Abstract

MORENO-BREA, M. R.. Aspirin tolerability. Rev. Soc. Esp. Dolor [online]. 2005, vol.12, n.6, pp.357-372. ISSN 1134-8046.

The acetylsalicylic acid (ASA) is a widely used drug worldwide, both as prescription and over-the-counter products, and both as the only active drug or associated to other drugs in fixed doses. It is used either occasionally for the management of acute symptomatic conditions, or continuously in prophylactic anti-thrombotic regimes. Its profile of adverse reactions and potential interactions with other drugs makes it very important to have a well-tolerated and safe substance. Both things are particularly relevant when the population exposed to this drug has reached a certain age, since its specific features may increase its susceptibility to side effects and complications. Aspirin shares the general profile of adverse reactions of the NSAIs and it is considered as its prototype. When acutely administered, the incidence of side effects, most of them light, are the same as with other analgesics. Gastrointestinal effects are the most frequent of all and several risk factors have been identify for the development of severe gastrointestinal complications. These risk factors must be considered along with the need to take prophylactic measures in order to reduce the morbi-mortality. In recent years, special attention has been devoted to hypersensitivity reactions, in particular Aspirin-induced asthma, and potential cross-reactions with other frequently used NSAIs. The most susceptible sub-population for asthmatic reactions has well-defined features. The anti-aggregation effects of Aspirin can complicate some conditions associated to hemostasis disorders; however, its benefit has been shown for the prevention of athero-thrombotic vascular accidents. The Reye´s Syndrome is a rare but severe condition in which the use of Aspirin is contraindicated in children or adolescents with fever or certain viral infections. Given the extensive use of Aspirin, it can generally be considered a well-tolerated drug whose most severe adverse reactions require special pharmacovigilance, as well as special attention to high risk populations. This also suggests the need to implement health education programs about the use of analgesics. In any case, Aspirin is still a reference drug with a high therapeutic potential derived from the benefits provided by its use.

Keywords : Aspirin; NSAIs; Tolerability; Adverse reactions to drugs; Interactions; Elderly; Gastropathy; Asthma.

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