Acetylsalicylic Acid (Aspirin)

ACETYLSALICYLIC ACID (ASPIRIN)
It is a peripherally acting NSAID, not a very safe drug in pregnancy (Cat C), Cat D in the 3rd trimester (i.e. not to be used in 3rd trimester)
Indications-

• Pain with a significant inflammatory component (e.g. pain after a dental extraction)
• Musculoskeletal pain
• Dysmennorhoea
• As an anti-pyretic
• Anti-platelet action (prophylaxis for Cerebrovascular disease or MI)

Available as-

• 300 mg tablets
• 300 mg dispersible tablets
• 75 mg tablet (specific for antiplatelet action)

Tab. ASPENT (Ranbaxy) 60 mg

Tab. ASPIN 100 Enteric Coated (Cipla) 100 mg

Dose-

• Analgesia and Antipyresis - 325-650 mg QID (Max. 4 gm per day)
• Antiplatelet - 75 to 300 mg per day

Administration- should be taken WITH FOOD

Contraindications-

• Bronchial asthma (risk of precipitation of bronchoconstriction)
• Children under 12 yrs (risk of Reye's Syndrome)
• H/O Peptic Ulcers (aspirin is ulcerogenic)
• Uncontrolled Hypertension
• Patients suffering from gout (aspirin is uricosuric, i.e. causes uric acid to appear in the urine)
• Patients with hemostatic disorders (aspirin decreases platelet aggregation due to its anti-platelet action, and hence increases bleeding time)
• Patients with known hypersensitivity to the drug.
• Patients with renal/hepatic compromise.

Precautions-

• Pregnant patients
• Breastfeeding mothers

Side Effects-

• Aspirin is highly ulcerogenic, and can cause an "Aspirin burn" if kept pressed against the oral mucosa for a long time.
• Causes bleeding time to increase, and hence hemostatic problems
• Uricosuric, so can precipitate an attack of gout
• In high doses, can cause tinnitus due to an increase in the labyrinthine pressure.

Drug Interactions-

• Should not be prescribed to patients on anticoagulant therapy, since it would lead to a more fragile hemostatic state (due to its antiplatelet effect)
• Enhances the effects of antiepileptic drugs (phenytoin sodium and sodium valproate)
• Aspirin and corticosteroid, both are ulcerogenic, so should be avoided in patients giving history of peptic ulceration.
• Should not be used along with Oral hypoglycemic agents, as it can precipitate hypoglycemia.