Aspirin is indicated for the following conditions:

• Prevention of arterial thrombotic events: Including myocardial infarction, recurrent myocardial infarction, post-coronary bypass surgery, and acute ischemic stroke or transient ischemic attack (TIA).
• Mild to moderate pain relief: Such as headache, muscle pain, dysmenorrhoea, and toothache.
• Chronic inflammatory conditions associated with pain: For example, osteoarthritis.
• Antipyretic use: Management of fever associated with common cold and influenza.

Aspirin inhibits platelet aggregation, thereby reducing thrombus formation in the arterial circulation where platelet aggregation plays a major role and anticoagulants are less effective. It is commonly used as an analgesic for headache, transient musculoskeletal pain, and dysmenorrhoea. Aspirin also possesses anti-inflammatory and antipyretic properties. Enteric-coated formulations help minimize gastrointestinal irritation and reduce the risk of ulceration associated with aspirin use.

Pain, inflammatory diseases and as antipyretic: Aspirin 300 mg 1-3 tablets 6 hourly with a maximum daily dose of 4 gm.

Suspected acute coronary syndrome: 150 mg -300 mg immediately unless there are clear contraindications.

After myocardial infarction: Aspirin 150 mg daily for 1 month. Long-term use of aspirin in a dose of 75 mg daily is recommended thereafter.

Acute ischaemic stroke/Transient ischaemic stroke (TIA): The starting dose is 150 mg-300 mg daily and Aspirin 75 mg daily thereafter.

Following bypass surgery: 75 mg-300 mg daily starting 6 hours post-procedure.

Salicylates may potentiate the effects of anticoagulants, oral hypoglycaemic agents, phenytoin, and sodium valproate. They can reduce the uricosuric action of probenecid and may increase the toxicity of sulphonamides. In susceptible individuals, they may also trigger bronchospasm or asthma attacks.

Aspirin is contraindicated in children under 12 years of age due to the risk of Reye’s syndrome, in breastfeeding mothers, and in patients with active peptic ulcer. It is also contraindicated in patients with bleeding disorders such as haemophilia, intracranial haemorrhage, or other active bleeding conditions.

At usual doses, aspirin is generally well tolerated; however, mild adverse effects such as nausea, dyspepsia, gastrointestinal irritation or ulceration, and bronchospasm may occur.

Aspirin should be avoided during the last trimester of pregnancy unless clearly indicated, as it may cause complications in the fetus or during delivery. Since aspirin passes into breast milk, it should be used cautiously in breastfeeding mothers.

Aspirin should be used with caution in patients with asthma, uncontrolled hypertension, and during pregnancy. It should also be used cautiously in individuals with nasal polyps or a history of nasal allergy.

Overdose may lead to dizziness, tinnitus, sweating, nausea, vomiting, confusion, and hyperventilation. Severe overdose can result in central nervous system depression with coma, cardiovascular collapse, and respiratory depression. Patients suspected of overdose should be monitored for at least 24 hours, as salicylate levels may continue to rise. Management includes gastric lavage and forced alkaline diuresis, with haemodialysis considered in severe cases.

Antiplatelet drugs

Keep all medicines out of reach of children. Store in a cool, dry place protected from light.