Aspirin is a medication given to relieve pain and reduce fever. The name "aspirin" was originally a trademark, first used when the drug was introduced in Europe in 1899. Aspirin was developed by a German chemist named Felix Hoffman as a treatment for his father's arthritis.
Aspirin is still used to relieve many kinds of minor aches and pains—headaches, toothaches, muscle pain, menstrual cramps, joint pains associated with arthritis, and the general achiness that many people experience with colds and flu. Some people take aspirin daily to reduce the risk of stroke, heart attack, or other heart problems.
Aspirin, also known as acetylsalicylic acid, is not a prescription drug. It is sold over the counter in many forms, from the familiar white tablets to chewing gum and rectal suppositories. Coated, chewable, buffered, and extended-release forms are available. Many other over-thecounter medications contain aspirin. Alka-Seltzer Original Effervescent Antacid Pain Reliever (R), for example, contains aspirin for pain relief as well as sodium bicarbonate to relieve acid indigestion, heartburn, and sour stomach.
Aspirin belongs to a group of drugs called salicylates. Other members of this group include sodium salicylate, choline salicylate, and magnesium salicylate. These drugs are more expensive and no more effective than aspirin; however, they are a little easier on the patient's stomach. Aspirin is quickly absorbed into the bloodstream and provides rapid and relatively long-lasting pain relief. Aspirin in high doses also reduces inflammation. Researchers believe these effects are due to aspirin's ability to block the production of pain-producing chemicals called prostaglandins.
In addition to relieving pain and reducing inflammation, aspirin also lowers fever by acting on the hypothalamus, which is the part of the brain that regulates temperature. The brain then signals the blood vessels to dilate (widen), which allows heat to leave the body more quickly.
PAIN RELIEF OR FEVER REDUCTION. The usual dosage is one to two tablets every three to four hours, up to six times per day.
RISK REDUCTION FOR STROKE. One tablet four times a day or two tablets twice a day.
RISK REDUCTION FOR HEART ATTACK. Aspirin may be used as a first-line treatment for a heart attack. The patient should chew a single uncoated aspirin tablet, since chewing makes it easier for the body to absorb the medication rapidly. Aspirin will not stop a heart attack, and proper emergency care is essential; however, an aspirin tablet may reduce the amount of damage done by the heart attack.
Patients should check with a physician for the proper dose and number of times per week they should take aspirin to reduce the risk of a heart attack. The most common dose for this purpose is a single baby aspirin tablet taken daily. Enteric-coated aspirin is often used, since it reduces the risk of stomach irritation.
Parents should consult the child's physician about the proper dosage for their child's condition.
Aspirin—even children's aspirin—should never be given to children or teenagers with flu-like symptoms or chickenpox. Aspirin can cause Reye's syndrome, a life-threatening condition that affects the nervous system and liver. As many as 30% of children and teenagers who develop Reye's syndrome die. Those who survive may have permanent brain damage.
Parents should consult a physician before giving aspirin to a child under 12 years of age for arthritis, rheumatism, or any condition that requires long-term use of the drug.
No one should take aspirin for more than 10 days in a row unless instructed to do so by a physician. Anyone with fever should not take aspirin for more than three days without a physician's advice. In addition, no one should take more than the recommended daily dosage.
People in the following categories should not use aspirin without first checking with their physician:
Aspirin should not be taken before a surgical procedure, as it can increase the risk of excessive bleeding during surgery. People scheduled for an operation should check with their surgeon to find out when they should discontinue taking aspirin.
Aspirin can cause stomach irritation. Taking aspirin with food or milk, or drinking an eight-ounce glass of water with it may help to prevent damage to the stomach lining. Some patients find that using coated or buffered aspirin reduces the risk of stomach upset. Patients should be aware, however, that drinking alcoholic beverages can make the stomach irritation worse.
Patients with any of the following symptoms should stop taking aspirin immediately and call their physician:
Patients should discard any aspirin that has developed a vinegary smell. That is a sign that the medication is too old and ineffective.
The most common side effects of aspirin include upset stomach, heartburn, loss of appetite, and small amounts of blood in the stool. Less common side effects are rashes, hives, fever, vision problems, liver damage, thirst, stomach ulcers, and bleeding. People with asthma, rhinitis, polyps in the nose, or allergies to aspirin may have trouble breathing after taking the drug.
Aspirin may increase, decrease, or change the effects of many drugs. Aspirin can increase the toxicity of such drugs as methotrexate (Rheumatrex) and valproic acid (Depakote, Depakene). Taken with such blood-thinning drugs as warfarin (Coumadin) and dicumarol, aspirin can increase the risk of excessive bleeding. Aspirin counteracts the effects of certain other drugs, including angiotensin-converting enzyme (ACE) inhibitors and beta blockers, which lower blood pressure, and medicines used to treat gout (probenecid and sulfinpyrazone). Blood pressure may drop unexpectedly and cause fainting or dizziness if aspirin is taken along with nitroglycerin tablets. Aspirin may also interact with diuretics , diabetes medications, other nonsteroidal anti-inflammatory drugs (NSAIDs), seizure medications, and steroids. Anyone who is taking these drugs should ask his or her physician whether they can safely take aspirin.
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American Society of Health-System Pharmacists (ASHP). 7272 Wisconsin Avenue, Bethesda, MD 20814. (301) 657-3000. http://www.ashp.org .
Aspirin Foundation of America. (800) 432-3247; fax (202) 737-8406. http://www.aspirin.org .
United States Food and Drug Administration (FDA). 5600 Fishers Lane, Rockville, MD 20857-0001. (888) INFO-FDA. http://www.fda.gov .
Sam Uretsky, PharmD