Aspirin: Complete Guide with FAQs
Class
- Non-Steroidal Anti-Inflammatory Drug (NSAID)
- Antiplatelet Agent
Indications
- Relief of mild to moderate pain (e.g., headache, muscle aches, toothache).
- Reduction of fever.
- Anti-inflammatory treatment for conditions like arthritis.
- Prevention of blood clots in cardiovascular conditions (e.g., heart attack, stroke).
- Management of acute coronary syndrome and post-stroke care.
Mechanism of Action
- Irreversibly inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandins and thromboxane.
- Reduces inflammation, pain, and fever; inhibits platelet aggregation.
Dosage and Administration
For Pain or Fever
- Adults: 325–650 mg every 4–6 hours as needed, up to 4,000 mg/day.
For Cardiovascular Prevention
- Low-dose aspirin: 75–100 mg daily for long-term prevention of blood clots.
For Acute Heart Attack (Emergency Use)
- 160–325 mg chewed immediately upon onset of symptoms.
Administration Tips
- Take with food or a full glass of water to minimize stomach irritation.
- Do not crush or chew enteric-coated tablets; swallow whole.
Forms Available
- Tablets: 75 mg (low-dose), 325 mg, 500 mg (can vary in countries)
- Enteric-coated tablets: 75 mg, 325 mg
- Effervescent tablets
- Rectal suppositories
Brand Names and Manufacturers
- Bayer Aspirin (Bayer)
- Bufferin (Sun Pharma)
- Excedrin (combination with acetaminophen and caffeine, GSK)
- Generic aspirin widely available.
Cost
- Affordable, typically $5–$20 depending on dosage and brand.
Contraindications
- Allergy to aspirin or other NSAIDs.
- Active gastrointestinal bleeding or peptic ulcer disease.
- Severe liver or kidney disease.
- Bleeding disorders (e.g., hemophilia).
- Children under 16 with viral infections (risk of Reye’s syndrome).
Precautions
- Use with caution in patients with asthma, as it may trigger bronchospasm.
- Avoid alcohol to reduce the risk of gastrointestinal bleeding.
- Monitor closely in elderly patients due to increased risk of bleeding.
Side Effects
Common
- Nausea, vomiting
- Heartburn or indigestion
- Mild abdominal discomfort
Less Common
- Dizziness
- Ringing in the ears (tinnitus)
Rare but Serious
- Gastrointestinal bleeding or ulcers
- Hemorrhagic stroke
- Severe allergic reactions (e.g., anaphylaxis)
- Reye’s syndrome in children
Drug Interactions
- Anticoagulants (e.g., Warfarin, Heparin): Increased bleeding risk.
- Other NSAIDs (e.g., Ibuprofen): Reduced cardioprotective effects of aspirin; space doses appropriately.
- Corticosteroids: Increased risk of gastrointestinal bleeding.
- Methotrexate: Increased toxicity at high aspirin doses.
- ACE Inhibitors and Diuretics: Reduced effectiveness in managing hypertension.
Monitoring Parameters
- Signs of bleeding (e.g., black or tarry stools, unusual bruising).
- Platelet count and clotting parameters in long-term use.
- Symptoms of salicylate toxicity (e.g., tinnitus, confusion).
Patient Counseling Points
- Use only as directed; avoid exceeding the maximum daily dose.
- Take low-dose aspirin consistently if prescribed for cardiovascular prevention.
- Report any signs of bleeding, such as bloody stools or prolonged bruising.
- Avoid using other NSAIDs or blood thinners without medical advice.
- Inform healthcare providers of aspirin use before any surgery or dental procedure.
- Store in a cool, dry place and keep away from children.
FAQs About Aspirin
Q1: Can aspirin be taken daily for heart health?
- Yes, but only under a doctor’s recommendation to prevent risks of bleeding.
Q2: Is aspirin safe during pregnancy?
- Low-dose aspirin may be prescribed in certain cases (e.g., preeclampsia prevention); avoid high doses.
Q3: Can children take aspirin?
- No, aspirin is contraindicated in children under 16 with viral infections due to the risk of Reye’s syndrome.
Q4: Can I take aspirin with other painkillers?
- Aspirin can be taken with acetaminophen but should not be combined with other NSAIDs without medical advice.
Q5: What should I do if I miss a dose of daily low-dose aspirin?
- Take it as soon as you remember unless it’s close to the next dose; do not double doses.
Q6: How long does aspirin stay in the system?
- Aspirin’s effects on platelets last 7–10 days, while the drug itself is cleared in 4–6 hours.
Q7: Can aspirin cause stomach ulcers?
- Long-term or high-dose use increases the risk of ulcers; take with food or use enteric-coated tablets.
Q8: Is aspirin effective for migraines?
- Yes, aspirin can reduce migraine pain, especially when combined with caffeine.
Q9: How does aspirin prevent heart attacks?
- By inhibiting platelet aggregation, aspirin reduces the formation of clots that can block blood flow.
Q10: Can I drink alcohol while taking aspirin?
- Avoid alcohol, as it increases the risk of gastrointestinal bleeding.
Q11: Can aspirin be used topically?
- Aspirin is not recommended for topical use; it is designed for oral or rectal administration.
Q12: What should I do in case of an aspirin overdose?
- Seek immediate medical attention; symptoms may include ringing in the ears, confusion, rapid breathing, or vomiting.
Q13: Is aspirin suitable for long-term use?
- Yes, at low doses for cardiovascular prevention, but regular monitoring is essential to avoid side effects.
Q14: Can aspirin reduce cancer risk?
- Some studies suggest low-dose aspirin may reduce the risk of colorectal cancer, but this use is not universally recommended.
Q15: Does aspirin interact with herbal supplements?
- Yes, supplements like ginkgo biloba and fish oil may increase bleeding risk when taken with aspirin.