http://reference.medscape.

com/drug/zorprin-bayer-buffered-aspirin-343279
Dosage Forms & Strengths
Pain & Fever
325-650 mg PO/PR q4-6hr PRN
Controlled/extended/delayed-release products (enteric-coated): 650-1300 mg PO q8hr; not to exceed 3.9 g/day

Acute Coronary Syndrome

For use as adjunctive antithrombotic effects for ACS (ST-segment elevation myocardial infarction [STEMI],
unstable angina [UA]/non-ST-segment elevation myocardial infarction [NSTEMI])
Acute symptoms

160-325 mg PO; chew nonenteric-coated tablet upon presentation (within minutes of symptoms)
If unable to take PO, may give 300-600 mg suppository PR
Maintenance (secondary prevention)

75-81 mg PO qDay indefinitely (preferred dose); may give 81-325 mg/day

Regimen may depend on coadministered drugs or comorbid conditions
Coadministered with ticagrelor: 81 mg PO qDay
Percutaneous transluminal coronary angioplasty

Adjunctive aspirin therapy to support reperfusion with primary PCI (with or without fibrinolytic therapy)
Preoperative dose: 162-325 mg PO before procedure
Maintenance: 81 mg PO qDay indefinitely (preferred dose) may give 81-325 mg/day
Regimen may depend on coadministered drugs or comorbid conditions
Coadministered with ticagrelor: 81 mg PO qDay

Primary & Secondary Prevention

Durlaza: Indicated to reduce the risk of death and MI in patients with chronic CAD (eg, history of MI, unstable
angina, or chronic stable angina); also indicated to reduce the risk of death and recurrent stroke in patients who
have had an ischemic stroke or TIA
Extended-release capsule (Durlaza [Rx]): 162.5 mg PO qDay
Use immediate-release aspirin, not extended release capsule in situations where a rapid onset of action of
action is required (such as acute treatment of myocardial infarction or before percutaneous coronary
intervention)

Ischemic Stroke & Transient Ischemic Attack

50-325 mg/day PO within 48 hours of stroke or TIA, then 75-100 mg/day PO

Osteoarthritis
Up to 3 g/day PO in divided doses

Rheumatoid Arthritis
3 g/day PO in divided doses; increased PRN for anti-inflammatory efficacy (target plasma salicylate, 150-300
mcg/mL)

Spondyloarthropathy
3.6-5.4 g/day PO in divided doses; monitor serum concentrations

Colorectal Cancer (Off-label)

Prophylaxis

600 mg/day PO
Decreases risk of developing hereditary colorectal cancer (ie, Lynch syndrome) by 60% if taken daily for at
least 2 years

Dosing Modifications
Renal impairment

CrCl >10 mL/min: Dose adjustment not necessary

CrCl <10 mL/min: Not recommended
Hepatic impairment

Severe liver disease: Not recommended

Mechanism of Action
Inhibits synthesis of prostaglandin by cyclooxygenase; inhibits platelet aggregation; has antipyretic and
analgesic activity

Absorption
Bioavailability: 80-100%
Onset: PO, 5-30 min; PR, 1-2 hr
Duration: PO, 4-6 hr; PR, >7 hr
Peak plasma time: PO, 0.25-3 hr
Peak plasma concentration: Analgesia/antipyresis, 30-100 mcg/mL; anti-inflammatory, 150-300 mcg/mL

Distribution
Protein bound: 100 mcg/mL, 90-95%; 100-400 mcg/mL, 70-85%; higher concentrations, 25-60%
Vd: 170 mL/kg

Metabolism
Metabolized by liver via microsomal enzyme system
Metabolites: Salicylurate, salicyl phenolic glucuronide, salicyl acyl glucuronide, 2,5-dihydroxybenzoic acid
(gentisic acid), 2,3-dihydroxybenzoic acid, 2,3,5-trihydroxybenzoic acid, gentisuric acid (active)
Enzymes inhibited: Cyclooxygenase (insignificant)

Elimination

Half-life: Low dose, 2-3 hr; higher dose, 15-30 hr

Renal clearance: 80-100% in 24-72 hr
Excretion: Urine (80-100%), sweat, saliva, feces
Dialyzable: Yes