Aspirin

What Does Aspirin Do?

Aspirin, or acetylsalicylic acid, is an over-the-counter medication widely used for its analgesic, antipyretic, and anti-inflammatory properties. It is commonly prescribed for headaches, muscle aches, toothaches, menstrual cramps, fever, common cold symptoms, and painful joint conditions such as osteoarthritis and rheumatoid arthritis. Moreover, due to its antiplatelet effect, aspirin also assists in preventing blood clots, aiding in cardiovascular disease prevention. Off-label uses encompass rheumatic fever treatment, clot prevention in patients with atrial fibrillation, and potential reduction of colon cancer risk.

How Does Aspirin Work? (the complicated stuff)

Aspirin inhibits the enzyme cyclooxygenase, notably the COX-1 isoform. This action blocks the synthesis of prostaglandins, thromboxane A2, and prostacyclin, lipid compounds that play vital roles in inflammation, pain, and fever. Furthermore, by hampering the production of thromboxane A2, aspirin prevents platelet aggregation, crucial in blood clot formation.

Drug Type and Category of Aspirin

Aspirin is classified as a nonsteroidal anti-inflammatory drug (NSAID) and an antiplatelet agent.

What dosage of Aspirin should you be taking?

Chest Pain

NICE CG95 recommends a loading dose of 300 mg aspirin as soon as possible for people with suspected acute coronary syndrome, unless they are allergic to it. ¹

Stroke and TIA

NICE NG128 recommends offering aspirin 300 mg daily, unless contraindicated, to people who have had a suspected TIA, to be started immediately. ¹

For acute ischemic stroke, NICE NG128 recommends aspirin 300 mg orally or rectally as soon as possible within 24 hours, where a diagnosis of intracerebral hemorrhage has been excluded. ¹

Colorectal Cancer Prevention

NICE NG151 recommends daily aspirin (commonly 150 mg or 300 mg) for 2 years or more to help prevent colorectal cancer in people with Lynch syndrome. ¹

Pre-eclampsia

The International Federation of Gynaecology and Obstetrics recommends 150 mg aspirin at night from 11-14 weeks gestation until delivery or diagnosis of pre-eclampsia for women identified as high risk. ¹

What are the side-effects of Aspirin?

Mild side effects:

• Upset stomach, indigestion
• Bleeding more easily, such as nosebleeds and bruising

Serious side effects (rare):

• Coughing up blood or having blood in urine, stool, or vomit
• Yellowing of the eyes or skin, indicating liver problems
• Painful joints, a sign of high uric acid levels
• Swelling of the hands or feet, indicating water retention

Aspirin can also cause stomach ulcers, especially with long-term or high-dose use. Those with a history of ulcers may be advised not to take aspirin.

In rare cases, aspirin can cause a serious allergic reaction (anaphylaxis) with symptoms like swelling of the lips, tongue, or throat, difficulty breathing, and confusion or dizziness.

Interactions

Aspirin should not be taken with other medications that contain aspirin, ibuprofen, or naproxen due to the increased risk of stomach upset, nausea, or ulcers. ³

It can also interact with antidepressants, potentially causing bruising or bleeding easily. ⁵

Food and Alcohol Interactions

Alcohol may increase the risk of gastrointestinal bleeding when taken with aspirin. ^4,6

Disease Interactions

Aspirin has interactions with several diseases, including:

• Coagulation: Aspirin can increase bleeding risk.
• Asthma: Aspirin can trigger asthma attacks.
• GI toxicity: Aspirin can cause stomach ulcers and bleeding.
• Renal dysfunction: Aspirin can affect kidney function.
• Reye's syndrome: Aspirin can cause this serious condition in children.
• Anemia: Aspirin can cause anemia.
• Dialysis: Aspirin can affect patients undergoing dialysis.
• G-6-PD deficiency: Aspirin can cause hemolytic anemia in patients with this deficiency.
• Hepatotoxicity: Aspirin can cause liver damage. ²

Special Considerations

• Children and teenagers should not use aspirin to treat fever, flu symptoms, or chickenpox due to the risk of Reye's syndrome. ^3,5
• Pregnant women should use aspirin only under medical supervision, as it can harm the unborn baby during certain stages of pregnancy. ^3,5
• Older adults may require a smaller dose due to a stronger reaction to the medication. ³

Natural Alternatives to Aspirin

Let time heal...

White Willow Bark

White willow bark contains salicin, a compound similar to the active ingredient in aspirin. It can help thin the blood and reduce inflammation. ¹¹

Typical dose: 1-3 grams per day or 60-120 mg of salicin.

Turmeric/Curcumin

The active compound curcumin in turmeric has anti-inflammatory and blood-thinning properties that may help prevent heart disease. ^7,9

Typical dose: 400-600 mg of dried turmeric powder per day.

Garlic

Garlic contains allicin, a compound with antioxidant and antimicrobial effects that can improve circulation and reduce blood clotting. ⁹

Typical dose: 1-3 cloves of fresh garlic per day.

Ginger

Ginger has anti-inflammatory properties and may help prevent blood clots from forming. ⁷

Ginkgo Biloba

Ginkgo biloba contains compounds that can inhibit blood clotting. ⁷

Policosanol

Policosanol, a wax extract from sugar cane, is known for its ability to reduce blood clotting and cholesterol levels. ⁸

Interesting facts about Aspirin

Aspirin is one of the most widely used medications globally, with an estimated 40,000 tonnes (44,000 tons) (50 to 120 billion pills) consumed each year.

Aspirin may have a protective effect against Alzheimer's disease and other forms of dementia. ¹⁰

Disclaimer

This article is generated for informational purposes only. It was created in December 2024. Medications and medical guidance can change over time. Therefore, it is essential to consult with your general practitioner or healthcare provider before making any decisions regarding medications or treatment plans. Your GP can provide personalised advice based on your specific health needs and conditions.

References

1. https://www.aspirin-foundation.com/scientific-information/guidelines/uk-guidelines-aspirin/
2. https://www.drugs.com/drug-interactions/aspirin.html
3. https://my.clevelandclinic.org/health/drugs/20592-aspirin-tablets
4. https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/types-of-medicine/aspirin/
5. https://www.drugs.com/aspirin.html
6. https://go.drugbank.com/drugs/DB00945
7. https://www.medicalnewstoday.com/articles/322384
8. https://medicinewithheart.com/natural-alternatives-to-aspirin-heart-health/
9. https://www.livestrong.com/article/111921-natural-alternatives-aspirin-heart-health/
10. https://www.thehealthsite.com/diseases-conditions/aspirin-10-amazing-facts-you-should-know-sh214-121591/