Aspirin

Why is this medication prescribed?

Prescription aspirin is used to relieve the symptoms of rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), osteoarthritis (arthritis caused by breakdown of the lining of the joints), systemic lupus erythematosus (condition in which the immune system attacks the joints and organs and causes pain and swelling) and certain other rheumatologic conditions (conditions in which the immune system attacks parts of the body).

Nonprescription aspirin is used to reduce fever and to relieve mild to moderate pain from headaches, menstrual periods, arthritis, colds, toothaches, and muscle aches. Nonprescription aspirin is also used to prevent heart attacks in people who have had a heart attack in the past or who have angina (chest pain that occurs when the heart does not get enough oxygen). Nonprescription aspirin is also used to reduce the risk of death in people who are experiencing or who have recently experienced a heart attack. Nonprescription aspirin is also used to prevent ischemic strokes (strokes that occur when a blood clot blocks the flow of blood to the brain) or mini-strokes (strokes that occur when the flow of blood to the brain is blocked for a short time) in people who have had this type of stroke or mini-stroke in the past. Aspirin will not prevent hemorrhagic strokes (strokes caused by bleeding in the brain). Aspirin is in a group of medications called salicylates. It works by stopping the production of certain natural substances that cause fever, pain, swelling, and blood clots.

Aspirin is also available in combination with other medications such as antacids, pain relievers, and cough and cold medications. This monograph only includes information about the use of aspirin alone. If you are taking a combination product, read the information on the package or prescription label or ask your doctor or pharmacist for more information.

How should this medicine be used?

Prescription aspirin comes as an extended-release tablet (tablet that releases medication slowly over a period of time). Nonprescription aspirin comes as a regular tablet, an enteric-coated, delayed-release tablet (tablet that first begins to release medication some time after it is taken), a chewable tablet, and a gum to take by mouth and a suppository to use rectally. Prescription aspirin is usually taken two or more times a day. Nonprescription aspirin is usually taken once a day to lower the risk of a heart attack or stroke. Nonprescription aspirin is usually taken every 4 to 6 hours as needed to treat fever or pain. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take aspirin exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.

Swallow the extended-release tablets whole with a full glass of water. Do not break, crush, or chew them.

Swallow the tablets with a full glass of water.

Chewable aspirin tablets may be chewed, crushed, or swallowed whole. Drink a full glass of water, immediately after taking these tablets.

Ask a doctor before you give aspirin to your child or teenager. Aspirin may cause Reye's syndrome (a serious condition in which fat builds up on the brain, liver, and other body organs) in children and teenagers, especially if they have a virus such as chicken pox or the flu.

If you have had oral surgery or surgery to remove your tonsils in the last 7 days, talk to your doctor about which types of aspirin are safe for you.

Delayed-release tablets begin to work some time after they are taken. Do not take delayed-release tablets for fever or pain that must be relieved quickly.

Stop taking aspirin and call your doctor if your fever lasts longer than 3 days, if your pain lasts longer than 10 days, or if the part of your body that was painful becomes red or swollen. You may have a condition that must be treated by a doctor.

To insert an aspirin suppository into the rectum, follow these steps:

* Remove the wrapper.
* Dip the tip of the suppository in water.
* Lie down on your left side and raise your right knee to your chest. (If you are left-handed, lie on your right side and raise your left knee.)
* Using your finger, insert the suppository into the rectum, about 1/2 to 1 inch in infants and children and 1 inch in adults. Hold it in place for a few moments.
* Do not stand up for at least 15 minutes. Then wash your hands thoroughly and resume your normal activities.

Other uses for this medicine:

Aspirin is also sometimes used to treat rheumatic fever (a serious condition that may develop after a strep throat infection and may cause swelling of the heart valves) and Kawasaki disease (an illness that may cause heart problems in children). Aspirin is also sometimes used to lower the risk of blood clots in patients who have artificial heart valves or certain other heart conditions and to prevent certain complications of pregnancy.

What special precautions should I follow?

Before taking aspirin,

* tell your doctor and pharmacist if you are allergic to aspirin, other medications for pain or fever, tartrazine dye, or any other medications.
* tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acetazolamide (Diamox); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril, (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); anticoagulants ('blood thinners') such as warfarin (Coumadin) and heparin; beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); diuretics ('water pills'); medications for diabetes or arthritis; medications for gout such as probenecid and sulfinpyrazone (Anturane); methotrexate (Trexall); other non steroidal anti-inflammatory medications (NSAIDs) such as naproxen (Aleve, Naprosyn); phenytoin (Dilantin); and valproic acid (Depakene, Depakote). Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.

* if you are taking aspirin on a regular basis to prevent heart attack or stroke, do not take ibuprofen (Advil, Motrin) to treat pain or fever without talking to your doctor. Your doctor will probably tell you to allow some time to pass between taking your daily dose of aspirin and taking a dose of ibuprofen.
* tell your doctor if you have or have ever had asthma, frequent stuffed or runny nose, or nasal polyps (growths on the linings of the nose). If you have these conditions, there is a risk that you will have an allergic reaction to aspirin. Your doctor may tell you that you should not take aspirin.
* tell your doctor if you often have heartburn, upset stomach, or stomach pain and if you have or have ever had ulcers, anemia, bleeding problems such as hemophilia, or kidney or liver disease.
* tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while taking aspirin, call your doctor. Aspirin may harm the fetus and cause problems with delivery if it is taken during the last few months of pregnancy.
* if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking aspirin.
* if you drink three or more alcoholic drinks every day, ask your doctor if you should take aspirin or other medications for pain and fever.

What side effects can this medication cause?

Aspirin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

* nausea
* vomiting
* stomach pain
* heartburn

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

* hives
* rash
* swelling of the eyes, face, lips, tongue, or throat
* wheezing or difficulty breathing
* hoarseness
* fast heartbeat
* fast breathing
* cold, clammy skin
* ringing in the ears
* loss of hearing
* bloody vomit
* vomiting material that looks like coffee grounds
* bright red blood in stools
* black or tarry stools

Aspirin may cause other side effects. Call your doctor if you experience any unusual problems while you are taking this medication.

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