ASA drug and its uses and side effects

ASA drug or aspirin is one of the popular drugs to reduce pain (analgesic) and prevent stroke. This drug is a salicylate and non-steroidal anti-inflammatory drug that is also used to reduce fever and relieve mild and moderate pain. Some of its important uses include pain and fever, acute coronary syndrome, anti-inflammatory, ischemic stroke and transient ischemic attack, colorectal cancer, primary prevention of ASCVD with low-dose aspirin, etc. In this article, we will review the dosage forms, uses, cautions, how to use and… aspirin in adults and children.

Pharmaceutical forms of ASA

ASA dosage forms include 81 mg, 325 mg, and 500 mg tablets, 162 mg, 325 mg, and 500 mg delayed-release tablets, 81 mg chewable tablets, 81 mg enteric-coated tablets, 162 mg g, 325 mg and 650 mg, liquid-filled capsules (Vasalore) are 81 mg and 325 mg, extended-release capsules are 162.5 mg.

Uses of ASA medicine

It is a low-dose aspirin used to reduce the risk of heart attack in people with heart disease. It is also used to reduce the risk of stroke in people who have already had a stroke or “mini-stroke” (transient ischemic attack). Aspirin is known as a salicylate and a non-steroidal anti-inflammatory drug (NSAID). This medicine works by preventing platelets from clumping together and forming blood clots that can cause a heart attack or stroke. Other forms of aspirin (immediate-release) should be used when a quick effect is needed, such as immediately after a heart attack or for pain relief.

Uses of ASA in adults

1. pain and fever
2. Acute coronary syndrome
3. Anti-inflammatory
4. Ischemic stroke and transient ischemic attack
5. Primary prevention of ASCVD with low-dose aspirin
6. Colorectal cancer (off label)

Uses of ASA in children

1. Juvenile rheumatoid arthritis
2. Kawasaki disease
3. pain and fever

Pharmacological effects and mechanism of action of aspirin

The mechanism of action of ASA (aspirin) inhibits prostaglandin synthesis by cyclooxygenase and prevents platelet aggregation. It also has antipyretic and analgesic activity. The bioavailability is 80-100% and the maximum plasma concentration of analgesic and antipyretic is 30-100 micrograms per milliliter and anti-inflammatory is 150-300 micrograms per milliliter. This drug is metabolized by the liver through the microsomal enzyme system and finally excreted through urine (80-100%), sweat, saliva and feces.

Dosage of aspirin tablets

Take this medication orally once a day as directed by your doctor. Do not cut, crush, or chew ASA capsules, swallow the capsule whole. Doing so (crushing or cutting the medicine in half) can release all the medicine at once and increase the risk of side effects. If stomach upset occurs while taking this medicine, take it with food or milk. Take this medication by mouth with a full glass of water (8 oz/240 mL) unless your doctor tells you otherwise. Do not lie down for at least 10 minutes after taking the medicine.

Time to take ASA medicine

Medication information and how to use are clearly stated on the medication packaging. If you are taking this medicine without a prescription, use the medicine manufacturer’s instructions. Do not take this medicine 2 hours before or 1 hour after drinking alcohol. Nonsteroidal anti-inflammatory drugs (NSAIDs) (such as ibuprofen, naproxen) may decrease aspirin’s ability to prevent heart attack and stroke. If you are using an NSAID, take it at least 8 hours before or at least 2 to 4 hours after this medication (see also Drug Interactions). Take it at the same time every day to help you remember.

Dosage of ASA in adults

1. Pain and fever (immediate release): 325-650 mg every 4 hours or 975 mg every 6 hours for 10 days.
2. Primary prevention of ASCVD with low-dose aspirin: For this disease in adults 40 to 70 years of age, use of low-dose aspirin (75-100 mg/day) is recommended for selected adults at higher risk of atherosclerotic cardiovascular disease (ASCVD). ), but not at risk of bleeding. For adults over 70 years of age, low-dose aspirin should not be routinely prescribed for primary prevention of ASCVD.
3. Note that do not use low-dose aspirin for primary prevention at any age.
4. Ischemic stroke and transient ischemic attack: The initial dose is 160-325 mg within 48 hours of the onset of stroke or TIA, followed by 75-100 mg per day. Maintenance (secondary prevention) is also Durlaza extended-release capsules 162.5 mg per day.
5. Anti-inflammatory: The use of non-aspirin non-steroidal anti-inflammatory drugs has largely replaced the use of aspirin for osteoarthritis, rheumatoid arthritis, and other inflammatory arthritis. For immediate release, the usual maintenance dose of 2.1-7.3 g/day in divided doses (separate dose) and monitoring of serum salicylate concentration is suggested.
6. Colorectal cancer (off-label): 600 mg daily for prevention and reduces the risk of hereditary colon cancer (eg, Lynch syndrome) by 60% if taken daily for at least 2 years.

Precautions

Before taking aspirin, if you are allergic to it or other salicylates (such as choline salicylate) and NSAIDs (such as ibuprofen, naproxen), avoid taking it. Before using patients, their medical records such as aspirin-sensitive asthma (history of worsening breathing with runny nose and stuffy nose after taking aspirin or other NSAIDs), bleeding and blood problems (eg, hemophilia, vitamin K deficiency, low platelets), kidney disease , liver disease, stomach problems (such as ulcer, heartburn), growth in the nose (nasal polyps), etc., inform the doctor. Also, daily consumption of alcohol and tobacco while using this medicine may increase the risk of stomach bleeding.

1. Patients, if taking ASA without a prescription, consult a doctor. Note that you should not use ibuprofen during or after the 20th week of pregnancy, unless prescribed by a doctor. Because it may cause problems in the fetus or complications during childbirth.
2. It should be used with caution in anemia, malabsorption of the gastrointestinal tract, history of gastric ulcer, gout, liver disease, hypochlorhydria, hypoprothrombinemia, renal failure, thyrotoxicosis, vitamin K deficiency, kidney stones, ethanol consumption, etc.
3. To avoid gastrointestinal side effects, it should be taken with food or 8 to 12 ounces of water.
4. This medicine is not recommended for children with viral diseases. The use of salicylates in children with varicella or influenza-like illness is associated with an increased incidence of Reye’s syndrome.
5. Risk of heart failure (HF), NSAIDs (nonsteroidal anti-inflammatory drugs) have the potential to provoke HF by inhibiting prostaglandins, leading to sodium and water retention, increased systemic vascular resistance, and decreased response to diuretics. Also, high-dose aspirin (more than 325 mg g) should be avoided or discontinued if possible.

ASA contraindications

1. Allergy to aspirin or NSAID; Aspirin-related hypersensitivity reactions including aspirin-induced urticaria, asthma in aspirin intolerance (HLA-DPB1*0301)
2. Allergy to tartazine dye
3. Absolute contraindication for use in bleeding gastrointestinal ulcers, hemolytic anemia caused by pyruvate kinase (PK) and glucose-6-phosphate dehydrogenase (G6PD) deficiency, hemophilia, hemorrhagic diathesis, hemorrhoids, nursing mothers, nasal polyps with asthma, sarcoidosistopeniaculitis, Sarcoidozytopeniacolitis

Aspirin side effects

Most people who use aspirin do not have serious side effects. If you have any serious side effects, including easy bruising or bleeding, uncontrolled bleeding from the gums or nose, loss of appetite, dark urine, yellowing of the eyes or skin, unusual tiredness, signs of kidney problems (such as changes in the amount of urine) and … See a doctor. This medicine may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. If you notice serious side effects, stop taking the medicine and see a doctor.

1. angioedema
2. Bronchospasm
3. Gastrointestinal pain, ulcers, bleeding
4. Hepatotoxicity
5. hearing loss
6. nausea
7. Inhibition of platelet aggregation
8. premature hemolysis
9. Pulmonary edema (due to salicylate, non-cardiac)
10. urticaria
11. kidney damage
12. Tinnitus
13. Vomit

ASA drug interactions

Drug interactions may change how your medications work or increase your risk of serious side effects. Do not start, stop, or change any medication without your doctor’s approval. Mifepristone drugs, drugs that can cause bleeding and bruising (including antiplatelet drugs such as clopidogrel, blood thinners such as warfarin and dabigatran), corticosteroids (such as prednisone), ginkgo biloba, etc. will cause drug interactions with ASA. . Before using any drug, check the drug information and the ingredients of the drug to avoid drug interactions.

1. Category X interactions (avoid): Influenza virus vaccine (live or attenuated), ketorolac (nasal, systemic), masimorelin, omastaxin, sulfinpyrazone, urokinase, vaccines containing chicken pox virus, dex ibuprofen, dex ketoprofen, fluctaphenine
2. Reducing the effects of drugs by aspirin: multivitamin or mineral (containing vitamins A, E, without iron), multivitamin and mineral (containing vitamins A, D, E, K, folate, iron), non-steroidal anti-inflammatory drugs (non-selective), probenecid, Cincalid, spironolactone, sulfinpyrazone, ticagrelor, tildronate, benzbromarone, carisoprodol, dexketoprofen, hyaluronidase, lesinorad, loop diuretics, macimorelin, multivitamins and fluoride (containing vitamins A, D and E)
3. Aspirin level reduction by drugs: dexketoprofen, fluctaphenine, alcohol (ethyl), corticosteroids (systemic), dex ibuprofen, ketorolac (nasal, systemic), non-steroidal anti-inflammatory drugs (non-selective), sucroferic oxyhydroxide
4. Aspirin increases the effects of drugs: dex ibuprofen, dex ketoprofen, edoxaban, enoxaparin, gold sodium thiomalate, heparin, ibritomumab thioxan, methotrexate, nicorandil, nonsteroidal anti-inflammatory drugs (COX-2 selective), obinotuzumab, omastaxin, pralatrexate, rivaroxaban, salicylates, Telniflumate, thiopental, ajmaline, alendronate, angiotensin-converting enzyme inhibitors, anticoagulants, apixaban, bemiparin
5. Increasing the effects of aspirin by drugs: ketorolac (nasal, systemic), limaprost, loop diuretics, multivitamin or fluoride (containing vitamins A, D and E), multivitamin and mineral (containing vitamins A, D, E, K, folate and iron), antiplatelet drugs, alcohol (ethyl), ammonium chloride, calcium channel blockers (non-dihydropyridine), dasatinib, oil emulsion (based on fish oil), flavinac

Taking ASA tablets (aspirin) during pregnancy and breastfeeding

Avoid chronic or intermittent high doses during pregnancy, as it affects the homeostasis mechanisms of the mother and the baby and leads to an increased risk of bleeding. High doses also increase perinatal mortality with intrauterine growth restriction and teratogenic effects. In some cases, premature closure of the ductus arteriosus may occur if the full dose of aspirin is used for a short period of time. ASA (aspirin) enters breast milk, considering the importance of the drug for the mother, a decision should be made about stopping breastfeeding or stopping the drug.

ASA drug storage conditions

ASA medicine should be kept away from light and moisture and at room temperature. Keep all chemical and herbal medicines out of the reach of children and animals. If this medicine is no longer needed or its expiration date has passed, dispose of the medicine properly.

The last word about ASA medicine

In this article from Positive Green Online Pharmacy magazine, we examined the ASA drug in detail, which is one of the most important and widely used drugs in the field of medicine and improving human health. This drug, with a long historical history and multiple uses, is one of the common drugs in the treatment of heart problems, angina pectoris, preventing blood clot formation and improving blood flow. This drug is used alone or as part of treatment programs under the supervision of doctors.

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