RIVO-75RIVO-75

(acetylsalicylic acid)(acetylsalicylic acid)

PlateletsPlatelets

► Platelets are released by Platelets are released by special cells in the bone special cells in the bone marrow marrow “megakaryocytes”.“megakaryocytes”.

► Platelets are circulating as Platelets are circulating as small discs in the blood, small discs in the blood, they are responsible for they are responsible for homeostasis “the homeostasis “the stoppage of bleeding” and stoppage of bleeding” and maintaining the maintaining the endothelial lining of the endothelial lining of the blood vessels. Life span 7 blood vessels. Life span 7 to 10 days. to 10 days.

Role of plateletsRole of platelets

Platelets responds to Platelets responds to vascular trauma by vascular trauma by “ “activation processactivation process”.”.

Activation process takes Activation process takes place in three main place in three main steps:steps:

► 1-1-Adhesion of platelets to Adhesion of platelets to the site of injury.the site of injury.

► 2-2-Release of intracellular Release of intracellular granules (chemical granules (chemical mediators that cause the mediators that cause the aggregation of the platelets aggregation of the platelets together).together).

► 3-3-Aggregation of the Aggregation of the platelets.platelets.

Mechanism of Mechanism of coagulationcoagulation

► Chemical mediators Chemical mediators eg: “eg: “ThromboxaneThromboxane A2A2 (TXA2),ADP, serotonin”. Produced (TXA2),ADP, serotonin”. Produced by activated platelets has by activated platelets has prothrombotic properties by prothrombotic properties by stimulating activation of new stimulating activation of new platelets as well as increased platelet platelets as well as increased platelet aggregation.aggregation.

Platelet Aggregation Platelet Aggregation InhibitorsInhibitors

There are different therapeutic groups There are different therapeutic groups that can be used for inhibiting the that can be used for inhibiting the platelets aggregation.platelets aggregation.

►1-Theinopyridine “Clopidogrel”1-Theinopyridine “Clopidogrel”►2-Dipyridamole2-Dipyridamole►3-Cilostazol3-Cilostazol►4-NSAIDS4-NSAIDS

Clopidogrel “Plavix, Stroka”Clopidogrel “Plavix, Stroka”

Mechanism of action:Mechanism of action:► Irreversible blocking of ADP receptors on the Irreversible blocking of ADP receptors on the

platelets.platelets.

Side effects:Side effects:► Severe bleeding “in nose, stomach and urine”.Severe bleeding “in nose, stomach and urine”.► Agranulocytosis “lack in formation of WBC”Agranulocytosis “lack in formation of WBC”► Diarrhoea, hallucination, confusion, decrease Diarrhoea, hallucination, confusion, decrease

in blood pressure and joint pain.in blood pressure and joint pain.► Skin disorders such as rashes and itching.Skin disorders such as rashes and itching.

Dipyridamole “Persantin”Dipyridamole “Persantin”

Mechanism of action:Mechanism of action:► It is a vasodilator that inhibits platelets It is a vasodilator that inhibits platelets

aggregation by inhibiting cAMP uptake in aggregation by inhibiting cAMP uptake in the platelets.the platelets.

Side effects:Side effects:►Due to vasodilator effect it cause Due to vasodilator effect it cause

hypotension, hot flushes and tachycardia.hypotension, hot flushes and tachycardia.►Hypersensitivity reactions such as severe Hypersensitivity reactions such as severe

Bronchospasm, rash and urticaria.Bronchospasm, rash and urticaria.

Therapeutic line of our Therapeutic line of our drugdrug

(NSAIDS)(NSAIDS)RIVO-75RIVO-75 is our is our

drug with active drug with active constituent (acetyl constituent (acetyl salicylic acid), which salicylic acid), which has antiplatelet has antiplatelet aggregation effect at aggregation effect at low low concentrations(75-concentrations(75-100 mg\day). 100 mg\day).

Mode of actionMode of action

►RIVO-75 RIVO-75 blocks Thromboxane A2 blocks Thromboxane A2 synthesis from arachidonic acid in synthesis from arachidonic acid in platelets by irreversible acetylation platelets by irreversible acetylation and inhibition of cyclooxygenase (Cox and inhibition of cyclooxygenase (Cox enzyme).enzyme).

►The inhibitory effect is rapid and lasts The inhibitory effect is rapid and lasts for the life of the platelet (7 to 10 for the life of the platelet (7 to 10 days). days).

. . Indications:Indications:

1.Cardio-vascular and Cerebral 1.Cardio-vascular and Cerebral treatment:treatment:

► ProphylaxisProphylaxis against intra-arterial against intra-arterial thrombosis.thrombosis.

► ProphylaxisProphylaxis against transient cerebral against transient cerebral ischemic attacks.ischemic attacks.

► ProphylaxisProphylaxis against myocardial infarction. against myocardial infarction.► Reduce mortality in post myocardial Reduce mortality in post myocardial

infarction patients.infarction patients.► Treatment of Unstable Angina.Treatment of Unstable Angina.► Prevention of atherosclerosis. Prevention of atherosclerosis.

Effect of platelets in Effect of platelets in atherosclerosisatherosclerosis

► Platelet aggregation -- and Platelet aggregation -- and thrombosis -- after Type II thrombosis -- after Type II injury are thought to play injury are thought to play key roles in the progression key roles in the progression of atherosclerosis.of atherosclerosis.

►     Platelets release growth Platelets release growth factors that stimulate factors that stimulate migration and proliferation migration and proliferation of smooth muscle cells and of smooth muscle cells and also contribute to the also contribute to the formation of sub endothelial formation of sub endothelial "fibrointimal lesions" and "fibrointimal lesions" and possibly to formation of the possibly to formation of the outside capsule of outside capsule of predominantly "fatty predominantly "fatty lesions". lesions".

Indications: (Cont.)Indications: (Cont.)

2. Gynecological treatments:2. Gynecological treatments:►Treatment of Treatment of preeclampsiapreeclampsia and and

in prophylaxis from in prophylaxis from threatened threatened abortionabortion during pregnancy. during pregnancy.

►In post-menopausal women to In post-menopausal women to increase the elasticity of the increase the elasticity of the arteries. arteries.

Indication (Con’t)Indication (Con’t)

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

PharmacokineticsPharmacokineticsthe effect of the body on the drugthe effect of the body on the drug

►AbsorptionAbsorption::

It is rapidly absorbed as such from It is rapidly absorbed as such from stomach and upper part of small stomach and upper part of small intestine. intestine. Minimal local irritation effect.Minimal local irritation effect.

► It is rapidly hydrolyzedIt is rapidly hydrolyzed RivoRivo

Salicylic acid

H2O

acetate

Cox(active)

Acetylated Cox(inactive)

Rapid onset of action

(Con’t)(Con’t)

►Metabolism:Metabolism: Metabolized in the Liver Metabolized in the Liver by the conjugation with glycine and by the conjugation with glycine and glucoronic acid. Bound to plasma glucoronic acid. Bound to plasma proteins (albumin) 80%proteins (albumin) 80%

►Excretion: Excretion: Mainly by the Kidney Mainly by the Kidney through the urine.through the urine.

Long duration of action, can be used For patients of liver disorders

Rapid excretion of free radicals

PharmacodynamicsPharmacodynamicsthe effect of the drug on the bodythe effect of the drug on the body

► Rivo-75 Rivo-75 cause irreversible acetylation of cause irreversible acetylation of cyclooxygenase enzyme.cyclooxygenase enzyme.

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Marketing plan Marketing plan

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

GoalsGoals

All Goals must be SMARTAll Goals must be SMART

SSpecificpecific

MMeasurableeasurable

AAchievablechievable

RReliableeliable

TTime framedime framed

Feature vs BenefitsFeature vs Benefits

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

► Rapid excretion, Rapid excretion, rapid elimination of rapid elimination of toxic free radicals. toxic free radicals.

► Less side effects ,Less side effects ,More safeMore safe than any than any other group.other group.

► More potentMore potent than Dipyridamole as it is than Dipyridamole as it is used conjugated with used conjugated with RIVORIVO..

► Chewable with orange flavor (unique).Chewable with orange flavor (unique).

L.EL.E ConcConc. Pack. Comp. Trade Name

1.75 75 mg 30 T. Adco Rivo 75

2.00 75 mg Cid Aspocid Infantile

20 T.

1.25 150 mg Cid Aspocard

1.00 75 mg Ramida Aggrex 75

7.50 75 mg Multipharm Ezacard

10 100 mg Bayer Aspirin protect

1.25 81mg 30 T. Unipharm Aspico

Competitors of the same Competitors of the same group group

IMS dataIMS data

►Aspocid 75mgAspocid 75mg 2,261,000 unit till 2,261,000 unit till year 2007year 2007

►Aggrex Aggrex 999,000 unit 999,000 unit►Rivo-75mg Rivo-75mg (712,000 – 531,000 – (712,000 – 531,000 –

415,000) in years 2005 – 2006 – 2007 415,000) in years 2005 – 2006 – 2007 respectively. respectively.

TCG ( Target customer TCG ( Target customer group)group)

TARGET AUDIENCE: TARGET AUDIENCE:

1-IM1-IM

2-CARDIOLOGIST 2-CARDIOLOGIST

3-GP3-GP

4-Gyn. 4-Gyn.

PositioningPositioning

The most trusted BRAND NSAID The most trusted BRAND NSAID medication for the treatment and medication for the treatment and prophylaxis of cardiovascular and prophylaxis of cardiovascular and

cerebral attacks .cerebral attacks .

THANK YOUTHANK YOU