Aspirin is one of the most common over the counter drugs marketed all over the world with different trade or brand names like Disprin, Ecotrin etc. Aspirin also named as acetylsalicylic acid falls in the category of non steroidal anti-inflammatory drugs (NSAIDs). It is further subcategorized in the group named as Salicylates. Although it falls in the group of non steroidal anti-inflammatory drugs (NSAIDs), however, the mechanism of action differs from other drugs in the same group. Aspirin decreases the synthesis of prostaglandins and thromboxanes by irreversibly inhibiting the enzyme COX-1 (cyclo-oxygenase 1) and modifying the enzyme COX-2. This decreased synthesis of prostaglandins and thromboxane is responsible for most of the clinical benefits of Aspirin. Moreover, aspirin is found to have an effect on hypothalamopituitary- adrenal axis.
What is Aspirin used for?
In late 19th century, Felix Hoffman, one of the chemists of Bayer pharmaceutical company produced Aspirin to be marketed all over the world. Aspirin has a wide range of uses depending on the dose of the drug.
Few of them are:
- Pain relief – although aspirin can be prescribed for almost all the types of pains; however it is not a good choice for muscle cramps or abdominal cramps. Aspirin is a drug of choice for all the types of headaches including migraine, tension headache and cluster headache because of its rapid onset of action. The pain mediating effect of aspirin depends on the prostaglandin synthesis inhibition in the body. Moreover, certain combinations of aspirin and caffeine are available in the market for better pain control
- Fever – aspirin is also used in the management of fever as it suppresses the synthesis of prostaglandins responsible for causing fever. It has never been the drug of choice for treating fever
- Cardiovascular disease – low dose aspirin (usually 75 mg) has an anti-platelet effect. So, it is used for the both the primary and secondary prevention of ischemic heart disease. Although use of aspirin has decreased the incidence of heart attacks, however, few side effects like gastrointestinal bleeding may restrict its use in some individuals
- Neurovascular disease – similarly it is also effective in the prevention of cerebrovascular accident or stroke
- Post percutaneous coronary intervention (PCI) – 300 mg of Aspirin once daily is prescribed to the patient in order to keep the blood thin and prevent further clotting.
- Prevention of cancers – few studies support the role of long term use of Aspirin in the prevention of colorectal carcinoma
- Rheumatoid arthritis – it is used commonly for the symptomatic treatment of rheumatoid arthritis
- Other uses of aspirin are in acute rheumatic fever, Kawasaki disease, pericarditis and myocardial infarction
Common side effects of Aspirin
Common side effects of Aspirin are:
- Gastrointestinal – gastrointestinal irritation and bleeding is a well known side effect of Aspirin. It destroys the protective layer on the wall of stomach allowing hydrochloric acid and gastric juices to act on the mucosal layer of the stomach. These agents destroy the stomach lining and cause both acute hemorrhage as well as chronic acid peptic disease. Numerous studies have shown that using ascorbic acid or vitamin C with Aspirin reduces the risk of gastrointestinal damage and bleeding
- Ringing of ears – aspirin causes tinnitus (ringing of ears) in some of the users
- Anemia – it may cause iron deficiency anemia due to gastrointestinal bleeding
- Reye’s syndrome – it occurs in children or may be adolescents if Aspirin is given for the treatment of fever especially in viral infections
- Allergic reactions – Aspirin can cause some serious allergic reactions which require urgent management
- Asthma – aspirin induce asthma may cause severe bronchospasm
- Hives – Aspirin can cause local or generalized swelling and hives associated with severe headache in few individuals. This is the effect of intolerance to salicylic acid and not due to allergy
- Aspirin can cause hemolytic anemia is individuals having glucose-6-phosphate-dehydrogenase deficiency (G6PD)
- Angioedema – studies show that aspirin intake may cause soft tissue swelling in the body usually when taken in combination with other NSAIDs
Aspirin side effects on children
The most common side effect which led to discontinuation of this drug in children or adolescents is Reye’s syndrome. Reye’s syndrome is characterized by hepatic encephalopathy. In this syndrome fatty liver develops and brain tissue may also get damaged. It usually occurs in the children being treated with Aspirin for fever due to any viral infection like chicken pox, respiratory tract infection or diarrhea due to rotavirus.
Aspirin side effects on men
No additional side effects on men. Generally is same as the common side effect stated for all age groups.
Aspirin side effects on women
The most serious side effect of Aspirin in women is bleeding. Bleeding can be from gastrointestinal tract, nose and genitourinary tract commonly. It can be so severe that it may require blood transfusion. Moreover, easy bruising has also been observed in the women using aspirin. Numerous studies have shown that there is increased incidence of hemorrhagic stroke in women taking aspirin regularly for the prevention of stroke or heart attack.
Aspirin side effects on pregnant women
It is always better to consult your health care provider if you are planning to conceive regarding aspirin use. Although aspirin is prescribed for the management of some conditions like preeclampsia and antiphospholipid antibody syndrome, however, long term use of high dose aspirin can cause problems both for the mother and baby. Few studies show that aspirin use increases the risk of miscarriage and abruptio placentae. Moreover it may cause growth retardation of the fetus. Babies of mothers on aspirin during pregnancy may experience hemorrhagic, cardiac and respiratory problems after birth.
Aspirin side effects on elderly
All the side effects of aspirin can be manifested in the elderly but few side effects like bleeding and renal problems can be very serious in this age group. In elderly, aspirin can decrease the excretion of uric acid from the kidneys.