Classes
Antiplatelet Agents, NSAIDs, Salicylates
DEA Class: OTC, Rx
Description
Oral and rectal nonsteroidal anti-inflammatory drug (NSAID)
Used for temporary relief of minor aches and pains, to reduce the risk of death and myocardial infarction in patients with chronic coronary artery disease, and to reduce the risk of death and recurrent stroke in patients who have had an ischemic stroke or transient ischemic attack
May cause gastric ulceration and bleeding
Indications
Use for the treatment of mild pain associated with arthralgia, dental pain, dysmenorrhea, headache, musculoskeletal pain (including backache), and/or the common cold.
For antiplatelet therapy before and following carotid endarterectomy.
For patients with rheumatic mitral valve disease with atrial fibrillation or a history of systemic embolism, who suffer systemic embolism while receiving oral anticoagulant therapy at a therapeutic INR.
For all patients undergoing balloon angioplasty of the lower extremity (with or without stenting).
Contraindications
Hypersensitivity to aspirin or NSAIDs; aspirin-associated hypersensitivity reactions include aspirin-induced urticaria, aspirin-intolerant asthma. Aspirin is contraindicated in conditions like GI ulceration, Hypoprothrombinemia.
Maximum Dosage
Aspirin dosage must be individualized and is highly variable depending on the indications, coexisting conditions, and on patient response.
Adverse Effects
Angioedema, Bronchospasm, CNS alteration, Dermatologic problems, GI pain-ulceration-bleeding, Hepatotoxicity, Hearing loss, Nausea, Platelet aggregation inhibition, Premature hemolysis, Pulmonary edema (salicylate-induced, noncardiogenic), Rash, Renal damage, Tinnitus, Urticaria, Vomiting
Warnings
Anemia, GI malabsorption, history of peptic ulcers, gout, hepatic disease, hypochlorhydria, hypoprothrombinemia, renal impairment, thyrotoxicosis, vitamin K deficiency, renal calculi, ethanol use (may increase bleeding)
Discontinue therapy if tinnitus develops
Not indicated for children with viral illness; use of salicylates in pediatric patients with varicella or influenzalike illness is associated with increased incidence of Reye syndrome
NSAIDS have the potential to trigger HF by prostaglandin inhibition that leads to sodium and water retention, increased systemic vascular resistance, and blunted response to diuretics
Pregnancy and Lactation
Avoid chronic or intermittent high doses during pregnancy; may affect maternal and newborn hemostasis mechanisms, leading to an increased risk of hemorrhage
Drug enters breast milk; a decision should be made regarding whether to discontinue nursing or to discontinue drug, taking into account importance of drug to mother
Dosage
Tablet:
81mg, 325mg, 500mg
Tablet, delayed-release:
162mg, 325mg, 500mg
Tablet, chewable:
81mg
Tablet, enteric-coated:
81mg, 162mg, 325mg, 650mg