Take baby aspirin with food
Answers about aspirin - Harvard Health
Should you be taking it? If so, when, how much, and what kind?
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Photos: Thinkstock Daily aspirin can prevent heart attack and stroke, but it's often misused. |
Aspirin is often hailed as a wonder drug, thanks to its ability to help stave off
heart attacks and clot-caused strokes. But fewer than half of the people who
could benefit from a daily low-dose aspirin take it, while many others take it
when they shouldn't.
If you don't have heart disease but do have high blood pressure or other risk factors, don't automatically assume daily aspirin is a good idea. "A lot of people take aspirin who really shouldn't," says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital and professor of medicine at Harvard Medical School. "Everyone assumes aspirin is harmless, but it's not. " For some, the downsides of aspirin—mainly gastrointestinal bleeding—outweigh its benefits.
Here's what you need to know about aspirin, including details about dosage, formulations, and ways to boost aspirin's benefits and lessen its risks.
Who should take aspirin?
If you've had a heart attack or an ischemic stroke (the type caused by a blood clot), taking a low-dose (81-mg) aspirin every day is probably a wise move. The same is true if you face a high risk of having a heart attack—for example, if you have chest pain (angina) from heart disease, or have had bypass surgery or angioplasty to treat a narrowed heart artery.
Aspirin prevents platelets from clumping together in your blood and forming a clot. Most heart attacks happen when a clot blocks blood flow in a vessel that feeds the heart, so dampening the clot-forming process lowers your odds of a blockage.
To estimate your risk of having a heart attack or stroke over the next 10 years, you can use one of the calculators listed at /147.
If your value is 10% or higher, daily low-dose aspirin may be helpful. But the decision should always be based on a discussion with your doctor. He or she should consider other health conditions you have, medications you take, and even your weight.
Beware of bleeding
In addition to lowering the blood's ability to clot, aspirin also inhibits helpful substances that protect the stomach's delicate lining, creating a "double whammy" effect. As a result, stomach upset or bleeding in the stomach and intestines can occur. If you take daily low-dose aspirin and your stomach starts bothering you, call your doctor, says Dr. Cannon. With minor bleeding, a blood test may reveal a low red blood cell count (anemia). With more serious bleeding, your stools turn black and smelly, and in rare cases, you may vomit blood, which requires hospitalization and a possible blood transfusion.
Taking aspirin with food may help; so do drugs to treat heartburn, which help protect your stomach. These include simple antacids like Tums, acid blockers like famotidine (Pepcid, Fluxid, generic), or proton-pump inhibitors (PPIs) such as omeprazole (Prilosec, Zegerid, generic).
A pill that combines aspirin and omeprazole may soon be available.
Daily aspirin users can also lower their risk of gastrointestinal bleeding by avoiding nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen. And those who drink alcohol should do so in moderation: no more than one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men 65 and younger.
Think it's a heart attack? Call 911, then chew an aspirinWhether or not you take daily low-dose aspirin, keep a stash of regular, full-strength (325-mg) aspirin handy. Why? If you think you're having a heart attack, doctors recommend chewing an aspirin, right after you call 911. If you don't have 325-mg pills, take four low-dose pills. Failing that, most emergency medical services will give you one en route to the hospital or once you're there. Chewing the pills gets the anti-clotting chemicals into your bloodstream much faster than if you swallow it. |
In one study, platelet activity dropped by 50% within five minutesEnteric-coated or buffered?
Most of the low-dose aspirin sold in the United States is enteric-coated (sometimes called safety-coated). The coating allows the aspirin to pass through the stomach to the intestine before fully dissolving. That is supposed to lessen stomach upset, but in reality aspirin still affects the entire digestive tract via the bloodstream.
"Enteric-coated aspirin does not decrease the risk of gastrointestinal bleeding compared with uncoated aspirin," says digestive disease expert Dr. Loren Laine, a professor of medicine at Yale University. The same is true for so-called buffered aspirin, which combines an antacid such as calcium carbonate (found in Tums) or aluminum hydroxide (found in Maalox) with aspirin.
There's also evidence that not all the aspirin in coated pills gets into your circulation, which can compromise its heart benefits.
Your best bet may be chewable low-dose aspirin, which you may remember from childhood as orange-flavored "baby" aspirin.
New guidelines: Should you take daily baby aspirin to prevent heart attack, stroke?
There are new guidelines about who should take daily baby aspirin, also known as low-dose aspirin. Who needs it? It’s complicated. Photo: Getty Images.Millions of American adults for years have been taking a daily low-dose aspirin — or baby aspirin as it’s commonly known — to prevent a heart attack or stroke.
But many older adults who are not at elevated risk for heart attack or stroke should not start taking daily baby aspirin, according to new guidance from the U.S. Preventive Services Task Force.
That’s because the bleeding risks associated with taking daily baby aspirin increase as people get older and can outweigh the protective cardiovascular benefits for those who have never had a heart attack or stroke.
Even so, the advice is not as simple as it sounds.
Most people who have had strokes or a heart attack in the past should keep taking daily baby aspirin. It’s important for these patients to consult with their doctors.
“There are still many patients who potentially will benefit from taking a daily low-dose aspirin, including those who have already had a cardiovascular event and those who are at high risk for having one,” said UCHealth cardiologist Dr. Steven Simon.
To sort out confusion over the new guidance and to help you figure out if you should be taking daily baby aspirin, we consulted with Simon, who is an assistant professor of cardiology at the University of Colorado School of Medicine on the Anschutz Medical Campus in Aurora.
Why have adults been taking low-dose or daily baby aspirin in the first place?Cardiovascular disease is the leading cause of death in the U.S., accounting for about one in three deaths, according to the Preventive Services Task Force. Each year, an estimated 605,000 Americans have a first heart attack and about 610,000 experience a first stroke.)
So prevention is key. And, for decades, doctors have often advised older adults to take daily baby aspirin to prevent heart attacks and strokes.
Here are the new guidelines, which are currently in draft form and should be finalized by the end of the year:
- Adults ages 60 and older who have not had a prior heart attack, stroke, stents or heart or artery surgery, or significant atherosclerosis (clogging of the arteries) should not start taking daily baby aspirin. That’s because there’s “no net benefit” when considering the associated bleeding risks, according to the prevention experts.
- People ages 40 to 59 who have a greater than 10% risk of having a stroke or heart attack over 10 years may get a “small net benefit” from taking a daily low-dose or baby aspirin. These people should consult with their doctors to weigh the pros and cons.
- People who have already had a stroke or heart attack and have been advised by their doctors to take a daily baby aspirin should continue with their aspirin regimen.
Anyone with questions about their specific circumstances should consult with their doctor prior to stopping aspirin.
Simon emphasizes that the new guidance does not apply to everyone. Initial headlines might have made it seem like everyone should immediately stop taking baby aspirin. That’s not correct, Simon said.
“This applies to a very specific patient group,” he said.
Who should continue taking baby aspirin?“People who have had a heart attack or ischemic stroke absolutely need to stay on their aspirin,” Simon said.
If you have a history of heart disease or stroke in your immediate family or have had your own history of cardiovascular disease or atherosclerotic disease, your doctor may recommend you continue taking a daily low-dose or baby aspirin.
This is also true for people who have had stents or coronary bypass surgery.
If you are at all confused, consult your doctor.
Remind me. What are the different kinds of stroke?- An ischemic stroke is the result of decreased blood flow to the brain.
It occurs when a vessel supplying blood to the brain is blocked. About 87% of all strokes are the result of ischemic strokes.
- A hemorrhagic stroke is the result of a blood vessel in the brain leaking or rupturing, resulting in bleeding in the brain.
- A mini-stroke or transient ischemic attack (TIA) is caused by a temporary lack of blood flow to the brain. A TIA is an important warning sign and patients should take them seriously.
Aspirin interferes with the process of forming a blood clot. While this is helpful for preventing a blood clot from forming in the heart or brain arteries, it is also why it increases the risk of bleeding.
“Aspirin has been shown to be beneficial for reducing risk of heart attacks and ischemic stroke,” Simon said.
What should younger people who have a risk of heart disease do?They should talk with their doctors and decide whether a daily dose of baby aspirin benefits them.
“Patients ages 40 to 59 who have a greater than 10% risk of having a stroke or heart attack over 10 years should have a patient-centered discussion with their doctor about whether to start using aspirin. There may be a small net benefit for them. This should be a patient decision based on bleeding risk versus cardiovascular risk,” Simon said.
How do you know if you are at greater risk for heart disease or stroke?The risk of suffering a stroke or a heart attack increases with age. Family history, additional medical conditions, ethnic or racial background and lifestyle factors also play a role.
According to the U.S. Centers for Disease Control and Prevention, nearly half of Americans (47%) have at least one of the three key risk factors for heart disease: they smoke cigarettes, have high blood pressure or high cholesterol.
Who is most at risk for heart attacks and stroke?Both age and sex affect risk. Older people are at greater risk of suffering heart attacks and strokes.
Men tend to experience cardiovascular problems at younger ages than women.
And heart disease takes a greater toll on ethnic and racial minorities. Black Americans have among the highest rates of cardiovascular disease.
Which groups of people should not start taking baby aspirin?“If you are over 60 and have no known atherosclerotic heart disease and you are not currently taking aspirin, these recommendations suggest you should not start taking aspirin. That’s a pretty narrow group compared to what the initial headlines suggested,” Simon said.
Why is the advice about baby aspirin changing?The new guidelines are not a surprise to experts. They have been in the works since data from a series of major clinical trials were released in 2018. These trials compared the benefits of cardiovascular risk protection versus the risk of bleeding in a series of patient populations.
The pivotal research includes the following studies:
• https://pubmed-ncbi-nlm-nih-gov.
proxy.hsl.ucdenver.edu/30158069/
• https://pubmed-ncbi-nlm-nih-gov.proxy.hsl.ucdenver.edu/30221595/
• https://pubmed-ncbi-nlm-nih-gov.proxy.hsl.ucdenver.edu/30221597/
• https://pubmed-ncbi-nlm-nih-gov.proxy.hsl.ucdenver.edu/30221596/
• https://pubmed-ncbi-nlm-nih-gov.proxy.hsl.ucdenver.edu/30146931/
Simon said there is broad support among experts for the new guidelines.
“If you are over 60 and don’t have a history of heart or vascular disease, then the risk of bleeding likely exceeds the cardiovascular benefits,” Simon said. “The new recommendations are completely reasonable based on the available evidence, and generally are in line with recommendations from other medical groups.”
View patient resources related to coronary heart disease from the National Heart, Lung, and Blood Institute.
Review detailed recommendations from the American College of Cardiology and the American Heart Association.
What should people over age 60 do if they’re confused about baby aspirin?If you are confused about whether you are at greater risk for heart attacks and stroke, talk with your doctor.
Many patients will still be recommended to continue taking low-dose daily aspirin.
If you are in good health and have no history of cardiovascular disease, you should not start taking a daily low-dose or baby aspirin without consulting with your primary care provider.
If I should not be taking baby aspirin, but previously started doing so, is it safe to stop suddenly?Yes. Unlike some medications which you should not stop taking abruptly, it is safe to stop taking low-dose aspirin without weaning off of it.
“If you are someone who should stop taking a daily low-dose aspirin, then you can stop it without weaning,” Simon said.
But, he urges caution for anyone whose doctor previously recommended a daily baby aspirin.
“I would not stop it without first talking with whoever prescribed it,” he said.
Is baby aspirin safe for babies? Why is it called baby aspirin?Aspirin should not be given to babies and children except if prescribed by a doctor for rare medical conditions.
The term “baby aspirin” stems from the lower dose that used to be used for children, but this is no longer recommended. The proper name now should be low-dose aspirin, but many people still refer to the lower doses as baby aspirin.
In the United States, the most common dose is 81 milligrams.
Should you take baby aspirin with food?Yes. Aspirin can upset people’s stomachs, so if you are supposed to take it daily, it’s best to take it with a small meal.
What are the side effects of daily aspirin?Bleeding is, of course, a possible side effect of taking a daily low-dose aspirin. So, if you are heading in for surgery or you are at risk of bleeding, be sure to tell your doctor about all medications you are taking, including baby aspirin.
Can baby aspirin cause ulcers?Yes. Baby aspirin or a daily low-dose aspirin increases the risk of developing a stomach ulcer.
If you already have a bleeding ulcer or gastrointestinal bleeding, do not take aspirin without consulting with your doctor.
Yes. According to the American Academy of Allergy, Asthma and Immunology, some people are allergic to aspirin and can have hives, itching, swelling, shortness of breath, nasal congestion, wheezing or can even pass out. When these reactions are severe, the reaction is called anaphylaxis.
Is daily aspirin a blood thinner?Yes. That’s precisely why it can help people who are at risk of blood clots, but dangerous for people who are at risk of hemorrhages or excessive bleeding.
If I want to prevent heart disease, a heart attack or stroke, what is the best advice for staying healthy?Small steps can make a big difference. The Million Hearts Campaign urges people ages 55 and older to get on track with simple steps, like scheduling their medical appointments, getting physically active and eating a healthy diet.
Get more ideas about taking simple steps to improve your health.
Pharmacy
Medlikbez: How to take pills without instructions
There are drugs that are sold not only without a prescription, but also without instructions.
It is assumed that we all know how to use pills, the names of which have been known since the time of our grandmothers. But is it? We have collected contraindications and tips for the five most popular drugs among the people.
1 Analgin. Although the packaging does not say so, this drug has serious contraindications. In some countries it is banned altogether. Why?
Prolonged use has a negative effect on the hematopoietic system.
It should not be taken in case of bronchospasm, liver or kidney dysfunction, in the first trimester of pregnancy.
Never give it to babies during the first three months of life without a doctor's permission. In general, it is not shown to children under 15 years of age.
Take analgin after meals. Maximum doses for adults: at a time - 0.25-1 g; per day - 3 g. Sometimes, for a stronger and faster effect, the tablet can not be swallowed, but placed under the tongue until it is completely absorbed.
2 Aspirin (acetylsalicylic acid). One of the most common and affordable painkillers, antipyretics and anti-inflammatory drugs. In addition, it is now fashionable to take aspirin to prevent heart attacks and strokes. But with prolonged use, gastric or intestinal bleeding may occur, and blood clotting disorders are possible.
American doctors cite an alarming figure: in the United States more than 15,000 people die every year from self-administration of aspirin and other similar drugs. In our country, unfortunately, there are no such statistics.
Aspirin should be used with extreme caution in people with allergies and asthma patients. In people with uncontrolled high blood pressure, chronic severe liver and kidney disease, it can increase the symptoms of these diseases.
Contraindicated in women with menstrual irregularities and during pregnancy.
Avoid alcohol while taking aspirin.
3 Paracetamol. One of the most popular cold medicines. And it will ease the headache and save you from the heat. It is produced both in pure form and as part of combined preparations, such as coldrex, fervex, solpadein, pentalgin. Fans of self-medication often use several drugs at the same time, and this is a direct path to a dangerous overdose. Paracetamol has a toxic effect on the liver. Liver problems can also occur if paracetamol is taken as a cure for a hangover headache. In combination with alcohol, it is especially dangerous. For the same reason, it is better to give up coffee, strong tea, and chocolate while taking the drug. Do not take paracetamol along with allergy medications. It is also not recommended for those suffering from bronchial asthma, renal failure, viral hepatitis, hematopoietic disorders; with great care it should be taken by the elderly and pregnant women.
Paracetamol should be taken with plenty of liquid 1-2 hours after a meal (if immediately after a meal, the therapeutic effect is delayed). The maximum daily dose for adults is 4 g; the maximum duration of treatment is 5-7 days.
4 Citramon. The drug consists of acetylsalicylic acid, caffeine, paracetamol. It originally contained phenacetin, which was discontinued due to unwanted side effects (especially on the kidneys and liver). They also wanted to ban citramon, but then they replaced phenacetin with paracetamol, and the drug was called citramon P.
We have already said about the contraindications of aspirin and paracetamol, and caffeine in excessive doses leads to the depletion of nerve cells; under its influence, breathing and heartbeat become more frequent, which contributes to increased blood pressure, insomnia. Refrain from taking Citramon if you suffer from ischemia, glaucoma, hyperactivity. Do not give Citramon to children. Do not use the medicine at the same time as sleeping pills and anticonvulsants.
And it is incompatible with alcohol.
Take one tablet with or immediately after meals, no more than
every four hours. In case of an overdose, stomach pains, nausea, sweating, pale skin, palpitations, and frequent nosebleeds appear. First aid - gastric lavage and activated charcoal.
5 Activated carbon. One of the most "popular" sorbents (substances capable of absorbing toxic substances and gases when taken orally). With its help, drug, food and alcohol poisoning has been treated and is being treated. However, few people know that this drug is not designed for long-term, continuous use. After all, it binds in the stomach not only toxic, but also many substances and enzymes useful for the body, can significantly weaken or negate the effectiveness of other drugs. Therefore, it is important to take activated charcoal, keeping a 2-3 hour interval between taking other medications.
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34 countries have deliberately reduced the production of analgin, and in the USA, Norway, Great Britain, the Netherlands, and Sweden, this medicine is generally excluded from sales.
| 💊 Ingredients of the drug Aspirin ® ✅ Use of the drug Aspirin ® Save Search for analogues Interaction Description of the active ingredients of the preparation Aspirin ® (Aspirin ® ) The scientific information provided is general and cannot be used to make decisions. Update date: 2021.06.15 Marketing authorization holder:BAYER JSC (Russia)
Manufactured:BAYER BITTERFELD GmbH (Germany) ATX code: N02BA01 (Acetylsalicylic acid) Active substance: acetylsalicylic acid (acetylsalicylic acid) Ph.Eur. European Pharmacopoeia Dosage form
Release form, packaging and composition Aspirin®Tablets white, round, slightly biconvex, beveled to the edge, with an imprint in the form of a brand name ("Bayer" cross) on one side and "ASPIRIN 0.5" on the other.
Excipients : microcrystalline cellulose, corn starch. 10 pcs. - blisters (1) - packs of cardboard. Clinical and pharmacological group: NSAIDs. Antiplatelet agent Pharmacotherapeutic group: NSAID Pharmacological action NSAIDs. It has anti-inflammatory, analgesic and antipyretic effects, and also inhibits platelet aggregation. The mechanism of action is associated with the inhibition of the activity of COX, the main enzyme of the metabolism of arachidonic acid, which is a precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever. A decrease in the content of prostaglandins (mainly E 1 ) in the center of thermoregulation leads to a decrease in body temperature due to vasodilation of the skin and increased sweating. The analgesic effect is due to both central and peripheral action. Reduces aggregation, platelet adhesion and thrombus formation by suppressing the synthesis of thromboxane A 2 in platelets. In a daily dose of 6 g or more, it inhibits the synthesis of prothrombin in the liver and increases the prothrombin time. Increases plasma fibrinolytic activity and reduces the concentration of vitamin K-dependent coagulation factors (II, VII, IX, X). Increases hemorrhagic complications during surgical interventions, increases the risk of bleeding during anticoagulant therapy. In high doses, it stimulates the excretion of uric acid (impairs its reabsorption in the renal tubules). Blockade of COX-1 in the gastric mucosa leads to inhibition of gastroprotective prostaglandins, which can cause erosive and ulcerative lesions of the mucous membrane and subsequent bleeding. PharmacokineticsWhen taken orally, it is rapidly absorbed mainly from the proximal small intestine and, to a lesser extent, from the stomach. The presence of food in the stomach significantly alters the absorption of acetylsalicylic acid. Metabolized in the liver by hydrolysis to salicylic acid followed by conjugation with glycine or glucuronide. Approximately 80% of salicylic acid binds to plasma proteins. Salicylates easily penetrate into many tissues and body fluids, incl. into the cerebrospinal, peritoneal and synovial fluids. Small amounts of salicylates are found in the brain tissue, traces - in bile, sweat, feces. It quickly crosses the placental barrier and is excreted in small amounts in breast milk. In newborns, salicylates can displace bilirubin from albumin and contribute to the development of bilirubin encephalopathy. Penetration into the joint cavity accelerates in the presence of hyperemia and edema and slows down in the proliferative phase of inflammation. When acidosis occurs, most of the salicylate is converted into non-ionized acid, which penetrates well into tissues, incl. into the brain. Excreted mainly by active secretion in the tubules of the kidneys in unchanged form (60%) and in the form of metabolites. The excretion of unchanged salicylate depends on the pH of the urine (with alkalization of the urine, the ionization of salicylates increases, their reabsorption worsens, and excretion increases significantly). Indications of the active substances of the drug Aspirin®Fever in infectious and inflammatory diseases; pain syndrome of low and medium intensity of various origins (including neuralgia, myalgia, headache), algomenorrhea. Open list of ICD-10 codes
Dosing modeThe method of administration and dosing regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed. Individual. Single dose - from 250 mg to 1 g, daily - from 250 mg to 3 g; multiplicity of application - 2-6 times / day. Side effectsFrom the digestive system: nausea, vomiting, anorexia, epigastric pain, diarrhea; rarely - the occurrence of erosive and ulcerative lesions, bleeding from the gastrointestinal tract, impaired liver function. From the side of the nervous system: with prolonged use, dizziness, headache, reversible visual impairment, tinnitus, aseptic meningitis are possible. On the part of the hematopoietic system: rarely - thrombocytopenia, anemia. On the part of the blood coagulation system: rarely - hemorrhagic syndrome, prolongation of bleeding time. From the urinary system: rarely - impaired renal function; with prolonged use - acute renal failure, nephrotic syndrome. Allergic reactions: rarely - skin rash, Quincke's edema, bronchospasm, "aspirin triad" (a combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid and pyrazolone drugs). Other: in some cases - Reye's syndrome; with prolonged use - increased symptoms of chronic heart failure. Contraindications for use Erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, gastrointestinal bleeding, inflammatory bowel disease in the acute phase (ulcerative colitis, Crohn's disease), "aspirin triad", a history of indications of urticaria, rhinitis caused by taking acetylsalicylic acid and other NSAIDs, bleeding, hemophilia, hemorrhagic diathesis, hypoprothrombinemia, dissecting aortic aneurysm, severe liver failure, active liver disease, portal hypertension, severe renal failure (CC <30 ml / min), vitamin K deficiency, combined use methotrexate at a dose of ≥15 mg / week, simultaneous use of oral anticoagulants and acetylsalicylic acid at a dose of > 3 g / day, Reye's syndrome, children under 15 years of age (risk of developing Reye's syndrome in children with hyperthermia due to viral diseases), pregnancy, breastfeeding period, hypersensitivity to acetylsalicylic acid e and other salicylates. With caution Gout, hyperuricemia, mild to moderate liver failure, moderate renal failure (CC 30-60 ml / mi), with bronchial asthma, erosive and ulcerative lesions and bleeding from the gastrointestinal tract in history, with increased bleeding or with simultaneous anticoagulant therapy, decompensated chronic heart failure, COPD, hay fever, nasal polyposis, drug allergy, simultaneous use of oral anticoagulants and acetylsalicylic acid at a dose of <3 g / day, taking methotrexate at a dose of less than 15 mg / week ., acyclic uterine bleeding, hypermenorrhagia. Use during pregnancy and lactationUse during pregnancy and lactation is contraindicated. Use in hepatic impairmentUse with caution in patients with liver disease. Contraindicated in severe renal failure, active liver disease, portal hypertension. Use in impaired renal functionUse with caution in patients with kidney disease. Contraindicated in severe renal insufficiency (CC<30 ml/min). Use in childrenContraindication: children's age (up to 15 years - the risk of developing Reye's syndrome in children with hyperthermia on the background of viral diseases). Use in elderly patientsUse with caution to avoid the risk of exacerbation of chronic diseases. Special instructionsAcetylsalicylic acid, even in small doses, reduces the excretion of uric acid from the body, which can cause an acute attack of gout in predisposed patients. When carrying out long-term therapy and / or the use of acetylsalicylic acid in high doses, a doctor's supervision and regular monitoring of hemoglobin levels are required. The use of acetylsalicylic acid as an anti-inflammatory agent in a daily dose of 5-8 g is limited due to the high likelihood of side effects from the gastrointestinal tract. Before surgery, to reduce bleeding during surgery and in the postoperative period, salicylates should be discontinued 5-7 days in advance. During long-term therapy, complete blood count and fecal occult blood tests should be performed. The use of acetylsalicylic acid in pediatrics is contraindicated, since in the case of a viral infection in children under the influence of acetylsalicylic acid, the risk of developing Reye's syndrome increases. Symptoms of Reye's syndrome are prolonged vomiting, acute encephalopathy, liver enlargement. The duration of treatment (without consulting a doctor) should not exceed 7 days when prescribed as an analgesic and more than 3 days as an antipyretic. During the treatment period, the patient should refrain from drinking alcohol. Drug interactionsWhen used simultaneously, 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, insulins, methotrexate, phenytoin, valproic acid is enhanced. When used simultaneously with corticosteroids, the risk of ulcerogenic action and the occurrence of gastrointestinal bleeding increases. With simultaneous use, the effectiveness of diuretics (spironolactone, furosemide) is reduced. Concomitant use of other NSAIDs increases the risk of side effects. Acetylsalicylic acid may 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, a violation of the absorption of acetylsalicylic acid is possible. A case of spontaneous hemorrhage in the iris is 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 plasma salicylate C max and AUC is possible. With simultaneous use with acetylsalicylic acid, the concentrations of digoxin, barbiturates and lithium salts in blood plasma increase. Concomitant use of high doses of salicylates with carbonic anhydrase inhibitors may cause intoxication with salicylates. Acetylsalicylic acid at doses less than 300 mg/day has little effect on the efficacy of captopril and enalapril. When using acetylsalicylic acid in high doses, it is possible to reduce the effectiveness of captopril and enalapril. With simultaneous use, caffeine increases the absorption rate, plasma concentration and bioavailability of acetylsalicylic acid.  .
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decisions about the use of a particular drug. 
500 mg: 10, 20 or 100 pcs. 
The concentration of salicylates in plasma is variable. 
T 1/2 acetylsalicylic acid is approximately 15 min. T 1/2 salicylate when taken in low doses is 2-3 hours, with increasing doses it can increase up to 15-30 hours. 
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