How Genes Influence The Breakdown Of Aspirin

What Is Aspirin?

Aspirin is a common, non-prescription drug used to relieve pains, aches, and fever.

Some people also use aspirin as an anti-inflammatory drug and a blood thinner.

The generic name for aspirin is acetylsalicylate, and this compound is found in willow trees and myrtle plants.

Aspirin is usually available in the oral form but may also be available with other medications like antacids, pain killers, and cold and cough medicines.

Non-prescription aspirin is available as a regular tablet, a delayed-release tablet, a chewable tablet, powder, and gum to be taken orally.

Non-prescription aspirin is usually recommended to be taken every four to six hours for fever and pain and once a day if you take the drug to reduce the risk of heart attack or stroke.

Prescription aspirin comes in extended-release or long-acting tablets and is recommended to be taken two or more times a day.

Due to the risks associated with taking the drug, you must always take aspirin exactly as directed by your physician.

Is Aspirin An NSAID?

Aspirin is a nonsteroidal anti-inflammatory drug or NSAID and was the first drug of this class to be discovered.

It reduces the number of prostaglandins (compounds made in response to tissue damage or infection) produced by the body and thereby relieves pain.

Other NSAIDs include ibuprofen, naproxen, etc.

What Is Baby Aspirin?

Baby aspirin refers to the lowered dose of the drug used in children.

A single pill of baby aspirin contains 81 milligrams of the drug and is one-fourth of the amount found in adult aspirin, which is 325 milligrams.

According to a new study published in the USA, baby aspirin dosage may be the best for heart health.

According to the latest guidelines on the use of baby aspirin for heart health, a thorough evaluation of your health and benefits vs. the risk of taking the drug must be performed by an expert before prescribing it.

What Is Aspirin Used For?

Due to its analgesic, anti-inflammatory, and antipyretic (fever lowering) properties, aspirin has a wide range of uses:

To relieve pain and swelling

Aspirin is used to relieve mild and moderate pain, aches, and swelling that are commonly seen in conditions like:

Cold and flu
Menstrual cramps
Toothache
Muscle sprains and strain
Arthritis
Migraines

To prevent cardiovascular events

Aspirin is also routinely used in low doses to lower the risk of blood clot formation and prevent cardiovascular diseases in a few people who:

Have heart disease or disease or blood vessels
Have poor blood flow to the brain
Have high cholesterol levels in the blood
Have high blood pressure
Have diabetes
Smoke

It is important to note that taking aspirin long-term can be harmful in people other than those who fall in the aforementioned groups.

To treat cardiac events

Aspirin may be prescribed to individuals who have suffered a stroke, heart attack, or any other cardiovascular event to prevent clot formation. It may be recommended to some individuals who have:

Had a revascularization surgery like angioplasty or coronary bypass surgery
Had a mini-stroke
Had an ischaemic stroke caused by a blood clot

Other uses

In addition to the uses of aspirin mentioned above, the drug may also be used to treat the following conditions:

Rheumatic and inflammatory joint conditions
Systemic lupus erythematosus
Inflammation around the heart (called pericarditis)

Low-dose aspirin is also recommended in people with:

Retinal damage
Diabetes for over ten years
A high risk of colorectal cancer

How Does Aspirin Work?

You feel pain when your nerves send an electrical signal to your brain. The damaged or injured tissues release chemicals called prostaglandins.

You feel pain when your nerves send an electrical signal to your brain.

Prostaglandins further intensify the electrical signal coming from the nerves, which increases the pain you feel.

Aspirin modifies an enzyme called COX or cyclooxygenase which is required to produce prostaglandins.

When the structure of the COX enzyme is changed, it results in the blocking of prostaglandins producing, thereby relieving pain and inflammation.

https://www.xcode.life/wp-content/uploads/2022/01/aspirin_nsaid_painkiller_cox_mechanism.png

Image: Pain relieving mechanism of Aspirin

Is Aspirin A Blood Thinner?

Low doses of aspirin are used as a blood thinner to prevent stroke and heart attacks in people at high risk of experiencing these events.

Aspirin makes blood less sticky and reduces its clotting ability when given in low doses.

Aspirin as a blood thinner is prescribed to individuals who have recently undergone heart surgery or have had chest pain due to heart disease, etc.

Low doses of aspirin are also used as a blood thinner in children with Kawasaki disease (a rare illness that may require heart surgery).

Before taking low doses of aspirin, inform your doctor if you have any of the following conditions to avoid any adverse effects:

Allergy to aspirin or NSAID painkillers
History of stomach ulcer
High blood pressure
Digestion issues
Heavy menstrual bleeding or periods
Recent history of stroke in some individuals
Asthma
History of lung disease
Clotting trouble
Liver and kidney problems
Gout

Can Aspirin Lower Blood Pressure?

Most NSAIDs are known to increase blood pressure and reduce the effect of anti-hypertensive drugs.

However, studies have shown that low doses of aspirin may lower blood pressure and can be used to prevent hypertension.

A Spanish study showed that taking low doses of aspirin at night lowered blood pressure in prehypertensive patients.

Pregnant women at a high risk of developing preeclampsia may be prescribed low doses of aspirin at bedtime to reduce blood pressure.

Can You Give Dogs Aspirin?

Seeing your canine friend in pain can be difficult if you are a dog owner.

Many dog owners reach out for the aspirin in their drug cabinet for relieving their dog’s pain.

However, never give your dog aspirin without a vet’s prescription.

Though veterinarians prescribe aspirin to dogs in pain, they do so only for certain conditions like osteoarthritis or to relieve musculoskeletal inflammation.

Aspirin in greater quantities may be toxic to your dog or cause severe side effects in them.

Side Effects Of Aspirin

Though aspirin is readily available as an over-the-counter medicine and is largely safe, it may cause side effects in some people.

Some common side effects of aspirin are:

Irritation in the stomach or gut
Nausea
Indigestion
Heartburn
Stomach pain
Vomiting

Some less common or rare side effects of aspirin include:

Worsening of asthma symptoms
Inflammation in the stomach
Stomach bleeding
Bruising on the skin

If you experience any of the following serious side effects of aspirin, discontinue it and call your doctor immediately:

Hives
Rash on the skin
Wheezing or difficulty in breathing
Swelling of the face, eyes, lips, and throat
Cold and clammy skin
Heart palpitations
Blood in vomit
Ringing in the ears
Black, tarry stools
Bright red blood in stools

Some severe side effects of aspirin are bleeding in the brain and stomach and kidney failure.

How Long Does Aspirin Stay In Your System?

Once aspirin reaches the stomach, it is rapidly absorbed there and in the intestine.

Around 75% of the drug is eliminated via the urine.

The usual effect of aspirin lasts about 4-6 hours, but the platelet inhibitory effect (or blood-thinning effect) may last up to 10 days.

Can Aspirin Hurt Your Kidneys?

Taking excessive amounts of aspirin long-term can damage your kidneys.

According to the National Kidney Foundation, around 3% to 5% of new chronic kidney failure cases are due to excessive usage of painkillers like aspirin.

Taking aspirin or other pain killers worsens kidney damage.

Kidney damage due to pain killers can be due to reduced blood flow to the kidney.

Is Aspirin Good For Your Heart?

Aspirin helps prevent blood clotting, which is a major cause of cardiac events, heart attacks, and strokes.

Therefore, lower doses of aspirin are prescribed to people at a high risk of developing heart attacks and stroke.

Aspirin: Interactions With Other Drugs

Aspirin may interact with other medications when taken together.

So, you must inform your doctor about the current medications that you are taking.

Some significant drug interactions of Aspirin are:

NSAIDs

Taking aspirin with other NSAIDs like ibuprofen, naproxen, or diclofenac may increase the risk of stomach bleeding.

Therefore, always speak to your doctor before taking these drug combinations.

Can I Take Aspirin And Ibuprofen Together

Both aspirin and ibuprofen are NSAIDs that are used to treat mild to moderate pain.

But, you should not take them together as it increases the risk of stomach bleeding, hearing problems, and allergic reactions.

Selective Serotonin Reuptake Inhibitors (SSRI) and Antidepressants

Consuming aspirin with drugs like citalopram, fluoxetine, paroxetine, or venlafaxine, can increase the risk of bleeding.

Warfarin

Warfarin is a blood thinner, just like aspirin.

When these two drugs are taken together, it enhances the anticoagulant effect on the body and significantly increases the risk of bleeding.

Methotrexate

Methotrexate is used in the treatment of cancer and some autoimmune diseases.

If you are taking methotrexate, taking aspirin can make eliminating methotrexate difficult, thereby increasing its levels in the body.

This accumulation of methotrexate may cause harmful effects.

Aspirin: Gene-Drug Interactions

The PPARG Gene

The PPARG gene gives instructions for producing peroxisome proliferator-activated receptor subfamily of nuclear receptors.

A type of these receptors called the gamma variant plays a role in conditions like obesity, diabetes, atherosclerosis, and cancer.

Studies have shown that a single nucleotide polymorphism or SNP, rs3856806, in the PPARG gene plays a role in developing aspirin-intolerant asthma.

People with the TT type of this SNP have an increased risk for aspirin hypersensitivity than those with the CT and the CC types.

The PEAR1 Gene

The PEAR1 gene gives instructions for the production of platelet endothelial aggregation receptor 1 .

This receptor plays a role in platelet aggregation, which leads to blood clotting.

rs12041331 is an SNP in the PEAR1 gene.

When treated with aspirin, people with the AA type of this SNP were more likely to experience a cardiovascular event like heart attack, stroke, or death than those with AG and GG alleles.

Recommendations To Use Aspirin

Medical History

Inform your doctor about your medical history and any conditions like heartburn, stomach pain, bleeding problems like hemophilia, kidney or liver disease, as these conditions may get aggravated on taking aspirin.

History of Allergy

Suppose you have had an allergic reaction to aspirin, any other medication used to reduce fever and pain, or tartrazine dye, you must inform your doctor before taking aspirin.

Additionally, if you have a history of asthma, frequent stuffy or runny nose, or nasal polyps, you may be at a high risk of developing an allergy to aspirin.

Pregnancy and Breastfeeding

Inform your doctor if you are pregnant, plan to conceive soon, or breastfeed.

Pregnant women are not recommended to take aspirin over 81 mg around or after 21 weeks of pregnancy and never without a doctor’s prescription.

In some women, a low dose of aspirin may be prescribed to prevent complications of hypertension.

Aspirin is excreted into breast milk and may cause adverse effects in your baby. So, you must inform your doctor if you are breastfeeding before taking aspirin.

Alcohol Consumption

If you consume alcohol (more than three drinks a day), inform your doctor about the same before taking aspirin or other pain and fever-relieving medicines.

Genetic Testing

Genetic testing helps your doctor determine your risks after taking aspirin and if you are susceptible to cardiovascular events like stroke, heart attacks, etc.

Analyze Your Genetic Response to Aspirin

How Much Aspirin Can You Take In One Day?*

The recommended dosage of aspirin varies based on the need, from 50 mg to 6000 mg per day.

You should always take aspirin with food.

Condition	Dosage
Mild to moderate pains and aches	350 mg to 650 mg every 4 hours or 500 mg every 6 hours
Rheumatoid arthritis	500 mg every 4-6 hours; 650 mg every 4 hours; 100 mg every 4-6 hours; 1950 mg twice a day
To prevent heart attacks in high-risk individuals	75-325mg/day
Heart attack symptoms	160 to 325 mg non-enteric coated aspirin
Stroke prevention	75-100mg/day

*The dosage recommendations are for informational purposes only. Please consult with your physician for the appropriate drug dosage.

Who Should Not Take Aspirin?

The following people should avoid aspirin:

Those with liver or kidney disease
Those who consume more than three alcoholic drinks per day
Those with uncontrolled high blood pressure
Those on anticoagulant therapy (on blood thinners)
Those who experience symptoms of stroke
Pregnant and breastfeeding women

Summary

Aspirin is a common NSAID drug used to relieve pains, aches, and fever.
In low doses, aspirin is also used to prevent heart attack and stroke in high-risk individuals.
Though usually available as a solo drug, aspirin may be found in combination with other pain relievers and antacids.
Like other NSAIDs, aspirin relieves pain by reducing the production of prostaglandins.
Aspirin acts as a blood thinner as it prevents the aggregation of platelets (a requirement for blood clotting).
Aspirin may be used to lower blood pressure in some individuals, but research is still underway in this regard.
Though largely safe, aspirin may cause side effects in some individuals.
Aspirin reacts with other NSAIDs, antidepressants, warfarin, and methotrexate.
PPRAG and PEAR1 genes influence how you may respond to aspirin and your risk for various side effects.
To ensure the safe use of aspirin, inform your doctor about your medical history, medications, allergy, pregnancy, and breastfeeding.
Genetic testing helps your doctor determine your risk of adverse reactions due to aspirin consumption.

References

A Sneak Peek Into The Personalized Medicine Report

Know Your Response To Drug Therapies Using Your 23andMe, AncestryDNA Raw Data!