Somewhere in your medicine cabinet you might have a bottle of aspirin. Maybe it’s leftover from years ago, or maybe it’s something you reach for every day. Aspirin is a versatile medicine that, these days, is often taken for reasons other than a headache. Is aspirin safe to take? And should you take it?
What is aspirin?
Aspirin is a common medicine that’s used to reduce fever and to relieve mild to moderate pain from headaches, menstrual periods, arthritis, toothaches, and muscle aches.
Aspirin is in a class of drugs called salicylates and is also a NSAID (non-steroidal anti-inflammatory drugs), a class of medicine that also includes ibuprofen, naproxen, celecoxib, and indomethacin.
A brief history of aspirin
Aspirin has a long history, dating back to at least 2500 BCE, according to the International Aspirin Foundation. Salicylic acid (a natural substance related to today’s aspirin), from myrtle, willow and meadow sweet was used in ancient times for medicinal purposes. Chinese, Roman and Native American civilizations have used plants that contain salicylic acid for their medicinal benefits.
A German chemist, Felix Hoffman who worked at Friedrich Bayer and Co., produced acetylsalicylic acid (ASA) for the first time in 1897. This was a milestone, as it was the “birth” of aspirin and was the first time a drug was made synthetically. The International Aspirin Foundation writes, “The new compound was named and registered Aspirin on February 1st, 1899.” Bayer was the first company to produce and sell aspirin.
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How else is aspirin used?
Besides treating fever and headaches, aspirin is used for other reasons:
- Reduce pain and swelling from arthritis, lupus, and other chronic conditions
- Manage migraines
- Reduce the risk of heart attack and stroke
- Reduce the risk of death in people who have recently had a heart attack
- Prevent preeclampsia, a serious condition during pregnancy that causes high blood pressure and protein in the urine
- Reduce the risk of developing or dying from colorectal cancer
Aspirin reduces the formation of blood clots by making platelets less “sticky.” Platelets are small cells that help the body form clots and stop bleeding. Most heart attacks and strokes occur when a blood clot forms in a blood vessel, blocking the flow of blood. If a clot forms in a blood vessel of the heart, a heart attack can happen; if it forms in a blood vessel going to the brain, a stroke can happen. For this reason, many health care providers prescribe low-dose aspirin to prevent a second heart attack or stroke.
What are the risks of taking aspirin?
While low-dose aspirin (generally between 75 and 150 milligrams [mg], although typically 81 mg) is likely safe for most people, some people should not take it. These include people who have:
- An allergy to aspirin or salicylates
- A bleeding disorder, such as hemophilia or a vitamin K deficiency
- Recent bleeding of the stomach or intestines
- Uncontrolled high blood pressure
- Severe liver or kidney disease
Also, anyone who is taking a prescription blood thinner medication such as warfarin, Pradaxa (dabigatran etexilate), or Xarelto (rivaroxaban), or who takes ibuprofen or naproxen should avoid taking aspirin. Taking aspirin if you take certain dietary supplements, such as fish oil or vitamin E, can increase the risk of bleeding, as well. Always tell your health care providers (including your dentist) if you are taking aspirin, especially if you are going to have a surgical procedure or dental work.
Should people with diabetes take aspirin?
In their Standards of Medical Care—2021, the American Diabetes Association states the following:
“Aspirin has been shown to be effective in reducing cardiovascular morbidity and mortality in high-risk patients with previous MI or stroke (secondary prevention) and is strongly recommended. In primary prevention, however, among patients with no previous cardiovascular events, its net benefit is more controversial.”
What might this mean for you? Here is a summary:
- Aspirin therapy (75-162 mg daily) may be used as a secondary prevention strategy in people with diabetes and a history of heart disease.
- Aspirin therapy (75-162 mg daily) may be a primary prevention strategy in people with diabetes who are at a high risk of heart disease.
- Aspirin isn’t recommended for people at low risk of heart disease, such as people under the age of 50 who have no other major heart disease risk factors (risk factors include a family history of premature heart disease, high blood pressure, high lipids, smoking, chronic kidney disease).
- Aspirin isn’t usually recommended for people under the age of 21 due to the risk of Reye’s syndrome, a rare condition that can cause serious brain and liver damage.
If you are taking aspirin or if you think you could benefit from taking aspirin, talk with your health care provider. They should review your history and risk factors for heart disease, as well as the pros and cons of taking aspirin. In addition, be sure to always let your provider know what other medications (both prescription and over the counter) and dietary supplements that you’re taking.
Want to learn more? Read “Diabetes and Aspirin.”