Caution to be excercised while using aspirin with anticoagulants

Large doses of salicylates including aspirin may exert hypoglycemic action and may enhance
the effect of oral hypoglycemics.
If necessary the dose of hypoglycemic agent may be reduced while salicylate is given

Aspirin may decrease the effects of probenecid, sulfinpyrazone and phenylbutazone

Sodium excretion produced by spironolactone may be decreased in the presence of salicylates

Alcohol and salicylates may exhibit synergistic effect in causing GI bleeding.

Risk of GI ulceration  may be seen following concomittant administration of pyrazolone derivatives
( phenylbutazone, oxyphenylbutazone and possibly   dipyrone ) with aspirin.

Prophylaxis of angina
Prophylaxis of myocardial infarction

Aspirin-
epigastric discomfort,    gastric bleeding,   rhinitis,   urticaria,   angioneurotic oedema.
worsening of asthma,   elevation nof transaminase, hepatomegaly

Isosorbide mononitrate-                                                                                                                  urinary and faecal incontinence, abdominal pain, headache,  apphrension,  restleesness
weakness, veritigo,   dizziness,  tachycardia,  palpitation, orthostatic  hypotension.

Aspirin-
gastro-ulceration,  hypoprothrombinemia, patient with a history of ulceration or dyspepsia

Child- < 12 yr, bleeding diathesis

Isosorbide mononitrate-
hypersensitivity, acute circulatory failure, cardiogenic shock

Special Precautions-
Infants  with hypobiliruinuria because of risk of kernicetrus resulting from displacement
of bilirubin from plasma albumin.

Neonates, nursing mothers, elderly,
hypotension induced by ISMN  may be accompanied paradoximal bradycadia and increased
angina pectoris

Nitrate therapy may aggrevate the angina caused by hypertrophic cardiomyopathy.

Indication-
Prophylaxis of angina
Prophylaxis of myocardial infarction

Dosage-
Starting dose of ISMN and aspirin  60mg/75mg is one or two in the morning
ISMN 60mg/150mg is  one tablet in the morning

Use contraindicated. Observe caution