High-dose aspirin reduces pain for severe headache and migraine

Peter Goadsby, MD, PhD

An inexpensive, hundred-year-old therapy for pain – aspirin – is effective in high doses for the treatment of severe headache and migraine caused by drug withdrawal, according to a new study by researchers with the UCSF Headache Center.  Study participants were administered aspirin through an IV and 25 percent of the time they reported a significant reduction in pain – three points on the 10-point pain scale.  (A difference of three points downgrades a headache from severe to moderate, moderate to mild, or from mild to pain-free).  Participants reported a more modest pain reduction about 40 percent of the time.

The findings are noteworthy because high-dose intravenous aspirin is not widely available for headache sufferers in the United States, the authors say.  Aspirin also is nontoxic, non-addictive, non-sedating, has few side effects for adults, and is less expensive than drug regimens such as triptans that physicians typically prescribe to headache patients to combat severe pain.  

The study was published in the September 21, 2010, issue of Neurology, the medical journal of the American Academy of Neurology.

“These results tell migraine sufferers, their doctors and insurance providers that high-dose intravenous aspirin is a beneficial way to treat difficult withdrawal headaches via a medicine that is not addictive or toxic,” said Peter Goadsby, MD, PhD, lead investigator of the study, professor and director of the UCSF Headache Center.  “We hope to make this inexpensive therapy more available to patients seeking treatment for severe pain.” 

Many headache and migraine sufferers can manage pain without hospital stays.  However, for severe pain that is difficult to manage, medication overuse often is a complicating factor.  To develop a successful treatment plan for these patients, physicians first turn to a hospital inpatient program where medication withdrawal can be overseen by a neurologist or pain specialist.  High-dose intravenous aspirin can help patients manage headache pain while undergoing medication withdrawal, the study shows.

The American Academy of Neurology estimates that more than 30 million Americans suffer from migraine, a syndrome characterized by recurrent, often excruciating headaches.  The National Headache Foundation estimates that migraine causes 157 million lost workdays each year due to pain and associated migraine symptoms, resulting in a $13 billion burden on American employers.

Further research is needed to understand how exactly the aspirin works to reduce headache pain, the UCSF team said, but the findings give neurologists a safe and effective treatment option for migraine sufferers that is less expensive than the alternative multi-drug alternative.  At present, the cost for IV aspirin costs around $7 per dose depending on the drug provider.  Triptans cost about $22 per pill.

For the study, researchers reviewed the charts of 168 patients ranging in age from 18 to 75 years – 51 were men and 117 were women. Nearly all subjects (159) were admitted to the hospital for severe headache complicated by medication overuse.   Participants received doses of one gram of aspirin – the equivalent of three times the dose for typical pain relief – through an IV, and averaged five doses. 

Nurses’ notes and the hourly diaries of 86 participants were used to measure the safety and effectiveness of the high-dose intravenous aspirin.  Participants kept hourly diaries about their pain before, during and after treatment, rating their pain on a 10-point scale.  Scores of 1-3 associate with a mild headache, 4-7 indicates a moderate headache, and 8-10 signifies a severe headache. 

Approximately six percent of participants experienced side effects ranging from nausea and vomiting to pain from the IV insertion, but none were considered severe.  Potential side effects of aspirin include heartburn, nausea, bleeding, worsening of asthma, rash and kidney impairment.

“It is important to acknowledge that a placebo was not used in this case because participants knew they were receiving aspirin therapy,” Goadsby said.   “However, a number of previous placebo-controlled trials have shown intravenous aspirin to be effective for migraine.”

UCSF has the first headache clinic in the West that provides comprehensive outpatient and inpatient hospital care to relieve the most debilitating headaches that don’t respond to medications and other therapies. Headache specialists at the UCSF Headache Center diagnose and treat specific types of headaches in patients of all ages, including children and adolescents. In addition, the center conducts basic and clinical research, exploring the basic mechanisms of headache and how existing and novel therapies might treat the debilitating disorder.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

acetaminophen, aspirin, and caffeine | Michigan Medicine

What is the most important information I should know about this medicine?

Do not give this medicine to a child or teenager with a fever, flu symptoms, or chicken pox. Aspirin can cause Reye’s syndrome, a serious and sometimes fatal condition in children.

Do not take more than the recommended dose. An acetaminophen overdose can damage your liver or cause death.

Call your doctor at once if you have: nausea, upper stomach pain, loss of appetite, dark urine, yellowing of your skin or eyes, clay-colored stools, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

In rare cases, acetaminophen may cause a severe skin reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

What is acetaminophen, aspirin, and caffeine?

Acetaminophen is a pain reliever and a fever reducer. Aspirin is a salicylate (sa-LIS-il-ATE). Caffeine is a central nervous system stimulant.

Acetaminophen, aspirin, and caffeine is a combination medicine used to treat pain caused by tension headaches, migraine headaches, muscle aches, menstrual cramps, arthritis, toothaches, the common cold, or nasal congestion.

Do not use aspirin for heart or blood vessel conditions unless your doctor tells you to.

Acetaminophen, aspirin, and caffeine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking this medicine?

Do not give this medicine to a child or teenager with a fever, flu symptoms, or chicken pox. Aspirin can cause Reye’s syndrome, a serious and sometimes fatal condition in children.

You should not use this medicine if you are allergic to acetaminophen (Tylenol), aspirin, caffeine, or any NSAIDs (diclofenac, ibuprofen, indomethacin, meloxicam, naproxen, Advil, Aleve, Motrin, and others).

Aspirin may cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking this medicine.

Ask a doctor or pharmacist if this medicine is safe to use if you have ever had:

• liver disease, cirrhosis, a history of alcoholism, or if you drink more than 3 alcoholic beverages per day;
• asthma or seasonal allergies;
• fever with a stiff neck;
• stomach ulcer, stomach or intestinal bleeding, ulcerative colitis;
• bleeding problems;
• kidney disease; or
• if you use medicine to treat glaucoma or prevent blood clots.

If you take acetaminophen, aspirin, and caffeine to treat headache pain, seek medical attention if you have:

• a headache so bad you have to lie down;
• a headache that causes vomiting;
• what feels like the worst headache you’ve ever had;
• a headache that seems different from your usual headaches;
• a headache every day;
• a headache after coughing, bending, exercising, or head injury;
• if you have never had migraines diagnosed by a doctor; or
• if you are having your first headache after age 50.

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Taking aspirin during late pregnancy may cause bleeding in the mother or the baby during delivery. Ask a doctor before using this medicine if you are pregnant.

Do not give this medicine to anyone younger than 18 years old without medical advice.

How should I take this medicine?

Use exactly as directed on the label, or as prescribed by your doctor. Never use more than the recommended dose. An overdose of acetaminophen can damage your liver or cause death.

Take with food or milk if the medicine upsets your stomach.

Call your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever lasting longer than 3 days, or any swelling or pain lasting longer than 10 days.

Overuse of migraine headache medicine (more than 10 days per month) can make headaches worse. Tell your doctor if this medicine seems to stop working as well.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using acetaminophen, aspirin, and caffeine.

If you need surgery, dental work, or a medical procedure, you may need to stop taking this medicine for a short time.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since acetaminophen, aspirin, and caffeine is used when needed, you may not be on a dosing schedule. Skip any missed dose if it’s almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of acetaminophen can damage your liver or cause death.

Early signs of acetaminophen overdose include loss of appetite, nausea, vomiting, sweating, or weakness. Later symptoms may include upper stomach pain, dark urine, and yellowing of your skin or eyes.

Overdose symptoms may also include ringing in your ears, headache, diarrhea, hallucinations, fast or slow heart rate, or seizure (convulsions).

What should I avoid while taking this medicine?

Avoid drinking alcohol. It may increase your risk of liver damage or stomach bleeding.

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to acetaminophen or aspirin (such as ibuprofen, ketoprofen, or naproxen).

Avoid coffee, tea, cola, energy drinks or other sources of caffeine while taking this medication. They can add to the side effects of the caffeine in the medication.

What are the possible side effects of this medicine?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.

Stop using this medicine and call your doctor at once if you have:

• severe anxiety, agitation, confusion, panic;
• easy bruising or bleeding;
• a light-headed feeling, like you might pass out;
• dehydration symptoms –feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin;
• symptoms of stomach bleeding –bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• high potassium –nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement; or
• liver problems –nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

• upset stomach, heartburn;
• depressed mood, feeling anxious or restless; or
• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect acetaminophen, aspirin, and caffeine?

Other drugs may affect acetaminophen, aspirin, and caffeine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about acetaminophen, aspirin, and caffeine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2021 Cerner Multum, Inc. Version: 8.02. Revision date: 7/29/2020.

Single Dose of Aspirin Effective in Relieving Migraine Pain

April 19, 2010 — A single 1000-mg dose of aspirin is an effective treatment of acute migraine headaches for more than half of people who take it, and the addition of 10 mg of metoclopramide may reduce nausea, according to the findings of a literature review published online April 14 in the Cochrane Database of Systematic Reviews.

“Aspirin plus metoclopramide would seem to be a good first-line therapy for acute migraine attacks in this population,” write Varo Kirthi, MD, and colleagues, with the Pain Research and the Nuffield Department of Anaesthetics at the John Radcliffe Hospital, in Oxford, United Kingdom.

The researchers searched Cochrane CENTRAL, MEDLINE, EMBASE, and the Oxford Pain Relief Database for studies through March 10, 2010. The 13 selected studies, including 4222 participants, were randomized, double-blind, placebo-controlled, or active-controlled; evaluated the use of aspirin to treat a single migraine headache episode; and included at least 10 participants per treatment group. In addition, studies compared aspirin 900 mg or 1000 mg (alone or in combination) and metoclopramide 10 mg vs placebo or other active comparators (typically sumatriptan 50 mg or 100 mg).

Compared with placebo, aspirin reduced associated symptoms of nausea, vomiting, photophobia, and phonophobia. A single 1000-mg dose of aspirin reduced pain from moderate or severe to no pain by 2 hours in 24% of people vs 11% taking placebo. Severe or moderate pain was reduced to no worse than mild pain by 2 hours in 52% taking aspirin vs 32% taking placebo. Headache relief at 2 hours was sustained for 24 hours more often with aspirin vs placebo.

In addition, metoclopramide, when combined with aspirin, significantly reduced nausea (P < .00006) and vomiting (P = .002) vs aspirin alone, although it had minimal effect on pain. Fewer participants taking aspirin needed rescue medication vs those taking placebo. Adverse events were reported more often with aspirin vs placebo but were mostly mild and transient.

The review also found that aspirin alone was comparable to the prescription medication sumatriptan 50 mg for 2-hour pain-free relief and headache relief, whereas sumatriptan 100 mg was superior to aspirin plus metoclopramide for 2-hour pain-free, but not headache, relief; no data comparing sumatriptan with aspirin for 24-hour headache relief were available.

“Aspirin plus metoclopramide will be a reasonable therapy for acute migraine attacks, but for many it will be insufficiently effective,” noted study author R. Andrew Moore, DSc, in a written release. “We are presently working on reviews of other OTC [over-the-counter] medicines for migraines, to provide consumers with the best available evidence on treatments that don’t need a prescription,” he said.

Cochrane Database Syst Rev. Posted online April 14, 2010. Abstract

Migraine Headaches? Consider Aspirin for Treatment and Prevention

Aspirin is readily available without a prescription, is inexpensive, and based on the review by FAU researchers and collaborators, was shown to be effective in many migraine patients when compared with alternative more expensive therapies.

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.

Co-authors of the study are Alexander Gitin, a first-year medical student at the University of Florida College of Medicine; and Philip B. Gorelick, M.D., M.P.H., a professor in the Department of Translational Neuroscience at Michigan State University College of Human Medicine.

-FAU-

How Does Excedrin Migraine Work

Aspirin Tames Pain-Causing Inflammation

A well-known non-steroidal anti-inflammatory that has been used for more than a century, aspirin works is by blocking the body’s production of prostaglandins in the peripheral nervous system. Prostaglandins are one of the inflammatory chemicals that cause the blood vessels to become inflamed and swell during a migraine attack.⁴ In general, aspirin helps to prevent the transmission of pain signals to the brain by stopping the production of prostaglandins.

Acetaminophen: The Tried-and-True Pain Reliever

Acetaminophen, like aspirin, also appears to inhibits enzymes in the body that produce pain-causing prostaglandins. ^{4, 5} However, while aspirin inhibits prostaglandins in the peripheral nervous system, acetaminophen appears to focus its pain-fighting power in the central nervous system.⁵ While the way acetaminophen works is not fully understood, it is believed to elevate the pain threshold. This allows you to tolerate more pain, therefore providing pain relief.

Caffeine: The Amplifier

Caffeine has been shown to increase the potency of aspirin and acetaminophen—the two pain relievers in Excedrin^® Migraine —by up to 40 percent.⁶ This means less acetaminophen and aspirin is needed to relieve your migraine pain when combined with caffeine.

Ease Your Migraine Pain With Excedrin

^® Migraine

Even though the cause of migraines is still largely unknown, and triggers vary from person to person, you should treat your migraines right away. One study found that a whopping 49 percent of migraine sufferers avoid or delay taking medications when they feel an attack coming on. ⁷ Treating a migraine as soon as you feel pain leads to a better outcome.8 Be sure to talk to your doctor about your migraines and the best treatment plan for you.

Key Differences and Which to Take

• Aspirin and ibuprofen contain different active ingredients — whereas aspirin is made with salicylic acid, ibuprofen is made with propionic acid. 
• However, both aspirin and ibuprofen can be used to treat pain caused by inflammation or injury, headaches, fevers, arthritis, and menstrual cramps.
• People at risk of cardiovascular disease may want to avoid ibuprofen, as it may increase your risk of heart troubles. 
• This article was medically reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine. 
• Visit Insider’s Health Reference library for more advice.

LoadingSomething is loading.

If you’ve taken an over-the-counter pain reliever before, you’ve likely had aspirin or ibuprofen. These are both very common nonsteroidal anti-inflammatory drugs, or NSAIDs, that are typically used to treat pain, inflammation, and fevers. 

They are popular active ingredients in various brand name products such as Advil and Motrin (ibuprofen) or Bayer and Ecotrin (aspirin). However, just because they are over-the-counter, it doesn’t mean that they come without risks or are safe for everyone to use. 

Here’s what you need to know about the difference between both medications.

The difference between aspirin and ibuprofen

While aspirin and ibuprofen are both NSAIDs, they are made from different key ingredients.  

Aspirin is made out of salicylic acid, and ibuprofen is made from propionic acid. The difference between the two acids is due to their chemical structures, particularly where the carbon and oxygen are located. 

Although they have slight chemical differences, aspirin and ibuprofen work in the same way. They both inhibit an enzyme called cyclooxygenase (also known as the COX enzyme). By doing this, they prevent the formation of prostaglandins, which are chemicals that cause inflammatory reactions. 

“When we inhibit those prostaglandins, we inhibit that inflammatory cascade of reactions which is what is causing pain. So, we eliminate the inflammation, or, reduce inflammation, and with it goes the pain as well,” says Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

Also, the dosing of each medication is different. Aspirin typically comes in 325-milligram doses, whereas ibuprofen typically comes in 200-milligram doses. Both medicines can be taken every 4 to 6 hours, as needed for pain, fever, or other conditions. 

Which one should you take?

Both aspirin and ibuprofen are suited to treat pain and inflammation in the short term, over the course of a few days. They should not be used long term — consistently over the course of a few weeks or more — unless recommended by your doctor.

Mikhael says for some chronic pain conditions, ibuprofen may be taken long term during flare-ups, as long as they “interrupt” the doses and take a week or two off from the medication. Ibuprofen is more suitable than aspirin for longer-term use in situations like this.

Overall, Mikhael says they can both be used to treat the same problems, including:

Related

How aspirin can help with a heart attack in 2 different ways

One of the differences, though, is that aspirin can be used long term to prevent heart attack and stroke, Mikhael says. However, this is only when the aspirin is taken at a much lower dose of 81 milligrams. This is commonly referred to as baby aspirin. 

Your doctor may recommend that you take daily baby aspirin if you are at high risk for heart attack or stroke, like if you have very high blood pressure or have had a heart attack before.

Side effects of aspirin and ibuprofen

As with most medications, aspirin and ibuprofen both run the risk of side effects, including serious ones. Some potential side effects include:

• Abdominal pain
• Indigestion or heartburn
• Nausea
• Constipation
• Diarrhea
• Headache

Most commonly, Mikhael says somebody would experience the side effect of abdominal pain or heartburn, especially if they took the medication on an empty stomach. This is an indication that you might be dealing with gastritis or inflammation of the lining of the stomach. Aspirin is more likely to cause gastrointestinal side effects than ibuprofen.

Taking high doses of aspirin or ibuprofen long term can result in serious side effects such as peptic ulcers (ulcers in the stomach or small intestines) or kidney failure, Mikhael says. Your risk for peptic ulcers is higher with aspirin. 

But unlike aspirin, ibuprofen may increase your risk of cardiovascular problems. This is why it’s so important to use medications as directed and only short term, not long term, to avoid these serious side effects.

Some people may need to avoid aspirin and ibuprofen together if they have certain conditions. Mikhael says the following groups of people may want to avoid aspirin due to the increased risk of related side effects:

• People at increased risk of bleeding
• People with a history of kidney problems
• People with a history of peptic ulcer disease or severe gastritis

The following groups of people may want to avoid ibuprofen due to the increased risk of related side effects: 

• People with a personal history or family history of cardiovascular disease
• People with a history of kidney problems
• People with a history of peptic ulcer disease or severe gastritis

Additionally, if you are pregnant you should not use either medication, Instead, Mikhael recommends opting for acetaminophen (Tylenol) if you need a pain reliever during pregnancy.

The bottom line

Whether you take aspirin or ibuprofen is mostly up to a personal preference, since they are indicated for use for the same ailments and they both risk serious side effects. If you aren’t sure if these NSAIDs are right for you, check with your doctor before taking either one of them to be safe, and always take the medications as directed. 

Migraine headaches? Consider aspirin for trea

image: Aspirin is readily available without a prescription, is inexpensive, and based on this review, was shown to be effective in many migraine patients when compared with alternative more expensive therapies.
view more 

Credit: Florida Atlantic University

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.

###

Co-authors of the study are Alexander Gitin, a first-year medical student at the University of Florida College of Medicine; and Philip B. Gorelick, M.D., M.P.H., a professor in the Department of Translational Neuroscience at Michigan State University College of Human Medicine.

About the Charles E. Schmidt College of Medicine:

FAU’s Charles E. Schmidt College of Medicine is one of approximately 152 accredited medical schools in the U.S. The college was launched in 2010, when the Florida Board of Governors made a landmark decision authorizing FAU to award the M.D. degree. After receiving approval from the Florida legislature and the governor, it became the 134th allopathic medical school in North America. With more than 70 full and part-time faculty and more than 1,300 affiliate faculty, the college matriculates 64 medical students each year and has been nationally recognized for its innovative curriculum. To further FAU’s commitment to increase much needed medical residency positions in Palm Beach County and to ensure that the region will continue to have an adequate and well-trained physician workforce, the FAU Charles E. Schmidt College of Medicine Consortium for Graduate Medical Education (GME) was formed in fall 2011 with five leading hospitals in Palm Beach County. The Consortium currently has five Accreditation Council for Graduate Medical Education (ACGME) accredited residencies including internal medicine, surgery, emergency medicine, psychiatry, and neurology.

About Florida Atlantic University:

Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University, with an annual economic impact of $6.3 billion, serves more than 30,000 undergraduate and graduate students at sites throughout its six-county service region in southeast Florida. FAU’s world-class teaching and research faculty serves students through 10 colleges: the Dorothy F. Schmidt College of Arts and Letters, the College of Business, the College for Design and Social Inquiry, the College of Education, the College of Engineering and Computer Science, the Graduate College, the Harriet L. Wilkes Honors College, the Charles E. Schmidt College of Medicine, the Christine E. Lynn College of Nursing and the Charles E. Schmidt College of Science. FAU is ranked as a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. The University is placing special focus on the rapid development of critical areas that form the basis of its strategic plan: Healthy aging, biotech, coastal and marine issues, neuroscience, regenerative medicine, informatics, lifespan and the environment. These areas provide opportunities for faculty and students to build upon FAU’s existing strengths in research and scholarship. For more information, visit fau.edu.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

90,000 Aspirin and paracetamol are not at all so harmless | Scientific discoveries and technical innovations from Germany | DW

My head hurts – take a pill! Chills, caught a cold, aching toothache, aching joints – take a pill! One did not help – take the second! It would seem that it could be easier.

About four million Germans do just that: they regularly swallow pain relievers and antipyretic drugs, especially since the most common of them – aspirin and paracetamol – are available to everyone: they are inexpensive and sold without a prescription in any pharmacy.In addition, they seem to be time-tested: aspirin has been used in medicine for more than a hundred years, paracetamol for more than half a century.

What problems can arise here? Moreover, advertising also contributes to the wide distribution of not only these pain relievers themselves, but also a carefree attitude towards them. Meanwhile, all this causes serious concern among doctors.

Paracetamol has no place in pharmacies

The fact is that supposedly harmless pills can cause extremely severe and even life-threatening side reactions.”Today, paracetamol would not be approved as a drug at all, not even by prescription, let alone over the counter,” said Kay Brune, professor of pharmacology at the University of Erlangen School of Medicine.

“Even the permitted daily dose – four grams – can cause severe poisoning and liver damage, and just a double excess of this dose is fraught with acute liver failure, – assures Kai Brune. – In other words, we have a free sale on the market. a medication that, even with a slight overdose, can cause coma and death.Moreover, acute liver failure is a very painful death lasting several days. In short, this drug has no place at all in pharmacies. “

Taking aspirin is an unjustified risk

According to the scientist, only slightly better than paracetamol and aspirin – the second classic non-narcotic analgesic over the counter. Aspirin – that is, acetylsalicylic acid – also causes there are too many side reactions, so this drug is only justified for patients with serious cardiovascular disease, not as a pain reliever.

“The analgesic effect of acetylsalicylic acid lasts only a few hours, and the effect of blood thinning lasts for several days,” says Professor Brune. , a wound in the mouth after a visit to the dentist. Such patients are contraindicated for surgery, even if several days have passed since the last time they took aspirin. That is, taking aspirin means an increased – and, as a rule, unjustified – the risk of bleeding. “

There is more harm than good from aspirin

Therefore, to the recommendations from time to time to take aspirin preventively, without any indication, just for preventive purposes – to prevent atherothrombosis and coronary heart disease or to reduce the risk of cancer , – a pharmacologist is extremely skeptical.

And in this opinion, Professor Brune is by no means alone: ​​a new scientific study by British doctors, the results of which were recently published in the journal Archives of Internal Medicine, suggests that the risk associated with taking aspirin is justified only for patients already have had severe myocardial infarction or stroke.The head of the study, Kausik Ray, a professor at St George’s University in London, has no doubt: “Aspirin does more harm than good to healthy people. ”

Triplets, five-links and other pentalgins

Especially dangerous, according to Professor Brune, are combined preparations – all these triplets, five-links and other pentalgins. “This is just a disgrace, – the scientist is indignant. – In such drugs, the positive effects are rarely cumulative, but the negative properties of each of the ingredients in combination give a cumulative negative effect.Moreover, when taking such combined drugs, the patient is practically unable to track the dosage of individual biologically active components. This can quickly lead to exceeding the maximum permissible daily doses. ” says Professor Brune: “Acetylsalicylic acid and paracetamol remain on the market by tradition, they were taken by our grandmothers.Both substances are no longer protected by patents, they can be produced by any pharmaceutical company, and no one wants to invest in additional research, the results of which can be used by competitors. “

Alternatives – ibuprofen and diclofenac

So what to do if Professor Brune recommends turning to the alternatives ibuprofen and diclofenac, which have been thoroughly researched over the past 30 years and approved for over-the-counter sales, in full accordance with current knowledge of drug safety.

“Of course, these substances can be harmful, especially if taken for a long time and in high doses, – says the scientist. – Among the possible side effects – and increased blood pressure, and stomach bleeding. After all, these are drugs, not lozenges “But in general, these substances are much better tolerated than aspirin or paracetamol. The advantages of ibuprofen and diclofenac are also that they are quickly eliminated from the body, and therefore the risk of overdose is much lower – and it does not pose a threat to life.”

90,000 Ideal headache medicine: what and how much to take? | Healthy life | Health

Headache can be caused by many reasons: noisy children, hangover, cold, heavy lifting, cough, spinal diseases, tumors, etc. But the most common is tension headache, or stress headache. It is regularly tested by 90% of women and 70% of men.

Unpleasant, but tolerant

Something presses, pulls or, on the contrary, “bursts” the head. Does it sound familiar? Such pain is monotonous, tolerantly moderate – there seems to be no reason to quit work, but life is not sweet either.This torment lasts for at least 30 minutes, but sometimes it does not let go for almost a week. With a protracted version of the development of events, some even begin to stir up, irritate light and sound.

– Today, two main reasons for the appearance of such pain are called: muscle tension in the shoulder girdle and neck, in which the blood supply to the head deteriorates, and biochemical changes in the brain, – says Roman Petrov, neurologist, Ph.D. – It has been noticed: if a person pauses every 30-40 minutes during intense mental work, kneads his neck, massages his head or rubs his temples, the likelihood of the appearance or development of an attack decreases.Those who exercise for at least 20 minutes a day experience less tension headaches.

If during work the head starts to hurt, but there is no opportunity to rest, relax – you need to take a pill. ”

No more than two doses

– How much medication should I take? There is no consensus on this matter, – continues Roman Petrov. – But it is believed that if there is a high likelihood of a headache returning in the next 2-4 hours (for example, when a person is forced to continue working), you need to take the most effective dose.If it is paracetamol, then 1000 mg (2 tablets), aspirin -1000 mg, ibuprofen -200-400 mg. And before going to bed, half a tablet is enough. An important point: Extensive clinical studies show that combination drugs are more effective than simple analgesics. Moreover, the following composition is considered the most effective: the drug must contain at least 250 mg of paracetamol, 250 mg of aspirin and at least 65 mg of caffeine.

But in any case, remember the golden rule: with a headache caused by tension, you can take no more than 2 maximum single doses of the drug per day.There should be no more than two such days in a week, and no more than nine in a month. Otherwise, complications are possible. The most unpleasant thing is “drug abuse”, when uncontrolled intake of drugs leads to the opposite effect – an increase in the frequency of attacks, up to the occurrence of chronic daily headache. Side effects of some pain relievers, such as effects on the stomach and liver, are also dangerous.

If such an ailment torments you more often than 15 days a month, the attacks become longer, occur for no apparent reason, then the pain becomes chronic.

Immediately see a doctor if

■ headache lasts more than 72 hours;

■ appears in the form of a sudden “explosion” inside the head;

■ in addition to headache, visual disturbances, speech disorders, coordination of movements appear, the temperature rises or the neck becomes inactive, vomiting is noted, but there is no feeling of nausea;

■ headaches occur with the slightest physical effort.

Read also:

7 types of headaches: how they differ and what they say

The doctor told when you shouldn’t drink aspirin for a hangover

https: // ria. ru / 20200622 / 1573273551.html

The doctor told when you shouldn’t drink aspirin with a hangover

The doctor told when you shouldn’t drink aspirin with a hangover – RIA Novosti, 22.06.2020

The doctor told when you shouldn’t drink aspirin with a hangover

Mesh aspirin with coffee in the morning after heavy alcohol consumption is harmful to health, said the therapist, author of the book “How a doctor would be sick: little … RIA Novosti, 06/22/2020

2020-06-22T04: 01

2020-06 -22T04: 01

2020-06-22T04: 01

society

health

/ html / head / meta [@ name = ‘og: title’] / @ content

/ html / head / meta [@ name = ‘og: description’] / @ content

https: // cdnn21.img.ria.ru/images/155325/38/1553253850_0:160:3072:1888_1920x0_80_0_0_52512ecf0325c87536ea7432c4a9f118.jpg

MOSCOW, June 22 – RIA Novosti. Mixing aspirin with coffee in the morning after heavy alcohol consumption is unhealthy, said Olga Kashubina, a therapist and author of How A Doctor Would Be Sick: Little Tricks of Big Health Care, in an interview with Sputnik radio. The most striking consequence of alcohol poisoning is a headache in the morning after a meal. They traditionally try to calm it down with the help of anesthetic and strong coffee.This approach will give you the desired calming for a while, but then it can cause severe harm to the stomach, says Olga Kashubina. On the other hand, for common non-alcoholic headaches, combining coffee with pain relievers can be beneficial. Aspirin thins the blood, and caffeine helps to remove toxins from it.

https://ria.ru/20200616/1572974173.html

https://radiosputnik.ria.ru/20200102/1563070828.html

RIA Novosti

internet-group @ rian.ru

7 495 645-6601

FSUE MIA “Russia Today”

https: //xn--c1acbl2abdlkab1og.xn--p1ai/awards/

2020

RIA Novosti

[email protected]

7 495 645-6601

FSUE MIA “Russia Today”

https: //xn--c1acbl2abdlkab1og.xn--p1ai/awards/

News

ru-RU

https://ria. ru /docs/about/copyright.html

https: // xn – c1acbl2abdlkab1og.xn – p1ai /

RIA Novosti

[email protected]

7 495 645-6601

FSUE MIA “Russia Today”

https: //xn--c1acbl2abdlkab1og.xn--p1ai/awards /

https://cdnn21.img.ria.ru/images/155325/38/1553253850_171 0:2902:2048_1920x0_80_0_0_8d542a1321dc23e3a4deb60025c0ace2.jpg

RIA Novosti

internet20005

RIA Novosti

internet2000 FSUE MIA “Russia Today”

https: // xn – c1acbl2abdlkab1og.xn – p1ai / awards /

RIA Novosti

[email protected]

7 495 645-6601

FSUE MIA “Russia Today”

https: //xn--c1acbl2abdlkab1og.xn--p1ai / awards /

society, health

Is self-medication with aspirin dangerous – Rossiyskaya Gazeta

Aspirin can be deadly. Such alarming information has recently been shared by many publications. Journalists referred to the results of a recent international study: scientists have refuted the traditional opinion that taking acetylsalicylic acid (well known to all aspirin) helps older people reduce the risk of death from cardiovascular diseases and prolong life.

According to the media, scientists did not find confirmation of a decrease in the number of heart attacks and strokes in those taking the drug, but statistically determined that they had an increased risk of internal bleeding. “RG-Week” was looking into what kind of research we are talking about, and whether the situation with the old and seemingly well-studied drug is really so serious.

The publications have caused quite understandable concerns among many: firstly, aspirin is one of the most commonly prescribed medications used to reduce the recurrence of cardiovascular diseases, including in the elderly.Secondly, this is an over-the-counter medicine that can be freely purchased at the pharmacy, and many people perceive it as an absolutely safe remedy for many ailments – we drink it for headaches, colds, and some with a hangover.

As for the effect of acetylsalicylic acid on blood vessels – this drug reduces platelet aggregation (in other words, their ability to “stick together”, forming blood clots). Therefore, taking it reduces the risk of blockage of blood vessels and disruption of the heart, brain, and other organs.

But there is a downside to the coin: the drug increases the risk of bleeding, including in the gastrointestinal tract. What, by the way, is reported in the instructions for its use.

An article with the results of the international ASPREE study, conducted by a team of scientists from Australia and the United States, was published in the September issue of The New England Journal of Medicine. Its short translation from English into Russian made so much noise. The results of this study were discussed at the recent European Congress of Cardiology.The work is representative: scientists summarized data on 19 thousand patients, whose average age was 74 years, and followed them for about five years.

Half of the participants took a small dose of aspirin, the rest (control group) received a placebo. During the observation period, the frequency of cardiovascular diseases, including vascular accidents, was the same in both groups. But complications in the form of bleeding in the group that took the medication turned out to be almost 1.5 times higher (361 and 265 cases, respectively, for a group of 9.5 thousand people).

So, is aspirin dangerous after all? “RG – Week” addressed this question to cardiologist Igor Zhirov.

Competent

Igor Zhirov, Professor of the Department of Cardiology of the Russian Medical Academy of Continuing Professional Education, Leading Researcher at the National Medical Research Center of Cardiology

– I can immediately say that the information “aspirin kills” is not true. Cardiologists are, of course, aware of this research.Something absolutely new, which we would not have known before, we did not see in its results. Journalists, referring to the ASPREE study in publications, did not pay attention to an essential detail: this study did not study cardiovascular mortality. The aim of the study was different – to evaluate, among other things, the possibility of using aspirin for the prevention of Alzheimer’s disease (senile dementia) in elderly patients. It turned out that the addition of aspirin to therapy in these patients did not lead to a decrease in the risk of dementia.In other words, aspirin is useless to take as a preventive measure against senile dementia.

As for the conclusion about an increase in the number of bleeding, there are no discoveries, this is a known risk, and any cardiologist should take it into account. It should be said that any drug we prescribe and prescribe can cause side effects. And this statement fully applies to aspirin. This is not at all a “harmless” remedy. If we start giving aspirin to everyone, regardless of age, regardless of what concomitant diseases the patient has, then such an indiscriminate prescription of the drug can do more harm than good.

But if we prescribe aspirin to patients with coronary heart disease, those who have had myocardial infarction, patients with atherosclerosis of the peripheral arteries of the lower extremities (intermittent claudication) – in all these cases, the benefits of the drug are beyond doubt.

Now the approach to the appointment is as follows. We must carefully weigh all the risks for a particular patient. See if he has a stomach ulcer, other diseases of the internal organs. Put on one side of the scale

risk factors for cardiovascular catastrophe, on the other – the risk of complications of other diseases.And appreciate. And the decision should be individual for each patient.

As for the “home” use of aspirin – for the treatment of colds or relief from hangover, here aspirin is taken in a short course, a day or two. And in these cases, the risk of getting complications from the gastrointestinal tract is minimal. But when there is a need for long-term administration of the drug, there are indeed risks, and the doctor must take them into account when prescribing.

Aspirin is a dangerous but loyal friend / News from Krasnoyarsk and Krasnoyarsk Territory / Newslab.Ru

Perhaps, if you ask any of us to name the most famous drug, everyone will remember the same drug. This amazing pill saved us from a high temperature in childhood, and grown-up children thank it for its revitalizing effect – in the morning, after parties and other cases of reckless drinking. Some people know that doctors also often prescribe this drug to older people – in small doses, but for daily use.Are there too many features for one penny-priced tablet?

And this miracle cure also has a bad reputation – they say that it can make the stomach ache, but it is generally not recommended to give this to children. Everyone remembers an advertisement from TV – about effervescent tablets, which are supposedly better than ordinary ones, but there is an opinion that it is from them that even more harm is caused …

What kind of drug is this? Of course, aspirin .

Acetylsalicylic acid

Acetylsalicylic acid (this is how the original name of aspirin sounds) really has not only antipyretic, but also analgesic, anti-inflammatory and antiaggregatory effects. It was synthesized at the end of the 19th century by employees of the pharmaceutical corporation Bayer and began selling it under the Aspirin trademark. Later, other firms were also able to buy the right to manufacture this drug, and it spread everywhere. Now humanity consumes every year – just think! – over 80 billion aspirin tablets.

Aspirin once became the first drug from the group of non-steroidal anti-inflammatory drugs (abbreviated as NSAIDs). This became a real revolution in medicine – with its appearance, death from a fever was no longer common.Later, when the ability of aspirin to slow down the formation of blood clots in the vascular bed was revealed, people were able to prolong their life after suffering myocardial infarctions, strokes, with prosthetics of heart valves, etc.

Properties of aspirin

How can one and the same tablet help simultaneously with infectious diseases, rheumatism, migraine and heart disease?

Acetylsalicylic acid really has unique properties. It is able to suppress the activity of cyclooxygenase enzymes (COX-1, COX-2, etc.), which are responsible for the synthesis of inflammatory mediators – prostaglandins. As a result of the action of aspirin, the energy supply of the inflammation process decreases, which leads to its attenuation. This is especially important in cases where inflammation is harmful to the body – for example, in rheumatic diseases.

The antipyretic and analgesic effect of aspirin is associated with a depressing effect on the centers of the brain, which are responsible for thermoregulation and pain sensitivity.Therefore, at a high temperature, when the state of fever no longer helps, but only harms the body, it is recommended to drink this pill.

Aspirin affects blood cells – platelets, it reduces their ability to stick together and form blood clots. With regular intake of the drug, the blood “liquefies” a little, and the vessels dilate a little, which causes the effect of relief from increased intracranial pressure and headache, and also helps in the prevention of heart attacks, strokes and thromboembolism in patients with a tendency to thrombosis.

Negative Effects

Unfortunately, the notoriety of aspirin also has a reason. The fact is that suppression of the activity of cyclooxygenases (enzymes) also has a negative effect – one of these enzymes, COX-1, is responsible for the normal functioning of the cells of the gastric mucosa. Its blockage leads to disruption of the integrity of the gastric wall and is a factor in the development of ulcers.

When this side effect of aspirin was identified, the number of indications for its use narrowed somewhat: according to modern rules, it is not prescribed for people with peptic ulcer disease.In addition, a contraindication to the appointment of acetylsalicylic acid is bronchial asthma and … the age of children under 12 years of age in the presence of viral diseases (due to the likelihood of Reye’s Syndrome).

Effervescent

Aspirin manufacturers have tried to reduce the negative effect on the gastric mucosa by launching the production of effervescent tablets that dissolve in water before use. However, the systemic effect of the drug after absorption and the harmful effect of the main component of such tablets – citric acid – on the enamel of the teeth, the advantages of the new form neutralized its disadvantages.

Descendants of Aspirin

But there is no reason for the disorder – by now, pharmacologists have learned to separate the effects of suppressing the activity of COX of different types. There are drugs on the market that can, without harming the stomach, selectively suppress only those enzymes that cause the inflammatory process. These drugs have formed a subset of selective COX-2 inhibitors and are now widely marketed under various brand names.

The other effects of aspirin have also been taken as a basis for modern anti-inflammatory drugs, pain relievers and antiplatelet agents.But acetylsalicylic acid, although it partially gave way to “more advanced descendants”, still remains on the shelves of pharmacies and in the arsenal of drugs prescribed in medical institutions. I would like to say – as a tribute, but the reason is much more prosaic – this is still the cheapest way to lower the temperature, relieve pain and prevent the development of cardiovascular diseases.

Olga Darsavelidze

Aspirin instructions for use: indications, contraindications, side effects – description of Aspirin tab.500 mg: 10, 20 or 100 pcs. (1962)

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 flow 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, an increase in C _max of salicylate in blood plasma and AUC is possible.

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 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.

90,000 P – has an analgesic, antipyretic and anti-inflammatory effect

Askofen-P, an analgesic with an optimal * combination of three active components, can help cope with pain.Askofen-P is a gentle, time-tested product at an affordable price **

The analgesic effect of is achieved through a combination of three main active ingredients: paracetamol, acetylsalicylic acid and caffeine.

Acetylsalicylic acid in Ascofen-P has analgesic, antipyretic and anti-inflammatory effects. It is associated with the suppression of the enzyme cyclooxygenase 1 and 2 types, which regulate the synthesis of prostaglandins – mediators of pain and inflammation.

Paracetamol – an analgesic with analgesic and antipyretic effects, which are achieved by the action of the drug on the centers of pain and thermoregulation in the brain. Paracetamol has a well-studied mechanism of action and safety profile.

Caffeine – is an active ingredient that stimulates the respiratory and vasomotor centers of the brain and helps relieve fatigue and increase mental and physical performance.Caffeine acts as an auxiliary component, which, according to studies, is able to enhance the analgesic effect of paracetamol and acetylsalicylic acid.

Thanks to these components, the drug Askofen-P® helps to relieve common pain syndromes caused by neurological and inflammatory diseases, as well as muscle, headache, joint and toothache.

Indications for use

In adults and children (over 15 years of age) as an anesthetic for pain syndrome of mild to moderate severity:

• headache
• migraine
• toothache
• muscle and joint pain

neural

• algodismenorrhea

In adults, it can be used for ARVI and influenza as an antipyretic agent.

Askofen-P® is a time-tested and affordable ** analgesic that has been trusted for over 20 years.