Aspirin is mostly used in a low dose for preventing heart attacks and strokes, although it can be used in high doses (300mg or more) for reducing pain and high temperature. The information that follows explains the use of aspirin for reducing pain and high temperature.
What can aspirin be used for?
mild to moderate pain (for example, toothache, migraine, period pain), and
Use in children
Children under 16 years of age should not take aspirin, unless on the advice of a doctor. This is because aspirin use in children has been associated with Reye's syndrome. This is a very rare condition that affects the brain and liver and can be fatal.
Paracetamol or ibuprofen may be given to children to treat pain and high temperature as they are not associated with Reye's syndrome.
How does aspirin work?
Asprin is from a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).
It blocks the production of chemicals called prostaglandins. These are released in your body in response to illness and injury. They cause pain and inflammation (swelling). Prostaglandins released in your brain can cause fever (high temperature).
Aspirin begins to ease pain and lower high temperature about 20-30 minutes after a dose is taken. It usually lasts for 4-6 hours.
When shouldn’t you take aspirin?
You should not take aspirin if you have:
an allergy to aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs),
a peptic ulcer (ulcer anywhere in the digestive system and stomach, for example duodenal ulcer, gastric ulcer),
asthma that gets worse when you take aspirin or other non-steroidal anti-inflammatory drug (NSAID),
you are already taking another non-steroidal anti-inflammatory drug (NSAID). For example, aspirin, diclofenac, ibuprofen, indometacin, mefenamic acid, meloxicam, naproxen, and piroxicam.
You should use aspirin with caution if you have:
Asthma - aspirin worsens asthma in about 10% of people with asthma. You may take aspirin if you know that it doesn’t affect your asthma. However, if you are unsure then only try aspirin for the first time when your asthma is well controlled.
High blood pressure (hypertension) – only take aspirin if your blood pressure is well controlled.
Kidney problems – only take aspirin if advised by your doctor.
Had a peptic ulcer or bleeding in the stomach in the past – only take aspirin if advised by your doctor.
You should also take aspirin with caution if you are more than 75 years old as there is a greater risk of aspirin causing a peptic ulcer or serious bleed in your stomach.
Also, you should not take aspirin without first speaking to your doctor if you are taking any of the following medicines:
Can aspirin be taken if you are pregnant or breastfeeding?
Pregnancy
Paracetamol is the first choice painkiller during pregnancy. Aspirin may be taken in the 1st and 2nd trimesters (up to week 28) but should not be taken during the 3rd trimester (weeks 29 - 42). As with any medicine in pregnancy, it should be taken at the lowest effective dose for the shortest possible time. Low dose aspirin (usually 75mg a day) may be taken by women at risk of pre- eclampsia (a serious condition resulting in raised blood pressure and fitting) if advised to by a doctor. Breastfeeding
Aspirin should not be taken when breastfeeding. What are the possible side effects?
duodenal or gastric ulcers (ulcer in the digestive tract),
gastritis (inflammation of the stomach),
haematemesis (vomiting blood – which may indicate there is bleeding in the stomach),
increased bleeding (for example, bruising, cuts bleed for longer),
malaena (black stools – which may indicate that there is bleeding in the stomach or digestive tract),
worsening of asthma by causing bronchospasm (narrowing of the airways).
Does aspirin affect your ability to drive?
Aspirin is unlikely to affect your ability to drive. However some people may sometimes feel dizzy when taking aspirin and you should not drive if you experience this.
Is aspirin safe to take with other medicines?
When two or more medicines are taken at the same time, the effects of the medicines are sometimes different to when they are taken separately. This is known as an interaction.
Aspirin can sometimes affect other medicines. The more common and significant interactions are listed below.
However, this is not a complete list. If you want to check that aspirin is safe to take with your medicines, you should ask your doctor or pharmacist (chemist) or read the patient information leaflet that comes with your medicine.
Anti-inflammatory painkillers
Aspirin should not be taken with other anti-inflammatory painkillers. For example, diclofenac, ibuprofen, indometacin, meloxicam, naproxen, piroxicam. This will increase the risk of an ulcer or serious bleed in the stomach or digestive tract.
If you are taking low dose aspirin for its antiplatelet (blood thinning) effect, taking another NSAID may reduce the blood thinning effect of the aspirin.
Anti-platelets (for example, clopidogrel and dipyridamole)
Anti-platelets such as clopidogrel and dipyridamole prevent the blood from clotting so easily. Taking aspirin with these medicines increases the risk of bleeding.
Medicines for high blood pressure
Regular use of aspirin causes fluid retention which can cause an increase in blood pressure. Taking aspirin may reduce the benefits of taking medicines to lower blood pressure.
Methotrexate
Aspirin reduces the body's ability to remove methotrexate. This can cause methotrexate levels to build up in the body and may result in methotrexate poisoning.
SSRI antidepressants
SSRI antidepressants include citalopram, fluoxetine, paroxetine, and sertraline. Aspirin increases the risk of bleeding in people taking SSRI antidepressants.
Warfarin
Warfarin is an anticoagulant medicine that stops the blood from clotting. Aspirin may increase the anticoagulant (blood clotting) effect of warfarin. This may result in bruising or more serious bleeding such as blood in the urine or stools.
Can you drink alcohol?
Aspirin may be taken with small amounts of alcohol. However, heavy alcohol drinkers who take aspirin have an increased risk of bleeding in the stomach.
Are there any interactions with food?
There are no known interactions with food. However, it is best to take aspirin with or after food to reduce irritation to the stomach.
What if you forget to take a dose?
If you forget to take your dose of aspirin, the general advice is:
If the dose is less than 2 hours late - take the dose as soon as you remember and then take the next dose as normal. If the dose is more than 2 hours late – take the dose as soon as you remember and then the next dose at least 4 hours after the missed dose. Doses of aspirin should be at least 4 hours apart. Do not take more than the recommended number of tablets in 24 hours.
Check the patient information leaflet that comes with your medicine as this should give you advice about what to do.
What if you accidentally take an extra dose? If you accidentally take an extra dose of aspirin – don’t take the next dose so that you are not taking more than your recommended number of tablets in 24 hours and then carry on as normal. If you feel unwell or are concerned, call NHS Direct on 0845 4647 or contact your GP. If you have taken more than the recommended total daily dose of aspirin - seek advice immediately. Call NHS Direct on 0845 4647, contact your GP or go to your nearest accident and emergency department (A&E).
SAATCA Interim Committee Chairman's Communiqué March 2007 To all SAATCA registered auditors, training course providers and other interested parties. This is the third communiqué issued by the SAATCA Interim Committee, please refer to previous communiqués for published information on the committee’s work to date. The committee continues to take good strides forward towards handing t