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Heart Disease Health Center

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Safe Pain Relief With Aspirin Therapy

On aspirin therapy? Aspirin can interact with other drugs, causing side effects. Know your risks.

Safe Pain Relief When You're on Aspirin Therapy continued...

One over-the-counter option is acetaminophen, which is sold as Panadol and Tylenol. It is not an NSAID: it works differently and has different risks.

For more severe pain, Cryer says that you could turn to prescription narcotics. These include drugs like OxyContin, Percocet, and Vicodin.

However, these drugs have drawbacks as well. First of all, none of them will help with swelling. High doses of acetaminophen regularly can cause serious liver damage. Narcotics taken regularly have other side effects, including constipation and a risk of addiction.

But what if you have arthritis and a risk of heart attack? What if you need both a daily aspirin and an NSAID for pain and swelling?

Then there's another option, says Cryer. You could also take a proton pump inhibitor. These drugs -- like prescription Aciphex, Nexium, Prevacid, Prilosec, and Protonix and the over-the-counter Prilosec OTC -- reduce the amount of acid in your stomach. This lowers the risk of ulcers or bleeding, even if you are taking aspirin and another NSAID.

Aspirin Therapy: Working With Your Doctor

Cryer and Barr both say that we should not lose sight of aspirin's benefits.

"Having said all of these negative things about aspirin," says Cryer, "I want to stress that it's an excellent medicine for the right people. Everyone just needs to recognize that there are risks as well as benefits."

"Despite the risks, I think that more people should probably be on daily aspirin therapy," says Barr. "Many people at risk of cardiovascular disease -- men over 40, postmenopausal women, people with high blood pressure, high cholesterol or especially diabetes -- should be getting low-dose aspirin, but aren't."

If you take daily aspirin -- or are considering it -- here are some tips.

  • Make sure your doctor (or doctors) knows about all other medicines you take. This is key if you see multiple specialists, says Barr. For instance, a rheumatologist might prescribe an NSAID for your arthritis, but your cardiologist might suggest low-dose aspirin. Each doctor needs to know what the other is doing. Otherwise, you could get into trouble.

  • Watch out for NSAIDs in other products. NSAIDs, including aspirin, are common ingredients. They can pop up in places you might not expect, says Barr. For instance, some cold and flu remedies, sleep aids, and even antacids contain aspirin and other NSAIDs.

  • Watch out for signs of gastrointestinal bleeding. Signs include vomiting blood or dark stools. Unfortunately, these are often the first symptoms that something is wrong, says Cryer. Sometimes, stomach upset or pain can be an early warning.

  • Never start taking daily aspirin without your doctor's approval. It could do you more harm than good.

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