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Daily aspirin therapy: Understand the benefits and risks
Can you take aspirin if you regularly take ibuprofen for another condition?
Both aspirin and ibuprofen reduce the clotting action of blood platelets. Regular ibuprofen use can increase your bleeding risk.
If you need only a single dose of ibuprofen, take it eight hours before or 30 minutes after the aspirin. If you need to take ibuprofen more often, talk to your doctor about medication alternatives that won't interfere with daily aspirin therapy.
What are the possible side effects of daily aspirin therapy?
Side effects and complications of taking aspirin include:
- Hemorrhagic stroke. While daily aspirin can help prevent a clot-related stroke, it may increase your risk of a bleeding stroke (hemorrhagic stroke).
- Gastrointestinal bleeding. Daily aspirin use increases your risk of developing a stomach ulcer. And, if you have a bleeding ulcer, taking aspirin will cause it to bleed more, perhaps to a life-threatening extent.
- Allergic reaction. If you're allergic to aspirin, taking any amount of aspirin can trigger a serious allergic reaction.
- Ringing in the ears (tinnitus) and hearing loss. Too much aspirin (overdosing) can cause tinnitus and eventual hearing loss in some people.
If you're taking aspirin and need a surgical procedure or dental work, be sure to tell the surgeon or dentist that you take daily aspirin and how much. Otherwise you risk excessive bleeding during surgery.
The Food and Drug Administration also warns that people who regularly take aspirin should limit the amount of alcohol they drink because of its additional blood-thinning effects and potential to upset your stomach. If you take daily aspirin therapy, you should not have more than one drink a day if you're a woman or two drinks a day if you're a man.
What are possible drug interactions with daily aspirin therapy?
If you're already taking an anticoagulant such as warfarin (Coumadin) for another condition, combining it with aspirin may greatly increase the risk of major bleeding complications. However, there may be some conditions for which combining a low dose of aspirin with warfarin is appropriate (for example, with certain types of artificial heart valves for secondary stroke prevention), but this therapy always needs to be carefully discussed with your doctor.
Other medications and herbal supplements also may increase your risk of bleeding. Medications that can interact with aspirin include:
- Warfarin (Coumadin)
- Heparin
- Ibuprofen (Advil, Motrin, others), when taken regularly
- Corticosteroids
- Some antidepressants (clomipramine, paroxetine, others)
Taking some dietary supplements can also increase your bleeding risk. These include:
- Danshen
- Dong quai
- Evening primrose oil
- Ginkgo
- Omega-3 fatty acids (fish oil)
- Policosanol
- Willow bark
If you take daily aspirin, is it still safe to take an aspirin during a heart attack?
For most people experiencing heart attack symptoms, doctors recommend chewing and swallowing one plain regular-strength aspirin or two to four baby aspirin. This recommendation still holds true if you are on daily aspirin therapy. Chewing the aspirin speeds up the absorption process and minimizes any delay in the beneficial effects of aspirin.
If you have certain bleeding disorders, you shouldn't take an aspirin during a heart attack.
Don't take aspirin if you think you're having a stroke, because not all strokes are caused by blood clots; some are caused by ruptured blood vessels. Taking aspirin could make a bleeding stroke more severe.
Should you take a coated aspirin?
Enteric-coated aspirin is designed to pass through your stomach and not disintegrate until it reaches your intestines. It's gentler on the stomach and may be appropriate for some people who take a daily aspirin, especially in those with a history of gastritis or ulcers.
However, it takes longer for your body to absorb enteric-coated aspirin, and it doesn't appear to offer significant protection against bleeding in your stomach and intestines. More studies are needed to better understand the differences between plain aspirin and enteric-coated aspirin. If you have questions or concerns about the type of aspirin you take, ask your doctor to determine the best option for you.
What is superaspirin?
Superaspirin refers to a newer class of drugs that are available as an alternative or supplement to aspirin. These medications are called platelet aggregation inhibitors and reduce the risk of blood clots. Though they have similar effects as aspirin, they work by a slightly different action. This class of drugs includes clopidogrel (Plavix), eptifibatide (Integrilin) and others. These medications may be used:
- Along with aspirin, to reduce the risk of another heart attack or stroke in people who have had one
- During a heart attack or clot-related stroke
- Before and after angioplasty and stent placement, to help reduce procedure-related blood clots
- To treat blocked arteries in your arms and legs (peripheral artery disease)
Superaspirin may be an option if you are resistant to aspirin (meaning you don't get the clot-preventing benefits), are allergic to aspirin or can't tolerate its side effects. The combination of aspirin and clopidogrel (Plavix) is recommended only for people who have specific heart or blood vessel conditions. If you are currently taking Plavix and aspirin but haven't had a heart attack or stroke, don't stop taking it suddenly. Talk to your doctor first.
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- Aspirin drug interactions. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 12, 2010.
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- Aspirin. Lexi-Interact. Lexi-Comp. http://www.uptodate.com/crlsql/interact/frameset.jsp. Accessed Jan. 12, 2010.
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- Pignone M, et al. Aspirin for primary prevention of cardiovascular disease in people with diabetes. Circulation. 2010; In press. Accessed June 7, 2010.
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