Ascriptin

It is very important that your doctor check your progress while you are using this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

This medicine can not be used for treatment of a heart attack. Use an immediate-release aspirin in such an event.

Make sure your doctor knows if you are pregnant or breastfeeding. Do not use this medicine during the later part of a pregnancy unless your doctor tells you to.

This medicine may increase risk for bleeding problems, including stomach ulcers or bleeding. This usually occurs if you are taking aspirin with certain medicines (eg, NSAIDs, blood thinner). Check with your doctor right away if you have black, tarry stools, severe or continuing stomach pain, unusual bleeding, bruising, or weakness, or vomiting of blood or material that looks like coffee grounds.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Initial dose: 3 g orally per day in divided doses
Maintenance: Adjust dose as needed for anti-inflammatory efficacy

Comments:
-Dosing should be individualized.
-Target plasma salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response while plasma salicylate levels greater than 200 mcg/mL are associated with a higher incidence of toxicity.

Uses: For the relief of the signs and symptoms of rheumatoid arthritis, osteoarthritis, and arthritis and pleurisy associated with systemic lupus erythematous.

Initial dose: 3 g orally per day in divided doses
Maintenance: Adjust dose as needed for anti-inflammatory efficacy

Comments:
-Dosing should be individualized.
-Target plasma salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response while plasma salicylate levels greater than 200 mcg/mL are associated with a higher incidence of toxicity.

Uses: For the relief of the signs and symptoms of rheumatoid arthritis, osteoarthritis, and arthritis and pleurisy associated with systemic lupus erythematous.

Initial dose: 3 g orally per day in divided doses
Maintenance: Adjust dose as needed for anti-inflammatory efficacy

Comments:
-Dosing should be individualized.
-Target plasma salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response while plasma salicylate levels greater than 200 mcg/mL are associated with a higher incidence of toxicity.

Uses: For the relief of the signs and symptoms of rheumatoid arthritis, osteoarthritis, and arthritis and pleurisy associated with systemic lupus erythematous.

Immediate-release: 50 to 325 mg orally once a day

Extended-release (ER): 162.5 mg orally once a day

Comments:
-Therapy should be continued indefinately.
-ER capsules are designed to slowly release drug from encapsulated microparticles thereby prolonging the absorption across the gastrointestinal tract; the pharmacodynamic effect of ER 162.5 mg is similar to that attained with IR aspirin 81 mg..

Uses: To reduce the risk of death and recurrent stroke in patients who have had ischemic stroke or transient ischemia attack.

Primary Prophylaxis:
-50 years or older: 75 to 100 mg orally once a day
-Adults with type 1 or type 2 diabetes at increased CVD risk: 75 to 162 mg orally once a day

Comments:
-In adults 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk of bleeding, and have a life expectancy of at least 10 years, the United States Preventative Services Task Force (USPSTF) recommends initiating low dose aspirin for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) and colorectal cancer (CRC).
-The decision to initiate primary prophylaxis therapy in adults 60 to 69 years, should include the same parameters and additionally be individualized for risk; for adults 70 years or older, the current evidence is insufficient to assess the balance of benefits and harms.
-The American Diabetes Association Standards of Care recommends primary prophylaxis in adults with diabetes who are at increased risk of CVD; this includes most patients 50 years or older with at least 1 additional major risk factor; for patients less than 50 years, clinical judgement is required.

Secondary Prophylaxis:
Immediate-release (IR): 75 mg to 325 mg orally once a day
Extended-release (ER): 162.5 orally once a day

Comments:
-The optimal dose to prevent cardiovascular events is unknown; however, higher doses are associated with increased risk of bleeding.
-Current evidence supports use of low-dose IR aspirin 75 to 100 mg daily.
-ER capsules are designed to slowly release drug from encapsulated microparticles thereby prolonging the absorption across the gastrointestinal tract; the pharmacodynamic effect of ER 162.5 mg is similar to that attained with IR aspirin 81 mg.

Use: To reduce the combined risk of death and nonfatal myocardial infarction (MI) in patients with chronic coronary artery disease, such as patients with a previous MI.

12 years or older: 300 to 650 mg orally every 4 to 6 hours as needed
Maximum dose: 4 g in 24 hours

Comments:
-This drug should be avoided in pediatric patients with viral illness due to risk of Reye's syndrome.

Uses: As a temporary fever reducer or for the temporary relief of minor pain due to headache, menstrual pain, arthritis, muscle pain, or toothache.

Hemodialysis:
-Salicylate is removed and hemodialysis has been used to treat overdoses
-Consider administration after hemodialysis; monitor closely for bleeding

Peritoneal dialysis: May reduce aspirin concentrations

Administration advice:
-Take with a full glass of water, unless fluid restricted
-May take with or after meals to reduce gastrointestinal intolerance

Extended-release capsule:
-Take at approximately the same time every day
-Swallow capsules whole; do not cut, crush or chew
-Do not take 2 hours before or 1 hour after consuming alcohol

Enteric coated:
-Do not crush or chew

Suppository:
-Remove from plastic packet and insert into rectum as far as possible

Storage:
Suppository: Store in cool place (46F to 59F [8C to 15C]) or refrigerate

General:
-Dose-related adverse events may be minimized by prescribing the lowest effective dose.
-When aspirin is used in high doses, tinnitus has been used as a clinical signal of elevated plasma salicylate levels; however, this should not be used in patients with high frequency hearing loss.

Monitoring:
-Monitor for signs and symptoms of bleeding
-Monitor liver function in patients with liver impairment
-Monitor renal function in patients with renal impairment

Patient advice:
-Patients should understand that this drug effects their platelets and may cause them to bruise or bleed more easily; however, any prolonged, unusual or excessive bleed should be reported promptly to their health care provider.
-Patients should be instructed to limit alcohol consumption while taking this drug due an increased risk of bleeding with combined use.
-Patients should be instructed not to abruptly discontinue daily therapy without talking to their health care provider first.
-Patients should be instructed to speak with their healthcare provider if they are pregnant, plan to become pregnant, or are breastfeeding.

LactMed Record Number

332

Last Revision Date

20170502

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Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.