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Generic Name: aspirin (oral) (AS pir in)
Brand Name: Arthritis Pain, Ascriptin Enteric, Aspir 81, Aspir-Low, Bayer Aspirin, Bayer Childrens Aspirin, Bufferin, Easprin, Ecotrin, Ecpirin, Fasprin, Halfprin, Miniprin, St. Joseph Aspirin

What is aspirin?

Aspirin is a salicylate (sa-LIS-il-ate). It works by reducing substances in the body that cause pain, fever, and inflammation.

Aspirin is used to treat pain, and reduce fever or inflammation. Aspirin is sometimes used to treat or prevent heart attacks, strokes, and chest pain (angina). Aspirin should be used for cardiovascular conditions only under the supervision of a doctor.

Aspirin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about aspirin?

You should not use aspirin if you have a bleeding disorder such as hemophilia, a recent history of stomach or intestinal bleeding, or if you are allergic to an NSAID (non-steroidal anti-inflammatory drug) such as Advil, Motrin, Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.

Do not give this medication to a child or teenager with a fever, flu symptoms, or chicken pox. Salicylates can cause Reye's syndrome, a serious and sometimes fatal condition in children.

What should I discuss with my healthcare provider before taking aspirin?

Do not give this medication to a child or teenager with a fever, flu symptoms, or chicken pox. Aspirin can cause Reye's syndrome, a serious and sometimes fatal condition in children.

You should not use this medicine if you are allergic to aspirin, or if you have:

  • a recent history of stomach or intestinal bleeding;

  • a bleeding disorder such as hemophilia; or

  • an allergy to an NSAID (non-steroidal anti-inflammatory drug) such as Advil, Motrin, Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.

To make sure aspirin is safe for you, tell your doctor if you have:

  • asthma or seasonal allergies;

  • stomach ulcers;

  • liver disease;

  • kidney disease;

  • a bleeding or blood clotting disorder;

  • heart disease, high blood pressure, or congestive heart failure;

  • gout; or

  • nasal polyps.

This medication may be harmful to an unborn baby's heart, and may also reduce birth weight or have other dangerous effects. Tell your doctor if you are pregnant or plan to become pregnant while you are taking aspirin.

Aspirin can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take aspirin?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Take with food if aspirin upsets your stomach.

Do not crush, chew, break, or open an enteric-coated or delayed-release pill. Swallow it whole.

The chewable tablet form of aspirin must be chewed before swallowing.

If you use the orally disintegrating tablet or the dispersible tablet, follow all dosing instructions provided with your medicine.

If you need surgery, tell the surgeon ahead of time that you are using aspirin. You may need to stop using the medicine for a short time.

Do not take this medication if you smell a strong vinegar odor in the aspirin bottle. The medicine may no longer be effective.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since aspirin is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

What should I avoid while taking aspirin?

Do not use any other over-the-counter medication without first asking your doctor or pharmacist. Aspirin is contained in many medicines available over the counter. If you take certain products together you may accidentally take too much aspirin. Read the label of any other medicine you are using to see if it contains aspirin.

Avoid drinking alcohol while you are taking aspirin. Alcohol may increase your risk of stomach bleeding.

If you are taking aspirin to prevent heart attack or stroke, avoid also taking ibuprofen (Advil, Motrin). Ibuprofen may make aspirin less effective. If you must use both medications, take the ibuprofen at least 8 hours before or 30 minutes after you take the aspirin (non-enteric coated form).

Aspirin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using aspirin and call your doctor at once if you have:

  • ringing in your ears, confusion, hallucinations, rapid breathing, seizure (convulsions);

  • severe nausea, vomiting, or stomach pain;

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • fever lasting longer than 3 days; or

  • swelling, or pain lasting longer than 10 days.

Common side effects may include:

  • upset stomach, heartburn;

  • drowsiness; or

  • mild headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Aspirin dosing information

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.

What other drugs will affect aspirin?

Ask your doctor before using aspirin if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Ask a doctor or pharmacist if it is safe for you to use aspirin if you are also using any of the following drugs:

  • a blood thinner (warfarin, Coumadin), or other medication used to prevent blood clots; or

  • other salicylates such as Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others.

This list is not complete. Other drugs may interact with aspirin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about aspirin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 14.01. Revision Date: 2013-05-31, 1:24:19 PM.

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