From the Guidelines
The proper way to take aspirin (acetylsalicylic acid) is to swallow the tablet or capsule with a full glass of water, typically with food to reduce stomach irritation, with a recommended dose of 75-162 mg/day for secondary prevention in those with diabetes and a history of atherosclerotic cardiovascular disease, as stated in the most recent guidelines 1. When taking aspirin, it is essential to follow the specific dosing instructions provided by your doctor, as needs may vary based on your medical condition.
- For regular aspirin use, the standard adult dose for pain or fever is 325-650 mg every 4-6 hours as needed, not exceeding 4,000 mg per day.
- For heart attack prevention, a lower dose of 81-100 mg daily is typically recommended.
- Enteric-coated aspirin should be swallowed whole, not crushed or chewed, as the coating protects the stomach.
- If using aspirin for heart attack symptoms, chew a 325 mg tablet immediately for faster absorption. Aspirin works by blocking certain enzymes that produce prostaglandins, chemicals involved in pain, inflammation, and blood clotting.
- People with bleeding disorders, stomach ulcers, aspirin allergies, or those taking certain medications should avoid aspirin unless directed by a healthcare provider, as noted in previous studies 1. It is also important to consider potential interactions with other medications, such as ibuprofen, which may interfere with aspirin's ability to irreversibly acetylate the platelet COX-1 enzyme, as discussed in a scientific statement from the American Heart Association 1.
From the Research
Proper Way to Take Aspirin
To take aspirin (acetylsalicylic acid) properly, consider the following guidelines:
- The appropriate dose of aspirin can vary depending on the individual's condition and the purpose of taking the medication 2, 3.
- For the primary prevention of myocardial infarction (MI) in men, a dose of 160 mg/day is consistently effective 2.
- In women, doses of 50 mg, 75, and 100 mg/day did not significantly decrease the risk of MI, suggesting that the appropriate dose in women must exceed 100 mg/day 2.
- For the primary prevention of stroke in men and women, the appropriate dose has not been established, but doses of 75 and 100 mg/day have been ineffective 2.
- The lowest dose to prevent recurrent MI or death in patients with stable coronary artery disease (CAD) is 75 mg/day 2.
- In acute MI, the lowest dose is 160 mg/day 2.
- In patients with a history of stroke or transient ischemic attack (TIA), 50 mg/day has been shown to be effective in men and women 2.
- In acute stroke, 160 mg/day is effective in preventing recurrent stroke or death 2.
Administration Methods
- Chewing an aspirin tablet is the most effective way of accelerating absorption of aspirin into the blood and shortening the time required for an antiplatelet effect 4.
- Swallowing a whole tablet or taking an aspirin solution can also be effective, but may take longer to produce an antiplatelet effect 4.
- Buffered forms of aspirin, which protect the stomach, and sustained-release forms may be better tolerated and improve the benefit/risk ratio of aspirin 3, 5.
Precautions and Interactions
- Aspirin can cause major bleeding, and the risk of major bleeding with 160 mg/day is the same as with 80 mg/day: 1 to 2 cases per 1000 patient years of treatment 2.
- Aspirin can interact with other medications, such as anticoagulants, sulphonylureas, diuretics, methotrexate, and antacids, which can complicate the course of therapy 5.
- Elderly patients, especially those with complicated medical histories, are more prone to the adverse effects of salicylates and may develop gastrointestinal tract bleeding, renal insufficiency, asthma, and CNS toxicity 5.