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
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