From the Guidelines
A 325 milligram dose of aspirin can cause harm, particularly in individuals with certain health conditions or taking other medications, and the risk of harm may outweigh the benefits in some cases. The decision to take aspirin should be made on an individual basis, considering the potential benefits and harms, as well as the patient's preferences and values 1.
Key Considerations
- Aspirin can increase the risk of gastrointestinal bleeding, particularly in individuals with a history of ulcers or bleeding disorders 1.
- The risk of bleeding may also be increased in individuals taking other blood thinners or anti-inflammatory medications 1.
- Enteric-coated or buffered preparations do not clearly reduce the adverse gastrointestinal effects of aspirin 1.
- A dose of 75 mg per day seems as effective as higher doses, and the risk for gastrointestinal bleeding may increase with the dosage 1.
Patient-Specific Factors
- Individuals with aspirin allergies, bleeding disorders, stomach ulcers, or liver disease should avoid taking aspirin.
- Children and teenagers with viral illnesses should not take aspirin due to the risk of Reye's syndrome.
- Pregnant women in their third trimester should also avoid aspirin.
- Patients with uncontrolled hypertension or concomitant use of anticoagulants may be at increased risk for serious bleeding 1.
Clinical Recommendations
- Always consult with a healthcare provider before starting aspirin, especially if you have underlying health conditions or are taking other medications.
- A reasonable approach may be to assess cardiovascular and bleeding risk factors starting at age 50 years and periodically thereafter, as well as when cardiovascular and bleeding risk factors are first detected or change 1.
- The optimal dose of aspirin for preventing cardiovascular disease events is not known, but a dose of 75 mg per day seems as effective as higher doses 1.
From the FDA Drug Label
Warnings Stomach bleeding warning: This product contains an NSAID, which may cause severe stomach bleeding The chance is higher if you are age 60 or olderHave had stomach ulcers or bleeding problemsTake a blood thinning (Anticogulant) or steroid drugTake other drugs containing prescription or nonprescription NSAIDs (aspirin, ibuprofen, naproxen, or others)have 3 or more alcoholic drinks every day using this product
Yes, a 325 milligram dose of aspirin (acetylsalicylic acid) can cause harm, specifically severe stomach bleeding. The risk of stomach bleeding is increased in certain individuals, including those who are age 60 or older, have had stomach ulcers or bleeding problems, or take certain medications such as blood thinners or steroids. Additionally, consuming 3 or more alcoholic drinks every day while using this product can also increase the risk of harm 2.
From the Research
Aspirin-Related Harm
- A 325 milligram dose of aspirin can cause harm, particularly in the form of upper gastrointestinal (GI) side effects, including ulcers and bleeding 3, 4, 5, 6.
- The risk of aspirin-related upper GI complications is increased by factors such as a prior history of ulcer or GI bleeding, concomitant use with an NSAID, anticoagulant, or additional antiplatelet drug, and high aspirin dose 3, 6.
- Even low-dose aspirin can cause gastrointestinal bleeding, and the risk is not entirely dose-dependent 4, 7.
- Strategies to minimize the risk of developing upper GI side effects in patients taking aspirin include the use of gastroprotective agents such as proton pump inhibitors and eradication of Helicobacter pylori 3, 4, 5.
Risk Factors for Aspirin-Related Harm
- A history of peptic ulcer disease or gastrointestinal bleeding increases the risk of aspirin-related upper GI complications 3, 5, 6.
- Concomitant use of NSAIDs, anticoagulants, or other platelet aggregation inhibitors also increases the risk 3, 6.
- Older age and the presence of severe co-morbidities are additional risk factors 6.
- High aspirin dose, such as 325 milligrams, may increase the risk of upper GI complications compared to lower doses 6.