Please check your internet connection and try again.
# Ecospirin Enteric-Coated
## Overview
Ecospirin Enteric-Coated is a brand name for aspirin, a non-steroidal anti-inflammatory drug (NSAID) with antiplatelet, analgesic, and antipyretic properties. The enteric coating is designed to delay absorption and reduce gastric irritation.
## Primary Indications
* **Cardiovascular prophylaxis:** Prevention of myocardial infarction and stroke in patients with established cardiovascular disease or risk factors.
* **Pain and fever:** Management of mild to moderate pain and fever (less common due to availability of other agents with better safety profiles for these indications).
* **Inflammatory conditions:** Treatment of inflammatory conditions such as rheumatoid arthritis, osteoarthritis (less common for chronic use due to GI risks).
## Adult Dosing
* **Cardiovascular prophylaxis:**
* **Primary prevention:** Typically 75 mg to 150 mg once daily. Dosing decisions should be individualized based on risk assessment.
* **Secondary prevention:** Typically 75 mg to 325 mg once daily.
* **Pain and fever:** 325 mg to 650 mg every 4 to 6 hours as needed. Maximum dose: 4000 mg per day.
* **Inflammatory conditions:** 2.4 g to 3.6 g per day, divided into multiple doses. Titrate as needed up to 8 g per day.
## Pediatric Dosing
* **Pain and fever:** 10 mg/kg to 15 mg/kg every 4 to 6 hours. Maximum dose: 75 mg/kg per day.
* **Kawasaki disease:** Dosing varies based on phase of illness and is typically managed by specialists.
**Note:** Aspirin should generally be avoided in children and adolescents with viral illnesses due to the risk of Reye's syndrome.
## Dose Adjustments
* **Renal Impairment:** Use with caution. In severe renal impairment, dosage reduction may be necessary, but specific guidelines are not well-established.
* **Hepatic Impairment:** Use with caution.
## Contraindications
* Hypersensitivity to aspirin, salicylates, or NSAIDs.
* History of aspirin-induced asthma, urticaria, or other allergic-type reactions.
* Active peptic ulceration or gastrointestinal bleeding.
* Children and adolescents with viral infections (risk of Reye's syndrome).
* Bleeding disorders.
## Adverse Effects
* **Gastrointestinal:** Dyspepsia, heartburn, nausea, vomiting, abdominal pain, gastritis, peptic ulceration, gastrointestinal bleeding, perforation.
* **Hematologic:** Increased bleeding time, bruising, petechiae, epistaxis, prolonged bleeding from wounds, rare cases of severe hemorrhage.
* **Ototoxicity:** Tinnitus, hearing loss (usually with higher doses).
* **Renal:** Acute kidney injury, interstitial nephritis.
* **Hepatic:** Elevated liver enzymes, rare cases of liver injury.
* **Hypersensitivity:** Bronchospasm, urticaria, angioedema.
* **Reye's Syndrome:** In children and adolescents with viral illnesses.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, heparin, DOACs):** Increased risk of bleeding.
* **Other NSAIDs and COX-2 Inhibitors:** Increased risk of GI toxicity and bleeding.
* **Corticosteroids:** Increased risk of GI ulceration and bleeding.
* **Antihypertensives:** May decrease the efficacy of some antihypertensive agents.
* **Methotrexate:** Increased methotrexate toxicity.
* **Valproic Acid:** May displace valproic acid from plasma protein binding sites, increasing free valproic acid levels.
* **Uricosuric agents (e.g., probenecid):** May decrease their efficacy.
* **Alcohol:** Increased risk of GI bleeding.
## Monitoring
* Signs and symptoms of GI bleeding (e.g., melena, hematemesis, abdominal pain).
* Signs and symptoms of bleeding elsewhere (e.g., bruising, petechiae, epistaxis).
* Renal function (e.g., serum creatinine, BUN) in patients at risk.
* Liver function tests in patients with pre-existing liver disease or on long-term therapy.
* Tinnitus or hearing loss, especially with higher doses.
## Clinical Pearls
* The enteric coating does not prevent all gastric irritation; patients may still experience GI upset.
* Take with a full glass of water. Do not crush, chew, or break enteric-coated tablets.
* Discontinue aspirin at least 5-7 days prior to elective surgery if possible, in consultation with the surgeon and patient.
* In cases of overdose, salicylism (tinnitus, headache, dizziness, nausea, vomiting) may occur. Severe overdose can lead to metabolic acidosis, hyperthermia, respiratory alkalosis, seizures, coma, and death.
***
**Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and relevant clinical guidelines for complete details.
