Aspirin Side Effects: Aspirin is a member of the group of drugs called salicylates. They have been used for pain relief since ancient times when it was chewed as willow bark. Aspirin has been available over the counter as a stand-alone drug as well as in combination with a large number of drugs. It is available in 81 mg, 325 mg, 500 mg pills in both uncoated and enteric coated products, as well as in buffered products. Aspirin is used primarily for its antiplatelet effect. The anti-platelet effect of aspirin is permanent, inhibiting platelet agglutination for the duration of the life of the platelet, unlike many other anti-platelet drugs which have the effect only while they remain present in the bloodstream in adequate quantities. Aspirin is also used as an antipyretic for fever, for its anti-inflammatory properties in conditions like arthritis and for pain relief. It is expecially effective in some patients with migraine headache and other headache syndromes, often in combination with caffeine or acetaminophen.

Black Box Warnings: Aspirin is contraindicated for use in children younger than age 18 with viral syndromes because of an increased risk of Reye’s Syndrome.

Common Aspirin Side Effects: The common aspirin side effects are primarily related to its anti-platelet effects. Serious bleeding, especially gastrointestinal bleeding, is the most common serious side effect. Aspirin also frequently causes gastrointestinal irritation including gastritis, gastric and duodenal ulcers, and esophagitis. These combined with the anti-platelet effect which can cause any bleeding to be more severe make GI bleeding a common aspirin side effect. Especially when used in high doses aspirin causes tinnitus, or ringing in the ears. Irreversible ototoxicity can be an aspirin side effect. The common aspirin side effects related to the anti-platelet effect include bruising and bleeding. Gastrointestinal aspirin side effect symptoms include dyspepsia, nausea, vomiting, constipation, diarrhea and abdominal pain. Aspirin can also lead to reduced excretion of uric acid and hyperuricemia. Dizziness is also common, likely related to the ototoxicity.

Serious Aspirin Side Effects: For an over the counter medication aspirin has a list of serious side effects that rival most medications available only by prescription. Aspirin allergy is reasonably common, and serious aspirin allergic side effects include anaphylaxis, angioedema, and bronchospasm. Gi bleeding can be lifethreatening, and the irreversible anti-platelet effect can make this bleeding especially difficult to manage. Bone marrow toxicity can include suppression of any of the lines of blood cells, and manifest as thrombocytopenia, agranulocytosis, and aplastic anemia, or can affect all of the blood elements as pancytopenia. Like all of the NSAIDs aspirin can cause nephrotoxicity, especially with long term high dose use. For a complete list of common and serious aspirin side effects see the manufacturers detail documents.

Unusual Aspirin Side Effects: Tinnitis is among the more unusual and yet common aspirin side effects. Nasal polyps can be caused by aspirin allergy as another unusual aspirin allergy.

Drug Interactions: Aspirin when used in combination with other NSAIDs can greatly increase the risk of gastrointestinal bleeding. When used for long duration and higher dose in combination with acetaminophen there may be an increased incidence of nephrotoxicity. Aspirin used with either heparin or warfarin can greatly increase the risk of bleeding.

Pregnancy and Lactation Class: Aspirin is category D in pregnancy, meaning there is a possible risk shown to fetus with aspirin use. Aspirin is considered possibly unsafe for use in lactation.

Special Considerations: Avoid use in children with viral illness, after live virus vaccines like varicella and MMR vaccines because of a possible increased risk of Reye’s syndrome. Use of aspirin for prevention of heart attack and stroke is recommended by some physicians, and readers should discuss with their physician whether aspirin is indicated in their particular circumstances. There are often both risks and benefits of aspirin use, and an individual’s health status, history and other medications may make the risks or the benefits greater.

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