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# Ecospirin 75 mg Enteric-Coated Aspirin
## Overview
Ecospirin 75 mg contains aspirin (acetylsalicylic acid), a nonsteroidal anti-inflammatory drug (NSAID) with antiplatelet effects. The enteric coating is designed to prevent gastric irritation by delaying the dissolution of the tablet until it reaches the small intestine.
## Primary Indications
* **Cardiovascular Prevention:** Primary and secondary prevention of atherothrombotic events (e.g., myocardial infarction, stroke) in patients with established cardiovascular disease or risk factors.
## Adult Dosing
* **Cardiovascular Prevention:** 75 mg once daily. Higher doses may be used in specific clinical situations under medical supervision.
## Pediatric Dosing
* **Cardiovascular Prevention:** Aspirin is generally not recommended for routine use in children for cardiovascular prevention due to the risk of Reye's syndrome. Specific indications and dosing in pediatric patients should be determined by a specialist.
## Dose Adjustments
* **Renal Impairment:** Use with caution in patients with mild to moderate renal impairment. Avoid in severe renal impairment.
* **Hepatic Impairment:** Use with caution in patients with hepatic impairment.
## Contraindications
* Hypersensitivity to aspirin, salicylates, NSAIDs, or any component of the formulation.
* Active peptic ulceration or history of recurrent ulceration.
* History of bronchospasm, urticaria, or allergic-type reactions after aspirin or NSAID use.
* Severe hepatic or renal impairment.
* Severe heart failure.
* Patients with hemophilia or other bleeding disorders.
* Concomitant use with methotrexate at weekly doses of 15 mg or higher.
* Third trimester of pregnancy.
## Adverse Effects
* **Gastrointestinal:** Dyspepsia, nausea, vomiting, abdominal pain, occult bleeding, peptic ulceration, gastrointestinal perforation.
* **Hematologic:** Increased bleeding tendency (ecchymosis, epistaxis, prolonged bleeding time), thrombocytopenia.
* **Hypersensitivity:** Bronchospasm, asthma exacerbations, urticaria, angioedema, rhinitis.
* **Other:** Tinnitus, dizziness, headache.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, heparin, DOACs):** Increased risk of bleeding.
* **Other NSAIDs and Salicylates:** Increased risk of gastrointestinal bleeding and other adverse effects.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **SSRIs (Selective Serotonin Reuptake Inhibitors):** Increased risk of bleeding, particularly gastrointestinal bleeding.
* **Methotrexate:** Increased methotrexate toxicity, especially at higher doses.
* **Uricosuric agents (e.g., probenecid):** Reduced efficacy of uricosuric agents.
* **Antihypertensives:** NSAIDs can reduce the effectiveness of antihypertensive medications.
* **Alcohol:** Increased risk of gastrointestinal bleeding.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis, abdominal pain).
* Signs and symptoms of bleeding elsewhere (e.g., ecchymosis, epistaxis).
* Renal and hepatic function, especially in patients with pre-existing impairment or those on long-term therapy.
* Platelet function may be monitored if clinically indicated.
## Clinical Pearls
* The enteric coating helps reduce gastric upset but does not eliminate the risk of gastrointestinal bleeding.
* Patients should be advised to take Ecospirin with food or milk if stomach upset occurs, although this may slightly delay absorption.
* Do not crush or chew the enteric-coated tablets.
* Discontinue aspirin at least 5-7 days prior to elective surgery, in consultation with the prescribing physician.
* In patients with aspirin-exacerbated respiratory disease (AERD), aspirin can trigger severe bronchospasm.
**Disclaimer:** This information is intended for healthcare professionals. Always consult the most current prescribing information or an official drug reference for complete details and to confirm dosage and indications before administering any medication.
