By Eduardo Gonzales, MD
Is aspirin still the most prescribed antipyretic and analgesic? I read somewhere that aspirin has other uses, what are these? —email@example.com
Aspirin or acetyl salicylic acid is no longer extensively used for its analgesic, (for pain), antipyretic (for fever), or anti-inflammatory properties, but it is still one of the most prescribed drugs worldwide. Presently, aspirin is widely used for its proven beneficial effects on people who have had—or are at risk of—a heart attack or stroke.
When aspirin was presented into the market in the 1850s as an analgesic and antipyretic preparation it was so effective it became extremely popular in no time at all. Years after its initial introduction, aspirin’s popularity further heightened when researchers discovered that, at high doses, the drug has an anti-inflammatory effect. In time, aspirin became the prototypical drug for a group of substances called nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce swelling, pain, tenderness, and limitation of joint movement associated with arthritis and injuries.
Aspirin, however, has some adverse effects and when safer analgesics and antipyretics such as paracetamol (acetaminophen) and ibuprofen were released into the market in 1956 and 1969, respectively, and a host of NSAIDs a little later, the popularity of aspirin started to wane.
Why aspirin has regained its popularity
In the last 20 years, however, interest in aspirin has resurged because in the 1980s, it was established that at low doses, the drug is an effective anticoagulant that reduces the risk of clotting diseases, the underlying causes of many heart attacks and strokes.
At present, daily low-dose aspirin therapy (i.e., 75 or 81 mg) is recommended for those who have had a previous heart attack or stroke and those who have high risk for either. The latter group includes those who possess risk factors associated with heart attacks and strokes, including smoking, high blood pressure, high cholesterol levels, poor lipid profile, diabetes, family history of stroke or heart attack, sedentary lifestyle, stress, and heavy alcohol consumption.
Aspirin continues to amaze
Despite its already varied medical applications, aspirin continues to amaze. Recent research findings indicate that aspirin may also reduce a person’s chances of dying from cancer. A study by Yin Cao, an instructor in the Medicine, Clinical and Translational Epidemiology Unit at Massachusetts General Hospital and Harvard Medical School, looked at data of over 86,000 women and over 43,000 men from 1980 to 2012 showed that overall, the risk of death from cancer was seven percent lower for women and 11 percent for men who took aspirin regularly, compared with those who did not. The strongest connection was with colorectal cancer: There was a 31 percent lower risk for women and 30 percent for men who were among regular aspirin takers, as other studies have showed. Regular aspirin intake also lowers women’s risk of dying from breast cancer by 11 percent and men’s risk of dying from prostate cancer by 23 percent.
Aspirin will not benefit everyone
Notwithstanding its wide-ranging desirable effects, aspirin will not benefit everyone. In fact, for many people, the drug’s adverse effects outweigh any potential benefit.
Aspirin can irritate the stomach and produce nausea, vomiting, heartburn, persistent stomach pain, and even bleeding from the gastrointestinal tract. Thus, aspirin should not be taken by people who are at high risk for ulcers and gastrointestinal bleeding. It can also cause ringing in the ears, dizziness, drowsiness, confusion, diarrhea, indigestion, allergic reactions, and kidney damage.
In children and teenagers with fever, especially if caused by a viral infection, aspirin has likewise been associated with a rare but potentially fatal condition called Reye syndrome that is characterized by acute encephalopathy and fatty liver. For this reason, aspirin is not given to anyone under 20 who has a fever.
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