ASA · aspirin
Antiplatelet agent (irreversible COX inhibitor)
Preparation: i.v. – vial containing 500 mg acetylsalicylic acid (as lysine acetylsalicylate; reference product considered here) + 5 ml solvent = 87.5 mg/ml acetylsalicylic acid (its SmPC); whole vial = 500 mg acetylsalicylic acid – other products contain different salt amounts and concentrations: check the label/SmPC before calculating volumes
Acute coronary syndrome (STEMI, NSTE-ACS)
- 150–300 mg p.o. (chewed)[212]
- 75–250 mg i.v. – if oral administration is not possible[212]i.v. – vial containing 500 mg acetylsalicylic acid (as lysine acetylsalicylate; reference product considered here) + 5 ml solvent = 87.5 mg/ml acetylsalicylic acid (its SmPC); whole vial = 500 mg acetylsalicylic acid – other products contain different salt amounts and concentrations: check the label/SmPC before calculating volumes · = 0.86–2.86 ml
Loading dose as early as possible, then 75–100 mg/day. Also before fibrinolysis (together with clopidogrel and an anticoagulant).
Contraindications
- Known hypersensitivity to ASA/salicylates (e.g. analgesic-induced asthma, NSAID-exacerbated respiratory disease)
- Active gastrointestinal bleeding or acute ulcer
- Haemorrhagic diathesis
- Third trimester of pregnancy (SmPC of i.v. acetylsalicylic acid; different information applies to low-dose oral products – see the SmPC of the respective product)
Notes
- Do not give if aortic dissection or intracranial haemorrhage is suspected.
- Some SmPCs of the i.v. products state higher doses (up to 500 mg) – prefer the ESC dose.
- This lysine acetylsalicylate product: prepare freshly and filter before administration (5 µm filter, e.g. filter needle) – its SmPC (handling); for other products follow their SmPC.
- Calculate the volume from the labelled concentration of the product available – e.g. reference product 87.5 mg/ml → 250 mg ≈ 2.9 ml (not 2.5 ml).