Please check your internet connection and try again.
# Ecospirin (Aspirin, Enteric-Coated)
## Overview
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin and thromboxane synthesis. Enteric coating delays absorption and may reduce gastric irritation.
## Primary Indications
* **Cardiovascular protection:** Prevention of myocardial infarction, stroke, and cardiovascular death in patients with established cardiovascular disease or specific risk factors.
* **Analgesia and antipyresis:** Although less common for enteric-coated formulations due to slower onset.
* **Inflammation:** Less common for enteric-coated formulations in acute inflammatory conditions.
## Adult Dosing
* **Cardiovascular protection (Prevention):**
* **Secondary Prevention:** 75-162 mg daily. Doses up to 325 mg daily may be used initially in some acute settings.
* **Primary Prevention:** Typically 75-100 mg daily (or every other day in some guidelines). Benefit-risk assessment is crucial.
## Pediatric Dosing
* **Generally not recommended** for routine use in children and adolescents due to the risk of Reye's syndrome, especially during viral illnesses.
* Exceptions may exist for specific conditions under strict medical supervision (e.g., Kawasaki disease), but this is typically managed by pediatric subspecialists with specific protocols.
## Dose Adjustments
* No dose adjustment is typically needed for hepatic or renal impairment, but caution is advised. Higher doses or prolonged use in patients with severe impairment may necessitate closer monitoring.
## Contraindications
* Hypersensitivity to aspirin, salicylates, or NSAIDs.
* Active peptic ulceration or gastrointestinal bleeding.
* History of bronchospasm, urticaria, or allergic-type reactions after aspirin or NSAIDs.
* Children and adolescents with viral infections (risk of Reye's syndrome).
* Hemophilia, other bleeding disorders.
* Severe hepatic or renal insufficiency.
## Adverse Effects
* **Gastrointestinal:** Dyspepsia, heartburn, nausea, vomiting, abdominal pain, gastritis, peptic ulceration, GI bleeding, perforation.
* **Hematologic:** Increased bleeding time, bruising, epistaxis, petechiae.
* **Hypersensitivity:** Bronchospasm (especially in asthmatics), rash, angioedema, anaphylaxis.
* **Auditory:** Tinnitus, hearing loss (especially at higher doses).
* **Renal:** Acute kidney injury, interstitial nephritis.
* **Hepatic:** Elevated transaminases, hepatic dysfunction.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, DOACs) and antiplatelets (e.g., clopidogrel):** Additive risk of bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Selective Serotonin Reuptake Inhibitors (SSRIs):** Increased risk of bleeding.
* **Methotrexate:** Aspirin can decrease methotrexate clearance, increasing toxicity.
* **Valproic Acid:** Aspirin can displace valproic acid from plasma protein,
