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Aspirin

• Why have I been prescribed Aspirin?
• How does Aspirin prevent heart attacks?
• What are the side effects of Aspirin?
• What is the dose of Aspirin?
• What steps should I take to avoid these problems?

Why have I been prescribed Aspirin?

Aspirin or acetyl salicylic acid is one of the oldest drugs still used by the medical profession. Though previously widely used for the treatment of aches and pains, fever and headaches, this use has now been largely superseded by its properties for preventing cardiovascular disease. These conditions includes heart attacks, strokes, and narrowing of arteries (poor circulation) throughout the body.

Large research studies have shown that Aspirin is beneficial in preventing these cardiovascular problems in people who have already had one or more of these conditions as well as in people who are at risk for having cardiovascular disease but have not as yet an event. The dose of aspirin required to improve risk is very small yet the benefit of taking Aspirin must be weighed against the possible risks of long term Aspiring use. Discuss these issues further with your doctor.

How does Aspirin prevent heart attacks?

Aspirin has anti-inflammatory properties which is why it is effective in arthritis. It also has an important effect on blood platelets, which are tiny cell particles that help in forming clots. Aspirin makes platelets less sticky and therefore less likely to clump together and form clots. People with cardiovascular disease have narrowed arteries (blood vessels) due to deposits of fat in the vessel walls. The tendency to clot in these narrowed segments is greater as blood flow is sluggish. Aspirin used in this manner is often referred to as ‘anti platelet therapy’.

What are the side effects of Aspirin?

The main adverse effects of Aspirin are on the gastrointestinal system. It can cause nausea, vomiting, heartburn and discomfort in the upper tummy. It may also cause ulcers in the stomach or duodenum (small intestine just beyond the stomach). More worryingly it can make you prone to bleeding from the lining of the stomach or from a duodenal ulcer. This may manifest with anaemia or in extreme situations with vomiting of blood. The risk of bleeding in this manner is higher in the elderly, in people on treatment for arthritis, those on steroids or a drug called warfarin.

What is the dose of Aspirin?

Your doctor will usually prescribe a dose of 75-150 mg daily. In people who are suffering a heart attack a dose of 300 mg may be prescribed.

What steps should I take to avoid these problems?

• Aspirin is taken once a day – take it with a meal or after a meal.
• Watch out for early symptoms of heartburn and discomfort and let your doctor know about them
• Inform your doctor urgently if your stools turn tarry black in colour
• If you have a history of ulcers and still wish to take aspirin, consider taking a reduced dose or taking medication to reduce acidity in the stomach.
• An enteric coated formulation of Aspirin is available which is kinder to your stomach

Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospitals Diabetes Service.
October 2002