Bay Area Medical Information
Aspirin
Aspirin, the Good and the Bad

AspirinBrand Names: ASA, Aspergum, Bayer Aspirin, Easprin, Ecotrin, Empirin
Generic: Salicylate or salicylic acid

Here's How it Works: (The Good)

      • Aspirin decreases pain perception; it prevents pain receptors from passing the pain message to the brain

      • Aspirin is an anti-inflammatory drug that relieves pain and reduces fever. (Aspirin is in the class of NSAIDs)

      • Aspirin helps prevent dangerous blood clots from forming, and is used to lessen the chance of heart attack, stroke, or other problems that may occur when a blood vessel is blocked by blood clots. Specifically, The American Heart Association recommends aspirin use for patients who've had a myocardial infarction (heart attack), unstable angina, ischemic stroke (caused by blood clot) or transient ischemic attacks (TIAs or "little strokes"), if not contraindicated. (3)

        • Aspirin intake early in the course of a heart attack, along with other treatments EMTs and Emergency Department physicians provide, can significantly improve your chances of survival. If you think you're having a heart attack, call 9-1-1; the 9-1-1 operator may recommend that you take an aspirin once they determine that you don't have an allergy to aspirin or a condition that makes using it too risky. If the 9-1-1 operator doesn't talk to you about taking an aspirin, the emergency medical technicians or the physician in the Emergency Department will give you an aspirin if it's right for you.

        • Taking aspirin isn't advised during a stroke, because not all strokes are caused by blood clots. Most strokes are caused by clots, but some are caused by bleeding, ruptured blood vessels. Taking aspirin could potentially make these bleeding strokes more severe.

Caution signPotential Side Effects of Aspirin: (The Bad)
Aspirin should only be taken under the supervision of a physician. Here's why:

1) Children and teen-agers suffering from flu-like symptoms, chickenpox and other viral illnesses shouldn't take aspirin or aspirin products (acetylsalicylic acid / salicylates) because of the possibility of Reye's syndrome. Reye's Syndrome, a deadly disease, strikes swiftly and can attack any child, teen, or adult without warning. All body organs are affected, with the liver and brain suffering most seriously. Be sure to educate teen-agers, who may take OTC medicines without their parents' knowledge. Note: Check ingredient labels on all over-the-counter cold and flu medications to see if they contain aspirin. Even some topical use products contain aspirin and should not be used during a virus. Teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms. Children younger than 2 years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider.

2) The anticoagulant effect of aspirin may increase the chance of serious bleeding in some people. Therefore, aspirin should be used for its preventive anticoagulant effects only when your doctor decides, after studying your medical condition and history, that the danger of blood clots is greater than the risk of bleeding.

3) Aspirin can irritate the stomach or cause GI bleeding. Aspirin should always be taken with food, preferably after a meal due to its potential for stomach irritation and GI bleeding.

4) Aspirin is also contraindicated in: people with allergy to aspirin or NSAIDs (Advil, Motrin, Alleve, etc), 3rd trimester pregnancy. Precautions: History of asthma or peptic ulcer, severe hepatic (liver) or renal (kidney) dysfunction, bleeding disorders, diabetes, gout, pregnancy or nursing mothers. Aspirin interacts with many medicines. For more contraindications and a list of drugs that interact with aspirin, click here

In the News

Daily aspirin therapy tops the list of affordable and effective preventive measures
A recent report by the National Commission on Prevention Priorities, has identified the top 25 clinical services that are the most effective, yet relatively affordable.

Topping the list of of affordable and effective preventive measures was daily aspirin therapy. Men older than 40 and women older than 50, and those with any others at risk for heart disease should ask their doctors about taking one aspirin on a daily basis. There are important precautions, however, with respect to aspirin, so it's important to consult with your doctor before starting aspirin therapy. May 2006

Aspirin is a good drug for heart health in certain people, but often not used
Although it's well known that taking aspirin regularly can lower a person's risk of heart disease, few Americans take aspirin regularly for heart health. A new study finds that use of aspirin is underutilized in the prevention of a first or second heart attack or stroke, even among adults at increased risk for such events. There are many people that should be on aspirin, yet the researchers found that large numbers of people at relatively high risk for heart attack and stroke were not taking it regularly. American Journal of Preventive Medicine, May 2007

Daily long-term use of adult-strength aspirin may reduce cancer risk by about 15%
"A large analysis by American Cancer Society researchers suggests that daily long-term use of adult-strength aspirin may reduce cancer risk by about 15% in both men and women. Daily aspirin use is often recommended for preventing heart disease and stroke in people at high risk of these problems. The aspirin-cancer link has been widely studied, but researchers have not been able to come to any firm conclusion about whether it is useful for cancer prevention. In animals, aspirin inhibits the development of many types of cancer, including colorectal, breast, prostate, lung, bladder, and skin. Studies on people have been harder to interpret. Some have shown that aspirin can reduce the risk of colorectal cancer and polyps (growths that can lead to cancer). Others have linked aspirin use to lower risk of stomach and esophageal cancer, as well as breast, prostate, and lung cancer. Still others have found no effect on cancer at all." from the American Cancer Society, April 2007

Daily aspirin use appears to be beneficial in women
In a new study of almost 80,000 women, aspirin use at low to moderate doses was associated with a reduced risk of all-cause mortality, largely due to death from cardiovascular disease. It's very important to note, however, that women should not start taking daily aspirin without asking their doctor's advice first. Aspirin can cause ulcers and dangerous bleeding in certain people.Archives of Internal Medicine, March 2007

New guidelines from the American Heart Association urge women talk to their doctors about daily aspirin use
Nearly all American women are in danger of heart disease or stroke and need to be aggressive as men about lowering their risk. This includes asking their doctors about daily aspirin use. It's very important, however, that women should not start taking daily aspirin without asking their doctor's advice first. Aspirin can cause serious side effects, such as ulcers and dangerous bleeding in certain people. American Heart Assn February 19, 2007

FDA Alert: Use of Both Aspirin and Ibuprofen at the Same Time
Ibuprofen has been found to interfere with the anti-platelet effect of low dose aspirin (81 mg per day), potentially rendering aspirin less effective when used for cardioprotection and stroke prevention. Patients who use immediate release aspirin (not enteric coated) and take a single dose of ibuprofen 400 mg should dose the ibuprofen at least 30 minutes or longer after taking aspirin, or more than 8 hours before aspirin ingestion to avoid attenuation of aspirin’s effect.

Other nonselective OTC NSAIDs, such as Advil and Aleve, should be viewed as having the potential to interfere with the antiplatelet effect of low-dose aspirin as well. from the FDA, September 2006

References

1) Aspirin from the American Cancer Society
2) Long-term Aspirin Use Linked to Lower Cancer Risk from the American Cancer Society, April 2007
3) Aspirin in Heart Attack and Stroke Prevention from the American Heart Association


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