Nonsteroidal anti-inflammatory drugs(NSAIDs) are found among the most prescribed medicines in the world. They are mainly used for treating inflammation, edema, and painful disorders like OA, RA, and other musculoskeletal conditions. Aspirin is the oldest and widely studied NSAID, however it is considered separately from the others, due to its predominant use in the treatment of cardiovascular and cerebrovascular diseases, in low doses.
It is estimated that only in North America (USA) there are more of 70 million prescriptions for NSAIDs per year, to which we must add those acquired without a prescription (“Over the counter”). Older adults are the main consumers of NSAIDs.
Adverse reactions of NSAIDs are increased by self-medication. Self-medication with NSAIDs is a frequent practice in many developing countries and represents a complex problem, since educational and cultural factors are involved. Socioeconomic factors influence, because poor living conditions limit the access to health services.
What Age Is It Safe To Take Aspirin?
The treatment with non-steroidal anti-inflammatory drugs is associated with the appearance of hemorrhage, ulceration and perforation of the upper digestive tract. These episodes can appear at any time throughout the treatment, without previous symptoms and in patients without a history of gastric disorders. The risk increases with dose, in elderly patients (This population is more susceptible to their adverse reactions, especially of the digestive tract, because the senile gastric mucosa synthesizes less cytoprotective prostaglandins) and in patients with a history of gastric ulcer, especially if it was complicated by hemorrhage or perforation. Patients should be warned about these risks: melena, hematemesis, marked asthenia or any other sign or symptom suggestive of gastric bleeding. If any of these episodes appear, the treatment should be stopped immediately.
25% of reports of adverse effects of all drugs are related to NSAIDs. The main lesions produced by these drugs are localized in the digestive system and 30% of the deaths produced complicated ulcers were attributable to NSAIDs.
Recently it was reported that NSAIDs can almost double the risk of venous thrombosis, including deep vein thromboembolism and pulmonary embolism.
The main risk is in COX-2 inhibitors, whereas aspirin, a COX1 inhibitor, has been shown to be effective in preventing venous thromboembolism (VTE).
The mechanism that increases the risk of VTE is not known with precision, however, the fact that COX2 inhibits the synthesis of prostacyclin, and in turn also with platelet activation and aggregation could in turn induce the formation of the clot.
Aspirin (acetylsalicylic acid) is clinically effective for the prevention of vascular ischemic events. Very few trials of primary prevention have addressed the risk-benefit ratio of aspirin in the older adult. Older patients have a relatively high risk of developing a vascular disease, so one might also expect benefit of the regular administration of aspirin.
In primary prevention, the potential benefit of antiplatelet agents must be weighed against the risk of bleeding, which is higher in older patients. The risk-benefit ratio of using low doses of aspirin in the elderly has not yet been established, so caution should be exercised if it is decided to use aspirin in primary prevention.
A recent research suggests that for people between 50 and 65 years, taking a daily dose of aspirin can significantly reduce the risk of developing cancer of the colon, esophagus and stomach.
People who suffer from any problem of indigestion, or asthma, gout or those who are taking other medications that inhibit blood clotting, should not take aspirin. And that also applies to those under 16 years of age, especially those who come from families that have a history of colon cancer, for example, as a form of prevention, but this is very dangerous because a daily dose can cause liver damage.
It is almost absolutely contraindicated the use of aspirin in patients under 16 years old, (risk of Reye syndrome). However, aspirin causes a lot of side effects in all age ranges.
- Aspirin-exacerbated Respiratory Disease: Causes, Symptoms, Treatment, Prognosis, Pathophysiology, Complications
- Causes, Risk Factors of Aspirin Poisoning or Salicylate Poisoning & It’s Treatment
- How Can Aspirin Cause Reye’s syndrome?
- Aspirin Allergy: Symptoms & Management