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Aspirin Overdose: Symptoms, Diagnosis, Emergency Treatment

Medically reviewed by Sally Chao, MD. Last updated on May 9, 2021.

Official answer

by Drugs.com

Acetylsalicylic acid, commonly known as aspirin, is a pain-relieving drug found in many prescription and over-the-counter formulations. It blocks things in your cells that lead to fever, pain, swelling and the formation of blood clots. You may have taken aspirin to reduce the pain of a headache or toothache, relieve menstrual pain or deal with cold or flu symptoms, but like every drug, it comes with benefits as well as risks.

  • Aspirin can be harmful and lead to bleeding in the stomach or brain, or even kidney failure or death.
  • The regular use of aspirin is something you’ll want to discuss with your doctor.

Here’s why you might take aspirin:

  • In its over-the-counter form, aspirin may be used to treat fever and mild to moderate pain and may be recommended daily to help prevent heart attacks or strokes in certain high-risk groups.
  • Prescription aspirin can provide long-acting symptom relief to patients with certain kinds of autoimmune diseases, such as rheumatoid arthritis and lupus.

But, it’s important to note that children under 12 should never take aspirin, and caution is warranted for young adults, too. Aspirin comes with a risk of Reye syndrome, especially in children who took it while recovering from viral infections like chickenpox or flu. This rare but serious condition causes sudden damage to the brain and problems with the liver. Because of this risk, aspirin is not a recommended medication for routine treatment in children or young adults.

What is a standard dose of aspirin?

The proper dosage of aspirin depends on why you are taking aspirin, the type of aspirin you are taking and how well it is working for you.

Aspirin comes in various forms, including:

  • Regular tablets
  • Delayed-release tablets
  • Extended-release tablets
  • Chewable tablets
  • Rectal suppositories

Dosing may vary. Typical strengths you might purchase over the counter include:

  • 81 mg tablets or chewables are sometimes referred to as “baby aspirin” or “low-dose aspirin,” as this is the lowest dose available over the counter.
  • 325 mg tablets may be labeled "regular strength."
  • 500 mg aspirin tablets are considered "extra strength."

Other strengths may include:

  • 162.5 mg extended-release daily capsules may be prescribed.
  • 600 mg dosing may be found in rectal suppositories (as well as other lower strengths).
  • 650 mg dosing may be available as delayed-release tablets (as well as other lower strengths).

According to the label: for pain and fever, adults and children over age 12 may take aspirin every 4 to 6 hours, but your doctor may recommend other pain relievers instead, so it’s a good idea to check. For the prevention of heart attack or stroke, once-daily low-dose aspirin may be advised by your doctor and should only be done under the advice of a physician.

  • Take aspirin exactly as directed.
  • Talk to your doctor if you have any questions or concerns about the proper aspirin dose for you.

What is a potentially dangerous dose of aspirin?

Aspirin overdose can occur if a large dose is taken all at once (acute overdose) or if long-term, daily use leads to a harmful accumulation of aspirin in the body (chronic overdose).

Acute aspirin overdose may be accidental or intentional.

Because aspirin doses can affect people differently depending mainly on your body weight, toxic or potentially lethal doses are defined by milligrams per kilogram of body weight.

  • 200 to 300 milligrams per kilogram of body weight is considered a toxic dose of aspirin in adults. In other words, for a person who weighs around 68 kg (approximately 150 pounds), taking 13,600 to 20,400 mg of aspirin could be toxic.
  • 500 milligrams per kilogram of body weight is considered a potentially lethal dose of aspirin. In other words, for a person who weighs around 68 kg (approximately 150 pounds), taking 34,000 mg of aspirin could result in death.

Toxicity or overdose can occur at much lower doses in children. This, and the risk of Reye syndrome, are why aspirin is generally not recommended in children and teenagers. Make sure to keep aspirin out of sight and away from children.

Daily aspirin can lead to chronic aspirin overdose. It most often occurs in older adults or people with malfunctioning kidneys. Dehydration or hot weather can heighten the risk of chronic overdose. It’s important to discuss your use of aspirin with your doctor, as you may have factors that increase your risk of overdose.

What are the symptoms of aspirin overdose?

After taking a potentially toxic or lethal dose of aspirin, overdose symptoms will become increasingly severe as your body absorbs the drug and more of it enters the bloodstream. Seeking emergency medical treatment as soon as possible can help lower the amount of aspirin in the blood before it becomes life-threatening.

Aspirin overdose can come with a wide variety of symptoms, including:

  • Difficulty breathing or taking rapid breaths
  • Ringing in your ears
  • Blurry vision
  • Restlessness
  • Irritability
  • Confusion
  • Delirium
  • Seizures
  • Severe headache
  • Poor balance
  • Feeling drowsy
  • Collapsing, losing consciousness or coma
  • Rash
  • Vomiting and other stomach problems

Signs of chronic overdose may be different and develop over days or weeks. Chronic overdose symptoms may include:

  • Extreme tiredness
  • Low fever
  • Confusion
  • Collapsing or loss of consciousness
  • Fast heart rate
  • Taking rapid, uncontrollable breaths

When should you seek medical assistance for an aspirin overdose?

If you or someone around you has taken a potentially toxic dose of aspirin, or you suspect an aspirin overdose for another reason, you must seek emergency medical care as soon as possible or call your local emergency number. If you are in the United States, call 911 or contact the national, toll-free Poison Help hotline at 1-800-222-1222.

You can call the Poison Help hotline in the event of a potential aspirin overdose, even if it is not an emergency. Poison control experts can answer any questions you may have and provide advice on how to proceed.

How is an aspirin overdose diagnosed?

If an aspirin overdose is suspected, emergency room personnel will take a blood sample to measure how much aspirin is in your bloodstream, determining the severity of the overdose and influencing treatment. Your vital signs will be checked—such as your temperature, heart rate, breathing and blood pressure—to see how far-reaching the impact of the overdose is. A chest X-ray and urine test may also be performed.

How is an aspirin overdose treated?

Some of the potential treatment options for aspirin overdose include:

  • Gastric emptying or lavage (stomach pumping)
  • Laxative
  • Activated charcoal (if less than 3 hours have passed since the overdose occurred)
  • Breathing support such as oxygen, breathing tube (intubation) and a breathing machine (ventilator)
  • Intravenous (IV) fluids
  • Intravenous medicines, such as potassium salt and sodium bicarbonate
  • Kidney machine (hemodialysis)

Alongside the treatments aimed at reversing the overdose, medicines to relieve symptoms may also be used.

References
  1. U.S. National Library of Medicine (MedlinePlus). Aspirin Overdose. April 2, 2021. Available at: https://medlineplus.gov/ency/article/002542.htm. [Accessed April 21, 2021].
  2. U.S. National Library of Medicine (MedlinePlus). Aspirin. April 16, 2021. Available at: https://medlineplus.gov/druginfo/meds/a682878.html. [Accessed April 21, 2021].
  3. U.S. Food and Drug Administration (FDA). Aspirin for Reducing Your Risk of Heart Attack and Stroke: Know the Facts. December 16, 2019. Available at: https://www.fda.gov/drugs/safe-daily-use-aspirin/aspirin-reducing-your-risk-heart-attack-and-stroke-know-facts. [Accessed April 26, 2021].
  4. National Health Service (NHS). Aspirin for Pain Relief. November 15, 2018. Available at: https://www.nhs.uk/medicines/aspirin-for-pain-relief/. [Accessed April 21, 2021].
  5. U.S. National Library of Medicine (MedlinePlus). Reye Syndrome. April 2, 2021. Available at: https://medlineplus.gov/ency/article/001565.htm. [Accessed April 26, 2021].
  6. Arif H, Aggarwal S. Salicylic Acid (Aspirin). Updated 2020 Jul 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available at: https://www.ncbi.nlm.nih.gov/books/NBK519032/
  7. U.S. Food and Drug Administration (FDA). Aspirin Capsules label. January 14, 2013. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/203697Orig1s000lbl.pdf. [Accessed April 22, 2021].
  8. U.S. Food and Drug Administration (FDA). DURLAZA (aspirin) extended release capsules. September 2015. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/200671s000lbl.pdf. [Accessed April 21, 2021].

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