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RIVO-75

(acetylsalicylic acid)

Platelets

Platelets are released by special cells in the bone marrow “megakaryocytes”. Platelets are circulating as small discs in the blood, they are responsible for homeostasis “the stoppage of bleeding” and maintaining the endothelial lining of the blood vessels. Life span 7 to 10 days.

Role of platelets
Platelets responds to vascular trauma by “activation process”. Activation process takes place in three main steps: ► 1-Adhesion of platelets to the site of injury. ► 2-Release of intracellular granules (chemical mediators that cause the aggregation of the platelets together). ► 3-Aggregation of the platelets.

Mechanism of coagulation
► Chemical

mediators eg: “Thromboxane

A2 (TXA2),ADP, serotonin”. Produced

by activated platelets has prothrombotic properties by stimulating activation of new platelets as well as increased platelet aggregation.

Platelet Aggregation Inhibitors
There are different therapeutic groups that can be used for inhibiting the platelets aggregation. ► 1-Theinopyridine “Clopidogrel” ► 2-Dipyridamole ► 3-Cilostazol ► 4-NSAIDS

Clopidogrel “Plavix, Stroka”
Mechanism of action: ► Irreversible blocking of ADP receptors on the platelets. Side effects: ► Severe bleeding “in nose, stomach and urine”. ► Agranulocytosis “lack in formation of WBC” ► Diarrhoea, hallucination, confusion, decrease in blood pressure and joint pain. ► Skin disorders such as rashes and itching.

Dipyridamole “Persantin”
Mechanism of action: ► It is a vasodilator that inhibits platelets aggregation by inhibiting cAMP uptake in the platelets. Side effects: ► Due to vasodilator effect it cause hypotension, hot flushes and tachycardia. ► Hypersensitivity reactions such as severe Bronchospasm, rash and urticaria.

Therapeutic line of our drug
(NSAIDS) RIVO-75 is our
drug with active constituent (acetyl salicylic acid), which has antiplatelet aggregation effect at low concentrations(75100 mg\day).

Mode of action
► RIVO-75

blocks Thromboxane A2 synthesis from arachidonic acid in platelets by irreversible acetylation and inhibition of cyclooxygenase (Cox enzyme). ► The inhibitory effect is rapid and lasts for the life of the platelet (7 to 10 days).

. Indications: 1.Cardio-vascular and Cerebral treatment: ► Prophylaxis against intra-arterial thrombosis. ► Prophylaxis against transient cerebral ischemic attacks. ► Prophylaxis against myocardial infarction. ► Reduce mortality in post myocardial infarction patients. ► Treatment of Unstable Angina. ► Prevention of atherosclerosis.

Effect of platelets in atherosclerosis

Platelet aggregation -- and thrombosis -- after Type II injury are thought to play key roles in the progression of atherosclerosis.   Platelets release growth factors that stimulate migration and proliferation of smooth muscle cells and also contribute to the formation of sub endothelial "fibrointimal lesions" and possibly to formation of the outside capsule of predominantly "fatty lesions".

Indications: (Cont.) 2. Gynecological treatments: ►Treatment of preeclampsia and in prophylaxis from threatened abortion during pregnancy. ►In post-menopausal women to increase the elasticity of the arteries.

Indication (Con’t)
► For

GP : Aspirin is recommended for people above 40 years as it lowers the rates of heart attacks, strokes and even reduces the progression of some types of cancers “colon cancer”. And even reduce the progression of Alzheimer’s disease.

the effect of the body on the drug
► Absorption:

Pharmacokinetics

It is rapidly absorbed as such from stomach and upper part of small intestine. Minimal local irritation effect. ► It is rapidly hydrolyzed Cox
H2O
Rivo

(active) Acetylated Cox (inactive)

acetate Salicylic acid

Rapid onset of action

(Con’t)
► Metabolism:

Metabolized in the Liver by the conjugation with glycine and glucoronic acid. Bound to plasma Long duration of proteins (albumin) 80%action, can be used
For patients of liver disorders

► Excretion:

Mainly by the Kidney through the urine. excretion of free radicals Rapid

the effect of the drug on the body

Pharmacodynamics

► Rivo-75

cause irreversible acetylation of cyclooxygenase enzyme.

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Marketing plan

If u don’t have a goal you will never achieve

Goals
All Goals must be SMART

Specific Measurable Achievable Reliable Time framed

Feature vs Benefits

► Rapid

excretion, rapid elimination of toxic free radicals. ► Less side effects ,More safe than any other group. ► More potent than Dipyridamole as it is used conjugated with RIVO. ► Chewable with orange flavor (unique).

Long duration of action as RIVO cause irreversible acetylation of Cox enzyme and bounded to plasma proteins , more tolerable for patients.

Competitors of the same group
L.E 1.75 2.00 Conc. Pack. 75 mg 75 mg 20 T. 1.25 1.00 7.50 10 1.25 150 mg 75 mg 75 mg 100 mg 81mg 30 T. Cid Ramida Bayer Unipharm Aspocard Aggrex 75 Aspirin protect Aspico 30 T.
Comp. Trade Name

Adco Cid

Rivo 75 Aspocid Infantile

Multipharm Ezacard

IMS data
► Aspocid

75mg 2,261,000 unit till year 2007 ► Aggrex  999,000 unit ► Rivo-75mg  (712,000 – 531,000 – 415,000) in years 2005 – 2006 – 2007 respectively.

TCG ( Target customer group)
TARGET AUDIENCE: 1-IM 2-CARDIOLOGIST 3-GP 4-Gyn.

Positioning
The most trusted BRAND NSAID medication for the treatment and prophylaxis of cardiovascular and cerebral attacks .

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