What conditions and medications are incompatible with aspirin?
Published 26 Nov 2019 • By Camille Dauvergne
Used to thin the blood, as a pain-killer or to bring down a fever, aspirin is a commonly used medication. But what is the maximum amount that can be taken in a day? And what other treatments are incompatible with aspirin?
Follow our guide!
What is aspirin?
Aspirin, or acetylsalicylic acid (ASA), is one of the most widely consumed medications in the world. Every year, more than 25 million tablets are produced! Even if it’s become commonplace, aspirin is still a drug whose medical use should be carefully controlled.
Like ibuprofen, aspirin has several different properties: an anticoagulant in low doses (blood thinner), an analgesic (pain-killer), an antipyretic (lowers fever) and in stronger doses an anti-inflammatory.
Aspirin works by inhibiting the synthesis of prostaglandins by acting on cyclooxygenases (COX 1 and COX 2). Because it inhibits COX 1, aspirin may cause digestive issues and stomach bleeding.
When and how to take aspirin?
These days aspirin is usually prescribed in low doses, between 75 and 300mg once a day for its blood-thinning effect. It’s systematically prescribed for patients who are at high risk of cardiovascular incidents or following a heart attack, as well as for patients who have just had a stent inserted or who are trying to avoid the formation of blood clots.
To reduce pain and fever, the maximum dose for an adult is no more than 1g of aspirin every 8 hours, or 3 grams a day.
Aspirin’s anti-inflammatory power is only unleashed at high doses: a maximum dose of 6g per day, spaced out in 3 or 4 intakes per day with a minimum of 4 hours between each intake. In this form, aspirin can be used to treat muscle pain or the symptoms of rheumatoid arthritis.
What medications contain aspirin?
There are some medications that contain only aspirin while others combine aspirin with other molecules. It’s important to know which medications contain aspirin to avoid accidentally taking several at once. Otherwise, a patient may overdose, increasing the risk of a number of unpleasant side-effects.
Medications containing aspirin (non-exhaustive list)
- KARDEGIC 75/160/300/500 mg
- NU-SEALS 75/300 mg
- ACTAVIS 300g
- ALKA SELTZER 324 mg
- ASPEGIC 100/250/500/1000 mg (drinkable or injectable)
- CONCORDIA ASPIRIN
- ASPRO 320/500 mg
- BAYER 81mg/325mg
- DISPRIN 300mg
- MODIXIS 75 mg
Medications that combine aspirin with another molecule (non-exhaustive list)
- ANADIN EXTRA (AA+ paracetamol + caffeine)
- CO-CODAPRIN (AA +codeine)
- CODIS 500 (AA + codeine)
- MIGRAMAX (AA + Metoclopramide) : taken as a migraine treatment
When should you avoid taking aspirin?
Contra-indications with certain conditions
- A history of allergic reactions to medications in the AA family or to NSAIDs
- The presence of stomach or duodenum ulcers
- If there is a heightened risk of haemorrhaging (persons predisposed to uncontrolled bleeding, or women on their period)
- The presence of liver impairment or failure
- The presence of kidney impairment for failure
- The presence of uncontrolled heart impairment or failure
Usages requiring close supervision
People with histories of stomach or duodenum ulcers, asthma, gout, moderate kidney failure or women using intrauterine contraceptive devices (IUD) should consult with their physicians and alert them of any side effects!
Pregnancy and breastfeeding
The use of aspirin is not recommended for women who are 6-months or more pregnant, as there is a risk of intra-uterine death to the foetus. Women who are breastfeeding should also not take aspirin.
Infections
In the case of fever or infection-related pain (sore throat, cold, ear infection, cough, lung infection, skin rash or chickenpox), consult with your physician and use Paracetamol instead. Both ibuprofen and aspirin may mask the signs of infection which can cause complications if the infection is not treated in time.
What medications are incompatible with aspirin?
NSAIDs
They function similarly to aspirin and taking them together may pose a risk of overdose and an increased risk of severe side-effects including stomach ulcers and bleeding.
Oral anticoagulants (blood thinners)
There’s a heightened risk of internal bleeding if aspirin is taken with oral anticoagulants (such as Warfarin, Fluidione, Sinthrome, Eliquis, Pradaxa or Rivaroxaban [Xarelto]).
Other circumstances
Aspirin may interfere with medications like lithium or methotrexate.
For more information, feel free to watch our video on YouTube:
Warning: This article is a general overview and does not replace medical advice given by a health-care professional. It does not take into account individual patient cases which may vary. Each patient is different, always take your physician before beginning or altering your treatment!
Article written by Louise-B with Camille Dauvergne, 4th-year pharmacy student.
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10 comments
Thank you for an interesting article.
I have been on blood thinners, since June/July, 2019, and recently had brain aneurysm surgery in August, 2019. I was put on Aspirin and Clopidogrel at the same time which I continue to take - 75mg. of both daily. These have given me constant nose bleeds and bruising together with gastric problems; I am now on a waiting list for a Gastroscopy which I hope will happen in the near future.
Due to another operation coming up next year (stenting for brain aneurysm due to complications the 1st time), I had blood tests done last week, and now have too thin blood so they reduced Clopidogrel to 37.5mg which is not available. This has made me buy a 'pill cutter' and I now have the fun of cutting the tablets in two!
I found Anadin good for headaches (this contains Aspirin), but am told now to take Paracetamol due to the blood thinners. If I had my way I wouldn't take blood thinners, but regret am now on these for the rest of my life!
Paracetamol doesn't work but I've now found that Panadol does.
As I a developing heart condition I am now prescribed a low dose Aspirin. Hopefully won't affect my stomach to much but I am noticing a little increase in events in that area!
Thank you for informed anaylis of Asprin and complications with other medices and treatments.
Having been been on since I was 49. for the benefit of blood thinning properties, I recognise mentioned dangers but unfortunately have no choice but to take 75m.g. every morning. I also have to be stringent and careful after following a collapse, I was diagnoed with an Aortic anerursym 5. years ago. By a brilliant professor and heart specialist following week after another of being admitted as an Emergency. Also at a later date approximate 3. years I was further diagnosed with one Nocturnal Epeleptic Seizure. (Reason unknown?) Thankfully as just the once consultant has started reducing prescribed medication this month. Only need to continue seeing once yearly at present depending on how reduced tablet doze works? This added to previous Medical Conditions already previously explained in earlier comments. I further agree about various side affects e.g. nose bleeds when blood becomes very thin. Also various ailments including stomach ache of continous nature but for whatever reason or cause? Sadly I find have to suffer such to have such as current health Allows.
Thank you to Louse-B 4th. Year Pharmacy Student. Wish well in future career. Also taking time to investigate such matters as mentioned in Arcticle. Hopefully to see more! In future as knowlegde is forebearance of living.
Thank you for the link, however it is not exhaustive. Asthma is another condition made worse by asprin on a long term basis, another no no is if you have gout . I used to take it many years ago for arthritic pain but now have to abstain, this is possibly due to personal health history. I feel there should be more research done into the interaction of some everyday commonly used drugs in respect of long term use risks and individual risk factors or allergies.
Well I,m on blood thinners since hearth surgery and thank god every thing seem fine
