How much aspirin can you take: How many aspirin can you take in a day?
How Much Aspirin Can I Take Safely?
Medically reviewed by
HaVy Ngo-Hamilton, Pharm.D.
| May 19, 2022
Aspirin belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It’s been around for more than 100 years and is one of the most commonly used pain relievers and fever reducers. Some people take a baby aspirin (low-dose 81 mg aspirin) every day to prevent heart attack and stroke. However, inappropriate use of aspirin can put you at risk of serious bleeding.
Please continue reading to learn how much aspirin is safe to take and whether you should take a daily aspirin dose to reduce your risk of cardiovascular disease.
Always talk to your doctor before taking aspirin. The following health tips should be used to provide you with foundational knowledge of aspirin therapy so you can ask the right questions when you talk to your doctor.
Aspirin (acetylsalicylic acid) is a nonsteroidal anti-inflammatory drug (NSAID). It is a pain reducer available over-the-counter (OTC) or with a prescription.
Aspirin works by blocking the formation of natural substances in the body that cause pain, fever, inflammation, and blood clots.
What is aspirin used for?
Non-prescription aspirin is commonly used to relieve fever and mild to moderate pain such as toothache, headache, muscle ache, menstrual cramps, and mild arthritis.
Prescription aspirin is used to relieve osteoarthritis, rheumatoid arthritis, lupus, and pain and swelling associated with other rheumatologic conditions.
Daily low-dose aspirin (81 mg) is used in combination with other medications to prevent heart attacks and strokes. It can also help prevent transient ischemic attacks (TIAs or mini-strokes) and ischemic strokes (this type of stroke occurs when a blood clot blocks blood flow to a part of the brain). However, aspirin does not prevent hemorrhagic strokes (this type of stroke is caused by bleeding in the brain).
What is the typical dosage of aspirin?
Depending on the indication, the dosage of aspirin varies. For example, the typical aspirin dose for fever reduction is 325 to 650 mg every 4 to 6 hours as needed. For minor aches and pain, the aspirin dose is 325 to 650 mg every 4 hours. The same concept is applied to the max dose of aspirin; the maximum dose depends on the indication. However, the absolute maximum dose of aspirin is 4 g every 24 hours.
Low-dose aspirin is between 75 and 100mg, though aspirin 81 mg is the most commonly used dose; It is taken once daily to prevent heart attacks or strokes.
Your doctor can guide you on the most appropriate aspirin based on your medical needs.
Different dosage forms of aspirin include powder, rectal suppository, chewable, or delayed-release oral tablet. Enteric-coated aspirin does not dissolve immediately in the stomach; therefore, this form of aspirin causes fewer gastrointestinal adverse effects such as nausea and stomach upset.
Warning: Always consult a doctor before giving aspirin to a child or teenager. Aspirin can cause a rare but serious condition called Reye’s syndrome which can cause brain swelling, confusion, and liver damage. Reye’s syndrome, also known as Reye-Johnson syndrome, can occur in children or teenagers, especially those recovering from a viral infection such as the flu or chickenpox.
What are the risks of aspirin therapy?
Aspirin is an effective pain reliever and fever reducer. In addition to that, aspirin’s anti-clotting effects, patients taking aspirin have a lower risk of heart attack or stroke. But like all medications, aspirin carries some risks, including:
- Aspirin increases bleeding risk in the GI (gastrointestinal) tract and stomach ulcers
- Aspirin increases bleeding risk in the brain during a hemorrhagic stroke
- Aspirin can cause Reye’s syndrome in teenagers and children
Besides these serious side effects, aspirin can cause nausea, vomiting, stomachache, heartburn, and ringing in the ears.
Who can benefit from aspirin therapy?
Aspirin can benefit people with a history of cardiovascular diseases such as angina (chest pain), atherosclerosis (hardening of the arteries), congenital heart disease, and transient ischemic attack (TIA). Aspirin is also prescribed for those who have had heart attacks or ischemic strokes. In addition to that, aspirin is also used to prevent coronary events in high-risk patients such as those with high blood pressure, high cholesterol, diabetes, and other coronary diseases.
Who should not take aspirin?
The following individuals should not take aspirin without talking to a healthcare professional:
- Children under 18 years of age
- Pregnant women or women who are breastfeeding
- Heavy alcohol drinkers
- People who have a bleeding disorder
- People with upcoming surgical or dental procedures
- People taking other NSAIDs
- People with an aspirin allergy
How should I take aspirin?
- To prevent stomach upset, take it with food or snacks; avoid taking aspirin on an empty stomach.
- Do not crush, break, or chew the enteric-coat tablets.
- Do not drink alcohol while taking aspirin, as this can increase the risk of stomach bleeding.
- Many medicines for pain relief and cold and flu remedies contain aspirin. Make sure you do not exceed the total daily maximum dose of aspirin combined from all medicines.
- Tell your doctors you are taking aspirin before any emergency treatment, planned surgery, or dental work. You may need to stop taking aspirin temporarily prior to or following procedures, but your doctor should inform you if it is necessary.
Call 911 if you are experiencing symptoms of a heart attack. There are certain scenarios where aspirin therapy can be effective if taken within 30 minutes of symptom onset. However, you should not take aspirin if you have symptoms of a stroke.
Should I take daily aspirin to prevent heart attack or stroke?
Daily low-dose aspirin can help prevent clotting, which is a common cause of heart attacks and ischemic strokes, yet aspirin can increase the risk of major bleeding in the gastrointestinal tract and brain. Therefore, low doses of aspirin are not suitable for everyone, such as individuals with clotting disorders or a severe history of bleeds.
Your doctor will discuss with you your risk/severity of cardiovascular disease in comparison to your risk of bleeding. The decision on aspirin use will be made by weighing your specific medical presentation. There are two approaches to preventing cardiovascular disease; primary and secondary prevention. Primary prevention refers to people who have never had a cardiovascular event, such as but not limited to heart attack or stroke. Secondary prevention refers to people who have had previous cardiovascular events.
There is no question that taking a low-dose daily aspirin is helpful for secondary prevention since Aspirin is known to lower the risk of heart attack and clot-related stroke in patients with cardiovascular disease and those who have had a prior heart attack or stroke.
Given that there are so many factors to consider, your health professional can help you make the best choice of whether aspirin of any dose is necessary for you.
US Pharm. 2018;43(2):11-12.
Aspirin is one of the oldest, most widely used drugs in the world. Taken for pain relief for over 2,000 years, its active ingredient, salicin, is in the leaves and bark of the willow tree. In 1897, the Bayer company in Germany developed a synthetic version called acetylsalicylic acid and named it aspirin. The regular adult dosage is 650 mg taken every 4 hours when needed to treat pain, inflammation, and fever caused by a variety of ailments. Low-dose aspirin refers to dosages between 81 mg and 325 mg taken every day to prevent heart attacks, strokes, and colon cancer.
Most heart attacks and strokes happen when a blood clot forms and blocks blood flow in an artery. Under normal circumstances, the body develops a blood clot to stop the loss of blood after an injury. When a blood vessel is damaged, sticky cells called platelets begin to clump together, while proteins in the blood form strands of fibrin. The fibrin creates a net-like structure that holds the forming clot together. Blood clots can form in damaged vessels of the heart or the brain, and these can block blood to the tissue and cause a heart attack or stroke. Aspirin stops clots from forming by preventing the platelets from clumping together.
If you have had a heart attack or stroke, your doctor may prescribe low-dose aspirin to prevent a second event. Low-dose aspirin has been shown to reduce the risk of a first heart attack but has not been definitively proven to reduce the risk of a stroke. Speak with your physician before starting low-dose aspirin for prevention.
Anti-Inflammatory Actions Key
Aspirin is also a nonsteroidal anti-inflammatory drug (NSAID), which means that it reduces inflammation, although it is not a steroid like cortisone or prednisone. Similar to the formation of blood clots, inflammation is the body’s natural response to injury. When an injury occurs, the immune system is activated, and compounds called prostaglandins form in the area surrounding the injury. Prostaglandins increase blood flow to the injury, leading to the redness, heat, and swelling associated with inflammation. Aspirin prevents these prostaglandins from forming, reducing inflammation.
It is aspirin’s anti-inflammatory action that also makes it useful in the prevention of colon cancer and in preeclampsia, a serious condition of pregnancy believed to result from an inflammatory response. Recent research has also found regular aspirin use to be associated with lower rates of breast, prostate, lung, and ovarian cancer.
Aspirin Isn’t Right for Everyone
Even in low doses, aspirin can have significant side effects. The most common ones, occurring in up to 10% of people who take aspirin, are an increased tendency to bleed and stomach upset, including heartburn, nausea, vomiting, or bleeding in the stomach. Other less common side effects include kidney, liver, and nervous system problems.
Although low-dose aspirin is an OTC drug and safe for most people, the FDA recommends that certain individuals not take aspirin in any dose. Those with an allergy to aspirin or salicylates; those with a bleeding disorder such as hemophilia or vitamin K deficiency; and people with uncontrolled high blood pressure, severe liver or kidney disease, or asthma should avoid using aspirin. In addition, aspirin should not be used by someone who is also taking a prescription blood thinner such as warfarin, Pradaxa, or Xarelto, or another OTC NSAID such as naproxen (Aleve) or ibuprofen (Advil).
Before taking any OTC drug on a regular basis, even low-dose aspirin, be sure to talk with your healthcare provider first to find out if it’s right for you. Always ask your pharmacist to check your prescription and other OTC medications for aspirin interactions or incompatibilities. Even supplements such as fish oil and vitamin D can interact with aspirin.
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Scientists have determined the effectiveness of aspirin in the treatment of COVID-19
Aspirin can protect patients with COVID-19 from death and serious complications, US scientists report. This is probably due to the blood thinning and anti-inflammatory effect, but these data have yet to be verified.
Aspirin is a cheap over-the-counter drug that is commonly used to relieve pain of various kinds. But it is also used as a blood thinner to reduce the risk of heart attacks and strokes. Aspirin’s ability to prevent blood clotting can also help patients with COVID-19, a team led by scientists from George Washington University has found.who often die from clogged arteries. The study was published in the journal Anesthesia & Analgesia .
“The reason we started looking into the relationship between aspirin and COVID-19 is because we all realized in the spring that patients develop thrombotic complications, blood clots that form throughout the body,” says Dr. Jonathan Chow. —
That’s why we thought using an antiplatelet agent like aspirin might be helpful.”
The authors followed patients admitted to US hospitals from March to July 2020. In total, they collected data on 412 citizens around the age of 55, 314 of whom (76.3%) did not receive aspirin. The remaining 98 (23.7%) took it for several days before hospitalization or within a day after it. The average dose was quite low at 81 mg. Patients taking aspirin were more likely to have a history of hypertension, diabetes mellitus, coronary heart disease, and liver disease.
After adjusting for age, comorbidities and other factors,
patients who took aspirin were 44% less likely to require mechanical ventilation and 43% less likely to require intensive care. They were also 47% less likely to die from COVID-19.
“Aspirin use may be associated with improved outcomes in hospitalized patients with COVID-19,” the authors conclude. “However, a larger randomized controlled trial is needed to assess whether there is a causal relationship between aspirin use and reduced morbidity and mortality in patients.”
The potential benefits of aspirin for lung injury are suggested by researchers to be associated with reduced platelet and neutrophil accumulation in the lung, reduced inflammation, and stimulation of enzymes capable of restoring lung endothelial cell function.
Also, as an anti-inflammatory agent, aspirin reduces the production of interleukin-6 and C-reactive protein, which promote inflammation. This may reduce the risk of developing a cytokine storm.
However, do not self-medicate with COVID-19 and take aspirin in the hope of protecting yourself from the consequences. Uncontrolled medication can lead to sad consequences. So, aspirin, due to the content of acetylsalicylic acid in it (a substance that has an antipyretic effect), against the background of infectious diseases, can cause Reye’s syndrome – a dangerous condition in which acute liver failure and hyperammonemia occur (an increase in the concentration of ammonia in the body that can cause coma and even death), was warned by , the former head of the psycho-neurological department of polyclinic No. 4 of the head of the President of the Russian Federation, Irina Vereyutina.
“Patients with coronavirus infection need to use paracetamol,” she said, emphasizing that the use of aspirin and analgin in this case is “unacceptable.”
In addition, aspirin creates conditions for the penetration of coronavirus into the lungs, which accelerates the onset of pneumonia and alveolar lung damage, said virologist Nadezhda Zholobak.
Also, long-term use of aspirin and other non-steroidal anti-inflammatory drugs can cause the development of gastropathy – damage to the mucous membrane of the stomach and duodenum, which leads to the appearance of erosions and ulcers.
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Aspirin cut COVID-19 deaths by half
Aspirin may reduce the risk of death from COVID-19, US scientists have found. By thinning the blood, it prevents the formation of blood clots, thereby reducing the risk of stroke and other organ damage. If these results can be confirmed, aspirin could become a cheap and mass prophylactic for coronavirus.
Regular use of aspirin can reduce the risk of complications and death from COVID-19, doctors from the University of Maryland and other US research centers believe – by thinning the blood, it reduces the risk of blood clots. However, these results have yet to be confirmed in other studies. The work was published in the journal Anesthesia and Analgesia .
Researchers followed 412 patients hospitalized with COVID-19. About a quarter of them took low-dose aspirin (about 80 mg) during the week prior to admission.
These patients were found to have a 43% lower risk of being admitted to the intensive care unit, 44% less need for mechanical ventilation, and 47% less chance of dying in the hospital.
Patients taking aspirin did not experience a significant increase in complications, such as major bleeding.
The result was consistent with other factors such as age, sex, body mass index, race, presence of hypertension and diabetes. Heart disease, kidney disease, liver disease, and the use of beta-blockers to control blood pressure were also taken into account.
COVID-19 increases the risk of blood clots in the heart, lungs, blood vessels, and other organs. Blood clots can cause strokes, heart attacks, and multiple organ failure, eventually leading to death.
Doctors often recommend that patients who have had a heart attack or stroke due to a detached blood clot take a low dose of aspirin daily to prevent future clots. Daily use of aspirin may, however, increase the risk of bleeding or stomach ulcers.
“We believe that the blood thinning effect of aspirin is beneficial for COVID-19 patients by preventing microclots from forming,
,” said study co-author Dr. Michael Mazzeffi. “Patients with COVID-19 may be interested in taking a daily aspirin, but they should check with their doctor first.”
Patients with an increased risk of bleeding, such as from chronic kidney disease or regular use of certain medications such as steroids or anticoagulants, should not risk taking aspirin.
It’s not worth drawing too optimistic conclusions yet, the researchers warn. It is possible that those who took aspirin were generally more attentive to their health, visited doctors more often and suffered less infection. Or the results were just a coincidence. To find out, they will have to be replicated in other patient cohorts.
“This is a finding that needs to be confirmed by a randomized clinical trial,” says study lead author Dr. Jonathan Chow. If our result is confirmed, it would make aspirin the first widely available, over-the-counter drug to reduce mortality in patients with COVID-19″.
Doctors drew the attention of back in spring to the fact that coronavirus infection causes increased thrombus formation. Strokes are a natural consequence of thrombosis, they note. At first, this was associated with the elderly age of patients, but later it turned out that people aged 30-40 also suffer from strokes against the background of COVID-19.
Strokes themselves vary in severity. Some of them, with timely intervention, make it possible to fully recover. However, when large blood vessels are blocked, large areas of the brain responsible for vital functions can suffer – and this is exactly what happens with strokes against the background of COVID-19.