Should You Take a Low Dose Aspirin?

When you get a cut, clotting cells in your blood (platelets) clump to make a plug to stop the bleeding. But if platelets clump in the blood vessels when they are not meant to, it can cause a heart attack or stroke. Low dose aspirin makes platelets less able to form a clump (clot) in your blood vessels.

Should I take a low dose aspirin to prevent a heart attack or stroke?

Talk with your prescriber before you start taking low dose aspirin. Ask if aspirin’s benefits to you balance its risks. 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 in addition to cholesterol medications (see Crestor vs Lipitor) and/or diabetes medications (like metformin) and/or other blood thinners (see Xarelto vs Coumadin). These things can up your chance of a heart attack or stroke.

How much aspirin should I take?

Most patients only need to take 81 mg (one baby aspirin) daily. Taking more aspirin than your prescriber tells you will not make it work better. Higher doses can increase the chance of bleeding. Your prescriber will tell you how much aspirin to take.

What are the side effects of daily aspirin?

Aspirin can cause bleeding or bruising. You may notice that when 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.

When should I take aspirin?

There is no proof that taking aspirin more often than once a day is better. There is also no proof that taking it at bedtime is better than taking it in the morning. Take your aspirin once a day, every day, at a time that’s best for you.

Should I take an enteric-coated aspirin? A buffered aspirin?

There are three types of aspirin. 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.

I am taking an low dose aspirin every day. Can I stop it?

Stopping aspirin can increase your risk of having a heart attack or stroke. If you want to stop taking your aspirin, talk with your prescriber first.

What if I take other medications? Can they interact with a daily aspirin?

A number of drugs can interact with aspirin. Check with your prescriber or pharmacist before taking any prescription or over-the-counter medication or supplement. Taking ibuprofen (Motrin, others) or naproxen (Aleve, others) with your daily aspirin could block aspirin’s effect on platelets (clotting cells). If you take ibuprofen or naproxen, take it about one hour after the aspirin. Do not use enteric-coated aspirin with naproxen or ibuprofen. Separating the doses might not prevent the interaction.

Medicines that can increase the risk of bleeding with aspirin are anti-clotting drugs like Coumadin (warfarin), Plavix (clopidogrel), and Pradax and Apixaban (dabigatran; formerly Pradax in Canada). Your prescriber might want you to take aspirin with one of these medicines. 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. Let your pharmacist know you are taking aspirin so they can check for drug interactions.

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