Coxor

Coxor is a single-dose emergency medicine containing 300 mg acetylsalicylic acid, supplied as a powder and liquid for oral solution in a self-contained bottle. It is authorised for the emergency treatment of a suspected acute heart attack (acute myocardial infarction) in adults over 18 years, to be taken as soon as possible after contacting emergency medical services. The active substance is held as a white powder in the bottle cap; it is released into the liquid and shaken until dissolved immediately before drinking. Coxor is not an everyday painkiller. Marketing authorisation holder: Asamedic AS, Rosenholmveien 25, 1414 Trollasen, Norway.

Coxor is indicated in adults over 18 years for the emergency treatment of a suspected acute myocardial infarction (heart attack), after contacting emergency medical services. A single 300 mg dose (one bottle) should be taken as soon as possible. If emergency services cannot be reached, the dose should still be taken as soon as possible and immediate medical attention sought. Coxor is not indicated as an analgesic or antipyretic, and is not relevant for use in the paediatric population.

Because Coxor is given as a single 300 mg dose in an acute setting, the risk of adverse reactions is very low; the reactions listed below were identified in long-term studies of acetylsalicylic acid. Common: increased bleeding tendency. Uncommon: dyspnoea. Rare: hypersensitivity reactions, angioedema, allergic oedema, anaphylactic reactions including shock; intracerebral haemorrhage; haemorrhagic vasculitis; bronchospasm and asthma attack; severe gastrointestinal bleeding; Stevens-Johnson syndrome, toxic epidermal necrolysis, purpura, erythema nodosum, erythema multiforme; menorrhagia. Not known: bleeding with prolonged bleeding time such as nosebleed or gingival bleeding. Occult blood in the stool may be found on investigation.

Contraindicated in patients hypersensitive to acetylsalicylic acid, to any excipient, or to other salicylates or NSAIDs. Acetylsalicylic acid can cause bronchospasm and asthma attacks or other hypersensitivity reactions; risk factors include asthma, hay fever, nasal polyps and chronic lung disease. It is associated with bleeding, so possible bleeding should be monitored on admission to hospital. Each bottle contains 595 mg (26 mmol) sodium, equivalent to 30% of the WHO recommended maximum daily intake of 2 g sodium for an adult. Acetylsalicylic acid may be used in pregnancy as emergency treatment of a suspected acute myocardial infarction where necessary, but must not be used as a painkiller or fever reducer in pregnancy; short-term use of the recommended dose does not require breastfeeding to be interrupted. Treatment of an acute myocardial infarction is not compatible with driving or operating machinery. Taking Coxor is not dangerous if the symptoms turn out not to be a heart attack. Toxic dose is approximately 200 mg/kg in adults; single doses below 100 mg/kg are unlikely to cause serious poisoning. Once reconstituted, the solution must be drunk within 5 minutes.

Anticoagulants (for example coumarin, heparin, warfarin): increased risk of bleeding due to inhibited platelet function, damaged duodenal mucosa and displacement of oral anticoagulants from plasma protein binding sites; bleeding time should be monitored when the patient is admitted to hospital. Antiplatelet agents (for example clopidogrel and dipyridamole) and selective serotonin reuptake inhibitors (such as sertraline or paroxetine): increased risk of gastrointestinal bleeding, which can be monitored in hospital. Other NSAIDs: increased risk of ulcers and gastrointestinal bleeding through a synergistic effect, which can be monitored in hospital.