Aspirin

PRIOR VERIFY CARRY-FORWARD: the previous draft of this file was HELD for rendering that 300 mg/day cap as an unqualified, drug-level maximum on a page whose category still reads 'Antiplatelet / NSAID / Antipyretic / Analgesic' - roughly 13x below the analgesic maximum the page itself advertises. The maxDose above is now explicitly scoped to the antiplatelet indications; the underlying fix the verify asked for still stands - either scope this page to antiplatelet use, or source an SPC for a product licensed as an analgesic before republishing analgesic dosing. || INDICATION MATCH: this is a cardiology page whose existing dose leads with the antiplatelet indications (ACS and secondary prevention), and the fetched UK SPC for Aspirin 75 mg tablets doses precisely those indications by the oral route. || SCOPE STATED: the SPC covers antiplatelet use ONLY. Section 4.4 opens 'Aspirin is not suitable for use as an anti-inflammatory, analgesic or antipyretic.' Nothing in this bundle supports the analgesic/antipyretic regimen (300-900 mg every 4-6 hours, max 4 g/day) that the current page also carries, and nothing supports the page's Kawasaki-disease exception - source those separately before republishing them. || DIFFERENCES FROM THE CURRENT PAGE, all in the SPC's favour here: the page says antiplatelet '75 mg once daily' (SPC: 75-160 mg once daily), 'loading dose ACS: 300 mg' (SPC: 'The recommended loading dose is 150-300 mg followed by a lower dose (75-160 mg) daily thereafter'), and 'Acute ischaemic stroke/TIA: 300 mg for 2 weeks then 75 mg' (SPC gives 75-300 mg once daily for secondary prevention of TIA/CVA and states no 2-week step-down; the 2-week rule is a NICE recommendation, not SPC text, and is not in this bundle). || ELDERLY, verbatim: 'In general, acetylsalicylic acids should be used with caution in elderly patients who are more prone to adverse events. The usual adult dose is recommended in the absence of severe renal or hepatic insufficiency. Treatment should be reviewed at regular intervals.' 4.4 adds: 'Elderly patients are particularly susceptible to the adverse effects of NSAIDs and acetylsalicylic acid especially gastrointestinal bleeding and perforation which may be fatal.' || SURGERY, verbatim (4.4): 'There is an increased risk of haemorrhage and prolongation of bleeding time particularly during or after surgery (even in cases of minor procedures, e.g. tooth extraction). Use with caution before surgery, including tooth extraction. Temporary discontinuation of treatment may be necessary.' Bleeding effects 'may persist for a period of 4-8 days after acetylsalicylic acid discontinuation' (4.8). || CO-PRESCRIBING, verbatim (4.4): 'Concomitant treatment with Aspirin and drugs that alter haemostasis (i.e. anticoagulants, thrombolytic agents, antiplatelet agents, anti-inflammatory drugs and selective serotonin reuptake inhibitors) is not recommended, unless strictly indicated, because they may enhance the risk of haemorrhage. If the combination cannot be avoided, close observation for signs of bleeding is recommended.' || PAEDIATRIC (why paedDose is null), SPC 4.2 verbatim: 'Acetylsalicylic acid should not be administered to children and adolescents younger than 16 years, except on medical advice where the benefit outweighs the risk (see section 4.4).' 4.4: 'Recommended for use in adults and adolescents from 16 years of age. This medicinal product is not recommended for use in adolescents/children under 16 years unless the expected benefits outweigh the risks. Acetylsalicylic acid may be a contributory factor in the causation of Reye's Syndrome in some children.' No paediatric dose exists in this source and none has been invented; verify any under-16 use (including Kawasaki disease) against a children's formulary.