Aspirin

If you've watched the evening news on TV more than three times in your life, you might think you know all there is to know about aspirin. But what would you really know about the most widely-used pain reliever of all time? Not much, probably. Because in spite of the enormity of aspirin use, most of us know less about it than any other drug. Oh, we know it works -- usually, when taken as directed -- but that's about it. And there's a lot more to it than that. Because aspirin is a drug. And although it's safe and cheap and effective, it can be dangerous -- even deadly -- when used incorrectly or in larger-than-recommended doses.

It's your right -- your obligation, even -- to know about this popular and potent drug. And knowing more about aspirin could save you, or someone you care about, a headache or two -- or even a doctor or hospital bill someday.

Since its commercial introduction in 1899 by the Bayer Company, worldwide popularity of acetylsalicylic acid -- better known as aspirin -- has grown steadily. And so has the variety of aspirin available. Today the drug is sold in everything from tablets and capsules to chewing gum and elixirs. It's combined with caffeine and countless other drugs, both prescription and over-the-counter. It's swallowed to "prevent" heart attacks and taken to relieve headaches, fever, rheumatism, arthritis, inflammation, hangovers, and other disorders, real and imagined. But no matter what form you buy or where you find it, all aspirin works in the same way: by blocking production of hormone-like chemicals (called prostaglandins) involved in everything from blood circulation and clotting to body temperature, digestion, and breathing.

There are also a number of possible side effects and other problems you should be aware of if you take aspirin. Just consider these, for starters:

For some users, aspirin can cause ringing in the ears, dizziness, vomiting, and hearing loss. Such symptoms usually disappear when aspirin use stops. The most common effect of overuse is stomach upset -- from pain and nausea to bleeding ulcers and chronic indigestion. Regular aspirin use also damages the kidneys and can trigger sudden renal failure. Still, the greatest danger of overuse is overdose. As little as 10 grams -- about 30 regular-strength tablets -- can be fatal in adults. In 1996, aspirin ranked eighth among all drugs as a cause of overdose and poisoning. That's why aspirin overdoses should always be regarded as life-threatening emergencies requiring fast medical attention. As with any other drug, users should also be careful about interactions with other drugs. Aspirin interferes with many types of medication, including drugs taken for gout, diabetes, and kidney disease. Despite its use as a hangover cure, aspirin is even more irritating to the stomach when used with alcohol. Even when taken as directed, aspirin still stirs up problems for some people. Those with conditions such as hemophilia, asthma, or allergies should consult their doctors before using any amount of the drug. Because aspirin can disrupt normal blood clotting and cause bleeding, it should be avoided at least one week prior to surgery and during pregnancy. In fact, evidence of the drug's dangers in pregnancy -- including prolonged labor, heavier bleeding, and abnormal clotting in mother and child -- has prompted federal officials to recommend warning labels for all aspirin products.

Children and teenagers are also better off with substitutes. Aspirin can trigger a serious, often fatal sickness called Reye's syndrome in young people recovering from chicken pox or the flu. The syndrome can cause brain damage and death. Because of the risks, aspirin makers are required by law to add warning labels about Reye's syndrome to product packages.

In addition, regular aspirin use may increase risks of bleeding stroke, which is more often fatal than ischemic stroke.