Key takeaways:
Aspirin is an over-the-counter medication that can help prevent blood clots that cause a heart attack or stroke. It can also help relieve pain and inflammation.
Aspirin can raise the risk of stomach problems like ulcers or bleeding. It can also cause problems with some health conditions or medications.
Taking aspirin may be right for you if the health benefits outweigh the risk of harm. Your healthcare team can help you make that decision.
About 1 in 3 adults in the U.S. take aspirin every day to lower their risk for heart attacks and stroke, or to help with pain relief. Though, over the years, recommendations for taking a daily aspirin have changed. For some people, taking a daily aspirin is helpful. But for others, it can do more harm than good. So is aspirin bad for you?
Well, there’s a lot of debate. On one hand, it can be effective in preventing blood clots and relieving pain. But it can also cause serious side effects, such as stomach ulcers and bleeding. The answer may just depend on your own health background.
Aspirin is an over-the-counter (OTC) medication that belongs to a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). These medications are generally used to reduce pain, inflammation (swelling), and fever.
Aspirin is one of the oldest and most well-known NSAIDs. But it’s often used a bit differently than other NSAIDs. This is because of its blood-thinning properties.
Aspirin can also go by other names, such as acetylsalicylic acid, acetylsalicylate, and ASA. Many OTC products contain aspirin. So, it’s always good to check with your prescriber or pharmacist if you’re unsure if a product contains aspirin.
The most commonly used doses of aspirin include an 81 mg tablet (also called “baby aspirin” or “low-dose aspirin”) and a 325 mg tablet. If used as a blood thinner, it’s usually taken once daily. For pain relief, it can be taken up to every 4 hours as needed.
NSAIDs, including aspirin, work by blocking the proteins cyclooxygenase-1 and -2 (COX-1 and COX-2). This lowers the production of prostaglandins. Prostaglandins are naturally produced chemicals in the body that contribute to pain, fever, and inflammation. COX-1 helps protect the stomach lining, helps maintain kidney health, and helps platelets form a blood clot. COX-2 plays a role in causing pain and inflammation when you’re injured or sick.
Aspirin is a bit unique from other NSAIDs, though. It more strongly blocks COX-1 than COX-2. Other NSAIDs tend to equally block both proteins, or focus more on COX-2. Aspirin also affects another substance called thromboxane A2 (TxA2). TxA2 helps our bodies make blood clots. Other NSAIDs don’t directly affect TxA2.
By blocking the production of prostaglandins, aspirin relieves pain and inflammation. But because it affects TxA2, it also thins the blood.
Higher doses (325 mg) of aspirin can be used to treat fever, pain, and inflammation. Low-dose (81 mg) aspirin is sometimes recommended for people who have had severe blood clots causing a heart attack or stroke. Aspirin can help prevent blood clots from causing these events again.
Aspirin may also be used as a preventative treatment for stroke and heart attacks in people who have never had one of these events before but may be at higher risk.
The risks of taking a daily aspirin outweigh the benefits for many people. Taking aspirin every day can raise the risk of serious bleeding. But certain people have higher risks than others.
Risk factors for bleeding while taking daily aspirin include:
Age 60 years or older
History of peptic ulcer disease
Male sex
Smoking
Taking other medications that also raise the risk of bleeding, such as corticosteroids like prednisone
The safest bet is to check with your healthcare team before taking a daily aspirin. Generally, a daily aspirin is recommended only when the benefits likely outweigh the risks. But that can be hard for you to know on your own. Your prescriber can help you make this decision.
Aspirin isn’t safe for everyone. You should ask your healthcare team about taking aspirin first if you:
Are allergic to NSAIDs
Have a history of stomach ulcers or bleeding
Have a bleeding disorder, such as hemophilia
Are pregnant
NSAIDs, including aspirin can worsen kidney disease due to their effects on the kidneys. They reduce blood flow to the kidneys, which can increase your risk for kidney damage. People with chronic kidney disease may also have a greater risk of bleeding while taking aspirin. Your healthcare team can help determine whether you should avoid aspirin.
Aspirin has a risk of several side effects, including:
Nausea
Upset stomach
Tinnitus (ringing in the ears)
Bruising
Bleeding problems
Stomach ulcers
Kidney problems
Some types of aspirin, like enteric-coated aspirin or Valazore, may lower the chance of stomach irritation.
You shouldn’t give aspirin to infants, children, or teens without a healthcare professional’s OK. Aspirin can lead to a serious condition called Reye’s syndrome in children and adolescents. This is a potentially fatal condition that affects the brain and liver.
Aspirin and ibuprofen (Advil, Motrin) have a lot in common. They’re both NSAIDs that can help with pain, fever, and inflammation. And they have similar risks, too. Overall, whether aspirin or ibuprofen is safer depends on your age and why you’re taking it.
Ibuprofen is safer for kids. As discussed above, giving aspirin to children and adolescents can cause Reye's syndrome. But aspirin is considered safer if you’ve had a heart attack. Aspirin is often recommended to be used after a heart attack. But other NSAIDs, including ibuprofen, should be avoided. You may have a higher risk of cardiovascular problems while taking ibuprofen after a heart attack.
Yes, it's possible that mixing aspirin with other medications can be dangerous. Aspirin can interact with other medications, which can affect how those medications work in your body.
Here’s a list of some of the common interactions:
Blood thinners (anticoagulants), like apixaban (Eliquis) and warfarin (Coumadin, Jantoven)
Antiplatelet medications, like clopidogrel (Plavix)
Bisphosphonates for osteoporosis, such as alendronate (Fosamax)
Corticosteroid medications, like prednisone
Other NSAIDs, like ibuprofen
Be sure to share a current medication list with your prescriber and pharmacist. They can help you determine whether it’s safe to take aspirin based on your other medications.
Yes, mixing aspirin with alcohol can be dangerous. In fact, there are many medications that shouldn’t be mixed with alcohol. Combining alcohol with NSAIDs, such as aspirin or ibuprofen, can raise your risk of stomach ulcers and serious bleeding. You could also be more likely to have liver or kidney problems.
Ideally, you should avoid drinking any alcohol while you’re taking aspirin. If you want to drink alcohol while taking aspirin, talk to your prescriber first to see if there is a safe amount to drink in your situation. But to be safe, they may recommend avoiding alcohol altogether.
Aspirin can be beneficial for some people, but it's not right for everyone. Be sure to speak with your healthcare team before taking aspirin, and always follow their recommendations. Aspirin’s risks outweigh the benefits in many cases.
Additionally, aspirin can affect some health conditions and interact with other medications. So be sure to mention any other medications you’re taking when speaking with your healthcare team about whether or not aspirin is right for you.
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