Aspirin – Uses, Effects and Side Effects
Aspirin (acetylsalicylic acid) is a widely used pain reliever and fever reducer with anti-inflammatory properties. It is also used to prevent heart attacks and strokes.
Wissenswertes über "Aspirin"
Aspirin (acetylsalicylic acid) is a widely used pain reliever and fever reducer with anti-inflammatory properties. It is also used to prevent heart attacks and strokes.
What is Aspirin?
Aspirin is the brand name for acetylsalicylic acid (ASA), one of the most well-known and widely used medications in the world. It belongs to the class of nonsteroidal anti-inflammatory drugs (NSAIDs) and acts simultaneously as a pain reliever, fever reducer, anti-inflammatory agent, and – in low doses – a blood thinner. Aspirin has been established in medicine for over 120 years and is considered one of the foundational drugs of modern pharmacology.
Mechanism of Action
Aspirin works by inhibiting the enzyme cyclooxygenase (COX), specifically both COX-1 and COX-2. These enzymes are essential for the production of prostaglandins and thromboxanes – signaling molecules that trigger pain, inflammation, and fever, and promote blood clotting.
- Pain relief: By reducing prostaglandin synthesis, pain signals are dampened.
- Fever reduction: Prostaglandins are involved in the development of fever. Aspirin blocks this process.
- Anti-inflammatory effect: Reducing inflammatory mediators suppresses inflammatory responses in the body.
- Antiplatelet effect: At low doses, Aspirin irreversibly inhibits platelet aggregation, lowering the risk of blood clot formation.
Indications
Pain and Fever
Aspirin is commonly used for mild to moderate pain, including headaches, toothaches, muscle pain, and menstrual cramps. It is also used as a fever-reducing measure.
Cardiovascular Disease
At low doses (typically 75–100 mg daily), Aspirin is used for secondary prevention in patients who have already suffered a heart attack or stroke. It helps prevent the re-formation of blood clots in the blood vessels.
Inflammatory Conditions
At higher doses, Aspirin can be used to treat inflammatory conditions such as rheumatic disease or pericarditis (inflammation of the lining around the heart), although newer NSAIDs are often preferred in these contexts.
Dosage
The dosage of Aspirin depends on the intended use:
- Pain relief and fever: 500–1000 mg every 4–6 hours (adults), with a maximum of 3000–4000 mg per day.
- Cardiovascular prevention: 75–100 mg once daily (low dose, long-term use under medical supervision).
- Anti-inflammatory use: 3000–6000 mg daily in divided doses, only under medical supervision.
Aspirin should not be given to children and adolescents under 16 years of age during febrile illnesses due to the risk of Reye syndrome.
Side Effects
Aspirin is generally well tolerated but may cause side effects:
- Gastrointestinal complaints: Nausea, heartburn, stomach pain, and – with prolonged use – stomach ulcers or gastrointestinal bleeding.
- Increased bleeding risk: Due to its anticoagulant effect, the risk of bleeding may be increased, especially during surgery or injury.
- Hypersensitivity reactions: Rarely, allergic reactions, asthma attacks (so-called analgesic-induced asthma), or skin reactions may occur.
- Kidney function: Long-term use of high doses may impair kidney function.
- Reye syndrome: A rare but serious risk in children and adolescents associated with viral infections.
Drug Interactions
Aspirin can interact with various other medications:
- Anticoagulants (e.g., warfarin): Increased risk of bleeding.
- Other NSAIDs (e.g., ibuprofen): Enhanced side effects, especially on the gastrointestinal tract.
- Methotrexate: Increased toxicity due to reduced excretion.
- Antidiabetic drugs: Aspirin may enhance the blood-sugar-lowering effect.
Contraindications
Aspirin should not be taken in cases of:
- Known hypersensitivity to salicylates or other NSAIDs
- Active peptic ulcers or gastrointestinal bleeding
- Severe renal or hepatic impairment
- Children under 16 years of age during viral illness
- The last trimester of pregnancy
References
- World Health Organization (WHO) – Model List of Essential Medicines, 23rd Edition (2023). Available at: https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2023.02
- Patrono C. et al. – Platelet activation and atherothrombosis. New England Journal of Medicine, 2017; 376:1348–1360.
- Vane J.R. – Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nature New Biology, 1971; 231:232–235.
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