Aspirin, or acetylsalicylic acid (ASA), is widely used for mild aches and pains as a pain reliever and for fever control. This is also an anti-inflammatory drug which can be used as a thinner to the blood.
People with a high risk of blood clots, stroke, and heart attack can use aspirin in low doses over the long term.
Aspirin contains salicylate, from the willow bark. Its use was first recorded in the time of Hippocrates around 400 BCE, when people chewed willow bark to alleviate inflammation and fever.
Patients are also treated shortly following a heart attack to avoid further clot formation and death of cardiac tissue.
Fast facts on aspirin
Below are a few key points on aspirin. More specifics are given in the main article.
- Aspirin is one of the most widely used medications in the world.
- It comes from salicylate, which can be found in plants such as willow trees and myrtle.
- Aspirin was the first non-steroidal anti-inflammatory drug (NSAID) to be discovered.
- It interacts with a number of other drugs, including warfarin and methotrexate.
What is aspirin?
Aspirin is a non-steroidal anti-inflammatory drug (NSAID).
NSAIDs are medications with the following effects:
- Analgesic: Relieves pain without anesthesia or loss of consciousness
- Antipyretic: Reduces a fever
- Anti-inflammatory: Lowers inflammation when used in higher doses
These are not steroidal meaning these are not hormones. Steroids also have similar advantages but can have adverse side effects.
NSAIDs appear to be non-narcotic, as analgesics. This means they don’t trigger stupor or insensitivity. Aspirin was the first discoverable NSAID.
Salicylate has been used for over 2,000 years in the shape of a willow bark. Some people also use willow bark to treat headaches and mild aches and pains as a more natural cure.
Aspirin has been around in its present form for over 100 years. This remains one of the world’s most commonly used drugs. About 35,000 metric tonnes of aspirin are expected to be consumed annually.
Aspirin is a trademark belonging to Bayer, a German pharmaceutical corporation. The word aspirin generic is the acetylsalicylic acid (ASA).
Uses
Aspirin is one of the medications most commonly used to treat mild to severe pain, migraines and fever.
Popular uses include headaches, menstrual pains, colds and flu, sprains and strains, and long-term conditions like arthritis, for example.
It is used alone, for mild to moderate discomfort. This is also used for mild to extreme pain, along with other analgesic opioids and NSAIDs.
This can relieve or help the the effects in high doses of:
- rheumatic fever
- rheumatic arthritis
- other inflammatory joint conditions
- pericarditis
In low doses, it is used:
- to prevent blood clots from forming and reduce the risk of a transient ischemic attack (TIA) and unstable angina
- to prevent myocardial infarction in patients with cardiovascular disease by preventing clot formation
- to prevent a stroke, but not to treat a stroke
- to prevent colorectal cancer
Aspirin and children
Aspirin is typically not appropriate for those under the age of 16, as it may raise the likelihood of Reye’s syndrome that might occur after a illness, such because a cold, flu, or chicken pox. This may cause permanent damage to the brain or death.
However, if they have Kawasaki disease, a specialist can prescribe aspirin for a child under care, and to prevent the formation of blood clots following heart surgery.
More commonly, acetaminophen (paracetamol, Tylenol) and ibuprofen are used instead.
Low-dose aspirin
A low dose of aspirin, at 75-81 milligrams (mg) per day, can be used as an antiplatelet medication, to prevent blood clots from forming.
This may be given to patients following:
- a coronary artery bypass graft operation
- a heart attack
- a stroke
- atrial fibrillation
- acute coronary syndrome
Patients can also take low-dose aspirin if they have the following risk factors and if the doctor suspects heart disease or stroke is likely:
- high blood cholesterol levels
- hypertension, or high blood pressure
- diabetes
- smoking
Others who may be advised to take low-dose aspirin include:
- those with damage to the retina, or retinopathy
- people who have had diabetes for over 10 years
- patients who are taking antihypertensive medications
The United States (U.S.) Task Force on Preventive Services officially recommends routine low-level use of aspirin to prevent cardiovascular disease and colorectal cancer in adults 50 to 59 years of age who:
- have a 10 percent or higher risk of cardiovascular disease
- who do not have a high risk of bleeding
- are likely to live at least another 10 years
- are willing to take the dose for at least 10 years
For all these cases the patient will usually continue to take low-dose aspirin regularly for the rest of their life.
Precautions
Aspirin is not recommended for individuals who:
- have a peptic ulcer
- hemophilia or any other bleeding disorder
- a known allergy to aspirin
- an allergy to any NSAID, such as ibuprofen
- are at risk of gastrointestinal bleeding or hemorrhagic stroke
- drink alcohol regularly
- are undergoing dental or surgical treatment, however small
Those with the following conditions should take aspirin cautiously, and can do so only if the doctor agrees:
- asthma
- uncontrolled hypertension
- a previous peptic ulcer
- liver problems
- kidney problems
Aspirin is not offered during a stroke, since a clot is not responsible for all strokes. Aspirin can in some cases make the stroke worse.
Anyone planning to undergo surgery will inform their doctor whether they are taking aspirin regularly. We will need to avoid taking the medication at least seven days before surgery.
Patients who are pregnant or breast-feeding can take aspirin in low doses but only under the supervision of a doctor. It is not advised to take high-dose aspirin.
Interactions Often one drug may make another drug less successful, or the combination may increase the patient’s risk. This is called an interaction between drugs.
The most common medications which can interact with aspirin are:
- Anti-inflammatory painkillers such as diclofenac, ibuprofen, naproxen, and indomethacin. If taken in conjunction with aspirin, this can increase the risk of stomach bleeding.
- Methotrexate, which is used in cancer therapy and some autoimmune diseases. Aspirin can make removing methotrexate harder for the body, leading to elevated and potentially harmful levels of methotrexate in the body.
- Selective serotonin reuptake inhibitors, such as citalopram, fluoxetine, paroxetine, venlafaxine, and sertraline, are antidepressants. These, taken with aspirin, will increase the risk of bleeding.
- Warfarin, an anticoagulant, or a blood thinner that prevents clotting in the blood. If aspirin is taken with warfarin, the anticoagulant effects of this medication can be decreased and the risk of bleeding increased. However, in some cases a doctor may prescribe aspirin along with warfarin.
These are not the only drugs which can not be used with aspirin. Anyone taking aspirin should tell their doctor, as other medications can also interfere with each other.
Side effects
The most common side effects of aspirin are:
- irritation of the stomach or gut
- indigestion
- nausea
The following adverse effects are possible, but less common:
- worsening asthma symptoms
- vomiting
- inflammation of the stomach
- stomach bleeding
- bruising
Hemorrhagic stroke is one unusual side effect of low-dose aspirin.
Aspirin can be effective in preventing and treating a variety of conditions, but anyone taking aspirin should first talk with a doctor. Aspirin would usually not be taken by someone under the age of 16, except in exceptional circumstances and under medical supervision.
