Aspirin Dosage

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for Ankylosing Spondylitis

For treatment of inflammatory diseases such as ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, and SLE-associated arthritis and pleurisy:

3 grams per day in divided doses (spondyloarthropathies may require up to 4 grams per day in divided doses).

Serum salicylate levels may be useful in guiding therapeutic decisions regarding dosage titration. Serum salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response. However, the incidence of toxicity increases with salicylate levels greater than 200 mcg/mL.

Usual Adult Dose for Osteoarthritis

For treatment of inflammatory diseases such as ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, and SLE-associated arthritis and pleurisy:

3 grams per day in divided doses (spondyloarthropathies may require up to 4 grams per day in divided doses).

Serum salicylate levels may be useful in guiding therapeutic decisions regarding dosage titration. Serum salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response. However, the incidence of toxicity increases with salicylate levels greater than 200 mcg/mL.

Usual Adult Dose for Rheumatoid Arthritis

For treatment of inflammatory diseases such as ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, and SLE-associated arthritis and pleurisy:

3 grams per day in divided doses (spondyloarthropathies may require up to 4 grams per day in divided doses).

Serum salicylate levels may be useful in guiding therapeutic decisions regarding dosage titration. Serum salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response. However, the incidence of toxicity increases with salicylate levels greater than 200 mcg/mL.

Usual Adult Dose for Systemic Lupus Erythematosus

For treatment of inflammatory diseases such as ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, and SLE-associated arthritis and pleurisy:

3 grams per day in divided doses (spondyloarthropathies may require up to 4 grams per day in divided doses).

Serum salicylate levels may be useful in guiding therapeutic decisions regarding dosage titration. Serum salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response. However, the incidence of toxicity increases with salicylate levels greater than 200 mcg/mL.

Usual Adult Dose for Fever

325 to 650 mg orally or rectally every 4 hours as needed, not to exceed 4 g/day.

Usual Adult Dose for Pain

325 to 650 mg orally or rectally every 4 hours as needed, not to exceed 4 g/day.

Usual Adult Dose for Rheumatic Fever

80 mg/kg/day orally in 4 equally divided doses, up to 6.5 g/day.

Dosage may be adjusted according to patient response, tolerance, and serum salicylate levels (therapeutic range is 250 to 400 mcg/mL for rheumatic fever). Generally after 1 to 2 weeks, the dosage is decreased to approximately 60 to 70 mg/kg/day and given for an additional 1 to 6 weeks or longer if necessary, then gradually withdrawn over 1 to 2 weeks. An appropriate course of antibiotic therapy should be initiated at the time of diagnosis of rheumatic fever.

Usual Adult Dose for Myocardial Infarction

160 to 162.5 mg orally once a day beginning as soon as an acute myocardial infarction is suspected and continuing for 30 days. If a solid dose formulation is used, the first dose should be chewed, crushed, or sucked. Long-term aspirin therapy for secondary prevention is recommended after 30 days.

Usual Adult Dose for Ischemic Stroke

50 to 325 mg orally once a day. Therapy should be continued indefinitely.

Usual Adult Dose for Angina Pectoris

75 mg to 325 mg orally once a day beginning as soon as unstable angina is diagnosed and continuing indefinitely.

Usual Adult Dose for Angina Pectoris Prophylaxis

75 mg to 325 mg orally once a day, continued indefinitely.

Usual Adult Dose for Thromboembolic Stroke Prophylaxis

75 mg to 325 mg orally once a day, continued indefinitely.

Usual Adult Dose for Myocardial Infarction - Prophylaxis

75 mg to 325 mg orally once a day, continued indefinitely.

Usual Adult Dose for Ischemic Stroke - Prophylaxis

75 mg to 325 mg orally once a day, continued indefinitely.

Usual Adult Dose for Revascularization Procedures - Prophylaxis

For coronary artery bypass graft (CABG):
325 mg orally once a day beginning 6 hours after the procedure and continuing for 1 year or indefinitely as needed.

For percutaneous transluminal coronary angiography (PTCA):
325 mg orally once 2 hours prior to procedure, then 160 to 325 mg orally once a day indefinitely.

For carotid endarterectomy:
80 mg orally once a day up to 650 mg orally twice a day beginning prior to surgery and continuing indefinitely.

Usual Pediatric Dose for Fever

2 to 11 years: 10 to 15 mg/kg orally or rectally every 4 to 6 hours as needed, not to exceed 4 g/day.

12 years or older: 325 to 650 mg orally or rectally every 4 hours as needed, not to exceed 4 g/day.

Usual Pediatric Dose for Pain

2 to 11 years: 10 to 15 mg/kg orally or rectally every 4 to 6 hours as needed, not to exceed 4 g/day.

12 years or older: 325 to 650 mg orally or rectally every 4 hours as needed, not to exceed 4 g/day.

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis

2 to 11 years or less than or equal to 25 kg:
Initial: 60 to 90 mg/kg/day orally in equally divided doses.
Maintenance: 80 to 100 mg/kg/day orally in equally divided doses; higher dosages, up to 130 mg/kg/day, may be necessary in some cases, not to exceed 5.4 g/day.

12 years or older or greater than 25 kg:
Initial: 2.4 to 3.6 g/day orally in equally divided doses.
Maintenance: 3.6 to 5.4 g/day orally in equally divided doses; higher dosages may be necessary in some cases.

Serum salicylate levels may be useful in guiding therapeutic decisions regarding dosage titration. Serum salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response. However, the incidence of toxicity increases with salicylate levels greater than 200 mcg/mL.

Usual Pediatric Dose for Kawasaki Disease

Initial (acute febrile period): 80 to 100 mg/kg/day orally or rectally in 4 equally divided doses every 4 to 6 hours for up to 14 days (until fever resolves for at least 48 hours).

Maintenance (postfebrile period): 3 to 5 mg/kg orally or rectally once daily. Patients without coronary artery abnormalities should continue low-dose aspirin for 6 to 8 weeks or until ESR and platelet count are normal. Patients with coronary artery abnormalities should continue low-dose aspirin therapy indefinitely.

Usual Pediatric Dose for Rheumatic Fever

90 to 130 mg/kg/day in equally divided doses every 4 to 6 hours, up to 6.5 mg/day.

Dosage may be adjusted according to patient response, tolerance, and serum salicylate levels (therapeutic range is 250 to 400 mcg/mL for rheumatic fever). Generally after 1 to 2 weeks, the dosage is decreased to approximately 60 to 70 mg/kg/day and given for an additional 1 to 6 weeks or longer if necessary, then gradually withdrawn over 1 to 2 weeks. An appropriate course of antibiotic therapy should be initiated at the time of diagnosis of rheumatic fever.

Usual Pediatric Dose for Prosthetic Heart Valves - Mechanical Valves

less than 1 month:
Full term neonate: Antiplatelet effects: Postoperative congenital heart repair or recurrent arterial ischemic stroke: Oral: Adequate neonatal studies have not been performed; neonatal dosage is derived from clinical experience and is not well established; suggested doses: 1 to 5 mg/kg/day as a single daily dose. Doses are typically rounded to a convenient amount (e.g., 1/4 of 81 mg tablet).

1 month and older:
6 to 20 mg/kg orally once daily.

Aspirin may be administered in combination with an oral anticoagulant if systemic embolism occurs despite achieving target INR levels, or it may be used with low-dose oral anticoagulant and dipyridamole when full-dose warfarin is contraindicated.

Renal Dose Adjustments

Detailed information concerning the pharmacokinetic disposition of aspirin in patients with renal dysfunction is not available. Aspirin should be used with caution in chronic renal insufficiency, since it may cause a transient decrease in renal function. The use of aspirin in patients with severe renal impairment (CrCl less than 10 mL/minute) is not recommended due to the potential for increased risk of salicylate toxicity.

Liver Dose Adjustments

The use of aspirin in patients with severe hepatic impairment is not recommended due to the potential for increased risk of clinically significant bleeding and other adverse effects.

Precautions

The use of aspirin is contraindicated in patients with the syndrome of asthma, rhinitis, and nasal polyps. Aspirin may cause severe urticaria, angioedema, or bronchospasm in these patients.

The risk of bleeding is increased in patients receiving aspirin. Inhibition of platelet function occurs even at low doses of aspirin. Aspirin should not be given to patients with inherited or acquired bleeding disorders or in patients with a recent history of gastrointestinal (GI) bleeding.

Aspirin should not be used in children or adolescents with chickenpox or influenza symptoms due to the association with Reye's syndrome.

Dialysis

Detailed information concerning the removal of aspirin by hemodialysis is not available. Some investigators have suggested that aspirin and/or salicylate may be removed by hemodialysis and that aspirin dosing should follow dialysis sessions.

Other Comments

Use of a buffered or enteric-coated aspirin formulation may lessen the risk of gastrointestinal intolerance and toxicity. Aspirin should be administered with food or after meals.

The absorption of aspirin following rectal administration is slow and erratic. Oral administration is generally preferred. Because of the risk of mucosal damage, oral formulations of aspirin should never be administered by the rectal route.

Hide
(web5)