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# Ecospirin (Aspirin, Enteric-Coated)
## Overview
Ecospirin is an enteric-coated formulation of aspirin, a nonsteroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis. The enteric coating is designed to delay the dissolution of the tablet until it reaches the more alkaline environment of the small intestine, potentially reducing gastric irritation.
## Primary Indications
* Cardiovascular risk reduction (secondary prevention of myocardial infarction and stroke)
* Pain and inflammation (though other NSAIDs or acetaminophen may be preferred for simple analgesia due to GI risk)
* Kawasaki disease treatment
## Adult Dosing
* **Cardiovascular Risk Reduction:** Typically 75-325 mg once daily. The optimal dose for primary prevention is debated and not universally recommended. For secondary prevention, 75-100 mg daily is common.
* **Pain/Inflammation:** Dosing varies widely based on indication. For mild to moderate pain, 325-650 mg every 4-6 hours as needed. Higher doses may be used for inflammatory conditions, but significant GI risks accompany these. Maximum daily dose generally should not exceed 4000 mg, but lower maximums are often used for GI safety.
## Pediatric Dosing
* **Kawasaki Disease:** High-dose aspirin (80-100 mg/kg/day divided into 4 doses) for fever and inflammation, followed by low-dose aspirin (3-5 mg/kg/day once daily) for 6-8 weeks or longer. Specific protocols may vary.
* **Pain/Inflammation:** Aspirin is generally **not recommended** in children and adolescents due to the risk of Reye's syndrome, especially during viral illnesses.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised due to potential for accumulation and increased adverse effects. Use lowest effective dose.
## Contraindications
* Hypersensitivity to aspirin, salicylates, NSAIDs, or any component of the formulation.
* Children and teenagers with viral infections (chickenpox, influenza) due to the risk of Reye's syndrome.
* Active peptic ulcer disease.
* Bleeding disorders (e.g., hemophilia, thrombocytopenia).
* Severe hepatic or renal impairment.
* Asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs.
## Adverse Effects
* Gastrointestinal: Dyspepsia, nausea, vomiting, abdominal pain, occult bleeding, peptic ulceration, perforation.
* Hematologic: Increased bleeding time, bruising, epistaxis.
* Hypersensitivity: Bronchospasm, urticaria, angioedema.
* Ototoxicity
