Aspirin has earned its fame as a pain relief wonder drug. It eases
headaches, lowers fevers, and reduces swelling. What's more, studies show that
daily doses as low as 81 milligrams -- the amount in a baby aspirin -- can
reduce the odds of heart attacks and strokes in people who are at risk. About
25 million Americans take aspirin for heart disease
protection every day.
But there's a catch. Like any other drug, aspirin has dangers. When taken
regularly, it can cause bleeding of the stomach and intestine -- especially in
sensitive people. It can also interact with over-the-counter painkillers,
causing unwanted side effects. Yet many people don't know this. Some take
aspirin as casually as they pop a daily multivitamin.
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"People have this skewed impression that over-the-counter medicines are
harmless," says Curtis Barr, PharmD, associate professor of pharmacy
practice at the Creighton University School of Pharmacy and Health Professions
in Omaha, Neb.
That goes double for daily aspirin. "People think, 'It's just
baby aspirin after all,'" says Byron Cryer, MD, a spokesman for
the American Gastroenterological Association. "'So how bad could it
Yet it's a potent drug, and every year low-dose aspirin helps send tens of
thousands to the hospital with bleeding.
So you must never start daily aspirin without your doctor's OK. If you have
been prescribed daily aspirin, you need to know your risks -- before you next
reach for a bottle of pain reliever.
Aspirin: The Pros and Cons
While aspirin may be best known as a painkiller, it also works as a blood
thinner. Heart attacks and most strokes are caused by blood clots in the heart
or brain. Aspirin decreases the blood's natural tendency to clot, allowing it
to flow more easily -- reducing the risks of these complications.
But there's the problem. For the same reason that aspirin helps prevent
strokes and heart attacks -- reducing the blood's tendency to clot -- it also
raises the risk of bleeding elsewhere in the body. Bleeding that can be
caused by the reduced ability of blood to clot.
Aspirin also has a special impact on the gastrointestinal tract. It blocks
the effects of certain hormone-like substances called prostaglandins. These
chemicals protect the stomach and gastrointestinal tract from damage. Aspirin
can strip away this protection. Natural acids and enzymes in the stomach, which
help digest food, can then injure the lining of the gastrointestinal tract.
This can result in ulcers and bleeding. Whether
the aspirin is buffered or coated makes no difference. And because aspirin also
prevents clotting, the bleeding is worse than normal.
Unfortunately, even low doses of aspirin have this effect, says Cryer, who
is also an associate professor of medicine at the University of Texas
Southwestern Medical School in Dallas. He worked on a study that tried to find
a dose of aspirin that was low enough to avoid these side effects.
"We found that even just 10 milligrams -- which is too low to have any
cardiovascular benefit -- posed the same risk of gastrointestinal damage as
doses that were over 30 times higher," Cryer tells WebMD.