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Q: In India, aspirin is available as Ecosprin-75 mg, 150 mg and 325 mg whereas in foreign countries the preparations are 81 mg, 162.5 mg and 325 mg. Which is correct? A hypertensive person aged 50 taking Ecosprin-75 as prophylaxis happens to go for MRI brain which reveals tight high Parietal Lacunar Infarct with cerebral atrophy. He is on Amlopress AT twice, Losar-50 twice , TG TOR 10, NoCAD, Zyloric-100 once. The LVEF is 65%. Both the cardiologist and neurologist say Ecosprin 75 is appropriate whereas the treating internist says Ecosprin 150 or 162.5 is required. His TMT is negative and there is no underlying cardiac problem though he is obese. It is interesting to note that the chest pain he used to have intermittently before starting Ecoprin-150 or Loprin DS, stopped after starting the drug. Does it go to suggest that dose of Ecosprin-75 was inadequate? What is activated charcoal and simethicone? Is it indigenous drug for the treatment of dyspepsia. Tab Distenil (Sun Pharma) was prescribed having Activated charcoal 400 + Simethicone 80 mg ? What is this drug. Why some patients prescribed Simvastatin and some Attorvastatin for high lipids Is there and distinction in the two molecules?

A:The dose of aspirin for its anti-clotting effect is adequate if 75mg is taken. There is no added advantage in consuming a higher dose; in fact it will lead to more side effects, particularly on the stomach in the elderly. There is not much difference i-between 75 and 81mg. The higher dose of 325mg is meant for pain relief, rheumatoid arthritis etc. Simethicon (also called dimethicone) combined with charcoal is just a very ordinary antacid. In fact Distenil is a very expensive, excessively priced product (Rs. 16.70 for just 6 tablets) that is aggressively promoted to doctors even though its scientific merit is in serious doubt. Simethicone given alone or added to an antacid as an antifoaming agent to relieve flatulence is of uncertain value. A combination of simethicone with charcoal is not permitted to be sold in any advanced country in the West. Simethicone is generally combined with alum. hydrox gel and magnesium salts such as Digene, Diovol, Alucinol, Acidin etc. Such products are globally accepted and available. The cost of such products in India is under Re. 1 per tablet.

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