Western Medicine Acetylsalicylic Acid 100 mg 50 Enteric-coated
tablets (Inhibits prostaglandin synthesis)
Inhibits prostaglandin synthesis, resulting in analgesia,
anti-inflammatory activity, and platelet aggregation inhibition;
reduces fever by acting on the brain's heat-regulating center to
promote vasodilation and sweating
Rapidly and completely absorbed. T max is 1 to 2 h (salicylic acid).
Widely distributed to all tissues and fluids, including CNS, breast
milk, and fetal tissues. Approximately 90% of salicylate is protein
bound at concentrations of less than 100 mcg/mL and approximately
75% is bound at concentrations of more than 400 mcg/mL.
Rapidly hydrolyzed to salicylic acid (active). Salicylic acid is
conjugated in the liver to the metabolites.
Salicylic acid plasma half—life is approximately 6 h, but may
exceed 20 h in higher doses. The half—life is approximately 15 to
20 min for aspirin. Elimination follows zero-order kinetics. Renal
elimination of unchanged drug depends on urine pH. A pH of more
than 6.5 increases renal Cl of free salicylate from less than 5% to
more than 80%.
Indications and Usage
Treatment of mild to moderate pain; fever; various inflammatory
conditions; reduction of risk of death or MI in patients with
previous infarction or unstable angina pectoris, or recurrent
transient ischemia attacks (TIAs) or stroke in men who have had
transient brain ischemia caused by platelet emboli.
Prevention of cataract formation; prevention of toxemia of
pregnancy; improvement of inadequate uteroplacental blood flow in
pregnancy; prophylaxis against thromboembolic events in patients
with atrial fibrillation, mitral valve prolapse, peripheral
arterial disease, bioprosthetic or mechanical heart valves, and in
pregnant patients with prosthetic heart valves; antithrombotic
therapy in children with Blalock-Taussig shunt or ischemic stroke,
and in children after Fontan surgery.
Hypersensitivity to salicylates or NSAIDs; hemophilia, bleeding
ulcers, or hemorrhagic states.
Dosage and Administration
PO 160 to 325 mg as soon as MI is suspected. Continue 160 to 325 mg
daily for 30 days postinfarction. Consider further therapy after 30
days for prevention of recurrent MI. The American College of Chest
Physicians recommends maintenance dosages of 75 to 100 mg once
daily in patients post non–ST-segment elevation MI and 75 to 162 mg
once daily in patients after ST-segment elevation MI.
Adults and Children 12 yr of age and older
PO 324 to 1,000 mg every 4 to 6 h as needed of regular-release
products; max, 4,000 mg per 24 h. 1,300 mg followed by 650 to 1,300
mg every 8 h for controlled-release, delayed-release, or ER
products; max, 3,900 mg per 24 h.
Children 2 to 12 yr of age
PO 10 to 15 mg/kg per dose every 4 h as needed (up to
PO 75 to 325 mg once daily.
Arthritis and Other Rheumatic Conditions
PO 3 g/day in divided doses.
PO 80 mg once daily to 650 mg twice daily, started presurgery.
Coronary Artery Bypass Graft
PO 325 mg daily starting 6 h postprocedure. Continue therapy for 1
yr postprocedure. The American College of Chest Physicians
recommends 75 to 100 mg once daily, started 6 h after surgery.
[Ischemic Stroke and TIA]
PO 50 to 325 mg once daily. The American College of Chest
Physicians recommends 75 to 325 mg once daily in patients with
cardioembolic stroke who have contraindications to anticoagulation
and 50 to 100 mg once daily in patients with noncardioembolic
stroke or TIA.
[Juvenile Rheumatoid Arthritis]
PO 90 to 130 mg/kg/day in divided doses every 6 to 8 h.
PO 75 to 325 mg/day. The American College of Chest Physicians
recommends 75 to 100 mg once daily as primary prophylaxis.
[Percutaneous Transluminal Coronary Angioplasty]
PO 325 mg 2 h presurgery, then 160 to 325 mg daily.
PO Up to 4 g/day in divided doses.
Atrial Fibrillation Adults
PO 75 to 325 mg once daily.
Bioprosthetic Aortic Valve Adults
PO 50 to 100 mg once daily.
Bioprosthetic Mitral Valve Adults
PO 50 to 100 mg once daily after 3 months of anticoagulation.
Blalock-Taussig Shunt, Fontan Surgery, or Ischemic Stroke Children
PO 1 to 5 mg/kg/day. Continue for a minimum of 2 yr in children
with ischemic stroke.
Infrainguinal Arterial Reconstruction or Bypass Adults
PO 75 to 100 mg once daily, begun preoperatively.
Internal Mammary Artery Bypass Grafting Adults
PO 75 to 162 mg once daily.
Kawasaki Disease Adults
PO 80 to 100 mg/kg/day in 4 divided doses for up to 14 days within
10 days of symptom onset, followed by 1 to 5 mg/kg/day for a
minimum of 6 to 8 wk. Aspirin therapy may continue indefinitely in
patients with significant cardiac sequelae from Kawasaki disease.
PO 80 to 100 mg/kg/day in 4 divided doses until 48 to 72 h after
fever defervescence, followed by 3 to 5 mg/kg/day. Continue for 6
to 8 weeks or until erythrocyte sedimentation rate and platelet
count are normal and if no coronary artery abnormalities are
present, or indefinitely if coronary artery abnormalities persist.
Mechanical Heart Valve Adults
PO 50 to 100 mg once a day in addition to anticoagulation.
Mitral Annular Calcification With Systemic Embolism, Stroke, or TIA Adults
PO 50 to 100 mg once daily
Mitral Valve Prolapse With Documented TIA or Stroke Adults
PO 50 to 100 mg once daily.
Postherpetic Neuralgia Adults
Topical Aspirin (median dose, 1,000 mg) in diethyl ether applied as
a single dose. Other trials used multiple doses of different
topical applications (1,200 mg in 20 to 30 mL of chloroform; 750 mg
in 100 g of washable ointment).
Percutaneous Coronary Intervention (PCI) Adults
PO Initially, 300 to 325 mg between 2 and 24 h before PCI is
performed in patients not on daily aspirin therapy, or 75 to 325 mg
once before PCI is performed in patients on daily aspirin therapy.
Follow by 162 to 325 mg once daily for 1, 3, and 6 months for
patients with bare metal, sirolimus-eluting, and tacrolimus-eluting
stents, respectively. Maintenance dosage is 75 to 162 mg.
Peripheral Arterial Disease Adults
PO 75 to 100 mg once daily.
Prophylaxis of Thromboembolism in Pregnant Women Prosthetic Heart
PO 75 to 100 mg once daily.
Store oral forms at room temperature in tightly closed containers.
May increase risk of GI ulceration and prolong bleeding time.
[Antacids, corticosteroids, urinary alkalinizers]
May decrease aspirin levels.
[Carbonic anhydrase inhibitors (eg, acetohexamide), methotrexate,
May increase levels of these drugs.
[Heparin, oral anticoagulants]
May increase risk of bleeding.
Aspirin (more than 2 g/day) may potentiate glucose lowering.
May decrease uricosuric effect.
Laboratory Test Interactions
May increase levels of serum uric acid, cause false-positive
readings of urine glucose by copper reduction method ( Clinitest )
and false-negative readings by glucose oxidase method ( Clinistix
); may interfere with urine tests of 5-hydroxyindoleacetic acid,
ketone, phenolsulfonphthalein, vanillylmandelic acid.
Bleeding; dyspepsia; heartburn; nausea.
Anemia; decreased iron concentration; increased bleeding times.
Hypersensitivity reactions may include urticaria, hives, rashes,
angioedema, and anaphylactic shock.
Category D .
Excreted in breast milk.
Reye syndrome has been associated with aspirin administration in
children (including teenagers) with acute febrile illness.
Reaction may include bronchospasm and generalized urticaria or
angioedema; patients with asthma or nasal polyps have greatest
May decrease renal function or aggravate kidney diseases.
May cause hepatotoxicity in patients with impaired liver function.
Can cause gastric irritation and bleeding.
Aspirin may increase risk of postoperative bleeding. If possible,
avoid use 1 wk before surgery.
Convulsions, dizziness, hemorrhage, metabolic acidosis, nausea,
respiratory alkalosis, tinnitus, vomiting.
- Instruct patient to take drug with food or after meals and with
full glass of water. Advise patient to avoid antacids within 1 to 2
h after ingestion of enteric-coated tablets.
- Tell patient to discard any aspirin that has a vinegar-like odor.
- Instruct patient to report ringing in ears or unusual bleeding,
bruising, or persistent GI pain.
- Advise patient on long-term therapy to inform health care provider
or dentist before seeking surgery or dental care.
- Tell patient on sodium-restricted diet to limit use of effervescent
or buffered aspirin preparations.
- Caution parents to avoid giving aspirin to children or teenagers
with flu-like symptoms or chickenpox without first consulting
health care provider.
- Instruct patient to avoid intake of alcoholic beverages or other