Тромбитал Таблетки, 180 шт, 75+15.2 мг+мг

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"}},{"type":"paragraph","data":{"text":"Ацетилсалициловая\nкислота в высоких дозах обладает также противовоспалительным, обезболивающим,\nжаропонижающим эффектом. "}},{"type":"paragraph","data":{"text":"В высоких дозах\nацетилсалициловая кислота стимулирует выведение мочевой кислоты  (нарушает ее реабсорбцию в почечных\nканальцах)."}},{"type":"paragraph","data":{"text":"Блокада\nциклооксигеназы-1 в слизистой оболочке желудка приводит к торможению\nгастропротекторных простагландинов, что может обусловить изъязвление слизистой\nоболочки и последующее кровотечение. "}},{"type":"paragraph","data":{"text":"Магния гидроксид,\nвходящий в состав препарата Тромбитал, 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\nацетилсалициловая кислота подвергается пресистемному гидролизу  (слизистая желудочно-кишечного тракта,\nпечень) в салициловую кислоту под действием ферментов. Биодоступность\nсалициловой кислоты составляет 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":"·      \nПовышенная чувствительность к ацетилсалициловой\nкислоте, вспомогательным веществам препарата и другим нестероидным\nпротивовоспалительным препаратам (НПВП);"}},{"type":"paragraph","data":{"text":"·      \nкровоизлияние в головной мозг;"}},{"type":"paragraph","data":{"text":"·      \nсклонность к кровотечению (недостаточность\nвитамина К, тромбоцитопения, геморрагический диатез);"}},{"type":"paragraph","data":{"text":"·      \nэрозивно-язвенное поражение\nжелудочно-кишечного тракта (в фазе обострения);"}},{"type":"paragraph","data":{"text":"·      \nжелудочно-кишечное кровотечение; "}},{"type":"paragraph","data":{"text":"·      \nбронхиальная астма, индуцированная приемом\nсалицилатов и других  НПВП; "}},{"type":"paragraph","data":{"text":"·      \nполное или неполное сочетание бронхиальной\nастмы, рецидивирующего полипоза носа и околоносовых пазух с непереносимостью\nацетилсалициловой кислоты или других НПВП, включая ингибиторы циклооксигеназы-2\n(в том числе в анамнезе); "}},{"type":"paragraph","data":{"text":"·      \nодновременный прием метотрексата в дозе 15\nмг в неделю и более;"}},{"type":"paragraph","data":{"text":"·      \nбеременность (I и III триместры); "}},{"type":"paragraph","data":{"text":"·      \nпериод грудного вскармливания; "}},{"type":"paragraph","data":{"text":"·      \nдефицит глюкозо-6-фосфатдегидрогеназы;"}},{"type":"paragraph","data":{"text":"·      \nтяжелая почечная недостаточность (клиренс\nкреатинина (КК) менее 30 мл/мин); "}},{"type":"paragraph","data":{"text":"·      \nтяжелая печеночная недостаточность (класс\nВ и С по шкале Чайлд-Пью);"}},{"type":"paragraph","data":{"text":"·      \nхроническая сердечная недостаточность III и IV функционального класса по классификации NYHA;"}},{"type":"paragraph","data":{"text":"·      \nдетский 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 экскрецию\nмочевой кислоты."}},{"type":"paragraph","data":{"text":"При наличии в анамнезе\nязвенных поражений желудочно-кишечного тракта или  желудочно-кишечных кровотечений."}},{"type":"paragraph","data":{"text":"При печеночной\nнедостаточности (класс А по шкале Чайлд-Пью)."}},{"type":"paragraph","data":{"text":"При почечной недостаточности\n(КК более 30 мл/мин)."}},{"type":"paragraph","data":{"text":"При бронхиальной астме,\nхронических заболеваниях органов дыхания, сенной лихорадке, полипозе носа, аллергических\nсостояниях, лекарственной аллергии."}},{"type":"paragraph","data":{"text":"Во II триместре\nбеременности."}},{"type":"paragraph","data":{"text":"При сахарном диабете."}},{"type":"paragraph","data":{"text":"У пациентов пожилого\nвозраста."}},{"type":"paragraph","data":{"text":"При предполагаемом хирургическом\nвмешательстве (включая незначительные, например, экстракция зуба), т.к.\nацетилсалициловая кислота может вызывать склонность к развитию кровотечений в\nтечение нескольких дней после приема препарата."}},{"type":"paragraph","data":{"text":"При одновременном приеме\nсо следующими лекарственными средствами (см. раздел «Взаимодействие с другими\nлекарственными средствами»):"}},{"type":"paragraph","data":{"text":"·      \nс метотрексатом в дозе менее 15 мг в\nнеделю;"}},{"type":"paragraph","data":{"text":"·      \nс антикоагулянтами, тромболитическими или\nантиагрегантными средствами;"}},{"type":"paragraph","data":{"text":"·      \nс НПВП и производными салициловой кислоты\nв больших дозах;"}},{"type":"paragraph","data":{"text":"·      \nс дигоксином;"}},{"type":"paragraph","data":{"text":"·      \nс гипогликемическими средствами для приема\nвнутрь (производные сульфонилмочевины) и инсулином;"}},{"type":"paragraph","data":{"text":"·      \nс вальпроевой кислотой;"}},{"type":"paragraph","data":{"text":"·      \nс алкоголем (алкогольные напитки в\nчастности);"}},{"type":"paragraph","data":{"text":"·      \nс селективными ингибиторами обратного\nзахвата серотонина;"}},{"type":"paragraph","data":{"text":"·      \nс ибупрофеном,"}},{"type":"list","data":{"style":"ordered","items":["с препаратами лития,","с системными глюкокортикостероидами,","с этанолом,","с наркотическими анальгетиками,","с сульфаниламидами,","с ингибиторами карбоангидразы."]}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Салициловая кислота проникает\nчерез плацентарный барьер."}},{"type":"paragraph","data":{"text":"Препарат Тромбитал противопоказан\nк применению в I и III триместрах беременности, т.к. обладает тератогенным действием – при\nприменении в I триместре беременности приводит к возникновению у плода расщепления\nверхнего неба, в III триместре – вызывает торможение родовой деятельности (подавление синтеза\nпростагландинов), преждевременное закрытие артериального протока у плода,\nгиперплазию легочных сосудов и гипертензию в малом круге кровообращения. "}},{"type":"paragraph","data":{"text":"Прием препарата во II триместре возможен только в том случае,\nесли потенциальная польза для матери превышает риск для плода."}},{"type":"paragraph","data":{"text":"Ацетилсалициловая\nкислота и ее метаболиты проникают в грудное молоко. На время лечения кормление\nгрудью следует прекратить."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Препарат принимают\nвнутрь, один раз в день, запивая водой. Таблетку можно проглотить целиком,\nразжевать или предварительно растереть. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eНестабильная стенокардия и стабильная стенокардия:\u003c/i\u003e по 1-2 таблетки препарата Тромбитал 1 раз в\nсутки. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрофилактика повторного инфаркта миокарда:\u003c/i\u003e по 1-2 таблетки препарата\nТромбитал 1 раз в сутки.  "}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрофилактика повторной транзиторной ишемической атаки (ТИА) и повторного\nишемического инсульта у пациентов, ранее перенесших нарушение мозгового\nкровообращения:\u003c/i\u003e по\n1-2 таблетки препарата Тромбитал 1 раз в сутки. \n"}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрофилактика тромботических осложнений после операций и инвазивных\nвмешательств на сосудах (таких, как аортокоронарное шунтирование, эндартерэктомия\nсонных артерий, артериовенозное шунтирование, ангиопластика и стентирование\nкоронарных артерий, ангиопластика сонных артерий): \u003c/i\u003eпо 1-2 таблетки препарата Тромбитал 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 противопоказан пациентам с тяжелым нарушением функции\nпочек. Следует с осторожностью применять препарат Тромбитал у пациентов с\nнарушением функции почек, поскольку ацетилсалициловая кислота может повышать\nриск развития почечной недостаточности и острой почечной недостаточности (см.\nраздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПациенты с нарушением функции печени\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Препарат Тромбитал противопоказан пациентам с тяжелым нарушением функции\nпечени. Следует с осторожностью применять препарат Тромбитал у пациентов с\nнарушением функции печени."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДети\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Безопасность и эффективность применения препаратов ацетилсалициловой\nкислоты + [магния гидроксида] у детей в возрасте до 18 лет не установлена.\nДанные отсутствуют."}},{"type":"paragraph","data":{"text":"Применение препарата Тромбитал у пациентов младше 18 лет противопоказано."}},{"type":"paragraph","data":{"text":"Препарат предназначен для длительного применения. Длительность лечения и\nдоза препарата Тромбитал определяется врачом. \n"}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрименяйте препарат только согласно тем\nпоказаниям, тому способу применения и в тех дозах, которые указаны в инструкции.\u003c/i\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 ацетилсалициловой\nкислоты меньше "}},{"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 недостаточности,\nхарактеризующейся гипокалиемией, гипернатриемией, гипонатриемией;"}},{"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 экскреции;"}},{"type":"paragraph","data":{"text":"- гипогликемических средств для приема внутрь (производные\nсульфонилмочевины) и инсулина за счет гипогликемических свойств самой ацетилсалициловой\nкислоты в высоких дозах и вытеснения производных сульфонилмочевины из связи с\nбелками 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 снижают\nвсасывание 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 проконсультируйтесь с\nврачом.\u003c/i\u003e\u003c/b\u003e"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат следует применять по\nназначению врача."}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота может\nпровоцировать бронхоспазм, а также вызывать приступы бронхиальной астмы и\nдругие реакции повышенной чувствительности. Факторами риска являются наличие\nбронхиальной астмы в анамнезе, аллергических состояний, сенной лихорадки,\nполипоза носа, хронических заболеваний дыхательной системы, а также\nаллергических реакций на другие препараты (например, кожные реакции, зуд,\nкрапивница)."}},{"type":"paragraph","data":{"text":"Ацетилсалициловая кислота\nможет вызывать 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":"Следует соблюдать\nосторожность при применении препарата у пациентов с печеночной недостаточностью\n(класс А по шкале Чайлд-Пью), с почечной недостаточностью (КК более 30\nмл/мин)."}},{"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 (производные\nсульфонилмочевины) 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":"Следует соблюдать\nосторожность при одновременном приеме препарата с наркотическими анальгетиками,\nНПВП и производными салициловой кислоты в больших дозах."}},{"type":"paragraph","data":{"text":"Повышение дозы\nацетилсалициловой кислоты свыше терапевтических доз сопряжено с риском\nжелудочно-кишечного кровотечения."}},{"type":"paragraph","data":{"text":"Следует соблюдать\nосторожность при применении препарата при наличии в анамнезе язвенных поражений желудочно-кишечного тракта или желудочно-кишечных\nкровотечений."}},{"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":"Следует соблюдать осторожность при одновременном\nприменении препарата с дигоксином (вследствие снижения его почечной экскреции),\nвальпроевой кислотой (за счет ее вытеснения из связи с белками плазмы крови), препаратами лития (вследствие повышения их\nконцентрации в плазме крови), сульфаниламидами,\nингибиторами карбоангидразы, селективными ингибиторами обратного захвата\nсеротонина. "}},{"type":"paragraph","data":{"text":"При одновременном приеме ацетилсалициловой\nкислоты с алкоголем повышен риск повреждения слизистой оболочки\nжелудочно-кишечного тракта и удлинения времени кровотечения."}},{"type":"paragraph","data":{"text":"При длительном применении\nпрепарата следует периодически делать общий анализ крови и анализ кала на\nскрытую кровь."}}]},{"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 быстроты\nпсихомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки\nпокрытые пленочной оболочкой 75 мг + 15,20 мг."}},{"type":"paragraph","data":{"text":"По\n30, 100 или 180 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\nбанку темного (янтарного) стекла вместе с инструкцией по применению помещают в\nпачку из картона."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При\nтемпературе 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 применять по истечении срока годности."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают без рецепта."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Открытое акционерное общество\n\"Фармстандарт-Лексредства\""}},{"type":"paragraph","data":{"text":"(ОАО\n\"Фармстандарт-Лексредства\"), Россия Курская обл.,  г. \nКурск,   ул. 2-я   Агрегатная, д. 1а/18, тел./факс: (4712)\n34-03-13, www.pharmstd.ru"}}]},{"id":0,"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,\nд.10,      эт. 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, защищает слизистую оболочку желудочно-кишечного тракта от воздействия ацетилсалициловой кислоты.ФармакокинетикаАцетилсалициловая кислота всасывается из желудочно-кишечного тракта практически полностью. 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