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Is aspirin good for a headache: Aspirin for pain relief – NHS

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Aspirin for pain relief – NHS

The dose of aspirin that’s right for you depends on the kind of aspirin you’re taking, why you’re taking it and how well it helps your symptoms.

Aspirin tablets

Aspirin usually comes as 300mg tablets.

Dosage

The usual dose is 1 or 2 tablets, taken every 4 to 6 hours.

Aspirin comes as several different types of tablet:

  • standard tablets – that you swallow whole with water
  • soluble tablets – that you dissolve in a glass of water
  • enteric coated tablets – that you swallow whole with water

Enteric tablets have a special coating that may make them gentler on your stomach. Do not chew or crush them because it will stop the coating working. If you also take indigestion remedies, take them at least 2 hours before or after you take your aspirin. The antacid in the indigestion remedy affects the way the coating on these tablets works.

You can buy aspirin tablets and soluble tablets from both pharmacies and supermarkets.

Aspirin suppositories

Aspirin suppositories are medicine that you push gently into your bottom. To use them, follow the instructions on the leaflet inside the packet.

Aspirin suppositories come in 2 strengths. They contain 150mg or 300mg of aspirin. You can buy them from a pharmacy.

Dosage

If you’re taking:

  • 150mg – the usual dose is 3 to 6 suppositories, this is 450mg to 900mg, taken every 4 hours. The maximum dose is 24 of the 150mg suppositories in 24 hours.
  • 300mg – the usual dose is 1 to 3 suppositories, this is 300mg to 900mg, taken every 4 hours. The maximum dose is 12 of the 300mg suppositories in 24 hours.

If you need a dose of 450mg or 750mg, your doctor or pharmacist will give you a mixture of strengths and explain how to take it.

Aspirin mouth gel

You can buy aspirin mouth gel (Bonjela) from pharmacies and supermarkets. Do not give Bonjela to children. You can give Bonjela Teething Gel or Bonjela Junior to children as they do not contain aspirin.

Dosage

For mouth ulcers or sores, massage about a centimetre (half an inch) of gel onto the sore area. Apply it to the inside of your mouth or gums every 3 hours as needed.

If you have dentures (false teeth), take them out before you apply the mouth gel. Then wait at least 30 minutes after applying the gel before putting your dentures back in your mouth.

What if I take too much?

Taking 1 or 2 extra tablets is unlikely to be harmful.

The amount of aspirin that can lead to overdose varies from person to person.

If you need to go to A&E, do not drive yourself – get someone else to drive you or call for an ambulance.

Take the aspirin packet or leaflet inside it, plus any remaining medicine, with you.

Aspirin Effective in Treating Acute Migraine, Preventing Recurrent Migraine, Review Finds

Aspirin, in high doses from 900 to 1300 mg, was shown to be an effective and safe treatment option for acute migraine headaches, with further research showing its potential efficacy in preventing recurrent migraine headaches through lower doses of 81 to 325 mg, according to a November review published in The American Journal of Medicine. 1

As the authors note, treatment for acute migraine as well as prevention of recurrent attacks can be achieved using effective prescription drugs of shown benefit, but for those with high co-pays or without health insurance, these medications may not be available or affordable. Nationwide, rates of uninsured or underinsured individuals are estimated to be 8.5%, with a stark 13% prevalence in Florida.

Researchers from Florida Atlantic University’s Schmidt College of Medicine sought to address issues regarding affordability and access by examining the efficacy of low-cost aspirin as an effective and preventive treatment of acute migraine. Assessments conducted in the review included a meta-analysis of 13 randomized trials for the treatment of migraine in 4222 patients given either 900 to 1000 mg of aspirin, with and without 10 mg of metoclopramide, or 50 to 100 mg of sumatriptan. The review additionally included studies totaling more than 40,000 patients for prevention of recurrent attacks.

High-Dose Aspirin for Treatment at Onset of Acute Migraine

In the meta-analysis, the prespecified primary end point was distinguished as reduction in headache pain or complete remission of pain at 1 hour, 2 hours, and sustained reduction/remission over 24 hours.

Study results revealed that there were no significant differences between the 2 treatments between high-dose aspirin and either 50 mg or 100 mg of sumatriptan. For the primary end point, high-dose aspirin significantly reduced headache at 1 hour by 60% (95% CI, 1.3-2.0) when compared with 50 mg of sumatriptan. While 100 mg of sumatriptan produced a definite 37% reduction (95% CI, 0.45-0.87) when compared with high-dose aspirin and metoclopramide after 2 hours, the effectiveness of high-dose aspirin at initial onset of migraine stresses its efficacy as a low-cost treatment.

Low-Dose Aspirin for Preventive Treatment of Recurrent Migraines

In testing efficacy of low-dose aspirin as a preventive treatment, the researchers referenced multiple studies examining its impact on recurrent migraines. In a trial among British doctors cited in the review, 5139 men were randomized to 500 mg daily aspirin in an open design, with a significant 29% reduction in recurrent migraines exhibited at the end of the trial.

Additionally, the United States Physicians’ Health Study randomized 22,071 male physicians to either 325 mg aspirin on alternate days or matching placebo, and after 60.2 months of treatment and follow-up, the trial was terminated early based on the unanimous recommendation of the Data and Safety Monitoring Board. The recommendation was attributed to the statistically significant 44% reduction in first myocardial infarction among those assigned randomly to aspirin, and among this group, a 22% reduction in subsequent attacks of migraine at baseline was shown.

In an editorial on the review,2 Joseph Alpert, MD, editor-in-chief of The American Journal of Medicine, highlighted that “since aspirin is readily available without a prescription in the US, it certainly seems like something that should be tried in migraine sufferers before physicians prescribe more complex, expensive, and hence less available medications. ” As only 20% of people with migraine are shown to see a physician for their condition, and less than 10% receive effective therapy, the potential of aspirin as an over-the-counter, low-cost therapy could reduce migraine incidence and severity.

“If aspirin works to abort or ameliorate the headaches, then it should be tried as a prophylactic measure to see if it can prevent the occurrence of these debilitating headaches. Hopefully, this would lead to less disability and loss of employment time for these patients who are so common in the US and throughout the world,” said Alpert.

Reference

1. Biglione B, Gitin A, Gorelick PB, et al. Aspirin in the treatment and prevention of migraine headaches: possible additional clinical options for primary healthcare providers [published online November 8, 2019]. Am J Med. doi: 10.1016/j.amjmed.2019.10.023.

2. Alpert JS. A common drug may help patients with debilitating migraine headaches [published online December 2, 2019]. Am J Med. doi: 10.1016/j.amjmed.2019.11.002.

Migraine headaches? Consider aspirin for treatment and prevention — ScienceDaily

Migraine headache is the third most common disease in the world affecting about 1 in 7 people. More prevalent than diabetes, epilepsy and asthma combined, migraine headaches are among the most common and potentially debilitating disorders encountered by primary health care providers. Migraines also are associated with an increased risk of stroke.

There are effective prescription medications available to treat acute migraine headaches as well as to prevent recurrent attacks. Nonetheless, in the United States many patients are not adequately treated for reasons that include limited access to health care providers and lack of health insurance or high co-pays, which make expensive medications of proven benefit unaffordable. The rates of uninsured or underinsured individuals have been estimated to be 8.5 percent nationwide and 13 percent in Florida. Furthermore, for all patients, the prescription drugs may be poorly tolerated or contraindicated.

Researchers from Florida Atlantic University’s Schmidt College of Medicine have proposed aspirin as a possible option for consideration by primary care providers who treat the majority of patients with migraine. Their review includes evidence from 13 randomized trials of the treatment of migraine in 4,222 patients and tens of thousands of patients in prevention of recurrent attacks.

Their findings, published in the American Journal of Medicine, suggest that high-dose aspirin, in doses from 900 to 1,300 milligrams given at the onset of symptoms, is an effective and safe treatment option for acute migraine headaches. In addition, some but not all randomized trials suggest the possibility that daily aspirin in doses from 81 to 325 milligrams may be an effective and safe treatment option for the prevention of recurrent migraine headaches.

“Our review supports the use of high dose aspirin to treat acute migraine as well as low dose daily aspirin to prevent recurrent attacks,” said Charles H. Hennekens, M.D., Dr.PH, corresponding author, first Sir Richard Doll Professor and senior academic advisor in FAU’s Schmidt College of Medicine. “Moreover, the relatively favorable side effect profile of aspirin and extremely low costs compared with other prescription drug therapies may provide additional clinical options for primary health care providers treating acute as well as recurrent migraine headaches.”

Common symptoms of migraine include a headache that often begins as a dull pain and then grows into a throbbing pain, which can be incapacitating and often occurs with nausea and vomiting, and sensitivity to sound, light and smell. Migraines can last anywhere from four to 72 hours and may occur as many times as several times a week to only once a year.

“Migraine headaches are among the most common and potentially debilitating disorders encountered by primary health care providers,” said Bianca Biglione, first author and a second-year medical student in FAU’s Schmidt College of Medicine. “In fact, about 1 in 10 primary care patients present with headache and three out of four are migraines. Aspirin is readily available without a prescription, is inexpensive, and based on our review, was shown to be effective in many migraine patients when compared with alternative more expensive therapies.”

Approximately 36 million Americans suffer from migraine headaches and the cause of this disabling disorder is not well understood. There is a higher prevalence in women (18 percent) than men (9 percent). In women, the prevalence is highest during childbearing age.

Approximately 90 percent of migraine sufferers report moderate to severe pain, with more than 50 percent reporting severe impairment or the need for bed rest as well as reduced work or school productivity.

Story Source:

Materials provided by Florida Atlantic University. Original written by Gisele Galoustian. Note: Content may be edited for style and length.

Treating Frequent Headaches with Pain Relievers: Don’t take them too often

Treating Frequent Headaches with Pain Relievers: Don’t take them too often

Many people suffer from frequent, severe headaches, especially those with migraine. These headaches need careful treatment, with a focus on prevention. Talk to your health care provider about ways to prevent and treat your headaches.

  • Limit use of over-the-counter pain drugs. If you are taking them more than two days a week, cut back.
  • Avoid using prescription drugs containing opioids or butalbital, except as a last resort.

It is easy to use too much pain medicine. This can make headaches worse and cause other. Many people suffer from frequent, severe headaches. However, it is important to limit the use of over-the-counter and prescription drugs. medical problems. Here’s why:

Over-the-counter pain medicines can have dangerous side effects.

Aspirin, acetaminophen and ibuprofen often work well for headaches if you don’t use them often.

But if you take these drugs too often, you can get serious side effects. In rare cases, if you often take acetaminophen a number of days in a row, you can damage your liver. This can happen even if you take just a little over the recommended dose.
Rarely, these drugs can also cause kidney problems. Aspirin and ibuprofen can, at times, cause stomach bleeding.

Watch out for overuse headaches.

If you take pain medicines for headache too often, they may no longer help as much, and you may also get headaches more often. This worsening of headache is called “medication overuse headache.” Although all drugs used for treating individual migraine attacks can cause medication overuse headache if taken too often, the following drugs are the most likely ones to cause overuse headaches. They may also make you more sensitive to pain:

Prescription drugs:

  • Drugs with butalbital (Fiorinal, Pronal, Trinal, and generics)
  • Opioid painkillers
    • Codeine (Tylenol 3 and other brands and generics)
    • Hycodon (5 mg)
    • Oxycodone (OxyContin, Percocet, others)
    • Morphine

Some pain drugs can cause addiction.

Drugs that contain opioids or butalbital can make you drowsy. Long-term use of these drugs can cause addiction or physical dependence, in addition to overuse headaches.

Some people need headache treatment for years, or even decades. They should take addictive drugs only if safer treatments don’t work. If you do have to take addictive drugs, ask your doctor how to avoid overuse and addiction.

Lifestyle changes can help some people with severe headaches.

Often, you can prevent headaches or have them less often if you:

  • Reduce stress, or learn to cope with it more effectively.
  • Drink a minimum amount of alcohol.
  • Get enough sleep, and maintain a regular bedtime and wake time.
  • If you still get headaches more than once a week, you can consider taking a daily preventive drug.

If you need pain relief during a bad migraine, drugs called triptans work well for most people. They usually have fewer side effects than other prescription drugs. There are seven triptans approved by Health Canada, and with the exception of frovatriptan, they are all available as generics.


Tips to help you manage headache pain:

Keep a record of each headache. Note possible triggers—foods, beverages, sleep patterns, or other things that cause your headaches.

Reduce triggers. For example, consider using tinted glasses to reduce the effects of bright light.

If menstruation routinely leads to migraines, ask your doctor if you could ward off headaches by taking naproxen sodium regularly for a few days around your period.

Simple changes can sometimes prevent headaches:

  • Cut back on alcohol.
  • Control the effects of stress with bio-feed-back, meditation, relaxation, or in other ways.
  • Don’t skip meals.
  • Aim for 7 to 8 hours sleep each night. Go to bed and wake up around the same time. Don’t watch TV or use a computer in bed. If you snore, ask your doctor if you should be checked for sleep apnea.

If you need preventive drugs, start with safer choices. Choose drugs that have been proven to work. Many options are available and the choice should be based on your medical history. Discuss your options with your doctor.

Visit the Canadian Headache Society’s website for more information.

Aspirin With or Without Antiemetic for Acute Migraine Headaches in Adults – Cochrane for Clinicians

Cochrane for Clinicians

Putting Evidence into Practice

 

AARON SAGUIL, MD, MPH, Uniformed Services University of the Health Sciences, Bethesda, Maryland

JOEL HERNESS, MD, Fort Belvoir Community Hospital, Fort Belvoir, Virginia

Am Fam Physician. 2014 Feb 1;89(3):176-177.

This clinical content conforms to AAFP criteria for continuing medical education (CME). See CME Quiz Questions.

Author disclosure: No relevant financial affiliations.

Clinical Question

Is aspirin, with or without an antiemetic, an effective therapy for acute migraine headache in adults?

Evidence-Based Answer

Aspirin, with or without an antiemetic, is an effective treatment for acute migraine headache. Adding the antiemetic metoclopramide (Reglan) significantly reduces migraine-related nausea and vomiting compared with aspirin alone. (Strength of Recommendation: A, based on consistent, good-quality patient-oriented evidence.)

Practice Pointers

Migraines are an exceedingly common and disabling affliction; 16.6% of U.S. adults report having migraines or severe headaches.1 Direct costs average $1,533 per person annually,2 whereas indirect costs are an estimated $12 billion each year.3 Most persons who have migraines do not take preventive medications, but nearly all treat acute attacks. Commonly used treatments include triptans, nonsteroidal anti-inflammatory drugs, acetaminophen, and caffeine. Aspirin and metoclopramide are inexpensive, widely available medications, and the latter may improve outcomes by treating nausea and improving analgesic bioavailability. 4

This Cochrane review investigated the effectiveness of aspirin, with or without metoclopramide, for the treatment of migraine. More than 4,000 participants in 13 studies were randomized to receive either (1) 900 or 1,000 mg of aspirin with or without 10 mg of metoclopramide, or (2) placebo or 50 to 100 mg of sumatriptan (Imitrex). Six studies with 2,027 participants were pooled and demonstrated that more patients taking aspirin were pain free at two hours (24% vs. 11% of those taking placebo; number needed to treat = 8; 95% confidence interval [CI], 6.4 to 11). Similarly, patients taking aspirin were more likely to achieve headache improvement at two hours (i.e., intensity decreasing from moderate/severe to none/ mild) than those taking placebo (52% vs. 32%; number needed to treat = 5; 95% CI, 4.1 to 6.2). Adding metoclopramide to aspirin therapy was no more effective than aspirin alone for complete pain relief at two hours (two studies, 519 participants), but it was more effective for headache improvement at two hours (three studies, 765 participants). The addition of metoclopramide did not increase the ability of aspirin to keep the patient pain free at 24 hours.

Aspirin and sumatriptan are similarly effective in treating acute migraine. For the outcome “pain free at two hours,” 26% were relieved with aspirin and 32% with sumatriptan (relative benefit = 0.82; 95% CI, 0.65 to 1.03). Although metoclopramide appears to have a minimal role in enhancing analgesia when combined with aspirin, the combination was significantly better than aspirin alone for nausea, a common and disabling symptom of migraine. The findings of this review are consistent with current guidelines that list aspirin among the first-line mono-therapies (i.e., nonsteroidal anti-inflammatory drugs, triptans, and acetaminophen) for acute migraine headache.5,6 Antiemetics, such as metoclopramide, are primarily considered an adjunct treatment for refractory headache.5,6 This review provides evidence that metoclopramide should be reserved for those with significant nausea.

Headache Medications: Relief & Treatment

Headache pain may need to be managed with medications. Medications used to treat headache pain can be grouped into three different types:

  • Symptomatic relief
  • Abortive therapy
  • Preventive therapy

Each type of medication is most effective when used in combination with other recommendations, such as dietary modifications, lifestyle changes (at least 7-8 hours of sleep and adequate hydration [6-8 glasses of water/day], exercise and relaxation therapy).

Symptomatic relief

This group of medications is given for the relief of symptoms associated with headache. This includes the pain associated with headaches or the nausea and vomiting associated with migraine headaches. Many of the medications are available over-the-counter (without a prescription). Other medications require a prescription from your doctor. When taking these medications, avoid caffeine-containing foods and beverages and medications. Medications containing barbiturates (butalbital) or narcotics (codeine) should be avoided if possible. The use of aspirin should be avoided in children. Many of the medications listed for symptomatic relief are not recommended for use in young children (see end of document for discussion of ‘off-label’ use.

Over-the-Counter Medications for Symptomatic Relief

Non-steroidal anti-inflammatories

  • Generic Name:aspirin*
    • Brand Name: Bayer® , Bufferin®, Ecotrin®
    • Symptoms Relieved: Relief of fever and pain
    • Precautions and possible side effects: Do not use in children under 14 years of age due to the potential for Reye’s syndrome. Side effects may include: heartburn, gastrointestinal (GI) bleeding, bronchospasm or constriction that causes narrowing of the airways, anaphylaxis and peptic ulcer
  • Generic Name: acetaminophen, paracetamol
    • Brand Name: Tylenol®
    • Symptoms Relieved: Relief of fever and pain
    • Precautions and possible side effects: Few side effects, if taken as directed, although they may include changes in blood counts and liver function
  • Generic Name: ibuprofen (NSAID)**
    • Brand Name: Advil®, Motrin IB®, Nuprin®
    • Symptoms Relieved: Relief of fever, pain, and inflammation
    • Precautions and possible side effects: Side effects may include GI upset, GI bleeding, nausea, vomiting, rash and changes in liver function
  • Generic Name: naproxen sodium (NSAID)**
    • Brand Name: Aleve®
    • Symptoms Relieved: Headache pain relief
    • Precautions and possible side effects: Side effects may include GI upset, GI bleeding, nausea, vomiting, rash and changes in liver function

*Not recommended in pediatric patients **= nonsteroidal inflammatory drugs

Prescription Medications for Symptomatic Relief

  • Generic Name: Antiemetics promethazine HCI (available in tablet, syrup, injection or suppository forms)
    • Brand Name: Phenergan®
    • Symptoms Relieved: Nausea, vomiting
    • Precautions and Possible Side Effects: Confusion, drowsiness, dizziness, GI upset, excitability, nightmares, uncontrollable muscle movements, and lip smacking or chewing movements
  • Generic Name: chlorpromazine (available in suppository form)
    • Brand Name: Thorazine®
    • Symptoms Relieved: Nausea, vomiting
    • Precautions and Possible Side Effects: Confusion, drowsiness, dizziness, GI upset, excitability, nightmares, uncontrollable muscle movements, and lip smacking or chewing movements
  • Generic Name: prochlorperazine (available in suppository form)
    • Brand Name: Compazine®
    • Symptoms Relieved: Nausea, vomiting
    • Precautions and Possible Side Effects: Confusion, drowsiness, dizziness, GI upset, excitability, nightmares, uncontrollable muscle movements, and lip smacking or chewing
  • Generic Name: trimethobenzamide HCI (available in capsule injection, syrup, or suppository form)
    • Brand Name: Tigran®
    • Symptoms Relieved: Nausea, vomiting
    • Precautions and Possible Side Effects: Hypotension, blurred vision, drowsiness, dizziness, disorientation, uncontrollable muscle movements, and lip smacking or chewing
  • Generic Name: metoclopramide HCI (available in syrup, tablet, or injection form)
    • Brand Name: Reglan®
    • Symptoms Relieved: Nausea, vomiting
    • Precautions and Possible Side Effects: Uncontrollable muscle movements, lip smacking or chewing movements, sensitivity to sunlight, aching of lower legs, diarrhea
  • Generic Name: ondansetron HCI (available in solution, tablets/disintegrating tablets, injection)
    • Brand Name: Zofran
    • Symptoms Relieved: Nausea, Vomiting
    • Precautions and Possible Side Effects: Diarrhea, dizziness, headache, constipation, malaise/fatigue, fever
  • Generic Name: Antihistamines cyproheptadine HCI (available in syrup or tablet form)
    • Brand Name: Periactin®
    • Symptoms Relieved: May induce sleep, may shorten migraine attack
    • Precautions and Possible Side Effects: Weight gain, drowsiness (also used as preventive therapy)
  • Generic Name: diphenhydramine HCI (available in tablets, liquids, liquid-gels)
    • Brand Name: Benadryl® (over-the-counter)
    • Symptoms Relieved: Nausea, vomiting
    • Precautions and Possible Side Effects: Sleepiness, dizziness, disturbed coordination, and behavioral changes

NOTE: For people using symptomatic relief more than twice a week, daily preventive therapy may be considered by your doctor. In addition, appropriate non-medicinal therapy, such as exercise, biofeedback, adequate sleep (at least 8 hours/night), adequate hydration (6 to 8 glasses of water/day), and diet can be used to decrease the frequency of headache attacks, eliminating the need for frequent pain medicines.

Abortive Therapy

These medications are used early in a migraine headache to stop the process that causes the headache pain. In this way, they help minimize the symptoms of headache, such as nausea/vomiting and sound and light sensitivity. These medications are most effective if used at the first sign of a migraine. Some medications should not be used during a migraine aura; please follow the instructions of your doctor.

When headaches—and especially migraine headaches last longer than 24 hours and other medications have been unsuccessful in managing the attacks, medication administered in an “infusion suite” can be considered. An infusion suite is a designated set of rooms at a hospital or clinic that are monitored by a nurse and where intravenous drugs are administered. The intravenous drugs are usually able to end the migraine attack. Patients’ length of stay at the infusion suite can range from several hours to all day.

Use of abortive therapies has not been approved for children (see end of document for discussion of ‘off-label’ use).

Medications for Abortive Therapy

  • Generic Name: Ergot, dihydroergotamine, mesylate
    • Brand Name: DHE-45®, Injection Migranal® intranasal
    • Possible Side Effects: Nausea, numbness of fingers and toes
  • Generic Name: Triptans, Sumatriptan succinate*, zolmitriptan*, rizatriptan*, naratriptan HCI†, almotriptan malate*$, frovatriptan succinate†, eletriptan hydrobromide*
    • Brand Name: Imitrex® injection, oral or intranasal; Zomig®, oral or Intranasal; Maxalt® oral; Amerge®oral; Axert® oral; Frova® oral; Relpax ®oral
    • Possible Side Effects: Side effects for all the Triptans are similar This class of drugs is well tolerated, but side effects may include: Nausea, headache, sleepiness, dry mouth, dizziness, fatigue, headache, hot/cold sensations, chest pain, flushing, sense of tightness around chest and or throat, numbness

*short acting †= long-acting $ = FDA approved for teens ages 12 to 18

Overmedicating and Rebound Headache

People who are prone to having headaches may develop a pattern of daily or almost-daily headaches. In some people, migraine-type headache attacks may become so frequent that they finally blend together with no clear-cut beginning or end. In both of these cases, the development of more severe or frequent headaches may actually be caused from taking headache relief medications too frequently. Daily or almost daily use of over-the-counter medications such as aspirin, acetaminophen, ibuprofen, narcotics, barbiturates and caffeine-containing medications; or prescription medications such as the triptans, appears to interfere with the brain centers that regulate the flow of pain messages to the nervous system and may make your headache worse. In addition, overmedicating interferes with the effectiveness of prescribed preventive medications.

Rebound headaches may result from taking prescription or nonprescription pain relievers more than two days a week. If prescription or nonprescription abortives are overused, the headaches may rebound as the last dose wears off, leading you to take more and more medication and actually aggravate the pain. When the medications are no longer taken, headache pain will likely improve over a period of 6 to 12 weeks.

Preventive therapy

These medications are taken daily to prevent headaches. Some of these medications are used for other medical conditions and were accidentally discovered to help headache. While none of these medications cures headache, preventive medications may reduce the frequency, duration and severity of headache attacks.

The medications listed include both over-the-counter and prescription drugs. These drugs are not habit-forming, but any medication can cause unwanted side effects. Your doctor will work with you to carefully regulate the dosage so that side effects are minimized and headache relief is maximized.

To be effective, all preventive medications must be taken one or more times every day. It may be necessary to change the medications and modify their dosages in order to discover which medication or combination of medications, at which dosages, work best to reduce the frequency and severity of your headache pain.

While these medications are being used, carefully recording your headache frequency and severity on a daily basis will help your doctor judge how the medications are working. Most of these medications require days to weeks of daily use before they become fully effective in preventing headaches. A trial of about 8 weeks is recommended before the effectiveness of a medication can be judged by your doctor.

Once good headache control has been achieved and maintained for 6 months or a year, it may be possible to taper and stop these medications. In other cases, it may be necessary to take the medications for a longer period of time.

Preventive therapies have not been approved for use in children. (see end of document for discussion of ‘off label’ use).

Headache Checklist of Management Suggestions

  • Educate yourself and your family. Read about your type of headache and its treatment.
  • Maintain a headache diary
  • Ask your doctor for written instructions about what to do when you have a headache
  • Limit your use of over-the-counter and prescription abortive medications to two days per week. Excessive use can actually increase headaches
  • Follow a regular schedule:
    • Don’t skip meals, especially breakfast
    • Get eight hours of sleep nightly
    • Exercise 30 minutes/day
    • Drink 6-8 glasses of water/day
    • Learn to identify and avoid headache “triggers.” Common triggers include caffeinated foods and beverages (teas, chocolate, colas, coffee), nitrates (luncheon meats, sausage/hot dogs, pepperoni) tyramine (aged cheeses, pizza) Doritos® Ramen® noodles, other “junk” foods, and Asian foods containing MSG.
  • Daily school attendance IS A MUST
  • Initiate non-drug measures at the earliest onset of your headache
    • Seek rest in a cool, dark, quiet comfortable location
    • Use relaxation strategies and other methods to reduce stress
    • Apply a cold compress
  • Don’t wait! Take the maximum allowable dosage of recommended medications(s) at the first sign of a severe headache
  • Take prescribed medications regularly, as directed, and maintain regular follow-up visits.
  • Call your doctor when problems arise

Medications for Preventive Therapy

  • Generic Name: amitriptyline HCI
    • Brand Name: Elavil®
    • Possible Major Side Effects: Fatigue, dry mouth, weight gain, and constipation
    • Instructions When Used for Headaches: Frequently started at low dosages and slowly increased to a therapeutic level taken nightly, EKG optional
  • Generic Name: Antihistamines cyproheptadine HCI (available in syrup or tablet form)
    • Brand Name: Periactin®
    • Possible Major Side Effects: May induce sleep or may shorten migraine attack, weight gain, drowsiness
    • Instructions When Used for Headaches: Usually started at low dosages and slowly increased; often taken at bedtime
  • Generic Name: Selective Serotonin Receptor Inhibitors (SSRI)* fluoxetine HCI
    • Brand Name: Prozac®
    • Possible Major Side Effects: Nausea, dry mouth, increased appetite, agitation
    • Instructions When Used for Headaches: Usually started at low dosages and slowly increased; usually taken in the a. m.
  • Generic Name: Beta Blockers atenolol, Propranolol HCI
    • Brand Name: Tenormin®, Inderal®
    • Possible Major Side Effects: Fatigue, depression, weight gain, faintness and diarrhea, memory disturbance, decreased performance in athletes
    • Instructions When Used for Headaches: Depending on the form may be one to three times a day
  • Generic Name: Calcium Channel Blockers, verapamil, flunarizine
    • Brand Name: Calan®, Isoptin®, Sibelium®
    • Possible Major Side Effects: Constipation, dizziness; hair loss
    • Instructions When Used for Headaches: Frequently started at low dosages and slowly increased. Taken twice a day. Usually the first dose is in the a.m.
  • Generic Name: Anticonvulsants valproic acid
    • Brand Name: Depakote®
    • Possible Major Side Effects: Nausea, drowsiness, weight gain, tremors, and rare liver failure; may cause birth defects
    • Instructions When Used for Headaches: Frequently started at low dosages and slowly increased. Periodic blood tests required
  • Generic Name: topiramate
    • Brand Name: Topamax®
    • Possible Major Side Effects: Rare: glaucoma, kidney stone at higher doses (>150 mg): weight loss, word-finding difficulties
    • Instructions When Used for Headaches: Usually started at low dosages and slowly increased; may be taken two to three times/daily
  • Generic Name: gabapentin
    • Brand Name: Neurontin®
    • Possible Major Side Effects: Generally well tolerated
    • Instructions When Used for Headaches: Usually started at low dosages and slowly increased, maybe taken two to three times/daily

*Other SSRIs include citalopram (Celexa®), escitalopram (Lexapro®), fluvoxamine (Luvox®), paroxetine (Paxil®), sertraline (Zoloft®)

Important Note About ‘Off-Label’ Prescribing

Many of the medications listed in this handout have not been approved by the Food and Drug Administration (FDA) for use in children and adolescents with headaches. When a doctor chooses to prescribe a drug for a medical condition or for a certain patient type (eg, children) for which it has not received FDA approval, this practice is called ‘off-label’ prescribing. This is a common practice in the field of medicine. It is one of the ways by which new and important uses are found for already approved drugs. Many times, positive findings lead to formal clinical trials of the drug for new conditions other than what the drug was first approved for.

Many of the drugs prescribed to help prevent head pain disorders are prescribed in this off-label fashion. Please check with your doctor regarding other medications not mentioned in this handout or if you have any concerns or questions.

Other notes

Pain medications that are least likely to be habit-forming should be tried first. In general, narcotic analgesics are not used in children and adolescents or adults. In all but the most severe headaches, the lowest strength dose should be tried first. Caution should always be used when taking “stronger” medications, because the more frequently the medication is taken, the greater the possibility that they could become harmful and less effective.

Guidelines for Use of Over-the-Counter (OTC) Pain Relievers

Nonprescription pain relievers have been demonstrated to be safe when used as directed. In addition, keep the following precautions in mind:

  • Know the active ingredients in each product. Be sure to read the entire label.
  • Do not exceed the recommended dosage for age on the package—including for a single dose, for total daily dosage, and total weekly dosage.
  • Carefully consider how you use pain relievers and all medications; it is easy to over-medicate.
  • Check with your doctor before taking products containing aspirin, ibuprofen or naproxen sodium if:
  • Children should not use over-the-counter medications that contain aspirin and/or caffeine.
  • Children and teenagers should not be given aspirin, as aspirin has been associated with a rare but serious liver and brain disorder called Reye’s syndrome.
  • Avoid combination medications containing caffeine, barbiturates and narcotics.

Adapted from the American Council for Headache Education

Behind the headlines: Is aspirin an effective treatment for migraine?

UK researchers examined 13 studies, involving 4,222 people, that had looked at the use of aspirin, sumatriptan or placebo for treating migraine.

Dr Varo Kirthi and colleagues from Oxford University’s department of anaesthetics concluded that aspirin is an effective treatment for acute migraine headaches, similar to sumatriptan 50mg or 100mg.

‘Aspirin 900mg or 1,000mg is an effective treatment for acute migraine headaches, with participants in these studies experiencing reduction in both pain and associated symptoms, such as nausea and photophobia,’ they said.

For 52 per cent of people, this treatment would reduce moderate-to-severe migraine to no worse than mild pain within two hours, the researchers said.

‘The addition of 10mg metoclopramide may provide additional pain relief and greater reduction in associated symptoms, particularly nausea,’ they added.

Adverse events identified in the study were mainly mild and transient, but such events occurred less frequently in people treated with sumatriptan 100mg.

Was this not known before?
The researchers said that, although aspirin is frequently used to treat migraine headaches, they could find no systematic review of the efficacy of this intervention in adults.

‘It is important to know where this widely available and inexpensive drug fits in the range of therapeutic options for migraine,’ they said.

‘For many migraineurs, non-prescription therapies offer convenience and may be the only therapies available or affordable.’

Dr Kirthi and colleagues pointed out that, although trials indicated that the treatments did not differ markedly, there were limited data comparing aspirin with other analgesics.

Exeter GP Dr David Kernick, RCGP headache champion, said that strands of evidence on the benefits of aspirin had been around for some time, but that the new research had pulled them together.

Wendy Thomas, chief executive of The Migraine Trust, said the charity welcomed the fact that findings ‘confirm that aspirin can be an effective treatment of migraine symptoms for some sufferers’.

Why is this research significant?
Dr Kernick believes the new review is important because around 50 per cent of people with migraine self-medicate to treat the condition.

‘If aspirin works, it generally works every time, but it needs to be taken with an antiemetic,’ he said.

‘In the study they looked at it with metoclopramide, which is not available OTC in the UK. I suggest using domperidone, which is available OTC.’

He added: ‘Migraine is not just about pain, but also has an inflammatory component. My suggestion is that people take aspirin, which hits the inflammation, with paracetamol, which hits the pain, and domperidone.

Mrs Thomas said The Migraine Trust would ‘strongly encourage’ people who think they have migraine to consult their GP to get a firm diagnosis of their headache, even if they find OTC medication to be effective.

‘The Migraine Trust also recommends that if sufferers are considering taking aspirin they consult their GP for guidance about how, when and in what dosage to take it in order to ensure that it is effective and to avoid the risk of developing medication-overuse headache,’ she said.

Informing patients
  • Aspirin 900mg or 1,000mg is an effective treatment for acute migraine headaches.
  • Treatment is effective in around 52 per cent of people.
  • Addition of an antiemetic may boost pain relief and reduce other symptoms such as nausea.

 

90,000 Oral aspirin for the treatment of acute episodic tension headache in adults

Essence

This review found only very low-quality evidence that people with tension headache, with a frequency of 2 to 14 times a month, had sufficient pain relief after taking aspirin 1000 mg or lower. There are questions about how research is done with this type of headache. These questions include the type of people selected for the study and the types of outcomes reported.This limits the usefulness of the results, especially for people who rarely get headaches from time to time.

Relevance

People with frequent episodic tension headaches have 2 to 14 headache episodes every month. Tension headache makes it difficult for people to concentrate and work properly, and also leads to disability. When a headache occurs, it goes away over time without any treatment.Aspirin is a commonly used over-the-counter pain reliever (OTC). The usual oral dose is 300 to 650 mg.

Research characteristics

In September 2016, we searched the medical literature and found five studies involving 1812 participants who took aspirin for frequent episodic tension headaches. About 1,668 participants were included in the comparisons of aspirin (500 mg to 1000 mg) versus placebo (dummy tablet). The International Headache Society recommends accepting no pain as an outcome two hours after taking the medication, but other outcomes are also suggested. None of the studies reported no pain at 2 hours or other significant outcomes. Thus, we only have limited information to analyze the outcomes in terms of how well aspirin works.

Highlights

None of the studies reported no pain in participants 2 hours after taking the medication.And only one study reported an outcome that we rated as equivalent to no pain, or only mild pain after two hours. For aspirin 1000mg, about 10 out of 100 participants took additional pain relievers, compared with 30 out of 100 participants who took a placebo (very low-quality evidence). At the end of the study, 55 out of 100 participants were “satisfied” with the treatment, compared with 37 out of 100 who took a placebo (very low-quality evidence).About 15 out of 100 participants who took 1000 mg aspirin reported an adverse effect after taking a single dose of the drug, which was similar to the placebo group (low-quality evidence).

Quality of evidence

The quality of the evidence was low or very low for the comparison between aspirin and placebo. Low and very low quality evidence means we are very uncertain about the results.

Aspirin – life without pain

One of the most famous drugs in the world, ASPIRIN ® , appeared in 1897.in the laboratory of the German chemist Felix Hoffmann, who worked at the Bayer enterprise. The scientist was prompted to create it by the state of his father’s health – he suffered from severe rheumatic pain and could not move, and the means existing at that time did not help or caused too pronounced side reactions. It was the search for an effective and safe (see “Pharmaceutical Weekly” No. 42 (613) dated October 29, 2007 and No. 41 (612) dated October 22, 2007) an anesthetic that led F. Hoffman to the synthesis of the drug ASPIRIN ® .From that moment on, its triumphant march across the planet began, and today ASPIRIN ® remains one of the most famous and popular analgesics in the world.

Pain is a very important defense mechanism. In order to protect the body from a damaging factor, its motor component is manifested – the reflex of avoidance: withdrawing the hand, searching for a forced position, reducing motor activity. There are people with a congenital inability to feel pain, and as a result of the lack of its protective function, they suffer from serious injuries and fractures, as well as various diseases, since they do not feel pain symptoms and do not seek medical help in a timely manner.

Pain is a serious sign of trouble in the body, but as soon as the signaling function of pain is exhausted, it becomes evil. With prolonged exposure, painful sensations create constant discomfort, are accompanied by a deterioration in mood, the appearance of a feeling of fear, anxiety, lead to a decrease in immunity and psychosomatic disorders.

Non-steroidal anti-inflammatory drugs (NSAIDs, non-narcotic analgesics, antipyretics) are drugs of various chemical structures that have anti-inflammatory, analgesic and antipyretic effects and have no narcogenic potential.The analgesic effect of non-narcotic analgesics, including acetylsalicylic acid (ASA), develops, as a rule, 0.5–2 hours after taking them and manifests itself mainly in moderate pain syndrome, especially in case of somatic pain (occurs when a damaging stimulus is exposed to free nerves endings in the skin, subcutaneous layer, muscles and joints), to a lesser extent with visceral (develops with irritation of pain receptors located in the internal organs) and neuropathic (with irritation of peripheral nerves, afferent pathways of pain sensitivity in the spinal cord and brain).The funds of this group are practically ineffective for pain caused by severe trauma, cavity surgery, etc.

The analgesic effect of NSAIDs is primarily a consequence of their anti-inflammatory action, that is, it is associated, on the one hand, with a decrease in the formation of inflammatory mediators, which also exhibit the properties of algogenic substances (kinins, prostaglandins, cytokines, neuropeptides, etc. ), and on the other, with a decrease in edema tissues in the focus of inflammation and the weakening of mechanical compression of nociceptors in it.The key point in the anti-inflammatory action of NSAIDs is their inhibition of the enzyme cyclooxygenase (COX). ASA irreversibly inhibits COX-1 and COX-2.

It is known that the analgesic effect of NSAIDs develops after 10-30 minutes, and the anti-inflammatory effect – after 2-12 hours. This indicates the central component of the analgesic effect, which is not associated with the elimination of the inflammatory response. A number of studies have shown that ASA has the property of inhibiting the transmission of peripheral pain impulses in the central nervous system (Chen A.C.N., Chapman C.R., 1979; Yaksh T. et al., 1992).

A physician in any specialty is faced with the problem of pain and the fight against it. Just as often, pharmacists and pharmacists face this problem, to whom patients turn to with the issue of pain relief. They are particularly likely to ask for an over-the-counter analgesic to relieve acute or chronic pain of mild to moderate intensity that has not led them to see a doctor. The relief of more severe forms without first consulting a doctor carries a serious danger for the patient, since it can mask life-threatening pathological conditions.In this publication, we will consider the relief of pain using the now classic effective and safe drug ASPIRIN ® , which has been successfully used for over 100 years.

When contacting a pharmacy or a doctor with a question of pain relief, patients present complaints indicating the part of the body where the pain is localized – headache, toothache, joint pain, muscle and nerve pain .

Headache

Headache is one of the most common symptoms encountered by doctors.There are at least 45 known diseases in which headache can be the only or leading manifestation. It can be of a different nature and localized in different areas of the head, depending on the causes that caused it. Headache can be a sign of such threatening pathological conditions as hypertension, brain tumor, intracranial hypertension, meningitis, encephalitis, etc., and this is precisely what poses the danger of self-medication. However, there are several classic headache causes for which the use of ASPIRIN ® is very effective.

Migraine is a recurrent headache of a pulsating nature, the development of which is associated with spasm and expansion of the arteries of the brain. Usually the pain is one-sided, but the side can change from attack to attack. In children, headache is often bilateral and localized in the frontal region. In most cases, migraine first occurs between the ages of 10 and 30. The onset of an attack can be foreshadowed by an aura – a kind of stereotypical sensations that arise immediately before a painful attack: flickering in front of the eyes, flashes of light, distortion of the perception of the surrounding world, numbness of the limbs, discomfort in the abdomen, etc. However, an attack can start suddenly. Migraine very seriously reduces the quality of life of patients and their ability to work, forcing them to constantly live in fear of a new attack.

Migraine is considered a female disease, especially in women aged 18–45 years. Nevertheless, men often suffer from this ailment. As a rule, these are successful people, responsible and educated, at the same time emotionally vulnerable. Migraine is jokingly called a disease of great people – Julius Caesar, Frederic Chopin, Friedrich Nietzsche, Charles Darwin, Sigmund Freud, Thomas Jefferson, Edgar Poe and many other celebrities suffered from this disease.

Currently, a large number of drugs are used to relieve migraine attacks, among which a significant place is given to 5HT-serotonin receptor agonists – tryptans. These drugs relieve migraine pain well, but have 2 main drawbacks: high cost and limited use in patients with cardiovascular diseases. Therefore, there is a constant search for alternative medicines for the treatment of migraines. One of these drugs is the classic analgesic ASPIRIN ® .For example, in 2007, Professor Hans-Christoph Diener, an expert in the field of headache and director of the neurological clinic at the University of Essen in Germany, became the winner of the award for outstanding achievements in the study of this drug. And he received this award (at the XIII International Congress on Headache in Stockholm) precisely for researching the use of the drug ASPIRIN ® for migraine, the results of which proved its effectiveness.

The mechanism of the analgesic action of the drug ASPIRIN ® in migraine is not fully understood.It is believed that it has a combined effect (peripheral – blockade of COX and central – inhibition of the transmission of pain impulses in the spinal cord). Currently, the theory of blocking the endothelium-relaxing factor (nitrogen monoxide – NO), which causes vasoconstriction (an effect opposite to the use of nitrates in coronary heart disease) is also being considered. Thus, ASPIRIN ® – an effective, safe and inexpensive remedy for migraines – can serve as a drug to start with to stop an attack, and to switch to triptans should be used in the case when a pronounced analgesic effect was not achieved.

A large number of people also suffer from psychogenic headaches. This condition includes a headache of mental and physical stress, with anxiety and depression. It is most often caused by increased stress, chronic stress, fatigue, acute emotional experiences, excessive alcohol consumption, smoking – factors that have already become common in the life of a modern person. The mechanism for the development of such pain is associated with the tension of the cervical, masticatory, temporal muscles, facial muscles, which may be associated with emotional stress – an involuntary reaction of facial muscles and scalp muscles occurs in response to strong emotions, even positive ones! Pain syndrome often arises as a result of improper forced body position during sedentary work, uncomfortable posture during sleep; Prolonged squinting, clenching of teeth, chewing of gum can also cause it.Patients complain of aching or pressing headache, usually diffuse or localized in the occipital, temporal or frontal region and almost always bilateral.

Treatment of psychogenic headache has certain problems. As the name and mechanism of occurrence suggests, for successful therapy it is necessary to eliminate the wrong psychological stereotypes of the patient’s behavior. However, the situation is complicated by the fact that many people suffering from this type of headache have clinical signs of depression, and it is almost impossible to help them without adequate antidepressant therapy.

In any case, you should not endure a headache, because it aggravates unpleasant psychological experiences and can lead to an increase or consolidation of its stereotypical appearance in response to any psychological stress. And here ASPIRIN ® will be very useful – it allows you to effectively eliminate pain. To enhance the effect, it is recommended to carry out an independent massage of the temporal region, neck muscles, rubbing the scalp with your fingertips. And it will be possible to find out psychological problems after the pain has passed.

Headache can also appear with colds, and the use of the drug ASPIRIN ® in order to relieve this symptom has long been a classic method of treatment, especially since it has antipyretic and anti-inflammatory effects.

Toothache

Toothache is a clear signal that you need to see a dentist.Of course, if this cannot be done immediately, it must be eliminated, however, the constant use of an analgesic without adequate dental care can lead to tooth loss or the development of serious complications. ASPIRIN ® is able to reduce the severity or eliminate toothache, so it can be recommended as an analgesic in this case, especially since it is often at hand or in a home medicine cabinet. Both in the presence of a temporary effect and in its absence, it will be advisable to immediately consult a dentist.

Pain in joints and muscles

Acute, chronic, or frequently recurring pain in joints, bones and muscles is common in adults and is especially common in older people. In the pathogenesis of such pain, mechanical factors play an important role (overloading of the joint, especially of a sick or injured one, stretching of the tendon-ligamentous apparatus), inflammation of the synovial membrane, microcirculatory disorders; metabolic disorders in the bones; development of inflammatory and degenerative changes in the joints.As a result of these processes, algetics (tissue proteases, kinins, prostaglandins, histamine, serotonin) accumulate in the tissues of the joints, which irritate pain receptors (nociceptors) located throughout the body, with the exception of the brain, and give rise to the sensation of pain. There are no pain receptors in the synovium, cartilage and menisci, but joint pain in people of different ages is most often associated with changes in the periarticular tissues, which are richly supplied with nociceptors.

Clinical manifestations of rheumatic diseases are different, but there are characteristic – the so-called articular syndrome: severe prolonged pain, local inflammation manifested by edema, increased skin temperature over the affected joints, defiguration and deformation of the joint (change in its shape due to edema of periarticular tissues and pathological tissue growths) , restriction of movement in the joint and, as a consequence, a violation of its function.Inflammation is the most universal pathological process underlying the clinical manifestations of rheumatic diseases.

All drugs of the NSAID group, including ASPIRIN ® , are very effective in eliminating pain and inflammation in this pathology, however, once again, the danger of self-medication and the need to consult a doctor for prolonged and intense joint pain should be emphasized, and even more so if this is accompanied by their deformation or severe edema.However, in case of injury or sprain, ASPIRIN ® will effectively eliminate inflammation and pain.

The most common causes of muscle pain are the following: flu and other acute respiratory viral infections, sciatica, bruise or muscle strain – ASPIRIN ® will quickly and effectively eliminate pain in all these conditions.

Pathological pain

Separately, it is necessary to dwell on pathological pain – a condition when pain becomes an independent form of the disease.For a better understanding of the issue, we will briefly highlight modern views on the pathogenesis of pain.

The perception of pain as a reflex act is outdated. The modern views are based on the theory of neuromatrix – a new conceptual model of the nervous system (Melzack R., 1999). According to this theory, all qualitative characteristics of pain sensation are generated in the brain, and peripheral stimuli represent only nonspecific “triggers”. This means that signals of damage are transmitted to the central nervous system, where, based on past experience of painful experiences, social stereotypes, and the functional state of the body, a painful sensation is formed, which the person perceives.

With prolonged pain stimulation, normal sensory neurons become hyperexcitable, and areas of abnormal activity appear in them. This activity leads to the formation of algogenic substances in the nerve endings: serotonin, prostacyclins, leukotrienes, cytokines, bradykinins. All these biologically active substances significantly enhance and support peripheral pain stimulation. This pathological process is called neurogenic inflammation. Painful sensations can occur even with minor tissue irritation in all visceral organs, which is typical for patients with chronic degenerative diseases of the musculoskeletal system, irritable bowel syndrome, etc.

An increased flow of impulses in the central nervous system leads to central sensitization, which transfers the pathological process to a new level of development, the appearance of virtual pain sensations without the presence of an irritant, which is very painful for patients and dramatically worsens their quality of life.

ASPIRIN ® acts on the first two links of chronic pain weakens peripheral nociception and the associated peripheral sensitization of the nervous system. Therefore, the drug is indicated for the treatment of pathological pain, and also reduces the likelihood of such a condition due to untimely and inadequate relief of chronic pain syndrome.

We have touched on only some of the common cases of the use of the OTC analgesic ASPIRIN ® and were convinced that this well-known drug is effective and safe in relieving pain of various origins. Both the relief of pain without adequate medical care and the absence of the necessary pain relief can damage the patient’s health. As a golden mean, the drug ASPIRIN ® can be chosen.

Let’s summarize:

– ASPIRIN ® is effective for pain of low or moderate intensity, especially of inflammatory genesis;

– the use of ASA, like any other analgesic, eliminates only the symptoms, but not the cause of the disease, therefore the appearance of pain is a signal of the need to see a doctor as soon as possible;

– ASPIRIN ® is not recommended for use in diseases of the digestive tract, gout, hemophilia or other blood clotting disorders, when taking anticoagulants, hypersensitivity to ASA.

Concluding one more section of the medical “biography” of the drug ASPIRIN ® , it should be emphasized that despite its more than a century history in medicine, taking into account the deepening and expansion of our knowledge about the mechanisms of its action, as well as the pathogenesis of the onset and development of pain as a possible independent nosological unit, the use of the drug ASPIRIN ® and other ASA derivatives as an analgesic is still relevant today, which objectively implies a good scientific and practical perspective.o

A.P. Viktorov,
Doctor of Medical Sciences, Professor, Head of the Department of Clinical Pharmacology with the Laboratory of Functional Diagnostics of the National Scientific Center “Institute of Cardiology named after N. D. Strazhesko “AMS of Ukraine

90,000 aspirin and coffee with a hangover is a very bad combination ›Articles› 47news from the Leningrad region

It is possible to relieve the headache in the morning after heavy libations with the help of an anesthetic pill.However, there is a drug that in such cases it is absolutely not recommended to drink it with morning coffee. This is regular aspirin.

Some people believe that strong coffee helps them with a hangover. And someone decides to use both remedies at once – they wash down the medicine with a cup of coffee. Such a cardinal approach is strongly discouraged, therapist Olga Kashubina, the author of the book “How a Doctor Would Be Sick: Little Tricks of Big Health Care”, told Sputnik radio.

“Aspirin can really relieve headaches, but this is true for any type of headache.There is no particular point in taking aspirin for a hangover, but there is no particular harm here either. The only thing to remember is that aspirin has a negative effect on the stomach. In people who drink, the stomach is often irritated by alcohol, and if you add aspirin and coffee on top, this can cause additional pain or lead to an exacerbation of chronic gastritis. People with peptic ulcer disease are not shown such a combination. I would not experiment, “said Kashubina.

Meanwhile, according to her, for headaches not related to alcohol, the combination of coffee with this drug can give a good effect.Acetylsalicylic acid thins the blood, and caffeine helps to remove toxins from it, the doctor explained.

“There are even pills that combine aspirin and caffeine. The fact that pharmacology produces such pills suggests that these two substances are quite compatible with each other. There is no particular fear to drink an aspirin pill with a cup of coffee. Moreover, caffeine is often added to aspirin because it enhances the analgesic effect. These two substances potentiate each other, and the effect is stronger, “explained Olga Kashubina.

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Aspirin Cardio instructions for use: indications, contraindications, side effects – description of Aspirin Cardio tab., Cover. enteric coating, 100 mg: 20, 28, 56 or 98 pcs. (36740)

With the simultaneous use of antacids containing magnesium and / or aluminum hydroxide, slow down and reduce the absorption of acetylsalicylic acid.

With the simultaneous use of calcium channel blockers, agents that limit the intake of calcium or increase the excretion of calcium from the body, the risk of bleeding increases.

With simultaneous use with acetylsalicylic acid, the effect of heparin and indirect anticoagulants, hypoglycemic agents of sulfonylurea derivatives, insulin, methotrexate, phenytoin, valproic acid is enhanced.

With simultaneous use with GCS, the risk of ulcerogenic action and the occurrence of gastrointestinal bleeding increases.

With simultaneous use, the effectiveness of diuretics (spironolactone, furosemide) decreases.

With the simultaneous use of other NSAIDs, the risk of side effects increases.Acetylsalicylic acid can reduce plasma concentrations of indomethacin, piroxicam.

When used simultaneously with gold preparations, acetylsalicylic acid can induce liver damage.

With simultaneous use, the effectiveness of uricosuric agents (including probenecid, sulfinpyrazone, benzbromarone) decreases.

With the simultaneous use of acetylsalicylic acid and sodium alendronate, severe esophagitis may develop.

With the simultaneous use of griseofulvin, the absorption of acetylsalicylic acid may be impaired.

A case of spontaneous hemorrhage in the iris was described when taking ginkgo biloba extract against the background of long-term use of acetylsalicylic acid at a dose of 325 mg / day. It is believed that this may be due to an additive inhibitory effect on platelet aggregation.

With the simultaneous use of dipyridamole, it is possible to increase C max of salicylate in blood plasma and AUC.

With simultaneous use with acetylsalicylic acid, the concentration of digoxin, barbiturates and lithium salts in the blood plasma increases.

With the simultaneous use of salicylates in high doses with carbonic anhydrase inhibitors, intoxication with salicylates is possible.

Acetylsalicylic acid in doses less than 300 mg / day has little effect on the effectiveness of captopril and enalapril. When using acetylsalicylic acid in high doses, it is possible to reduce the effectiveness of captopril and enalapril.

With the simultaneous use of caffeine increases the rate of absorption, plasma concentration and bioavailability of acetylsalicylic acid.

With the simultaneous use of metoprolol can increase C max salicylate in blood plasma.

With the use of pentazocine against the background of long-term use of acetylsalicylic acid in high doses, there is a risk of developing severe adverse reactions from the kidneys.

With the simultaneous use of phenylbutazone reduces uricosuria caused by acetylsalicylic acid.

With simultaneous use, ethanol can enhance the effect of acetylsalicylic acid on the gastrointestinal tract.

Aspirin for a hangover: how much aspirin to drink for a hangover is safe

Of course, NSAIDs are not recommended to be used to alleviate the post-intoxication state, since it is unsafe for health. However, aspirin in a small dosage (75-100 mg) is an exception to this rule.

The instructions indicate that acetylsalicylic acid should not be drunk together with alcohol, as this can lead to an increase in the risk of gastric bleeding.Therefore, you need to take aspirin to fight a hangover carefully, following the recommendations of doctors, since their violation is fraught with bleeding of the gastrointestinal tract.

Acetylsalicylic acid, another name for aspirin, belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). This drug has an analgesic, antipyretic, anti-inflammatory and thinning (anti-thrombotic) effect.

The main feature of aspirin is that in a small dose it exhibits an antiplatelet effect to a large extent, that is, it promotes blood thinning, reduces platelet aggregation (adhesion) and thereby prevents the formation of blood clots (blood clots).

Thanks to this list of actions provided, it is used in the fight against a hangover. Aspirin is more effective than other drugs used for hangover, as it has a number of advantages. In addition, it can be used at home and is classified as an over-the-counter medication.

Advantage # 1 Effectively relieves pain

Aspirin is primarily classified as an analgesic drug. It suppresses pain syndromes of a different nature, in particular a headache, and, as you remember, it is this, together with dizziness, that is considered the main symptom of a hangover.Therefore, it is best to take aspirin for a hangover headache.

Benefit # 2 Thinns the blood

In addition to its analgesic and anti-inflammatory effect, aspirin also inhibits the formation of platelets (stops the synthesis of thromboxane A2), thereby thinning the blood.

Within 30 minutes after drinking alcohol, blood vessels dilate and blood viscosity decreases, thus improving blood flow. However, after this time, the process of ethanol decomposition occurs, and the blood begins to thicken again, and the vessels narrow.All this leads to blurred consciousness and headaches, which are most active in the morning. Aspirin, as a blood thinner, helps your blood vessels return to normal.

Benefit # 3 Fast acting

The first effect of acetylsalicylic acid appears within 10 minutes after its intake. So, the maximum amount of aspirin in the blood plasma is reached only 10-20 minutes after the person has drunk the pill. That is, this medication will help you very quickly cope with hangover syndromes.

Advantage # 4 There are forms of production with a minimum dosage

How much aspirin to drink for a hangover, because there are several dosages of it? Many people think that the more aspirin pills they take, the sooner their hangover will go away, but this is not entirely true.

On the contrary, one of the advantages of acetylsalicylic acid is that this drug is available in both minimal dosages (75mg, 100mg) and standard (250mg, 500mg).But the higher the dosage, the greater the likelihood of side effects.

If you drink even a large amount of acetylsalicylic acid, it will not accelerate the cessation of the hangover syndrome, but will only negatively affect your health. Therefore, the dosage of aspirin for a hangover should be 100 mg, since it is at this dose that it exhibits antiplatelet properties (thinning the blood) and exhibits a moderate analgesic effect, and in this case you do not have to worry about side effects.

Advantage # 5 Has a low cost

Of the many drugs that suppress hangover symptoms, aspirin has the lowest cost and has been scientifically proven to be effective.

90,000 aspirin for joint pain

aspirin for joint pain

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ASPIRIN is effective for pain of low or moderate intensity, especially of inflammatory genesis (headache, toothache, joints and muscles, pathological pain). Acute, chronic, or frequent pain in joints, bones, and muscles is common in adults, and is especially common in older people.In the pathogenesis of such pain, mechanical factors play an important role (overloading of the joint, especially of a sick or injured one, stretching of the tendon-ligamentous apparatus), inflammation of the synovial membrane, microcirculatory disorders; metabolic disorders in the bones; development of inflammatory and degenerative changes in the joints. Taking aspirin eliminated pain and swelling in the joints, which allowed the artist to continue to create. Discovery history. What came before? It is clear that people somehow coped with fever and pain even before the invention of aspirin.How? Traditional medicine gives many recommendations on this matter. Well, with joint pain – according to open sources – it was possible to cope with the root of elecampane, a mixture of honey and vodka, chestnuts and even. fly agaric tinctures. To whom and from what will aspirin help? Any new invention of any value is eventually enriched with data about it. Diseases of the joints. Vision. We are raising a baby. Time to take aspirin? One of the most widely used anti-clotting drugs is the nonsteroidal anti-inflammatory drug (NSAID) acetylsalicylic acid, or aspirin.The drug reduces the severity of inflammation, relieves pain, and relieves fever. However, these properties are typical for other representatives of the NSAID group. But the ability to prevent the formation of blood clots by suppressing the production of substances involved in the coagulation cascade, favorably distinguishes acetylsalicylic acid in a number of other drugs. Penetration into the joint cavity is accelerated in the presence of hyperemia and edema and slows down in the proliferative phase of inflammation. In small amounts, salicylates are found in the brain tissue, traces in bile, sweat, and feces.When acidosis occurs, most of the salicylic acid turns into non-ionized acid, which penetrates well into tissues, incl. to the brain. It quickly passes through the placenta, in small quantities it is excreted in breast milk. It is metabolized mainly in the liver with the formation of 4 metabolites found in many tissues and urine. Aspirin: how to take a drug for headaches, varicose veins and to improve heart function. Can I take it during pregnancy and what are the contraindications.Aspirin is a drug that helps fight inflammation and pain of various origins. Contents: Composition and form of release. When to take Aspirin. How to take Aspirin for the heart. How to drink Aspirin for a headache. How to take Aspirin for blood thinning. Is it possible to take aspirin for varicose veins. The use of Aspirin in cosmetology. Contraindications Adverse reactions and overdose. Can I take Aspirin during pregnancy? The gel relieves morning stiffness of the joints and causes a reduction in arthralgia.Ketoprofen is effective for muscle pain and post-traumatic injury. Alternative treatment options are considered before starting therapy. It is recommended to use the lowest possible effective dosage and the shortest duration of therapy in accordance with the treatment goals. Aspirin (acetylsalicylic acid) is one of the most common and affordable drugs on the globe. At one time, he was practically uncontested for the treatment of many diseases, from a banal headache and fever with a cold, to such serious, disabling diseases as rheumatoid arthritis, deforming diseases of the spine and joints.Aspirin (acetylsalicylic acid) is one of the most common and affordable drugs on the globe. At one time, he was practically uncontested for the treatment of many diseases, ranging from the banal. Treatment of acute inflammation of the joints with drugs and physiotherapy. What to do in case of exacerbations. taking certain medications – diuretics, aspirin, nicotinic acid, drugs to lower blood pressure (Concor), etc.; lead poisoning; increased breakdown of purines in blood diseases, psoriasis, etc.Joint pain at rest. Gouty arthritis of the upper limbs. Small articular joints of the hand and fingers often become inflamed, while the fingers become like sausages. Acetylsalicylic acid (Aspirin) is also recommended for treating fever in COVID-19. In addition, aspirin thins the blood, which is especially important in severe infections and the presence of cardiovascular diseases with a tendency to thrombosis. Sore throat is a nonspecific symptom of the infection caused by the coronavirus.They are accompanied by perspiration, a feeling of dryness of the mucous membrane. For pain, you can gargle with solutions of Rotokan, Chlorhexidine, Miramistin, 1% hydrogen peroxide and other antiseptics. This will reduce the viral load and wash away some infectious agents, prevent a large number of viruses from entering the lower respiratory tract. Joint pain is a common symptom that affects about 80% of people over the age of 35 to one degree or another. Bone aches can be a natural phenomenon, but when it bothers you for a long time, with great intensity, look for the problem deeper.Why do joints hurt? Most common problems. In any case, always read the summary of the preparation to the end. Prevention of joint pain. The best option for the appearance of joint pain is old age. If you have encountered a problem before, pay attention to your diet and lifestyle.

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In fact, a huge number of people on the planet are faced with common symptoms of diseases associated with the musculoskeletal system.The movable connecting part of the bones is subject to daily abrasion. This leads to discomfort in the muscles and tendons. Consequently, the leading diseases of people are local and extensive arthritis and arthrosis. It comes to the point that even at rest, the joints begin to hurt very much. I can’t imagine my life without working on my personal plot. I’m so used to the fact that I can dig up the ground on my own, weed and plant new plantings, and subsequently, get a bountiful harvest that I’m just afraid that the joints will start to fail.Ortex for joints helps me to maximize the vital integrity of the joint and bone tissues. Joint pains don’t bother me! The drug is recommended for practical use, since it is a 100% natural cream that does not pose a danger to the immune system and other body systems.

90,000 which foods and drinks thin the blood

Doctors advise revising your daily menu to improve your quality of life.

First, let’s try to understand what “thick blood” is.Experts say that this is not a separate disease, but a process that indicates serious disorders in the body. Thick blood is dangerous for many reasons. As you know, oxygen is carried through the body with the blood to the organs and muscles of a person. Viscous blood does it at the wrong time, too slowly, respectively, the work of the cardiovascular system, liver, changes in the membranes of erythrocytes and platelets are disrupted.

How to understand that you have “thick blood”

Doctors distinguish several symptoms: numbness of the limbs, frequent headaches, a constant feeling of fatigue, a feeling of thirst, pallor.If such signs appear often enough and for no particular reason, it is worth contacting a specialist. Clinical analysis will show the severity or absence of this phenomenon.

The reasons for the “thickening” of the blood are different. Varicose veins, diabetes mellitus, high cholesterol, hemoglobin, pancreatitis, leukemia, hepatitis – in these diseases, thick blood is the most common occurrence, and is especially dangerous for the human body.

What contributes to the thickening of blood flow

Experts note several factors, both external and internal: unhealthy diet, lack of vitamins.Excessive alcohol and tobacco use, insufficient water intake, obesity, certain medications, increased blood clotting.

Some doctors advise taking aspirin daily to prevent blood thickening. According to therapist Viktor Kramchenko, one should not hope for the help of this medicine. First, aspirin increases the risk of bleeding, especially in the gastrointestinal tract. Secondly, it is up to your doctor to decide whether to take it or not.Prevention is better than self-medication, and above all, dietary changes need to be made.

Foods that thin the blood

Experts insist that if you have thick blood, you should definitely include certain foods that thin it in your menu.

First of all, you need to consume up to two liters of clean water – this is important, and if you have a lot of weight, then the volume of fluid consumed should be at least three liters.Plus vitamins containing magnesium, calcium, iron, vitamin C – even if the most inexpensive that your wallet can afford.

The diet must include fatty fish. If not possible, at least use fish oil, flaxseed oil. Seaweed is also useful at any time of the year – it contains iodine.

Try to include vegetables in your diet: red and white cabbage, broccoli, tomatoes, herbs, garlic, black pepper, ginger. It’s good to have a ginger drink.It is prepared simply: 1 tsp. grated ginger, pour a glass of hot water. Insist and consume before meals. Do not bypass various seasonings – paprika, cinnamon, curry powder.

Fruits are useful for blood thinning: raspberries, strawberries, pineapple, grapes. Can’t buy? Replace with regular juice. If you are diagnosed with thick blood, try to consume at least 30 grams of any nuts per day.

It is not necessary to eat all these products every day, it is enough to enter at least one of them in the menu.That is: today you ate nuts, and tomorrow you can cook yourself buckwheat with fish or vegetables.