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Luai Al Bakour
El Temamy Pharmacy
Akoni Hijyen Teknolojileri Sanayi ve Dış Ticaret LTD. ŞTİ
Britton Chance Center for Biomedical Photonics
Arabian Trade Center - ATC
Medical Facility (32206):
Legality International. (Pvt.) Ltd.
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Symptomatic treatment of migraine headache and digestive disorders associated with (nausea, vomiting).
RELATED TO ASPIRIN: This medicine SHOULD NOT BE USED in the following cases: - History of hypersensitivity to salicylates (bronchospasm, anaphylaxis). - Children under 15 years because of the aspirin content. - Peptic Ulcer Disease. - Any constitutional or acquired bleeding disorder. - Risks of bleeding. - Association with methotrexate when it is used in doses greater than or equal to 15 mg / week (see Section Interactions). - Association with oral anticoagulants when salicylates are used at high doses (> 3 g / d) (see Section Interactions). - Pregnancy from the 6th month: From the 6th month of pregnancy, aspirin dose analgesics, antipyretics or anti-inflammatory drugs (> = 500 mg per day per catch), as all inhibitors of prostaglandin synthesis, can exhibit: the fetus toxicity with cardiopulmonary ductus arteriosus and pulmonary hypertension with renal dysfunction up to the renal failure with oligohydramnios, the mother and child in late pregnancy, an extension of bleeding time. This anti-aggregation may occur even at very low doses. As a result: from the 6th month of pregnancy outside of cardiology or obstetric uses extremely limited, and that warrant special monitoring while aspirin-based drug is contraindicated in from the 6th month. RELATED Metoclopramide: This medicine SHOULD NOT BE USED in the following situations: - Hypersensitivity to metoclopramide or any of the excipients. - Situation where the stimulation has a gastrointestinal risk (gastrointestinal hemorrhage, mechanical obstruction or gastrointestinal perforation). - History of tardive dyskinesia with neuroleptics. - Pheochromocytoma known or suspected. - In combination with drugs containing levodopa and dopamine agonists (see Section Interactions: amantadine, apomorphine, bromocriptine, cabergoline, entacapone, lisuride, pergolide, piribedil, pramipexole, quinagolide, ropinirole). - Previous history of methemoglobinemia seen with metoclopramide or deficit in NADH-cytochrome B5 reductase.
The following side effects have been observed with the combination of aspirin and metoclopramide: Tinnitus, asthenia, dizziness, muscle stiffness, myalgia, drowsiness, palpitations, diarrhea, digestive ulcers, stomach pains, increased duration of rules. Given the presence of two active ingredients, side effects associated with each of them can, in principle, be observed. Side effects may occur with aspirin: Tinnitus, a sensation of hearing acuity, headaches that are usually the mark of an overdose. Hemorrhagic syndromes. Risks of gastrointestinal ulcers. Accident allergic. Side effects may occur with metoclopramide: Drowsiness, fatigue, dizziness. Exceptionally: depressive tendency, headache, insomnia, abnormal bowel movements. As with all neuroleptics: Extrapyramidal symptoms. Tardive dyskinesia. Endocrine-related hyperprolactinemia.
RELATED TO ASPIRIN: RISK LINKED TO THE EFFECT antiplatelet: Several substances are involved in interactions, because of their anti-aggregating platelet: aspirin and NSAIDs, ticlopidine and clopidogrel, tirofiban, eptifibatide and abciximab, iloprost The use of multiple antiplatelet agents increases the risk of bleeding, as well as their association with heparin or the like (hirudins), oral anticoagulants and thrombolytics and should be taken into account while maintaining regular surveillance, clinical and biological Contra-indication: Oral anticoagulants (for aspirin doses> 3 g / d): Increased risk of bleeding (inhibition of platelet function and aggression in the gastroduodenal mucosa and the displacement of the oral anticoagulant of its plasma protein binding) Methotrexate in doses greater than or equal to 15 mg / week: Increased haematological toxicity of methotrexate (decreased renal clearance of methotrexate with anti-inflammatory drugs in general and displacement of methotrexate from its binding to plasma proteins by aspirin) Combination not recommended: Oral anticoagulants (low-dose aspirin for): Increased risk of bleeding (inhibition of platelet function and aggression of the gastroduodenal mucosa) Need for control, particularly in bleeding time Other NSAIDs (aspirin in doses> 3 g / day): Increased risk of gastrointestinal bleeding and ulcerogenic (additive synergy) Heparin (for aspirin doses> 3 g / day): Increased risk of bleeding (inhibition of platelet function and aggression in the gastroduodenal mucosa by aspirin) Regular clinical surveillanceDo not exceed a few days of treatment with aspirin Uricosuric (benzbromarone, probenecid): For benzbromarone, described for doses of aspirin less than or equal to 3 g / day Decreased uricosuric effect (competition for the elimination of uric acid in the renal tubules) Use another painkiller ASSOCIATIONS BEING OF PRECAUTIONS: Insulins: Increase of the hypoglycemic effect by high doses of acetylsalicylic acid (hypoglycemic action of acetylsalicylic acid) Warn the patient to enhance the SMBG Corticosteroids (gluco-) (general stream) except hydrocortisone used as replacement therapy in Addison’s disease: Decreased salicylate during treatment with corticosteroids and risk of overdose of aspirin after his arrest (increased elimination of aspirin with corticosteroids)Adapting dose aspirin for the association and after discontinuation of treatment with glucocorticoids Diuretics, angiotensin converting enzyme (ACE) inhibitors (for aspirin doses> 3 g / day): Acute renal failure in the patient dehydrated elderly (decreased glomerular filtration due to decreased renal prostaglandin synthesis)Furthermore, reduction of antihypertensiveHydrate the patient; monitor kidney function at baseline Methotrexate in doses below 15 mg / week: Increased haematological toxicity of methotrexate / (decrease renal clearance of methotrexate with anti-inflammatory drugs in general and displacement of methotrexate from its binding to plasma proteins by aspirin) Weekly monitoring of blood counts during the first weeks of the associationEnhanced surveillance in case of alteration (even mild) renal function and the elderly ASSOCIATIONS TAKE INTO ACCOUNT: Intrauterine device (for aspirin doses> 3 g / day): Risk (controversial) decreased effectiveness of intrauterine devices Dose heparin prophylaxis (outside the elderly): Increased risk of bleeding Topica gastrointestinal (salts, oxides and hydroxides of magnesium, aluminum and calcium): Increased renal excretion of acetylsalicylic acid by alkalinization of urine RELATED Metoclopramide: Contra-indication: Levodopa and dopamine agonists (amantadine, apomorphine, bromocriptine, cabergoline, entacapone, lisuride, pergolide, piribedil, pramipexole, quinagolide, ropinirole): Mutual antagonism of levodopa, dopamine agonists and neuroleptics Use an anti-emetic lacking extrapyramidal side effects Combination not recommended: Drink: Increase by alcohol the sedative effect of neurolepticsImpairment of vigilance can make dangerous driving and using machinery Avoid taking alcoholic beverages and medicines containing alcohol ASSOCIATIONS TAKE INTO ACCOUNT: Antihypertensives: Antihypertensive effect and increased risk of orthostatic hypotension (additive effect) Other CNS depressants: opioid derivatives (analgesics, antitussives and substitution treatment), barbiturates, benzodiazepines, anxiolytic other than benzodiazepines, hypnotics, antidepressants, sedatives, antihistamines, sedatives H1; central antihypertensive; baclofen; thalidomide Increase of the central depressionThe alteration of vigilance can make dangerous driving and operating machinery.
Due to the active principles of the association, not to exceed three pouches per 24 hours RELATED TO ASPIRIN: Aspirin should be used with caution in: history of peptic ulcer or gastrointestinal bleeding, renal, asthma, intrauterine device Aspirin is not recommended in gout Not recommended in menorrhagia because aspirin may increase the size and duration of rules Pregnancy: Studies in animals have shown a teratogenic effect of aspirin Clinical data about the appearance of malformation (first quarter): Aspirin spot treatment: the results of epidemiological studies seem to exclude a particular malformation effect of aspirin, taken during the first quarter Chronic aspirin therapy: There is currently no sufficient data to evaluate a possible effect of malformation of aspirin when given chronic therapy beyond 150 mg / d during the first trimester of pregnancy Clinical data about the appearance fetotoxic (second quarter): During the 4th and 5th month, the analysis of a large number of pregnancies exposed to brief treatment showed no effect fetotoxic particularHowever, only epidemiological studies would verify the absence of risk Therefore: in the first five months of pregnancy, aspirin spot treatment may be prescribed if necessary, as a precaution, it is preferable not to use aspirin in chronic treatment beyond 150 mg / d RELATED Metoclopramide: Not recommended in subjects with epilepsy (increased frequency and intensity of crises)
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Dr . Dirar Abboud
Dr. Samer Al-Jneidy
Samir Moussa M.D.
Dr. Tahsin Martini
Dr. Talal Sabouni
Dr. Hani Najjar
Yaser Habrawi , F.R.C.S.Ed
Dr. Faisal Dibsi