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Aspirin, also known as acetylsalicylic acid, has a long history and is the earliest, most widely used and most common antipyretic analgesic for colds, fever, headache, toothache, and joint pain. Large doses have anti-inflammatory and anti-rheumatic effects, and small doses can also inhibit platelet aggregation. They are used for the prevention and treatment of ischemic heart disease, angina pectoris, myocardial infarction, and cerebral thrombosis.

Although aspirin is a hundred-year-old drug, some side effects cannot be avoided. The adverse reactions to aspirin have always been the focus of attention. As this news report may cause blood coagulation problems, it is precisely one of the adverse reactions of aspirin.

Therefore, if you buy any medicine, you should check the medicine instructions carefully, identify the ingredients of the medicine, and consult doctors and pharmacists. Don’t take medicine blindly.

Aspirin adverse reactions

1. Gastrointestinal reaction

Clinical manifestations: upper abdominal discomfort, nausea, and vomiting. At higher doses (resistance to rheumatism), gastric ulcers and painless stomach haemorrhages are caused, and the original ulcers are aggravated.

Control measures:

  • Can be changed to medication after meals, and served with antacids, such as PPIs, H2 receptor antagonists and so on.
  • Combined use of PGE1 derivative misoprostol can reduce the incidence of ulcers.
  • Gastroduodenal ulcers and bleeding tendencies are prohibited.

2. Increase bleeding tendency

Mechanism: Aspirin inhibits cyclooxygenase irreversibly. The ability of platelets to synthesize TXA2 needs to wait until neoplatin supplementation takes 7-8 days. Platelet aggregation is inhibited and the bleeding time is prolonged; aspirin can inhibit the formation of prothrombin and cause clotting disorders. , increase bleeding tendency.

Control measures:

  • Vitamin K can be prevented.
  • Severe liver disease, bleeding tendency, maternal, pregnant women disabled.
  • Aspirin was stopped 1 week before surgery.

3. Salicylic acid reaction/salicylic acid excess or poisoning

Clinical manifestations: When the dosage of aspirin is more than 5g/d, headache, dizziness, nausea, vomiting, tinnitus, hearing loss, and total salicylic acid reaction may be present. It is the symptom of salicylate poisoning, severe deep breathing, acid-base balance Imbalance, dehydration, high fever, and even mental disorders.


  • Aspirin was stopped immediately.
  • Intravenous infusion of sodium bicarbonate alkalizes urine.

4. Allergic reactions / aspirin asthma / aspirin intolerance

Clinical manifestations:

  • Urticaria, angioneurotic edema, anaphylactic shock;
  • Dyspnea after taking the drug induces asthma attacks in asthmatic patients;
  • Some are the triple syndrome of “aspirin allergy + asthma + nasal polyps.”

Mechanism of occurrence: Not an antigen-antibody reaction-based allergic reaction. It is an increase in endogenous bronchoconstrictor substances such as leukotrienes produced by arachidonic acid after PG synthesis is blocked, and induces asthma.

Induced asthma treatment:

  • Patients with asthma, nasal polyps, and chronic urticaria are disabled.
  • Treated with antihistamines and glucocorticoids.
  • The adrenal gland has no effect on aspirin asthma.


5. Effects on the kidneys

Clinical manifestations: A small number of elderly people with heart, liver, and kidney damage, that is, normal renal function before use, can also cause edema, polyuria and other symptoms of impaired renal tubule function, occasionally interstitial nephritis, nephrotic syndrome, kidney decline.


  • There is negative kidney damage or glomerular hypoperfusion in the patient;
  • Aspirin inhibits PG, cancels the compensatory mechanism of PG, and appears edema symptoms;
  • Depends on the dose, especially when the dose of ambassador blood concentration of 250ug/mL is prone to occur.

6. Rae syndrome

In children with viral infectious diseases such as influenza, chickenpox, measles, mumps, etc. aspirin fever, even can cause acute hepatic steatosis – encephalopathy syndrome (Ruiyi syndrome), with liver damage combined with encephalopathy as the outstanding performance Poor prognosis.

Prevention: Children with viral infections were banned from aspirin fever and replaced with acetaminophen.

7. Trigger gout attack

Small doses of aspirin can reduce uric acid excretion, cause retention of uric acid, and trigger the onset of gout in susceptible individuals.

Medicine interactions

1. With the dual coumarin anticoagulant, adrenocorticotropic hormone competes for albumin binding sites, and increased to free plasma concentrations, easy to induce ulcers and bleeding. In particular, adrenal cortex hormones and pharmacodynamic synergies with aspirin. In combination with oral sulphonylurea hypoglycemic agents cause hypoglycemia.

2. In combination with furosemide, penicillin, methotrexate and other weakly basic drugs, they compete for secretory carriers of renal tubules and increase their free plasma concentrations.

3. Can reduce the uric acid of probenecid, probenecid can also reduce the excretion of salicylic acid from the kidneys.

4. Glucocorticoids can increase the excretion of salicylate, and in order to maintain the plasma concentration of this product, the dose of this product should be increased when necessary. This product is used with hormones for a long period of time, especially when used in large quantities. Salicylism can occur when hormones are reduced or stopped, and there is even a risk of increased gastrointestinal ulcers and bleeding.

5. Ethanol can increase aspirin-induced bleeding and stomach bleeding. Drinkers taking aspirin therapy may cause spontaneous haemorrhage, so it is not recommended to use aspirin in patients with traumatic hyphema.

6. Decrease the antihypertensive effect of captopril.

7. When using carbonic anhydrase inhibitors to treat glaucoma, aspirin can induce metabolic acidosis. When a large number of long-term medication should be regularly checked for hematocrit. Liver function and serum salicylic acid determination.

Which people should not take aspirin?

1. Suffering from stomach and duodenal ulcer, liver cirrhosis and cerebral hemorrhage, aspirin.

2. There is a history of surgery in the near future, especially in ophthalmology, internal organs, and brain surgery.

3. People with bleeding tendency, such as gums or skin bleeding, should not take it.

4. There is a history of asthma, and people who are allergic to aspirin should not take it.

5. Pregnant women should not take it. Ingestion within three months of pregnancy can cause abnormalities in the fetus; regular use can delay childbirth, and there is a greater risk of bleeding, which should be disabled 2-3 weeks before delivery.

6. Older patients over the age of 70 have coagulopathy and are prone to bleeding and should not take it.

7. People with severe arteriosclerosis with hypertension should not take long-term use.

8. Hypertension patients whose blood pressure is not controlled within the normal range are not suitable for long-term use. Otherwise, the chance of cerebral hemorrhage increases significantly.

Whether it needs to be taken or not, a combination of clinical risk and benefit should be combined with judgment and choice.

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