Aspirin (ASA)

Aspirin Brand Names

Anacin Adult Low Strength | Aspergum | Aspir-Low | Aspirtab | Aspir-Trin | Bayer Advanced Aspirin | Bayer Aspirin | Bayer Aspirin Extra Strength | Bayer Aspirin Plus | Bayer Aspirin Regimen | Bayer Children’s Aspirin | Bayer Extra Strength | Bayer Extra Strength Plus | Bayer Genuine Aspirin | Bayer Low Dose Aspirin Regimen | Bayer Womens Aspirin | DURLAZA | Easprin | Ecotrin | Genacote | Halfprin | MiniPrin | St. Joseph Adult Low Strength | St. Joseph Aspirin | Zero Order Release Aspirin | ZORprin

What is Aspirin

Aspirin is an oral and rectal nonsteroidal antiinflammatory drug (NSAID) indicated for the temporary relief of minor aches and pains associated with headache, backache, muscular aches, a cold, toothache, minor pain of arthritis, premenstrual and menstrual cramps, to reduce the risk of death and myocardial infarction (MI) in patients with chronic coronary artery disease, such as patients with a history of MI or angina pectoris or chronic stable angina, and to reduce the risk of death and recurrent stroke in patients who have had an ischemic stroke or transient ischemic attack (TIA).

Aspirin increases the risk of bleeding and may cause gastric ulceration and bleeding.

Reye’s syndrome, a potentially fatal disease, has been associated with aspirin use after active varicella infection or other viral illnesses in children; hence, aspirin use is children is primarily limited to the treatment of Kawasaki disease, for thrombosis prophylaxis, particularly in those with congenital heart disease after cardiac surgery, and for the treatment and secondary prevention of arterial ischemic stroke.

Guidelines for the treatment of juvenile idiopathic arthritis in children no longer recommend aspirin as a treatment option due to the availability of other NSAIDs (i.e., ibuprofen, naproxen) that are just as effective, safer, and better tolerated.

Observational studies have suggested that aspirin reduces the risk of colorectal cancer. However, long-term follow-up of the randomized Physicians’ Health Study found no association between aspirin use and colorectal cancer.

In contrast, randomized trials have shown that aspirin reduces the risk of recurrent adenomas in persons with a history of colorectal cancer or adenomas.

The role of aspirin in the chemoprevention of colorectal cancer, either as primary or secondary prophylaxis, has not been determined.

Indications

1. acute myocardial infarction
2. arterial thromboembolism prophylaxis
3. arthralgia
4. claudication
5. colorectal cancer prophylaxis
6. dental pain
7. dysmenorrhea
8. fever
9. headache
10. ischemic stroke
11. Kawasaki disease
12. migraine prophylaxis
13. mild pain
14. musculoskeletal pain
15. myocardial infarction prophylaxis
16. osteoarthritis
17. percutaneous coronary intervention (PCI)
18. pericarditis
19. preeclampsia prophylaxis
20. prosthetic heart valves
21. reduction of cardiovascular mortality
22. rheumatoid arthritis
23. stroke prophylaxis
24. thrombosis prophylaxis
25. unstable angina
26. vernal keratoconjunctivitis

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. agranulocytosis
4. anaphylactoid reactions
5. angioedema
6. aplastic anemia
7. azotemia
8. bleeding
9. bronchospasm
10. confusion
11. constipation
12. dehydration
13. diaphoresis
14. diarrhea
15. disseminated intravascular coagulation (DIC)
16. dizziness
17. drowsiness
18. dyspepsia
19. dysphagia
20. elevated hepatic enzymes
21. epistaxis
22. erythema nodosum
23. esophageal stricture
24. esophageal ulceration
25. esophagitis
26. fever
27. gastritis
28. GI bleeding
29. GI perforation
30. hallucinations
31. headache
32. hearing loss
33. hematoma
34. hemolytic anemia
35. hemorrhoids
36. hepatic encephalopathy
37. hepatic necrosis
38. hepatitis
39. hyperbilirubinemia
40. hyperglycemia
41. hypernatremia
42. hyperuricemia
43. hyperventilation
44. hypoglycemia
45. hypokalemia
46. hypoprothrombinemia
47. interstitial nephritis
48. intracranial bleeding
49. jaundice
50. laryngeal edema
51. leukocytosis
52. leukopenia
53. maculopapular rash
54. melena
55. metabolic acidosis
56. nausea
57. odynophagia
58. pancytopenia
59. peptic ulcer
60. platelet dysfunction
61. prolonged bleeding time
62. pulmonary edema
63. purpura
64. pyrosis (heartburn)
65. renal failure (unspecified)
66. renal papillary necrosis
67. renal tubular necrosis
68. respiratory depression
69. Reye’s syndrome
70. seizures
71. Stevens-Johnson syndrome
72. thrombocytopenia
73. tinnitus
74. toxic epidermal necrolysis
75. urticaria
76. visual impairment
77. wheezing
78. withdrawal

Monitoring Parameters

• LFTs
• serum creatinine/BUN
• serum salicylate concentrations
• stool guaiac

Contraindications

• abrupt discontinuation
• acid/base imbalance
• acute bronchospasm
• agranulocytosis
• alcoholism
• aneurysm
• anticoagulant therapy
• ascites
• asthma
• bone marrow suppression
• breast-feeding
• coagulopathy
• dehydration
• esophagitis
• G6PD deficiency
• gastritis
• geriatric
• GI bleeding
• GI disease
• gout
• head trauma
• heart failure
• hemophilia
• hepatic disease
• hypertension
• hypoprothrombinemia
• hypovolemia
• immunosuppression
• increased intracranial pressure
• influenza
• intracranial bleeding
• intramuscular injections
• iron-deficiency anemia
• labor
• metabolic acidosis
• metabolic alkalosis
• nasal polyps
• neonates
• neutropenia
• NSAID hypersensitivity
• obstetric delivery
• peptic ulcer disease
• pregnancy
• renal disease
• renal failure
• renal impairment
• respiratory acidosis
• respiratory alkalosis
• Reye’s syndrome
• salicylate hypersensitivity
• surgery
• systemic lupus erythematosus (SLE)
• thrombocytopenia
• thrombolytic therapy
• thrombotic thrombocytopenic purpura (TTP)
• tobacco smoking
• urticaria
• varicella
• viral infection
• vitamin K deficiency

Interactions

• Abciximab
• Acetaminophen
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetazolamide
• Acetohexamide
• Acidifying Agents
• Ado-Trastuzumab emtansine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alkalinizing Agents
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-glucosidase Inhibitors
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminoglycosides
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amoxicillin
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amoxicillin; Clavulanic Acid
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Ampicillin
• Ampicillin; Sulbactam
• Anagrelide
• Angiotensin-converting enzyme inhibitors
• Antithrombin III
• Antithymocyte Globulin
• Apixaban
• Ardeparin
• Ascorbic Acid, Vitamin C
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Atenolol; Chlorthalidone
• Azilsartan; Chlorthalidone
• Bacitracin
• Barbiturates
• Benazepril
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Beta-blockers
• Betrixaban
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bisphosphonates
• Bromocriptine
• Bumetanide
• Buspirone
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan; Hydrochlorothiazide, HCTZ
• Capreomycin
• Captopril
• Captopril; Hydrochlorothiazide, HCTZ
• Carbenicillin
• Cefixime
• Cefotetan
• Celecoxib
• Chlorothiazide
• Chlorpropamide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Cidofovir
• Cilostazol
• Citalopram
• Citric Acid; Potassium Citrate
• Citric Acid; Potassium Citrate; Sodium Citrate
• Citric Acid; Sodium Citrate
• Clomipramine
• Clopidogrel
• Colchicine; Probenecid
• Colistimethate, Colistin, Polymyxin E
• Collagenase
• Corticosteroids
• Cyclosporine
• Dabigatran
• Dalteparin
• Danazol
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Deferasirox
• Defibrotide
• Dichlorphenamide
• Diclofenac
• Diclofenac; Misoprostol
• Dicloxacillin
• Diflunisal
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Dipyridamole
• Doravirine; Lamivudine; Tenofovir disoproxil fumarate
• Drotrecogin Alfa
• Edoxaban
• Efalizumab
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Emtricitabine; Tenofovir disoproxil fumarate
• Enalapril, Enalaprilat
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Enoxaparin
• Epoprostenol
• Eprosartan; Hydrochlorothiazide, HCTZ
• Eptifibatide
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Escitalopram
• Esomeprazole; Naproxen
• Ethacrynic Acid
• Ethanol
• Ethotoin
• Etodolac
• Famotidine; Ibuprofen
• Fenoprofen
• Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
• Flavocoxid, Flavocoxid; Citrated Zinc Bisglycinate
• Fluoxetine
• Fluoxetine; Olanzapine
• Flurbiprofen
• Fluvoxamine
• Fondaparinux
• Foscarnet
• Fosinopril
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fosphenytoin
• Furosemide
• Gallium Ga 68 Dotatate
• Garlic, Allium sativum
• Ginger, Zingiber officinale
• Ginkgo, Ginkgo biloba
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Green Tea
• Griseofulvin
• Heparin
• Hyaluronidase
• Hyaluronidase, Recombinant; Immune Globulin
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Ibuprofen
• Ibritumomab Tiuxetan
• Ibrutinib
• Ibuprofen
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Iloprost
• Immune Globulin IV, IVIG, IGIV
• Incretin Mimetics
• Indapamide
• Indomethacin
• Inotersen
• Insulins
• Intravenous Lipid Emulsions
• Iron Sucrose, Sucroferric Oxyhydroxide
• Ketoprofen
• Ketorolac
• Lamivudine; Tenofovir Disoproxil Fumarate
• Lansoprazole; Naproxen
• Lesinurad
• Lesinurad; Allopurinol
• Linagliptin
• Linagliptin; Metformin
• Lisinopril
• Loop diuretics
• Low Molecular Weight Heparins
• Macimorelin
• Mannitol
• Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
• Meclofenamate Sodium
• Mefenamic Acid
• Meglitinides
• Meloxicam
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methazolamide
• Methotrexate
• Methyclothiazide
• Methylsulfonylmethane, MSM
• Metoclopramide
• Metolazone
• Moexipril
• Muromonab-CD3
• Mycophenolate
• Nabumetone
• Nafcillin
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Nateglinide
• Nitazoxanide
• Nitroglycerin
• Omacetaxine
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Oxacillin
• Oxaprozin
• Paroxetine
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Penicillin V
• Penicillins
• Pentosan
• Pentoxifylline
• Perindopril
• Perindopril; Amlodipine
• Phentermine; Topiramate
• Phenytoin
• Phosphorated Carbohydrate Solution
• Phosphorus
• Photosensitizing agents (topical)
• Pioglitazone
• Piperacillin
• Piperacillin; Tazobactam
• Piroxicam
• Pneumococcal Vaccine, Polyvalent
• Polymyxins
• Potassium Bicarbonate
• Potassium Chloride
• Potassium Citrate
• Potassium Phosphate
• Potassium Phosphate; Sodium Phosphate
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Prasugrel
• Probenecid
• Psyllium
• Quinapril
• Ramipril
• Repaglinide
• Rituximab; Hyaluronidase
• Rivaroxaban
• Rosiglitazone
• Salicylic Acid
• Saxagliptin
• Selective serotonin reuptake inhibitors
• Serotonin norepinephrine reuptake inhibitors
• Sertraline
• Sibutramine
• Simvastatin; Sitagliptin
• Sitagliptin
• Sodium Bicarbonate
• Sodium Hyaluronate, Hyaluronic Acid
• Sodium Lactate
• Sodium Thiosulfate; Salicylic Acid
• Spironolactone
• Sulfinpyrazone
• Sulfonamides
• Sulfonylureas
• Sulindac
• Tacrolimus
• Telavancin
• Tenofovir Alafenamide
• Tenofovir, PMPA
• Thiazide diuretics
• Thiazolidinediones
• Thrombin Inhibitors
• Thrombolytic Agents
• Ticagrelor
• Ticarcillin
• Ticarcillin; Clavulanic Acid
• Ticlopidine
• Tinzaparin
• Tipranavir
• Tirofiban
• Tolazamide
• Tolbutamide
• Tolmetin
• Topiramate
• Torsemide
• Trandolapril
• Trandolapril; Verapamil
• Trastuzumab; Hyaluronidase
• Trazodone
• Treprostinil
• Triamterene
• Tromethamine
• Valproic Acid, Divalproex Sodium
• Vancomycin
• Varicella-Zoster Virus Vaccine, Live
• Verapamil
• Verteporfin
• Vilazodone
• Vorapaxar
• Vortioxetine
• Warfarin
• Zafirlukast