Aspirin relieves pain and reduces the risk of cardiovascular disease. However, it can also cause bleeding in the stomach and other side effects. Following the recommendations for proper use of aspirin can help reduce the chance of these side effects occurring.

Aspirin should be taken with mild food or an antacid to reduce the chance of stomach irritation, unless it is coated to be gentler to the stomach (enteric coated). These coated tablets should not be chewed, crushed or broken, except in the case of emergency, such as during a heart attack. Some people’s gastrointestinal tracts cannot dissolve coated aspirin, and the medication will remain intact until it leaves the body in a bowel movement.

There are a number of side effects associated with aspirin use that have been reported by patients. These include:

• Stomach irritation, which could in time lead to ulcers, pain, heartburn, nausea, vomiting, internal bleeding or holes in the stomach or intestines
  
  
• Stomach damage, possibly indicated by bloody, black or tarry stools or by bloody vomit
  
  
• Facial swelling (usually indicates an allergy)
  
  
• Asthma attack (another indicator of allergy)
  
  
• Ringing in the ears (tinnitus), when taken in high doses
  
  
• Risk of bleeding in the brain, a medical emergency that could lead to stroke
  

Aspirin should never be taken in place of other medications or treatments recommended by a physician. Furthermore, people taking an anticoagulant (medication to prevent blood from clotting) should not take aspirin unless advised by a physician. This is because both medications increase the risk of bleeding.

People taking another nonsteroidal anti-inflammatory drug (NSAID) may also be discouraged from taking aspirin. If a physician recommends that a patient take a daily aspirin and another NSAID, the NSAID must be taken more than two hours after the aspirin or the aspirin will not be effective.

Finally, people should not take aspirin if they are pregnant, hypertensive, allergic to certain medications or about to undergo surgery, unless specifically recommended by their physician.

Recent research indicates that taking aspirin or other NSAIDs around the time of a vaccination may hinder the vaccine’s effectiveness. Organizations such as the American Diabetes Association advise people with diabetes to have a pneumonia vaccination and annual flu shots, and diabetic girls and women should ask their physician about how the new HPV vaccine may reduce the increased risk of cervical cancer that is associated with diabetes.

Patients are encouraged to consult their physician about the benefits and risks of aspirin. Regulators at the U.S. Food and Drug Administration are proposing tougher, mandatory warning labels for aspirin and other over-the-counter NSAIDs, such as the potential for stomach bleeding in people who are older than 60, have a history of gastric ulcers or bleeding, take anticoagulants, drink alcohol or take the drug for a period longer than directed.