The Scoop on Aspirin

Aspirin is a versatile, over-the-counter drug that is both inexpensive and a veteran in the class of nonsteroidal anti-inflammatory drugs (NSAIDs).

The benefits of Aspirin include its anti-clotting action and preventive properties. The U.S. Preventive Services Task Force recommends low-dose Aspirin for at-risk adults to prevent heart disease, stroke, pregnancy complications, and colorectal cancer.

History of Aspirin

Aspirin is made from salicylic acid, an organic compound found in a common shrub called Spiraea.

The white willow tree’s bark also contains the drug’s natural element. It’s been used naturally for thousands of years. The ancient Egyptians used it for joint pain, and Hippocrates recommended it for childbirth.

In 1897, a German chemist named Felix Hoffman created a chemically pure and stable form of salicylic acid–otherwise known as the active ingredient in aspirin, the drug which came to be produced by Bayer, the company he worked for.

It introduced a new world of pain relief, one that relied on an age-old cure.

Common Uses for Aspirin

Here are some common uses for Aspirin. 

1. Lower fever
2. Lower pain and aches
3. Reduce inflammation
4. Relieve headaches
5. Relieve cold
6. Lower menstrual cramps
7. Relieve arthritis
8. Prevent blood clotting
9. Prevent a heart attack
10. Treat chest pain
11. Lower muscle aches
12. Reduce toothaches
13. Kawasaki disease
14. Angina Pectoris
15. Osteoarthritis

Daily Aspirin

A significant deciding factor in whether to take a daily aspirin is if the goal is primary or secondary prevention. Primary prevention refers to preventing a first-time cardiovascular episode in someone who has never experienced it. Secondary prevention refers to preventing a repeat cardiovascular event in someone who’s already been through it.

 Don’t start taking a daily aspirin without talking to your healthcare provider. If your healthcare provider has told you to take an aspirin every day, contact them before stopping it.

Experts warn daily users to be cautious of these possible side effects: Stroke caused by a bursted blood vessel, gastrointestinal bleeding, and allergic reaction. 

Scientists Discover New Uses for Aspirin

“Aspirin is a magic drug, but long-term use of it can cause detrimental side effects such as internal bleeding and organ damage,” said study author Subhrangsu Mandal, a professor of chemistry and biochemistry, in a statement from the ASBMB. “It’s important that we understand how it works so we can develop safer drugs with fewer side effects.”

Aspirin inhibits enzymes called COX that produce chemicals causing inflammation. Researchers discovered multiple ways aspirin affects this process, including controlling transcription factors for cytokine expression, slowing tryptophan breakdown, and inhibiting the production of IDOs, particularly IDO1, during inflammation.

“Since aspirin is a COX inhibitor, this suggests potential interplay between COX and IDO1 during inflammation,” Mandel said.

According to the researchers, discovering the interplay between Aspirin and COX/IDO1 could have implications beyond its typical uses. They suggest that COX/IDO1 inhibitors, like Aspirin, could be used in immunotherapy treatments for cancer patients to enhance their immune response.

Warnings About Aspirin

In late April 2022, those recommendations were officially narrowed because of Aspirin’s major side effect: internal bleeding.

Recent guidelines advise against starting a daily aspirin regimen to prevent first-time heart attack or stroke in individuals aged 60 and older without known vascular disease due to the risk of bleeding.

Aspirin is a magic drug, but long-term use of it can cause detrimental side effects such as internal bleeding and organ damage.

Aspirin-Induced Asthma and Aspirin-Exacerbated Respiratory Disease (AERD)

Aspirin-induced asthma (AIA) is a severe reaction to painkillers that are typically safe for most people. Although the condition is named after Aspirin, other drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can also trigger AIA, which can be life-threatening.

AIA is especially common in people with severe adult-onset asthma and chronic rhinosinusitis involving nasal polyps. It’s rare in children, but it can occur.

Aspirin-exacerbated respiratory disease (AERD), also known as Samter’s Triad, is a chronic medical condition characterized by asthma, sinus disease with recurrent nasal polyps, and sensitivity to Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) that inhibit the enzyme cyclooxygenase-1.

Approximately 9% of all adults with asthma and 30% of patients with asthma and nasal polyps have AERD. In general, AERD develops quite suddenly in adulthood, usually between the ages of 20 and 50, and there is no clearly understood trigger that causes the disease.

Coated Aspirin

Enteric-coated Aspirin, also known as coated Aspirin, is formulated to avoid dissolving in the stomach and instead disintegrate in the small intestine. This makes it a more stomach-friendly option for daily aspirin takers, particularly those with a history of gastrointestinal inflammation or ulcers.

However, there is no proof that coated Aspirin reduces the likelihood of gastrointestinal bleeding. Furthermore, coated Aspirin may not be as effective as regular Aspirin in the event of a potential heart attack.

If you need to take ibuprofen or other NSAIDs, talk to your healthcare provider about alternatives that won’t interfere with daily aspirin therapy, such as acetaminophen (Tylenol, others).