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Indications/Uses
Listed in Dosage.
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Dosage/Direction for Use
Adult: PO Mild to moderate pain; Fever Initial: 300-900 mg, repeated 4-6 hrly. Max: 4 g daily. Rheumatic disorders 4-8 g daily in divided doses for acute disorders. 5.4 g daily in divided doses for chronic conditions. Angina pectoris; Myocardial Infarction; Acute ischaemic stroke Loading: 150-300 mg. Prophylaxis of cardiovascular events in high-risk patients Long term: 75-150 mg once daily. Short term: 150-300 mg daily. Rectal Mild to moderate pain; Fever As sup: 450-900 mg 4 hrly. Max: 3.6 g daily.
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Administration
Should be taken with food.
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Contraindications
Hypersensitivity to aspirin or other NSAIDs. Peptic ulcer, haemorrhagic disease, coagulation disorder (e.g. haemophilia, thrombocytopenia), gout. Severe hepatic and renal impairment. Children <16 years and recovering from viral infection. Pregnancy (doses >100 mg daily during 3rd trimester) and lactation. Concomitant use with other NSAIDs and methotrexate.
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Special Precautions
Patient with dyspepsia or lesion of the GI mucosa, asthma or allergic disorders, anaemia, dehydration, menorrhagia, uncontrolled hypertension, G6PD deficiency, thyrotoxicosis. Patients undergoing surgical procedures. Moderate hepatic and renal impairment. Pregnancy.
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Adverse Reactions
Significant: Salicylate sensitivity, tinnitus.
Blood and lymphatic system disorders: Anaemia, hypoprothrombinaemia, thrombocytopenia.
Gastrointestinal disorders: Dyspepsia, gastric irritation, nausea, vomiting.
Nervous system disorders: Dizziness, confusion.
Respiratory, thoracic and mediastinal disorders: Asthma, bronchospasm, dyspnea, rhinitis.
Skin and subcutaneous tissue disorders: Rash, urticaria.
Potentially Fatal: Paroxysmal bronchospasm and dyspnoea. Coma, CV collapse, resp failure, severe hypoglycaemia. Rarely, Reye's syndrome. Hypersensitivity reactions (e.g. Stevens Johnson syndrome, angioedema), gastrointestinal bleeding and perforation. |
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C
D if full-dose used in 3rd trimester.
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Drug Interactions
Increased risk of GI bleeding and ulceration with corticosteroids. Increased risk of bleeding with coumarin anticoagulants (e.g. heparin, warfarin, phenindione) and antiplatelet agents (e.g. clopidogrel, dipyridamole). May result in severe acidosis and increased CNS toxicity with carbonic anhydrase inhibitors (e.g. acetazolamide). Increases the hypoglycaemic effect of sulfonylureas. Reduces binding of phenytoin and valproate to serum albumin leading to increased free concentration of the drugs. Reduces the effect of uricosurics (e.g. probenecid, sulfinpyrazone). Impairs the renal excretion of lithium and digoxin.
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