Can You Overdose on Aspirin? What to Know About Salicylate Toxicity

Taking too much of any medication can be harmful, even ones you buy over the counter (OTC). For example, high doses of Tylenol (acetaminophen) can cause liver damage. High doses of aspirin can cause toxic effects, too. But how much is too much?

Here, we’ll sort it all out so you know how to take aspirin or use aspirin-containing products safely. Keep reading to learn whether an aspirin overdose is the same as salicylate toxicity, what to watch out for, and more.

What is an aspirin overdose?

An aspirin overdose can happen when someone takes too much aspirin or too much of an aspirin-containing product. Once it’s in the body, aspirin quickly breaks down into salicylic acid. In its salt form, this is called salicylate. This is the main chemical that can build up and cause harm if someone takes too much aspirin.

Because aspirin quickly turns into salicylate, the terms “aspirin overdose” and “salicylate overdose” are often used interchangeably.

There are two main types of aspirin overdose:

1. An acute aspirin overdose: caused by one large aspirin dose or several doses taken over a short period of time

2. A chronic aspirin overdose: occurs gradually when too much aspirin slowly builds up in the body over days or weeks

At toxic levels, salicylates can disrupt how the body uses energy. This can lead to dangerous changes in blood chemistry, such as too much acid in the blood or low blood glucose (sugar). Aspirin overdose, even when it’s only suspected, should be treated as a medical emergency.

Symptoms of an aspirin overdose

Even at safe doses, aspirin can cause side effects, such as heartburn and stomach upset. It can also cause serious problems, such as stomach ulcers or serious bleeding. With an aspirin overdose, these effects are more likely to happen and be more severe.

An aspirin overdose can also cause other symptoms, such as:

• Confusion or hallucinations

• Double vision

• Ringing in the ears (tinnitus)

• Rapid or slow, labored breathing

• Rapid heart rate

• Severe headaches

• Drowsiness

• Dizziness or loss of balance

An aspirin overdose can be life-threatening. And it can lead to the following complications:

• Seizures

• Loss of consciousness

• Loss of hearing

• Low blood pressure

• Aspiration pneumonitis (a lung infection caused by inhaling something other than air)

• Respiratory failure

• Cardiac arrest (a sudden stopping of the heart)

• Coma

If you’re experiencing symptoms of aspirin or salicylate toxicity, call 911 or go to the nearest ER.

Salicylate toxicity: Poisoning with salicylates other than aspirin

Some medications that don’t contain aspirin contain other forms of salicylates. Combining aspirin with other salicylates can raise the risk of salicylate toxicity.

Examples of salicylate medications that don’t contain aspirin include:

• Aspercreme (trolamine salicylate)

• Choline magnesium trisalicylate

• Diflunisal

• Diurex Water Pills (caffeine / magnesium salicylate)

• Doan’s Maximum Strength (magnesium salicylate)

• Mesalamine (Apriso, Asacol HD, Canasa, Lialda, Rowasa)

• Methyl salicylate

• Pepto-Bismol (bismuth subsalicylate)

• Salex (salicylic acid)

• Salonpas Pain Relieving Patch (camphor / menthol / methyl salicylate)

• Salsalate

The risk of toxicity is not the same with each of these medications. For example, Pepto-Bismol contains a salicylate form that rarely causes toxicity with recommended use. Salicylate toxicity is also rare with topical products, such as Aspercreme.

That being said, your body can still absorb small amounts of salicylates from a topical product. This is typically only a concern if the product is applied often, on large areas, and for long periods of time. Following the directions on your product’s package can help lower your risk of experiencing toxicity.

Good to know: Methyl salicylate is also called wintergreen oil. It’s added to some topical medications for fragrance and a cooling sensation. As an essential oil, it contains concentrated amounts of salicylates, which can be toxic if swallowed or applied directly to the skin. Keep products with methyl salicylate, or wintergreen oil, away from children and pets.

When should you seek medical care for an aspirin or salicylate overdose?

If you have symptoms of an aspirin or salicylate overdose, call 911 or go to the nearest ER. If you don’t have symptoms but think you’re at risk, contact Poison Control at 1-800-222-1222 for guidance.

An aspirin or salicylate overdose needs prompt medical treatment to help prevent organ damage and reduce the risk of death.

Tips for preventing an aspirin overdose

Steps you can take to help prevent an aspirin overdose include:

• Avoid drug interactions. Keep an updated list of all the medications and OTC products you take. Share the list with your pharmacist and prescribers. And check with them before taking a new prescription or OTC product.

• Check labels. Always read the OTC label of a medication before taking it. Salicylates may be written as “aspirin,” “ASA,” “salicylic acid,” or names ending in “salicylate,” such as trolamine salicylate.

• Store medications safely. Keep aspirin and other salicylates stored in a secure place away from children and pets.

• Check in with your care team. Only take aspirin regularly if your healthcare team recommends it. If it’s been a while since they advised you on this, consider checking in with them again, as guidance can change over time.

• Know about your options. There are many different topical analgesics, oral pain relievers, and nonmedication approaches to managing aches and pains. Knowing about different options can help you choose what’s safest for you.

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Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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