Aspirin: Fact vs Fiction
Most people are aware of the cardiovascular benefits of taking an aspirin daily, however, I often see a lot of confusion among my patients of how much and when is the best time to take it. Here is a little insight into the power of aspirin, and the side effects to be aware of:
How much aspirin should I take daily?
Most people only need to take 81 mg daily, this is often referred to as "baby aspirin". Taking more aspirin than your prescriber tells you will not make it work better and in fact higher doses can increase your chances of bleeding. It's important to talk to your prescriber about how much aspirin to take.
What are the potential side effects of taking aspirin daily?
Aspirin makes platelets less able to adhere together in your blood vessels, therefore, aspirin can cause bleeding or bruising. You may notice that when you take aspirin daily and you get cut, it takes a little longer to stop the bleeding. Also, aspirin can upset your stomach. Less common but serious side effects of aspirin are bleeding in the stomach or brain. Bleeding in the brain can cause a stroke. If aspirin upsets your stomach, take it with food or milk. Watch for black tarry stool, blood in your stool, nausea or vomiting, or a sudden severe headache. If any of these things happen, call your prescriber right away or get emergency help.
What is the best time of day to take aspirin?
Just like there is no evidence taking more than 81mg per day of aspirin adds more benefit to cardiovascular protection, there is also no proof that taking aspirin more often than once a day is better. Time of day is also irrelevant (i.e. bedtime vs morning). I've also had patients tell me they take aspirin every other day because it upsets their stomach. There is no evidence that taking aspirin every other day will reduce the risk of stomach bleed and you may still be putting yourself at cardiovascular risk. The most important thing to remember is to take your aspirin once a day, every day, at a time that’s best for you.
What's the difference between plain aspirin vs enteric-coated aspirin vs a buffered aspirin?
There are three types of aspirin available commercially in the United States. There is plain aspirin, enteric-coated aspirin, and buffered aspirin. Enteric-coated aspirin is coated to help protect the stomach. Buffered aspirin contains aspirin plus antacids. Enteric-coated or buffered aspirin might feel gentler on your stomach than plain aspirin. But they don’t prevent bleeding in the gut. There is no proof that one kind of aspirin works better than the others. If you are not sure about which kind of aspirin to take, ask your pharmacist or prescriber.
The benefits of aspirin are prevention of a heart attack or stroke. The risks of aspirin are bleeding in the stomach or brain. Aspirin is used by many people who have had a heart attack or stroke to prevent another one. Aspirin can also be used if you have not had a heart attack or stroke but have a high chance of one. If you have diabetes or high blood pressure or are a smoker, your prescriber might want you to take aspirin. These things can up your chance of a heart attack or stroke.
As you can see there are many benefits vs risks when considering adding daily aspirin to your medication regimen. It's important to talk with your prescriber before you start taking aspirin. Ask if aspirin’s benefits to you balance its risks.
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