What Should Be Avoided When Taking Aspirin?

Drugs that interact with aspirin include lithium, methotrexate, blood thinners, diuretics, antiplatelet drugs, antidepressants, other salicylates, phenytoin (Dilantin, Phenytek), cyclosporine, dichlorphenamide, mifepristone, corticosteroids (such as prednisone), and Ginkgo biloba.

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation in the body, to treat fever, to prevent blood clots, and to reduce the risk of strokes and heart attacks. 

Aspirin may be used off-label (a use not approved by the Food and Drug Administration, or FDA) to decrease the risk of developing hereditary colorectal cancer (i.e., Lynch syndrome).  

Brand and other names for aspirin include Bayer Buffered Aspirin, Durlaza, ASA, Bayer Children's Aspirin, Bayer Women's Low Dose, Bayer Low Adult Strength, Bayer Advanced Aspirin, Bayer Extra Strength, Bayer Extra Strength Plus, Bufferin, Bufferin Extra Strength, Ecotrin, Ecotrin Maximum Strength, Extended Release Bayer 8-Hour Caplets, Extra Strength Bayer Plus Caplets, Genuine Bayer Aspirin, Halfprin DSC, Maximum Bayer Aspirin, St. Joseph Adult Chewable Aspirin, St. Joseph Regular Strength, acetylsalicylic acid, and Vazalore.

Aspirin Drug Interactions

Aspirin may interact with other drugs, including: 

• Lithium
• Methotrexate
• Blood thinners, such as warfarin (Jantoven) or heparin
• Diuretics
• Antiplatelet drugs such as clopidogrel
• Antidepressants
• Other salicylates
• Phenytoin (Dilantin, Phenytek)
• Cyclosporine
• Dichlorphenamide
• Mifepristone
• Corticosteroids (such as prednisone)
• Ginkgo biloba

Check all prescription and over-the-counter (OTC) labels carefully since many medications contain pain relievers/fever reducers (including aspirin and other NSAIDs such as ibuprofen, naproxen, and ketorolac). 

Avoid use of aspirin if you: 

• Have a stomach or intestinal ulcer or you had bleeding in the gut because aspirin and other NSAIDs can damage the stomach or intestines
• Have heart disease or ever had a stroke, because aspirin and other NSAIDs can increase the risk of heart attack, heart failure, and stroke
• Have kidney disease, heart failure, or cirrhosis, because aspirin and other NSAIDs can worsen heart failure, kidney disease, and cirrhosis 
• Take diuretics (“water pills”), because aspirin and other NSAIDs can cause kidney problems in people taking diuretics or some other medicines to control blood pressure
• Have high blood pressure, because aspirin and other NSAIDs can raise blood pressure 
• Have disorders that increase the risk of bleeding
• Have surgery planned, because most people need to stop aspirin and other NSAIDs at least several days to a week before surgery to lower the risk of bleeding
• Are pregnant, because use of aspirin and other NSAIDs during the last 3 months of pregnancy should be avoided

Side effects of aspirin include:

• Rash
• Gastrointestinal ulcers or bleeding
• Abdominal pain
• Upset stomach
• Heartburn
• Drowsiness
• Headache
• Cramping
• Nausea
• Gastritis
• Bleeding
• Skin swelling (angioedema)
• Bronchospasm
• Liver toxicity
• Hearing loss
• Kidney damage
• Ringing in the ears (tinnitus)
• Hives
• Vomiting