ASPIRIN RISKS

Aspirin risks must be weighed against the benefits of a 20% reduction in the chance of death by cancer...as well as protection against strokes, heart attacks and possibly osteoporosis.

Research has shown that childrens aspirin can reduce the risk of death by cancer by twenty percent...in addition to providing protection against strokes and heart attacks. But does that mean that everyone should be taking aspirin?

ASPIRIN RISKS WITH DAILY INTAKE

There are a number of complications associated with taking aspirin daily. These include:

• Hemorrhagic stroke. Daily aspirin can help prevent a clot-related stroke but may increase the risk of a bleeding stroke (hemorrhagic stroke).
• Gastrointestinal bleeding. Daily aspirin use can increase the risk of developing a stomach ulcer and cause a bleeding ulcer to bleed more.
• Allergic reaction. If you're allergic to aspirin, taking any amount of aspirin can trigger a serious allergic reaction.
• Ringing in the ears (tinnitus) and hearing loss. Too much aspirin can cause tinnitus and eventual hearing loss in some people.

Daily aspirin use may also increase the risk of excessive bleeding during surgery.

ASPIRIN RISKS ASSOCIATED WITH HEALTH CONDITIONS

There may be an increased risk of bleeding or other complications with the following health conditions:

• A bleeding or clotting disorder (bleeding easily)
• Asthma
• Stomach ulcers
• Heart failure

The Food and Drug Administration (FDA) also warns that women who have more than one drink of alcohol a day and men who have more than two drinks a day should avoid daily aspirin therapy because of the additional blood-thinning effects.

ASPIRIN DOSAGE AND DURATION

Research on cancer prevention found that small daily doses of aspirin were enough to provide protection and that daily dosages above 75mg provided no additional benefits. (A low dose adult aspirin is typically 81mg.)

Daily intake of low-dose aspirin was required for prolonged periods before the benefits take effect.

• oesophageal, pancreatic brain and lung cancer: 5 years
• stomach and colorectal cancer-10 years
• prostate cancer-15 years

Stopping daily aspirin therapy suddenly should be avoided as it may trigger a blood clot and increase the risk of a heart attack or stroke.

ASPIRIN RISKS AND MEDICATION

Medications that can interact with aspirin and increase the risk of bleeding include:

• Warfarin (Coumadin)
• Heparin
• Ibuprofen (Advil, Motrin, others), when taken regularly
• Corticosteroids
• Some antidepressants (clomipramine, paroxetine, others)

Anticoagulants such as Warfarin (Coumadin) combined with aspirin may greatly increase the risk of bleeding complications. However, there are some conditions for which combining a low dose of aspirin with Warfarin is appropriate...for example, with certain types of artificial heart valves for secondary stroke prevention. Such therapies must be carefully discussed with your doctor.

As both aspirin and ibuprofen (Advil) increase the risk of bleeding, it is important to consider the combined impact of the the two medications. A single dose of ibuprofen should be taken eight hours before or 30 minutes after aspirin to avoid a cumulative effect. But if you need to take ibuprofen more often, a physician may be able to recommend medication alternatives that won't interfere with daily aspirin therapy.

ASPIRIN RISKS AND SUPPLEMENTS

Taking some dietary supplements along with daily aspirin can also increase bleeding risk. These include:

• Danshen
• Dong quai
• Evening primrose oil
• Ginkgo
• Omega-3 fatty acids (fish oil)
• Policosanol
• Willow bark

ASPIRIN RISKS DURING A HEART ATTACK OR STROKE

Is it still safe to take an aspirin during a heart attack or stroke?

HEART ATTACK

Doctors recommend chewing and swallowing one plain regular-strength aspirin (or 2-4 baby aspirin) for most people experiencing heart attack symptoms. This recommendation still holds true for those on a daily aspirin therapy. Chewing the aspirin speeds absorption and minimizes any delay in the benefits of the aspirin. However...if you have certain bleeding disorders, an aspirin is not recommended during a heart attack.

STROKE

As not all strokes are caused by blood clots, it is best to avoid taking aspirin if you think you're having a stroke. Strokes caused by ruptured blood vessels could become more severe after taking aspirin.

DOES COATED ASPIRIN REDUCE THE RISK OF BLEEDING?

Enteric-coated aspirin is designed to pass through the stomach and disintegrate in the intestines. It doesn't appear to offer significant protection against bleeding in the stomach and intestines, but more research is needed to assess potential benefits.

Aspirin risks should be discussed with your doctor before adding childrens aspirin to your health program.

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