New Aspirin Guidelines
All About Aspirin
This 100-plus-year-old remedy still has a variety of uses, starting with headache relief. But be careful not to overdo it, or your stomach might suffer.
By Brian Hoyle
Medically Reviewed by Niya Jones, MD, MPH
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It's never a great start to the day when you wake up with a pounding headache.
Fortunately, help is often as close as your medicine cabinet. You can pop a couple of aspirin, close your eyes, and, in all likelihood, that throbbing in your head will be soothed within the hour.
You’re in good company in your choice of remedy. The pharmaceutical giant Bayer, which first developed aspirin more than a century ago, sold million worth of the painkiller in the United States in the first 12 weeks of 2011, according to research firm SymphonyIRI.
And billions of aspirin tablets are taken worldwide, every year, for all types of headaches, including the excruciatingly painful form known as a migraine. That's a lot of pharmacological muscle.
Just what is behind aspirin's headache-relieving oomph?
Aspirin is one of a group of chemically related compounds called salicylates. Besides the Bayer trademark, you may also purchase generic aspirin with “ASA” on the label; the letters stand for acetylsalicylic acid, aspirin's specific formula.
ASA is a hard-working compound. It is:
- An analgesic that relieves pain
- A fever-reducing agent or antipyretic drug
- An anti-inflammatory medication that helps reduce swelling in the body
- An inhibitor of platelets, the blood cells that can cause potentially dangerous blood clots
Aspirin and Headache Relief
The pain associated with many headaches is chemically based. Specifically, when a headache occurs, a compound called prostaglandin (a hormone that helps send pain signals to the brain) is overproduced.
Because of its anti-inflammatory properties, aspirin is able to block the activity of an enzyme which helps make prostaglandin, called cyclooxygenase-1 (COX-1). By blocking the effects of COX-1, aspirin thereby decreases the levels of prostaglandin in the body.
Even though aspirin circulates throughout the entire body after you swallow it, the drug acts only at sites where prostaglandin is being actively produced. When the production of prostaglandin is impaired, the pain signals sensed by the brain stop. No more pain signals, no more headache.
Aspirin: How Much and How Often
Aspirin is an over-the-counter medication that can be purchased in various strengths. Chewable flavored aspirin typically contains 81 mg. Each pill or capsule of regular-strength aspirin version typically contains 325 mg of the drug, while the extra-strength version is 500 mg. For headache pain, the recommended adult dose of aspirin is 325 to 650 mg every three to four hours as needed, up to six times per day.
While aspirin may help alleviate acute migraine pain, it shouldn't be used more than twice a week for this purpose since rebound — or medication overuse — headaches can occur. If you suffer from frequent or severe migraines, talk to your doctor about starting a prescription medication.
It is possible to overdose on aspirin. This can occur if you take too much at any one time, or over a longer period of time with consistently heavy aspirin use. While too much aspirin may cause temporary symptoms such as nausea and vomiting, more severe effects can occur with an actual overdose. These include hallucinations, seizure, coma, and even death due to cardiac arrest.
Aspirin: Side Effects
Other side effects can also occur. Some people may note heartburn or indigestion, or stomach and abdominal cramping or discomfort. Other drugs can be taken to minimize this discomfort, or another form of pain relief can be used. Additional side effects of aspirin include:
- Heavy bleeding, particularly gastrointestinal bleeding
- Tinnitus, a ringing or buzzing sound in the ears
Side effects that are more serious and require prompt medical attention include loss of hearing, bleeding, and allergic reactions such as difficulty breathing, skin rash, and swelling of the lips, mouth, and throat (a severe reaction known as angioedema).
Aspirin should not be given to children under 12, or to any children and teenagers who display symptoms of the flu or chickenpox. This is because aspirin can cause a condition called Reye's syndrome, which affects the nervous system and the liver and can be lethal.
Indeed, up to 30 percent of children and teenagers with Reye's syndrome die, and survivors may have life-long brain damage. For pain relief without this risk, acetaminophen (Tylenol) is a safer choice.
Despite its possible side effects, aspirin is a mainstay of headache relief, as legions of headache sufferers can attest. In a world of seemingly countless new medications, good old aspirin remains widely used.
If you turn to aspirin to soothe a headache, just be sure to use it sensibly. And, as with any medication, take the lowest dose of aspirin that is effective for you to avoid unwanted side effects.
Video: The Power of Aspirin
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