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Тромбоасс и кардиомагнил в чем отличие

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17 августа 2019

В наше время самыми распространенными патологиями являются заболевания сердечно-сосудистой системы, кроме этого, от них и самая высокая смертность. Первая причина развития инфаркта миокарда и ишемического инсульта – перекрытие сосуда тромбом. Для профилактики образования кровяных сгустков используют препараты ацетилсалициловой кислоты. На фармакологическом рынке одними из самых распространенных являются Кардиомагнил и Тромбо АСС, каждый из которых стремиться быть лучшим. В чем между ними разница и какие преимущества каждого из них?

Каковы отличия препаратов?

Оба средства показаны пациентам, что страдают такими патологиями:

  • стенокардия и уменьшение риска инфаркта миокарда;
  • профилактика рецидивов после перенесенного инфаркта;
  • нарушения кровотока в сосудах головного мозга, в том числе и при ишемическом инсульте;
  • предупреждение тромбоза вследствие оперативного вмешательства на сосудах, включая состояния после аортокоронарного шунтирования;
  • профилактика транзиторных ишемических атак;
  • предупреждение развития тромбофлебита при варикозном расширении вен.

Кардиомагнил и Тромбо АСС в своем составе имеют одинаковое действующее вещество – ацетилсалициловую кислоту (АСК), что обладает противовоспалительным, жаропонижающим и дезагрегантным действием. Именно последнее свойство дало возможность широкого применения этих препаратов в лечении и профилактике сердечно-сосудистых заболеваний.

Отличается Кардиомагнил от Тромбо АСС составом дополнительных субстратов. В первом кроме ацетилсалициловой кислоты включены такие вспомогательные вещества: кукурузный крахмал, стеарат магния, целлюлоза, тальк и пропиленгликоль. Также в состав входит гидроксид магния, который оказывает защитное действие на слизистую оболочку желудка и ослабляет раздражающее влияние АСК, адсорбирует соляную кислоту, имеет обволакивающее свойство.

В составе Тромбо АСС в качестве вспомогательных веществ входят лактозный моногидрат, целлюлоза, коллоидный безводный диоксид кремния, крахмал, тальк, триацетин и дисперсия метакрилатного сополимера. Благодаря этим компонентам образуется оболочка препарата, которая может раствориться только в кишечнике в условиях преобладания щелочной среды, не затрагивая желудок, что позволяет снизить риск повреждающего эффекта его слизистой.

Еще одно различие препаратов – дозировка. Кардиомагнил выпускается в таблетках, которые могут содержать 75 или 150 мг ацетилсалициловой кислоты. Тромбо АСС производится с количествами действующего вещества 50 и 100 мг. Минимальная эффективная доза АСК для профилактики сердечно-сосудистых патологий разная для отдельных групп пациентов с высоким кардиоваскулярным риском приведена в таблице:

Группы пациентов Минимальная эффективная доза, мг
Транзиторная ишемическая атака или ишемический инсульт в анамнезе 50
Мужчины с высоким риском сердечно-сосудистых происшествий 75
Гипертоническая болезнь 75
Стабильная и нестабильная стенокардия 75
Стеноз сонных артерий 75
Истинная полицитемия 100
Острый ишемический инфаркт миокарда или острый ишемический инсульт 160

В зависимости от конкретной патологии нужна разная доза ацетилсалициловой кислоты. Тромбо АСС или Кардиомагнил имеют необходимое количество действующего вещества для каждого случая. Важно помнить, что препарат с кишечнорастворимой оболочкой нельзя разламывать, чтобы ее не повредить и не спровоцировать начало действия реагента в желудке.

Еще один достаточно важный критерий выбора препарата для пациента – цена. Стоимость Тромбо АСС почти в два раза меньше, чем у Кардиомагнила. Но стоить помнить, что ориентироваться нужно не только на цену, но и на безопасность назначения, рекомендованного доктором. Ведь именно специалист, терапевт или кардиолог, определяет необходимость лечения, дозировку и вид препарата.

Какому отдать предпочтение?

Перед тем, как определиться с выбором препарата, необходимо изучить противопоказания к назначению. Для обоих медикаментов они одинаковые:

  • повышенная чувствительность к салицилатам или какого-нибудь компонента препарата;
  • хроническое течение бронхиальной астмы, что вызвана приемом ацетилсалициловой кислоты или нестероидными противовоспалительными в анамнезе;
  • язвенная болезнь желудка в стадии обострения;
  • кровотечения и гематологические патологии (геморрагический диатез, гемофилия, тромбоцитопения);
  • выраженная недостаточность работы печени и почек;
  • одновременный прием с метотрексатом.

При неправильно подобранном виде фармпрепарата или его дозы, а также индивидуальной чувствительности и особенностей организма, возможно появление следующих побочных эффектов, вследствие чего необходима отмена или замена средства:

  • со стороны желудочно-кишечного тракта: изжога, отрыжка, болезненность в эпигастральной области, воспалительные и эрозивно-язвенные поражения, которые могут привести к кровотечению и перфорацию;
  • повышенный риск кровотечений из послеоперационных ран, появление гематом;
  • реакции гиперчувствительности: зуд, покраснение кожи, отек, бронхоспазм;
  • транзиторная печеночная недостаточность;
  • гипогликемия.
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Особенности назначения

Для того, чтобы решить, принимать Кардиомагнил или Тромбо АСС нужно проконсультироваться с лечащим врачом. Только доктор указывает на необходимость и дозировку медикаментов. В некоторых случаях самолечение препаратами для разжижения крови может быть опасно для здоровья и иметь серьезные побочные эффекты.

Например, лечение ацетилсалициловой кислотой запрещено во время беременности, особенно в первом и третьем триместре. Есть риск рождения ребенка с пороками развития (расщепление твердого и мягкого неба, нарушение строения сердца), появлению внутричерепных кровоизлияний. Также прием данных препаратов может нанести вред и матери: перенашивание беременности, слабость родовой деятельности, удлинение времени кровотечения. Если есть необходимость терапии, то доза препарата должна быть как можно меньше, а курс лечения короче.

При лечении варикозного расширения вен делают акцент на уменьшении вязкости крови, возможности тромбообразования и улучшении микроциркуляции. Для этого использования только Тромбоасса и Кардиомагнила недостаточно, так как они обладают лишь дезагрегантным свойством. В схему лечения включается Актовегин (улучшает кровоток и метаболические процессы), Курантил (предотвращает образование тромбов), а также препараты, что укрепляют сосудистую стенку.

Прежде, чем сделать выбор в пользу того или иного препарата, доктор тщательно собирает анамнез пациента, проводит физикальный осмотр (пальпация, аускультация), а также изучает лабораторные показатели крови. Одни специалисты утверждают, что гидроксид магния, что входит в состав Кардиомагнила, не достаточно хорошо выполняет функцию антацида, и отдают предпочтение кишечнорастворимой оболочке, как у Тромбоасса. Другие исследователи замечают слабо выраженное антиагрегантное действие низкодозированных препаратов, что растворяются в кишечнике.

Какой из двух препаратов подойдет определенному пациенту, должен решать только доктор. При появлении жалоб на диспептические расстройства, боли в животе, обострение эрозивных процессов желудочно-кишечного тракта необходимо отменить прием медикаментов или заменить его (при невозможности прерывания дезагрегантной терапии), дополнив лечение антацидами.

Выводы

Препараты ацетилсалициловой кислоты, а именно Тромбоасс и Кардиомагнил, обязательно должны быть включены в лечение пациентов с высоким кардиальным риском. Несмотря на возможность появления побочных реакций, ожидаемый положительный эффект значительно выше. Кроме этого, препараты доступны по цене и удобны в применении.

Для подготовки материала использовались следующие источники информации.

Сегодня фармакологические компании выпускают огромное количество схожих по действию и составу препаратов. И порой найти разницу и разобраться в том, какое именно лекарство будет лучше, без помощи квалифицированного специалиста достаточно сложно. Ярким примером тому является пара препаратов — «Тромбоасс» и «Кардиомагнил». Отличия и сходства, схема приема и принцип действия, состав и противопоказания – все эти важные моменты и будут рассмотрены далее.

Оба медикамента относятся к нестероидной группе противовоспалительных препаратов и выпускаются в таблетках. Алгоритм действия также похож, но почему тогда врачи в своей практике используют для лечения пациентов оба эти препарата? Что лучше, «Кардиомагнил» или «Тромбоасс»? Как понять, какое из этих лекарств будет более действенным в каждом отдельном случае? Чтобы разобраться, следует более детально изучить особенности и свойства каждого из представленных средств.

Показания к приему

Симптомы, с которыми способно справиться то или иное лекарственное средство, являются основным критерием выбора медикамента. Поэтому чтобы понять, что лучше — «Кардиомагнил» или «Тромбоасс», следует изучить показания к применению. Для рассматриваемой пары медикаментозных средств они следующие:

  • Лекарства используются для профилактики заболеваний сердечно-сосудистой системы, в том числе для исключения проявления тромбоза. Здесь можно было бы чисто интуитивно отдать предпочтение препарату «Тромбоасс», так как его название намекает о превосходстве в борьбе с данной проблемой, но делать поспешные выводы не стоит.
  • В инструкции к данным продуктам указаны такие показания, как гипертония и гиперлипидемия.
  • Препарат «Кардиомагнил» или «Тромбоасс» поможет справиться с проявлениями стенокардии, а также поможет при ишемическом инсульте.
  • И те, и другие таблетки назначают для профилактики тромбозов в постоперационный период, а также в период восстановления организма после перенесенного инфаркта.
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Из данной информации выходит, что препараты являются взаимозаменяемыми аналогами.

Состав препаратов

Активным действующим компонентом данных медикаментов выступает ацетилсалициловая кислота. И здесь совсем начинается путаница с ответом на вопрос о том, что лучше — «Кардиомагнил» или «Тромбоасс». Однако если несколько углубиться и изучить состав, обнаруживается, что в таблетки «Кардиомагнил» в качестве вспомогательного компонента включено вещество гидроксид магния, которое в определенной мере смягчает воздействие основного ингредиента на слизистую оболочку желудка.

В то же время нельзя упустить тот факт, что таблетки «Тромбоасс» имеют специальную оболочку, которая растворяется непосредственно в кишечнике, что минимизирует агрессивное действие ацетилсалициловой кислоты. Поэтому что лучше — «Кардиомагнил или «Тромбоасс», позволит определить следующий критерий выбора: дозировка.

Дозировка лекарств

Также при выборе того или иного медикамента врачи уделяют особое внимание потребностям организма в дозировке препарата, исходя из общей картины состояния пациента. Чем отличается «Тромбоасс» от «Кардиомагнила» по данному показателю? Ввиду того что в большинстве случаев схема приема определяется в индивидуальном порядке, врач может выбрать препарат исходя из количества активного вещества в одной таблетке. В медикаменте «Кардиомагнил» может содержаться 75 и 150 мл ацетилсалициловой кислоты, а в препарате «Тромбоасс» — 50 и 100 мл.

Алгоритм действия

Аналогичный состав активных компонентов препарата объясняет схожее действие лекарств, которое основано на способности ацетилсалициловой кислоты влиять на некоторые процессы организма. В частности, воздействовать на синтез тромбоксана, простагландинов и простациклинов.

Препарат быстро всасывается в ЖКТ и выводится через мочевую систему.

Данный показатель мало что может сказать о том, какой препарат выбрать — «Тромбоасс» или «Кардиомагнил». Что лучше будет в каждом отдельном случае, помогут определить другие критерии выбора.

Стоит отметить, что только врач сможет адекватно оценить ситуацию, осмотрев пациента и проведя ряд клинических анализов, и назначить наиболее приемлемый препарат.

Побочные эффекты

Таблетки «Тромбоасс» или «Кардиомагнил» — что лучше выбрать, учитывая негативные воздействия этих лекарств на организм? Одним из основных негативных последствий, которые могут проявиться после приема, является аллергическая реакция в виде отека Квинке или кожных высыпаний, включая крапивницу, пятна и анафилактический шок. В данных случаях препарат отменяют, а больного незамедлительно доставляют в больницу за врачебной помощью.

К менее опасным проявлениям можно отнести сонливость, головокружение. Также могут наблюдаться анемия, кровоточивость, которые требуют врачебного контроля.

Что же касается проявлений со стороны желудочно-кишечного трата, то минимальное агрессивное действие ацетилсалициловой кислоты в препарате позволит избежать рвоты, тошноты, язвы желудка и двенадцатиперстной кишки. Поэтому, выбирая между таблетками «Кардиомагнил» или «Тромбоасс», следует помнить, что первый вариант будет более щадящим.

Цена: определяющий фактор выбора для пациента

В наши дни не каждый может позволить себе дорогостоящее лечение, а потому вполне понятно, почему таблетки «Тромбоасс» — наиболее приемлемый вариант для пациентов. Их стоимость практически в два раза меньше. Однако не стоит забывать, что таблетки «Кардиомагнил» более щадящие для желудка, так как в их состав входит специальный, нейтрализующий пагубное воздействие на слизистую компонент.

Отзывы о препаратах

Делая выбор между двумя данным медикаментами, нельзя не обратить внимание на отклики пациентов, испытавших на себе действия данных средств, и специалистов, использующих данные препараты в своей практике для лечения больных. Итак, что лучше — «Кардиомагнил или «Тромбоасс»? Отзывы помогут выбрать наиболее предпочтительный вариант.

И здесь, как всегда, мнения разделились. Если врачи достаточно часто используют и то, и другое средство, исходя из более удобной дозировки, и отмечают положительную динамику в обоих случаях, то среди пациентов более распространен до боли знакомый принцип: зачем платить больше. Отчасти такая позиция понятна, но не каждый сможет без последствий пройти даже двухнедельный курс терапии без риска развития проблем со стороны желудка.

Однако отзывы о том, что оба рассматриваемых препарата вполне оперативно справляются с поставленной перед ними задачей, не могут не радовать. Если правильно расставить акценты, можно не только поддержать сердечно-сосудистую систему, но и сделать это с минимальным риском для других не менее важных органов.

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Самолечение – вред здоровью

Помните, только врач сможет сказать, какие именно таблетки стоит принимать в каждом отдельном случае. Самолечение опасно для жизни, особенно когда речь идет о сердце. Поэтому прочь все личные предпочтения, советы друзей и знакомых. Лишь адекватное мнение квалифицированного специалиста, знающего свое дело, поможет преодолеть столь серьезные заболевания, для лечения которых требуются таблетки «Кардиомагнил» и «Тромбоасс».

Хоть препараты и являются функциональными аналогами и входят в одну группу, между ними все же есть существенные отличия. В чем разница между Кардиомагнилом и ТромбоАССом и какой из них лучше?

Состав и воздействие препаратов

Для сравнения состав препаратов представлен таблицей:

ТромбоАСС Кардиомагнил
Основное действующее вещество
  • Ацетилсалициловая кислота – 50 или 100 мг
  • Ацетилсалициловая кислота – 75 и 150 мг
  • Гидроксид магния – 30,39 мг
Вспомогательные вещества
  • Целлюлоза
  • Лактоза
  • Диоксид кремния
  • Кортофельный крахмал
  • Целлюлоза
  • Магния стеарат
  • Кукурузный крахмал
  • Картофельный крахмал
Оболочка
  • Тальк
  • Триацетин
  • Кислота метакриловая
  • Сополимер этилакрилата
  • Тальк
  • Гипромеллоза
  • Пропиленгликоль

Принцип воздействия препаратов схож: основное назначение – препятствие тромбообразования благодаря ацетилсалициловой кислоте, обладающей антиагрегантными свойствами. ТромбоАСС в данном случае обладает менее выраженными свойствами, чем Кардиомагнил, так как доза вещества в нем меньше, но и побочное действие аспирина (ацетилсалициловой кислоты) гораздо реже. Основное, чем отличается Кардимагнил от ТромбоАССа, – это наличие магния, улучшающего работу кардиомиоцитов.

В чем разница?

Как видно из состава, разница между препаратами все же есть. Определить, что лучше Кардиомагнил или тромбоАСС, нужно, основываясь на всех параметрах, присущих препаратам.

При выборе антиагрегантного средства необходимо учитывать индивидуальные особенности пациента. В зависимости от этого, лечащим врачом и отдается предпочтение одному из препаратов.

Дозировка

Для антиагрегантного свойства достаточно небольших доз ацетилсалициловой кислоты. Обычно в сутки назначают от 75 до 300 миллиграмм.

Патология Кардиомагнил ТромбоАСС
Профилактика инсульта и инфаркта 1 таблетка 75 мг 2 таблетки 50 мг или 1 таблетка 100 мг
Стенокардия 1 таблетка 75 мг 2 таблетки 50 мг или 1 таблетка 100 мг
Высокий риск ишемии (сопутствующие эндокринные патологии типа сахарного диабета, инсульта и инфаркта в анамнезе, варикозное расширение вен ног и так далее) 2 таблетки по 150 мг 3 таблетки по 100 мг
Угроза тромбоэмболии легочной артерии (послеоперационный период, преимущественно постельный режим, пневмонии и так далее) 3 таблетки по 75 мг 2 таблетки по 100 мг

Второстепенный состав

Основное реально полезное вещество, которое значительно улучшает свойства препарата, – это магний, входящий в состав Кардиомагнила и как основное действующее соединение, и как вспомогательное. Он участвует как в процессе сокращения, высвобождая кальций и активируя сближение актина с миозином, так и в энергообразовании – синтезе и превращениях АТФ.

Также именно благодаря магнию значительно снижается побочное действие аспирина на слизистую желудка. Это позволяет избежать язв и эрозий с последующими кровотечениями, пенетрациями и перфорациями, хроническим малокровием (анемией). Так что в данном случае для пациентов с предрасположенностью выгоднее использовать Кардиомагнил, даже несмотря на то, что доза аспирина в нем больше, чем в ТромбоАССе.

Структура таблеток

Таблетки обоих препаратов покрыты оболочкой, которая растворяется под действием желудочного сока, высвобождая основные вещества. ТромбоАСС от Кардиомагнила отличается тем, что средство цельное и не может быть разделено пополам для более точного подбора необходимой дозы.

ТромбоАСС – бюджетный вариант. Кардиомагнил отличается более высокой стоимостью, так как является оригинальным препаратом, прошедшим гораздо больше клинических исследований.

Это не значит, что Кардимагнил является панацеей и только он необходим, ТробоАСС – достойный заменитель, имеющий абсолютно такие же побочные действия и противопоказания и оказывающий такое же действие.

Какой препарат лучше?

При выборе терапии всегда отдается предпочтение оригиналу. Тем не менее выбор должен осуществлять лечащий врач. Также необходимо учитывать индивидуальные особенности организма и реакцию.

Оба препарата обладают хорошими антиагрегантными свойствами и при правильном применении способны поддерживать нормальные реологические свойства крови, осуществляя профилактику жизнеугрожающих заболеваний. Различия между ними незначительные.

Автор: Ирина Васильева, врач,
специально для xVarikoz.ru

Полезное видео про Кардиомагнил

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