US Pharm. 2024;49(2):15-16.

May Prevent Heart Attack, Stroke

Aspirin is one of the oldest, most widely used drugs in the world. Taken for pain relief for thousands of years, its active ingredient, salicin, is found in the leaves and bark of the willow tree. In 1897, the Bayer company in Germany developed a synthetic version called acetylsalicylic acid and named it aspirin. The typical adult dosage is 325 mg to 1,000 mg every 4 to 6 hours as needed to treat pain, inflammation, or fever. Lower doses of aspirin between 81 mg and 325 mg may be taken every day after a heart attack or stroke. In some cases, it might be used to prevent first occurrences of a heart attack or stroke if the doctor believes the benefit is higher than the risk.

Decreases Chance for Clot Formation

Under normal circumstances, the body develops a blood clot to stop the loss of blood after an injury. However, when there are fatty deposits in the vessel walls, it can form a plaque, which contains cholesterol and other substances. The plaque could rupture and damage the vessel wall. When a blood vessel is damaged, sticky cells called platelets begin to clump together to form a clot. Fibrin also forms and creates a netlike structure that holds the clot together. These blood clots can prevent oxygen and blood from getting to the heart or brain, which leads to a heart attack or stroke. Aspirin decreases the chance of clots from forming by preventing the platelets from clumping together.

If you have had a heart attack or stroke before, your doctor may prescribe aspirin to prevent it from happening again. It is important to speak with your physician before starting aspirin for the prevention of a heart attack or stroke so that they can review your medical history, allergies, and current medications to determine if it is the best choice for you.

Interrupts Inflammatory Prostaglandins

Aspirin is also a nonsteroidal anti-inflammatory drug (NSAID), which means that it reduces inflammation. It is different from a corticosteroid like hydrocortisone or prednisone. Inflammation is the body’s natural response to injury. When an injury occurs, the immune system is activated, and compounds called prostaglandins form in the area surrounding the injury. Prostaglandins increase blood flow to the injury, leading to the redness, heat, and swelling associated with inflammation. Aspirin prevents these prostaglandins from forming, reducing inflammation.

It is aspirin’s anti-inflammatory action that also makes it useful in preeclampsia, a serious condition of pregnancy believed to result from an inflammatory response, and possibly the prevention of colon cancer. Some research suggests that aspirin could potentially lower the rates of other cancers too, but it may have to be taken for a while before those benefits are seen.

Significant Side Effects Are Possible

Even in low doses, aspirin can have significant side effects. The most common side effects are an increased tendency to bleed, heartburn, nausea, vomiting, or ulcers. Other less common side effects can affect the kidney, liver, and nervous system.

Although aspirin is an OTC drug, the FDA recommends that certain individuals not take aspirin. Those with an allergy to aspirin or salicylates, a bleeding or clotting disorder such as hemophilia or vitamin K deficiency, a history of stomach ulcers, bleeding, or gastritis, and people with severe liver or kidney disease should avoid using aspirin. In addition, increased risk of bleeding can occur if aspirin is used in those taking other blood thinners, such as warfarin (Jantoven), dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto), edoxaban (Savaysa), heparin, enoxaparin (Lovenox), fondaparinux (Arixtra), clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient), or another NSAID, such as naproxen (Aleve) or ibuprofen (Advil or Motrin). Sometimes, the doctor may prescribe other blood thinners in addition to aspirin depending on your medical history, such as your risk for developing a heart attack, a stroke, or other medical conditions.

Many different drug-drug and drug-food interactions can happen with blood thinners in drugs that are sold OTC. So before taking any OTC drug, even aspirin, be sure to talk with your doctor first to find out if it is right for you.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.