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acetylsalicylic acid and corticosteroids

M01BA03

Forms & Strengths

Tablets: 500mg/25mg, 750mg/50mg, 1000mg/100mg acetylsalicylic acid/corticosteroid
Capsules: 250mg/10mg, 500mg/25mg
Injectable solutions: 100mg/mL, 250mg/mL

Adult Dosing

OA: 250-1000mg tid, RA: 500-2000mg qid, Ankylosing spondylitis: 500-1000mg tid
Low dose for cardiovascular protection: 75-100mg qd
Corticosteroid component dosing adjusted based on condition severity

Pediatric Dosing

Juvenile idiopathic arthritis: 10-30mg/kg/day in 3-4 divided doses
Kawasaki disease: 80-100mg/kg/day in 4 divided doses
Pediatric dosing for other conditions based on clinical judgment

Indications

Rheumatoid arthritis
Osteoarthritis
Ankylosing spondylitis
Juvenile idiopathic arthritis
Kawasaki disease
Cardiovascular disease prevention

Mechanism of Action

Acetylsalicylic acid: COX-1/2 inhibition
Corticosteroid: glucocorticoid receptor agonism, anti-inflammatory and immunosuppressive effects
Inhibition of prostaglandin synthesis and leukotriene production

Contraindications

Active peptic ulcer disease
Aspirin sensitivity or allergy
Corticosteroid hypersensitivity
Bleeding disorders or coagulopathy
Pregnancy (third trimester) or breastfeeding

Adverse Reactions

Gastrointestinal: nausea, vomiting, dyspepsia, ulceration, bleeding
Renal: acute kidney injury, chronic kidney disease
Endocrine: Cushing's syndrome, adrenal insufficiency
Musculoskeletal: osteoporosis, myopathy
Skin: rash, urticaria, angioedema

Drug Interactions

Antiplatelet and anticoagulant agents: increased bleeding risk
Other NSAIDs: increased GI toxicity risk
Corticosteroid interactions: CYP3A4 inhibitors/inducers, warfarin, loop/thiazide diuretics
Proton pump inhibitors: decreased acetylsalicylic acid absorption

Curated Content: Needs Vetting Before Put to Clinical Use