Aspirin Powerful Action, Best Uses, Side effects & 20 Brands in Pakistan

Introduction

Aspirin, also known as acetylsalicylic acid (ASA), is a nonsteroidal anti-inflammatory drug (NSAID) widely used globally. It is known for its pain-relieving, anti-inflammatory, and antipyretic properties. It was first synthesized in the late 19th century and has since become a cornerstone of modern medicine. It is used to treat mild to moderate pain, inflammation, and arthritis, and also helps lower the risk of heart attacks, strokes, and blood clots when taken in low doses regularly.

Mechanism of Action

Aspirin works by inhibiting the enzyme cyclooxygenase (COX). This enzyme plays a key role in the synthesis of prostaglandins, which are compounds involved in inflammation, pain, and fever. By blocking COX, aspirin reduces the production of these prostaglandins, thereby alleviating symptoms.

Types of COX Enzymes

There are two main types of COX enzymes: COX-1 and COX-2. COX-1 maintains the stomach lining and regulates blood platelets, while COX-2 is primarily involved in inflammation and pain. Aspirin inhibits both COX-1 and COX-2, which explains its wide range of effects.

Aspirin in Pakistan

Aspirin is widely available and commonly used in Pakistan, reflecting its status as a foundational medication in healthcare. It is readily accessible in both urban centers and rural areas, often found in pharmacies and hospitals across the country.

Aspirin’s affordability and versatility make it a preferred choice for managing various conditions, including pain relief, fever reduction, and cardiovascular protection. Its role extends to preventive healthcare, particularly in reducing the risk of heart attacks and strokes when taken regularly in low doses.

Despite the availability of newer medications, it remains a trusted and widely utilized option due to its established effectiveness and cost-effectiveness in the healthcare landscape of Pakistan.

Uses of Aspirin

Aspirin is a versatile medication widely used in both over-the-counter and prescription treatments. It not only relieves pain but also plays an important role in heart health and may help prevent some cancers. Here is a detailed overview of the uses of aspirin:

Pain Relief

Aspirin is commonly used to relieve mild to moderate pain, such as headaches, toothaches, and muscle aches. Its effectiveness in pain relief is due to its ability to reduce inflammation and block pain signals.

Anti-Inflammatory

As an anti-inflammatory agent, aspirin is used to treat conditions like arthritis and other inflammatory disorders. By reducing inflammation, aspirin helps alleviate pain and improve function in affected joints.

Antipyretic

Aspirin is also used to reduce fever. It achieves this by acting on the hypothalamus, the part of the brain that regulates body temperature.

Cardiovascular Protection

One of the most significant uses of aspirin is in the prevention of cardiovascular diseases. Low-dose aspirin therapy is often recommended for individuals at high risk of heart attacks and strokes.Its antiplatelet properties help prevent blood clots, which can block blood vessels and lead to these life-threatening events.

Aspirin and Heart Attack

It is often given during a heart attack to reduce the risk of further clots and improve survival rates. Its rapid antiplatelet effect helps prevent the expansion of existing clots and the formation of new ones.

Aspirin and Stroke

For patients who have experienced a stroke or are at high risk, this drug reduces the likelihood of future strokes. However, it is crucial to consult a healthcare provider before starting aspirin therapy, as it is not suitable for everyone.

Aspirin and Cancer

According to Cancer Research UK, aspirin might lower the risk of developing certain cancers. It may also help prevent some cancers from spreading and reduce the risk of death from cancer. However, more research is needed to fully understand these potential benefits and establish clear guidelines for its use in cancer prevention and treatment.

 Dosage and Administration

The appropriate dosage of aspirin depends on the condition being treated. Here are the general guidelines:

• For pain relief and fever reduction: Take 325-650 mg every 4-6 hours.
• For cardiovascular protection: Take 81-325 mg per day.

As directed on the packaging or prescription label, take this drug orally along with a glass of water. You can take it with or without food, but if it makes you feel queasy, you should eat something. Never take it more frequently than prescribed.

Special Considerations

• Children: Consult your healthcare provider before giving this drug to children. It may be prescribed for children as young as 12 years for selected conditions, but precautions apply. Children and teenagers should not use aspirin to treat chickenpox or flu symptoms unless directed by a healthcare provider.
• Older Adults: Patients over 65 years old may have a stronger reaction and may need a smaller dose.
• Overdosage: If you think you have taken too much aspirin, contact a poison control center or emergency room immediately.

Missed Dose

Take the missed dose as soon as you remember if you’re on a regular schedule. Take only the next dose and skip the missed one if your next dose is soon due. Never take more than one dose or two.

Benefits

Key benefits of Aspirirn include:

Accessibility and Affordability

Aspirin is widely available and relatively inexpensive, making it accessible to a large population. Its over-the-counter status means that people can obtain it without a prescription.

Versatility

The versatility of aspirin is one of its greatest strengths. It can be used to treat a wide range of conditions, from minor aches and pains to serious cardiovascular diseases.

Long History of Use

With over a century of clinical use, it has a well-established safety and efficacy profile. This extensive history provides confidence in its use for various medical conditions.

 Side Effects

Aspirin may cause side effects. Inform your doctor if any of these symptoms are severe or do not go away:

• Nausea
• Vomiting
• Stomach pain
• Heartburn

Some side effects can be serious. Notify your physician if any of the following symptoms are severe or persistent:

• Hives
• Rash
• Swelling of the eyes, face, lips, tongue, or throat
• Wheezing or difficulty breathing
• Hoarseness
• Fast heartbeat
• Fast breathing
• Cold, clammy skin
• Ringing in the ears
• Loss of hearing
• Bloody vomit
• Vomit that looks like coffee grounds
• Bright red blood in stools
• Black or tarry stools

History of Aspirin

Medicines derived from willow and other salicylate-rich plants are documented in ancient Sumerian clay tablets and the Ebers Papyrus from ancient Egypt. Around 400 BC, Hippocrates mentioned using salicylic tea to reduce fevers. Willow bark preparations were a staple in Western medicine from classical antiquity through the Middle Ages. By the mid-18th century, willow bark extract was recognized for its effects on fever, pain, and inflammation. During the 19th century, pharmacists experimented with various chemicals related to salicylic acid, the active component of willow extract.

In 1853, chemist Charles Frédéric Gerhardt first synthesized acetylsalicylic acid by treating sodium salicylate with acetyl chloride. Later in the 19th century, other chemists refined its chemical structure and synthesis methods. In 1897, scientists at Bayer began investigating acetylsalicylic acid as a less irritating alternative to common salicylate medicines and discovered a new synthesis method. By 1899, Bayer branded the drug as Aspirin and began selling it worldwide. Although “Aspirin” was initially Bayer’s brand name, the company lost or sold its trademark rights in many countries. Aspirin’s popularity surged in the early 20th century, leading to fierce competition among various brands and products.

Aspirin’s popularity declined after the introduction of acetaminophen (paracetamol) in 1956 and ibuprofen in 1962. In the 1960s and 1970s, researchers like John Vane uncovered the basic mechanism of aspirin’s effects. Clinical trials from the 1960s to the 1980s demonstrated aspirin’s efficacy as an anti-clotting agent, reducing the risk of clotting diseases. The significant studies on low-dose aspirin for heart attack prevention published in the 1970s and 1980s played a role in reforming clinical research ethics and guidelines for human subject research, highlighting issues of gender bias in clinical trials.

Its sales revived significantly in the late 20th century and remain strong in the 21st century due to its widespread use as a preventive treatment for heart attacks and strokes.

Precautions

Before taking aspirin, it’s important to consider the following precautions:

• Allergies: Inform your doctor if you are allergic to aspirin, other pain or fever medications, tartrazine dye, or any other medications.
• Interactions: If you take this drug regularly to prevent heart attacks or strokes, do not use ibuprofen (Advil, Motrin) for pain or fever without consulting your doctor. Allow time between your aspirin dose and ibuprofen.
• Medical Conditions: Notify your doctor if you have asthma, frequent nasal congestion, nasal polyps, heartburn, stomach issues, ulcers, anemia, bleeding disorders, or kidney/liver disease.
• Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, discuss with your doctor before using aspirin. Low-dose aspirin (81 mg) may be prescribed during pregnancy, but higher doses can harm the fetus, especially after 20 weeks of pregnancy. Avoid doses higher than 81 mg unless specifically directed by your doctor.
• Surgery: Inform your healthcare providers, including dentists, that you are taking this drug if you are scheduled for surgery, including dental procedures.
• Alcohol Consumption: If you regularly consume three or more alcoholic drinks per day, consult your doctor before using this drug or other pain medications.

Drug Interactions

Avoid taking aspirin with the following medications:

• Cidofovir
• Ketorolac
• Probenecid

It may also interact with the following:

• Alcohol
• Alendronate
• Bismuth subsalicylate
• Flavocoxid
• Herbal supplements such as feverfew, garlic, ginger, ginkgo biloba, and horse chestnut
• Medications for diabetes or glaucoma like acetazolamide and methazolamide
• Medications for gout
• Medications that prevent or treat blood clots such as apixaban, clopidogrel, enoxaparin, heparin, rivaroxaban, and warfarin
• Other aspirin and aspirin-like medications
• NSAIDs and medications for pain and inflammation like ibuprofen or naproxen
• Pemetrexed
• Sulfinpyrazone
• Varicella live vaccine

This list may not include all possible interactions. Provide your healthcare provider with a comprehensive list of all medications, herbs, non-prescription drugs, and dietary supplements you use. Additionally, inform them about your smoking, alcohol consumption, and use of illegal drugs, as these factors can also interact with this medicine. Understanding potential interactions will help ensure safe and effective treatment.

Brands in Pakistan

Here’s a list of aspirin brand names from various pharmaceutical companies in Pakistan:

1. Anaprin – Opal Laboratories (Pvt) Ltd.
2. Angipro – Unimark Pharmaceuticals
3. Anticlot – Euro Pharma International
4. Aslow- 81 is manufactured by Helix Pharma
5. ASA – Don Valley Pharmaceuticals (Pvt) Ltd.
6. Ascard – Atco Laboratories Limited
7. Askprin – Askari Pharmaceuticals
8. Aspisafe – Zafa Pharmaceutical Laboratories (Pvt) Ltd.
9. Aspiwan – Nawan Laboratories (Pvt) Ltd.
10. Aspin is manufactured by Cipla Ltd.
11. Caprin EC – Candid Pharmaceuticals
12. Disprin is manufactured by Reckitt Benckiser Pakistan Ltd.
13. Doloprin-75 – Pacific Pharmaceuticals Ltd.
14. Ecotrin – Wilshire Laboratories (Pvt) Ltd.
15. Erocid – Eros Pharmaceuticals
16. Glorin – Global Pharmaceuticals
17. Jeprin – Genome Pharmaceuticals (Pvt) Ltd.
18. Loprin – Highnoon Laboratories Ltd.
19. Masprin – Mass Pharma (Private) Limited
20. Mini Prin – Bloom Pharmaceuticals (Pvt) Ltd.

Alternatives to Aspirin

Acetaminophen

Acetaminophen (Paracetamol) is an alternative pain reliever and fever reducer that does not have anti-inflammatory properties. It is less likely to cause gastrointestinal bleeding but can cause liver damage if taken in high doses.

Ibuprofen

Ibuprofen (Advil, Motrin) is another NSAID that relieves pain, reduces inflammation, and lowers fever. It is generally well-tolerated but can also cause gastrointestinal issues.

Other NSAIDs

Other NSAIDs, such as naproxen (Aleve), offer similar benefits to aspirin and ibuprofen. They can be used as alternatives for individuals who cannot tolerate this drug.

Aspirin in the Future

Ongoing Research

Research continues to explore new uses and benefits of this drug. Studies are investigating its potential role in preventing and treating various cancers, Alzheimer’s disease, and other chronic conditions.

Personalized Medicine

As our understanding of genetics and personalized medicine advances, there may be opportunities to tailor aspirin therapy to individual patients based on their genetic makeup and risk factors.

Conclusion

Aspirin remains a vital medication in modern healthcare. Its wide range of uses, from pain relief to cardiovascular protection, underscores its importance. However, it is essential to use this drug responsibly and under the guidance of a healthcare provider, especially given its potential side effects and interactions. As research progresses, we may uncover more benefits and applications for this remarkable drug.