Can you take aspirin if you regularly take ibuprofen or another nonsteroidal anti-inflammatory drug (NSAID) for another condition?

Both aspirin and other nonsteroidal anti-inflammatory medications, such as ibuprofen (Motrin, Advil, others) and naproxen (Aleve), reduce the clotting action of blood platelets. Regular use of nonsteroidal anti-inflammatory medications can increase your bleeding risk, as can other medications you may take for aches and pains (Tylenol, others).

If you need only a single dose of ibuprofen, take it eight hours before or 30 minutes after the aspirin. If you need to take ibuprofen or other NSAIDs more often, talk to your doctor about medication alternatives that won't interfere with daily aspirin therapy.

What are the possible side effects of daily aspirin therapy?

Side effects and complications of taking aspirin include:

  • Stroke caused by a burst blood vessel. 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 or bleeding anywhere else in your gastrointestinal tract, 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 need a 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 choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

What are possible drug interactions with daily aspirin therapy?

If you're already taking an anticoagulant, such as warfarin (Coumadin, Jantoven), dabigatran (Pradaxa) or rivaroxaban (Xarelto) 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, such as with 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. Medications that can interact with aspirin include:

  • Heparin
  • Ibuprofen (Advil, Motrin, others), when taken regularly
  • Corticosteroids
  • Some antidepressants (clomipramine, paroxetine, others)

Taking some dietary supplements can also increase your bleeding risk. These include:

  • Danshen
  • Dong quai
  • Evening primrose oil
  • Ginkgo
  • Omega-3 fatty acids (fish oil)
  • Policosanol
  • Willow bark

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

If you think you're having a heart attack, the most important thing for you to do is call 911 or emergency medical services. Don't delay calling for help. Aspirin alone won't save your life if you're having a heart attack.

The operator may advise you to chew an aspirin, but will first ask questions to make sure you're not allergic to aspirin or have any other health conditions that would make taking an aspirin during a heart attack too risky. It's OK to chew an aspirin if your doctor has previously told you to do so if you think you're having a heart attack — but call 911 or emergency medical services first.

Should you take a coated aspirin?

Enteric-coated aspirin is designed to pass through your stomach and not disintegrate until it reaches your small intestine. It's gentler on the stomach and may be appropriate for some people who take a daily aspirin, especially in those with a history of gastritis or ulcers. However, some researchers think there's no evidence that taking an enteric-coated aspirin decreases your chance of developing gastrointestinal bleeding. Talk to your doctor if you're concerned about ways to decrease your bleeding risk.

May. 20, 2014 See more In-depth