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# Ecospirin (Aspirin) Enteric-Coated
## Overview
Ecospirin is an enteric-coated formulation of aspirin, a nonsteroidal anti-inflammatory drug (NSAID) with antiplatelet, analgesic, and antipyretic properties. The enteric coating is designed to delay the release of aspirin until it reaches the small intestine, reducing gastric irritation.
## Primary Indications
* **Cardiovascular Risk Reduction:** Prevention of myocardial infarction and stroke in patients with established cardiovascular disease, diabetes mellitus, or multiple risk factors.
* **Secondary Prevention:** Following an acute coronary syndrome or ischemic stroke.
* **Pain and Inflammation:** For mild to moderate pain and inflammatory conditions (though other NSAIDs or acetaminophen may be preferred due to GI risk).
## Adult Dosing
* **Cardiovascular Prophylaxis:** Typically 75-100 mg once daily. Higher doses (e.g., 325 mg) may be used initially in certain acute settings, but lower doses are generally preferred for long-term use.
* **Pain/Inflammation:** Doses vary widely depending on indication, generally ranging from 325 mg to 650 mg every 4-6 hours as needed. Maximum daily dose for pain/inflammation is generally 4000 mg, but often lower limits are observed due to toxicity.
## Pediatric Dosing
Aspirin is generally **NOT recommended** in children and adolescents (<18 years) for fever or viral illnesses due to the risk of Reye's syndrome. Specific indications and dosing for pediatric patients must be determined by a specialist and are often for inflammatory conditions like Kawasaki disease, requiring careful monitoring.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is warranted, especially in severe disease, due to potential for toxicity and bleeding.
## Contraindications
* Hypersensitivity to aspirin, salicylates, or NSAIDs.
* Active peptic ulceration or gastrointestinal bleeding.
* Bleeding disorders (e.g., hemophilia, thrombocytopenia).
* Severe hepatic or renal impairment.
* Concurrent use with methotrexate.
* Children and adolescents with viral infections (risk of Reye's syndrome).
## Adverse Effects
* **Gastrointestinal:** Dyspepsia, heartburn, nausea, vomiting, abdominal pain, occult bleeding, peptic ulceration, GI perforation.
* **Hematologic:** Increased bleeding time, bruising, epistaxis, hematuria.
* **Hypersensitivity:** Bronchospasm (especially in aspirin-sensitive asthma), urticaria, angioedema.
* **Other:** Tinnitus, dizziness, headache, Reye's syndrome (in children/adolescents with viral illness).
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, heparin, DOACs):** Increased risk of bleeding.
* **Other NSAIDs and
