Possible Side Effects of Daily Aspirin Therapy

Even if you do have risk factors for heart attack or stroke, don't pop open your aspirin bottle just yet. If you're already taking an anticoagulant such as warfarin (Coumadin) for another condition, combining it with aspirin may greatly increase the risk of major bleeding complications. However, there may be some conditions for which combining a low dose of aspirin with warfarin is appropriate (for example, with certain types of artificial heart valves for secondary stroke prevention), but this therapy always needs to be carefully discussed with your doctor.

Other medications and herbal supplements also may increase your risk of bleeding. Be sure to talk to your doctor about all of your medications — prescription and over-the-counter and any supplements that you're taking, before beginning daily aspirin therapy.

Side effects and complications of taking aspirin include:

• Hemorrhagic stroke. While daily aspirin can help prevent a clot-related stroke, it may increase your risk of a bleeding stroke (hemorrhagic stroke).
• Gastrointestinal bleeding. Daily aspirin use increases your risk of developing a stomach ulcer. And, if you have a bleeding ulcer, taking aspirin will cause it to bleed more, perhaps to a life-threatening extent.
• Allergic reaction. If you're allergic to aspirin, taking any amount of aspirin can trigger a serious allergic reaction.
• Ringing in the ears (tinnitus) and hearing loss. Too much aspirin (overdosing) can cause tinnitus and eventual hearing loss in some people.

If you're taking aspirin and you must undergo even a simple surgical procedure or dental work, be sure to tell the surgeon or dentist that you take daily aspirin and how much. Otherwise you risk excessive bleeding during surgery.

The Food and Drug Administration also warns that people who regularly take aspirin should limit the amount of alcohol they drink because of its additional blood-thinning effects and potential to upset your stomach. If you take daily aspirin therapy, you should not have more than one drink a day if you're a woman or two drinks a day if you're a man.

If I take daily aspirin, is it still safe to take an aspirin during a heart attack?

For most people experiencing heart attack symptoms, doctors recommend chewing and swallowing one plain regular-strength aspirin or two to four baby aspirin. This recommendation still holds true if you are on daily aspirin therapy. Chewing the aspirin speeds up the absorption process and minimizes any delay in the beneficial effects of aspirin.

If you have certain bleeding disorders, you should not take an aspirin during a heart attack, and you're also not a candidate for daily aspirin therapy.

Don't take aspirin if you think you're having a stroke, because not all strokes are caused by blood clots; some are caused by ruptured blood vessels. Taking aspirin could make a bleeding stroke more severe.