение функции центральной нервной системы (сонливость,\nспутанность сознания, кома, судороги)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e: немедленная госпитализация в\nспециализированные отделения для проведения экстренной терапии – промывание\nжелудка, многократный прием активированного угля и слабительных, ощелачивание\nмочи (показано при уровне салицилатов выше 500 мг/л, обеспечивается внутривенной\nинфузией гидрокарбоната натрия – 88 мэкв в 1 л 5% раствора глюкозы, со\nскоростью 10-15 мл/кг/ч), восстановление объема циркулирующей крови и индукция\nдиуреза (достигается введением гидрокарбоната натрия в той же дозе и\nразведении, повторяют 2-3 раза); следует иметь в виду, что интенсивная инфузия\nжидкости пациентам пожилого возраста может привести к отеку легких. Не\nрекомендуется применение ацетозоламида для ощелачивания мочи (может вызвать\nацидемию и усилить токсическое действие салицилатов). При проведении щелочного\nдиуреза необходимо добиться значений pH между 7,5 и 8. Гемодиализ показан при\nуровне салицилатов в плазме крови более 1000 мг/л, а у больных с хроническим\nотравлением – 500 мг/л и ниже при наличии показаний (рефрактерный ацидоз, прогрессирующее\nухудшение состояния, тяжелое поражение центральной нервной системы, отек легких\nи почечная недостаточность). При отеке легких показана искусственная вентиляция\nлегких смесью, обогащенной кислородом, в режиме положительного давления в конце\nвыдоха; для лечения отека мозга применяют гипервентиляцию и осмотический\nдиурез. "}},{"type":"paragraph","data":{"text":"Наибольший риск развития\nхронической интоксикации отмечается у лиц пожилого возраста при приеме в\nтечение нескольких суток более 100 мг/кг/сутки. У детей и пациентов пожилого\nвозраста начальные признаки салицилизма (тошнота, рвота, шум в ушах, нарушение\nзрения, головокружение, головная боль, общее недомогание) не всегда заметны,\nпоэтому целесообразно периодически определять содержание салицилатов в плазме\nкрови."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"При одновременном\nприменении ацетилсалициловая кислота усиливает действие следующих лекарственных\nпрепаратов:"}},{"type":"paragraph","data":{"text":"- метотрексата за счет снижения почечного клиренса и\nвытеснения его из связи с белками, сочетание ацетилсалициловой кислоты с\nметотрексатом сопровождается повышенной частотой развития побочных эффектов со\nстороны органов кроветворения; "}},{"type":"paragraph","data":{"text":"- наркотических анальгетиков, других НПВП;"}},{"type":"paragraph","data":{"text":"- гепарина и непрямых антикоагулянтов за счет\nнарушения функции тромбоцитов и вытеснения непрямых антикоагулянтов из связи с\nбелками плазмы крови;"}},{"type":"paragraph","data":{"text":"- тромболитических, антиагрегантных и антикоагулянтных\nпрепаратов (тиклопидина);"}},{"type":"paragraph","data":{"text":"- дигоксина вследствие снижения его почечной\nэкскреции;"}},{"type":"paragraph","data":{"text":"- гипогликемических средств для приема внутрь\n(производные сульфонилмочевины) и инсулина за счет гипогликемических свойств\nсамой ацетилсалициловой кислоты в высоких дозах и вытеснения производных\nсульфонилмочевины из связи с белками плазмы крови; "}},{"type":"paragraph","data":{"text":"- вальпроевой кислоты за счет вытеснения ее из связи с\nбелками плазмы крови. "}},{"type":"paragraph","data":{"text":"Одновременное применение ацетилсалициловой кислоты с\nибупрофеном приводит к снижению кардиопротективных эффектов ацетилсалициловой\nкислоты."}},{"type":"paragraph","data":{"text":"Сочетание ацетилсалициловой\nкислоты с антикоагулянтами, тромболитиками и антиагрегантами сопровождается\nповышенным риском развития кровотечения."}},{"type":"paragraph","data":{"text":"Одновременный прием с\nацетилсалициловой кислотой повышает концентрацию барбитуратов и солей лития в\nплазме крови. "}},{"type":"paragraph","data":{"text":"Усиливая элиминацию\nсалицилатов, системные глюкокортикостероиды ослабляют их действие."}},{"type":"paragraph","data":{"text":"Глюкокортикостероиды, этанол\nи этанолсодержащие лекарственные средства усиливают негативное воздействие на\nслизистую оболочку желудочно-кишечного тракта и повышают риск развития\nжелудочно-кишечных кровотечений."}},{"type":"paragraph","data":{"text":"При одновременном приеме\nацетилсалициловой кислоты с этанолом наблюдается усиление токсического действия\nэтанола на центральную нервную систему."}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота\nослабляет действие урикозурических препаратов – бензбромарона, пробенецида\n(снижение урикозурического эффекта, вследствие конкурентного подавления\nпочечной канальцевой экскреции мочевой кислоты), ингибиторов\nангиотензинпревращающего фермента (отмечается дозозависимое снижение скорости\nклубочковой фильтрации (СКФ) в результате ингибирования простагландинов,\nобладающих сосудорасширяющим действием, и, соответственно, ослабление антигипертензивного\nдействия; клинически значимое снижение СКФ отмечается при суточной дозе\nацетилсалициловой кислоты более 160 мг), диуретиков (при совместном применении\nс ацетилсалициловой кислотой в высоких дозах отмечается снижение скорости\nклубочковой фильтрации в результате снижения синтеза простагландинов в почках).\n"}},{"type":"paragraph","data":{"text":"Антациды и колестирамин\nснижают всасывание ацетилсалициловой кислоты. "}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eЕсли Вы\nприменяете вышеперечисленные или другие лекарственные препараты (в том числе\nбезрецептурные), перед применением препарата Тромбитал Форте проконсультируйтесь\nс врачом.\u003c/i\u003e\u003c/b\u003e"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат следует применять\nпо назначению врача. "}},{"type":"paragraph","data":{"text":"Таблетки препарата Тромбитал Форте покрыты\nпленочной оболочкой, не имеют риски и не предназначены для деления, поэтому если\nврачом рекомендовано  снижение суточной\nдозы ацетилсалициловой кислоты до 75 мг, то требуется переход на прием другого\nлекарственного препарата, содержащего 75 мг ацетилсалициловой кислоты в 1\nтаблетке."}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота\nможет провоцировать бронхоспазм, а также вызывать приступы бронхиальной астмы и\nдругие реакции повышенной чувствительности. Факторами риска являются наличие\nбронхиальной астмы в анамнезе, сенной лихорадки, полипоза носа, хронических\nзаболеваний дыхательной системы, а также аллергических реакций на другие\nпрепараты (например, кожные реакции, зуд, крапивница). "}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота может\nвызывать кровотечения различной степени выраженности во время и после\nхирургических вмешательств.  За несколько\nдней до планируемого хирургического вмешательства должен быть оценен риск\nразвития кровотечения по сравнению с риском развития ишемических осложнений у\nпациентов, принимающих низкие дозы ацетилсалициловой кислоты. Если риск\nкровотечения значительный, прием ацетилсалициловой кислоты должен быть временно\nпрекращен."}},{"type":"paragraph","data":{"text":"Сочетание ацетилсалициловой\nкислоты с антикоагулянтами, тромболитиками и антитромбоцитарными препаратами\nсопровождается повышенным риском развития кровотечений. "}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота в\nнизких дозах может спровоцировать развитие подагры у предрасположенных\nпациентов (имеющих сниженную экскрецию мочевой кислоты)."}},{"type":"paragraph","data":{"text":"Сочетание ацетилсалициловой\nкислоты с метотрексатом сопровождается повышенной частотой развития побочных\nэффектов со стороны органов кроветворения. "}},{"type":"paragraph","data":{"text":"Высокие дозы\nацетилсалициловой кислоты оказывают гипогликемический эффект, что необходимо\nиметь в виду при назначении ее пациентам с сахарным диабетом, получающим\nгипогликемические средства для приема внутрь и инсулин."}},{"type":"paragraph","data":{"text":"При сочетанном применении\nсистемных глюкокортикостероидов и салицилатов следует помнить, что во время\nлечения концентрация салицилатов в крови снижена, а после отмены системных\nглюкокортикостероидов возможна передозировка салицилатов."}},{"type":"paragraph","data":{"text":"Не рекомендуется сочетание\nацетилсалициловой кислоты с ибупрофеном у пациентов с повышенным риском\nсердечно-сосудистых заболеваний: при одновременном применении с ибупрофеном\nотмечается уменьшение антиагрегантного действия ацетилсалициловой кислоты в\nдозах до 300 мг, что приводит к снижению кардиопротективных эффектов\nацетилсалициловой кислоты."}},{"type":"paragraph","data":{"text":"Повышение дозы\nацетилсалициловой кислоты свыше терапевтических доз сопряжено с риском желудочно-кишечного\nкровотечения."}},{"type":"paragraph","data":{"text":"При длительном приеме низких\nдоз ацетилсалициловой кислоты в качестве антиагрегантной терапии необходимо\nсоблюдать осторожность у пожилых пациентов в связи с риском развития\nжелудочно-кишечного кровотечения. "}},{"type":"paragraph","data":{"text":"При одновременном приеме\nацетилсалициловой кислоты с алкоголем повышен риск повреждения слизистой\nоболочки желудочно-кишечного тракта и удлинения времени кровотечения."}},{"type":"paragraph","data":{"text":"При длительном применении\nпрепарата следует периодически делать общий анализ крови и анализ кала на скрытую\nкровь."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В\nпериод лечения препаратами ацетилсалициловой кислоты необходимо соблюдать\nосторожность при управлении транспортными средствами и занятиях потенциально\nопасными видами деятельности, требующими повышенной концентрации внимания и\nбыстроты психомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки, покрытые пленочной оболочкой, 150 мг + 30.39 мг."}},{"type":"paragraph","data":{"text":"\nПо 30 или 100 таблеток в банки темного (янтарного) стекла, укупоренные\nнавинчивающейся крышкой белого цвета (из полиэтилена) с вмонтированной съемной\nкапсулой с силикагелем и кольцом, обеспечивающим контроль первого вскрытия."}},{"type":"paragraph","data":{"text":"1 банку темного (янтарного) стекла вместе с\nинструкцией по применению помещают в пачку из картона."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 25 °С. Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не использовать по истечении срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают без\nрецепта."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Открытое акционерное общество \"Фармстандарт-Лексредства\""}},{"type":"paragraph","data":{"text":"(ОАО \"Фармстандарт-Лексредства\"), Россия Курская  обл., \nг.  Курск,   ул. \n2-я Агрегатная,   д. 1а/18, тел./факс:\n(4712) 34-03-13, www.pharmstd.ru"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Акционерное общество \"Отисифарм\""}},{"type":"paragraph","data":{"text":"(АО \"Отисифарм\"), Россия"}},{"type":"paragraph","data":{"text":"123112, г. Москва, ул. Тестовская, д.10,\nэт. 12, пом. II, ком. 29"}},{"type":"paragraph","data":{"text":"Тел.: +7 (800) 775-98-19"}},{"type":"paragraph","data":{"text":"Факс: +7 (495) 221-18-02"}},{"type":"paragraph","data":{"text":"www.otcpharm.ru\u003cb\u003e\u003c/b\u003e"}}]}],"source":null},"description_toggle":false,"short_description":"ФармакодинамикаУменьшает агрегацию, адгезию тромбоцитов и тромбообразование за счет подавления синтеза тромбоксана А2 в тромбоцитах. Антиагрегантный эффект сохраняется в течение 7 суток после однократного приема (больше выражен у мужчин, чем у женщин). Ацетилсалициловая кислота снижает летальность и риск развития инфаркта миокарда при нестабильной стенокардии, эффективна при первичной профилактике заболеваний сердечно-сосудистой системы, особенно инфаркта миокарда у мужчин старше 40 лет, и при вторичной профилактике инфаркта миокарда. Подавляет синтез протромбина в печени и увеличивает протромбиновое время. Повышает фибринолитическую активность плазмы крови и снижает концентрацию витамин-К-зависимых факторов свертывания (II, VII, IX, X). Повышает риск развития геморрагических осложнений при проведении хирургических вмешательств, увеличивает риск развития кровотечения на фоне терапии антикоагулянтами. Ацетилсалициловая кислота в высоких дозах обладает также противовоспалительным, обезболивающим, жаропонижающим эффектом. В высоких дозах ацетилсалициловая кислота стимулирует выведение мочевой кислоты (нарушает ее реабсорбцию в почечных канальцах). Блокада циклооксигеназы-1 в слизистой оболочке желудка приводит к торможению гастропротекторных простагландинов, что может обусловить изъязвление слизистой оболочки и последующее кровотечение. Магния гидроксид, входящий в состав препарата Тромбитал Форте, защищает слизистую оболочку желудочно-кишечного тракта от воздействия ацетилсалициловой кислоты.ФармакокинетикаАцетилсалициловая кислота всасывается из желудочно-кишечного тракта практически полностью. Период полувыведения ацетилсалициловой кислоты составляет около 15 минут, т.к. при участии ферментов ацетилсалициловая кислота быстро гидролизуется в салициловую кислоту в кишечнике, печени и плазме крови. Период полувыведения салициловой кислоты составляет около 3 часов, но он может значительно увеличиваться при одновременном введении больших доз ацетилсалициловой кислоты (более 3,0 г) в результате насыщения ферментных систем. Биодоступность ацетилсалициловой кислоты составляет 70%, но эта величина в значительной степени колеблется, поскольку ацетилсалициловая кислота подвергается пресистемному гидролизу (слизистая желудочно-кишечного тракта, печень) в салициловую кислоту под действием ферментов. 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