ASPIRIN

Route of administration: oral. Adults and Children over 16 years: 1 to 3 caplets to be swallowed with water. The dose should not be taken more frequently than every 4 hours and not more than 4 times in any 24 hour period. 6g) every 24 hours in divided doses.

The elderly:

A total reduction in the daily dose may be advisable. g. for Kawasaki’s disease). Gastro-intestinal irritation may be reduced by taking aspirin with or immediately after food.

Side effects are generally mild and infrequent.

Blood Disorders:

Aspirin increases bleeding time, decreases platelet adhesiveness and, in large doses, may cause hypoprothrombinaemia. It may also cause other blood disorders including thrombocytopenia, aplastic anaemia, agranulocytosis and pancytopenia.

Haemolytic anaemia can occur in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Immune system:

Aspirin may precipitate bronchospasm and induce dyspnoea, asthma attacks, rhinitis, angioedema, urticaria, rash, or other hypersensitivity in susceptible individuals.

Gastro-intestinal:

There is a relatively high incidence of irritation with nausea, vomiting, diarrhoea, dyspepsia and slight asymptomatic blood loss. Haematemesis and/or melaena may occur. It may induce gastrointestinal ulceration and haemorrhage, occasionally major.

Hepatobiliary:

Increased aminotransferase levels, usually reversible on withdrawal; dose-dependent focal hepatic necrosis.

Renal and urinary disorders:

Haematuria may occur.

Skin:

Skin reactions, including Stevens-Johnson syndrome or toxic epidermal necrolysis, may occur in susceptible patients.

Caution should be exercised in patients with asthma, allergic disease, , impairment of hepatic or renal function (avoid if severe), impaired cardiac function, uncontrolled hypertension and dehydration, dyspepsia and in patients with nasal polyps or a history of nasal polyps.

Aspirin should be used with caution in patients with infections, since symptoms such as fever and inflammation may be masked. The elderly may be more susceptible to the toxic effects of salicylates. Continuous prolonged use of aspirin should be avoided in the elderly because of the risk of gastrointestinal bleeding.

Caution should be taken with patients with glucose-6-phosphate dehydrogenase deficiency as haemolytic anaemia may occur. Aspirin may interfere with insulin and glucagons in diabetes. Aspirin prolongs bleeding time, mainly by inhibiting platelet aggregation and therefore it should be discontinued several days before scheduled surgical procedures.

Renal, hepatic and haematological status should be monitored during prolonged and high dose aspirin therapy. If symptoms persist for more than 3 days consult your doctor. There is some evidence that drugs which inhibit cyclo-oxygenase / prostaglandin synthesis may cause impairment of female fertility by an effect on ovulation.

This is reversible on withdrawal of treatment. Keep out of the sight and reach of children. There is a possible association between aspirin and Reye’s syndrome when given to children. Reye’s syndrome is a very rare disease, which affects the brain and liver, and can be fatal.

g. for Kawasaki’s disease).

g for Kawasaki’s disease) ii) Active peptic ulceration or a history of peptic ulceration iii) Haemophilia, other coagulopathies or concurrent anticoagulant therapy. 1) In patients with a history of hypersensitivity to aspirin (or any of the excipients) or any other NSAIDs and in patients in whom attacks of asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or other NSAIDs.

v) Gout. vi) Doses > 100mg/day during the third trimester of pregnancy.