Aspirin
General
- Type: Antiplatelet, NSAID
- Dosage Forms: tablet, delayed-release tablet, chewable tablet, enteric-coated tablet, oral chewing gum, extended release capsule
- Common Trade Names: Aspirin, Baby Aspirin, ASA
- Usage: Analgesic, antipyretic, antiplatelet
Adult Dosing
- 325 to 650mg orally or rectally every 4 hours as needed, not to exceed 4 g/day
- 324mg chewable for ACS
- 81mg (baby) Aspirin common daily cardiac risk reduction dose
Pediatric Dosing
Avoid use in children, especially those with viral syndrome, due to risk of Reye syndrome
- Fever, pain
- >12yo: 325 to 650mg PO or PR q4-6h
- 2-11yo: 10 to 15 mg/kg PO or PR q4-6h
- Kawasaki: 80-100 mg/kg/day (divided q4-6h) PO until afebrile 48-72h or day 14, then 3-5mg/kg/day until no evidence of coronary changes
- Stroke: 1 to 5 mg/kg/day PO
- Juvenile RA: 90-130 mg/kg/day PO divided q4-6h
Special Populations
- Pregnancy Rating: C (1st-2nd trimester), D (3rd trimester)
- Lactation: Infant risk cannot be ruled out
- Renal Dosing: if CrCl <10, avoid use
- Hepatic Dosing: avoid if severe impairment
Contraindications
- Allergy to class/drug
- Syndrome of asthma, rhinitis, and nasal polyps
Adverse Reactions
Serious
- See Aspirin (Salicylate) Toxicity
- Reye syndrome - Children and teenagers should not use this medicine for chicken pox or viral symptoms
- GI ulcer
- Hemorrhage
- Exudative age-related macular degeneration
- Bronchospasm
- Tinnitus
- Angioedema
Common
Pharmacology
- Half-life: 20-60m, Salicylic acid: 6h
- Metabolism: Hepatic
- Excretion: Renal, dialyzable
- Mechanism of Action: Irreversible cyclooxygenase inhibitor, thus preventing prostaglandin synthesis and platelet activation
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Acute pain management | 650 mg PO q4-6h PRN or 1000 mg PO q6h PRN | Step 1 - Mild pain (non-opioid) | PO | Adult |
| Acute rheumatic fever | 50-100mg/kg/day PO divided q4-6h | Anti-inflammatory for carditis/arthritis | PO | Pediatric |
| Dressler's syndrome | 750-1000mg PO q6-8h, taper by 650-800mg/week over 3-4 weeks | NSAID, first-line | PO | Adult |
| Kawasaki disease | 30-100 mg/kg/day divided QID (acute), then 3-5 mg/kg/day (antiplatelet) | Anti-inflammatory/antiplatelet | PO | Pediatric |
| Non-ST-elevation myocardial infarction | 325mg chewed | Dual antiplatelet therapy; all ACS unless contraindicated | PO | Adult |
| Pericarditis | 650 mg q6hr x7-10 days, then taper over 3-4 weeks | 1st line anti-inflammatory | PO | Adult |
| ST-segment elevation myocardial infarction | 325 mg PO or 600 mg PR | Antiplatelet (immediate) | PO/PR | Adult |
| Transient ischemic attack | 325mg chewed, then 81mg PO daily | Antiplatelet, all TIA patients | PO | Adult |
| Unstable angina | 325mg chewed | Antiplatelet, first-line | PO | Adult |
See Also
References
http://www.drugs.com/aspirin.html