Aspirin - who's on regular and what dose?

[pellicle]

Hi

if you don't mind I'm curious about this as a recent study provided a linkage to Age related Macular Degeneration and long term aspirin use.

http://archinte.jamanetwork.com/article.aspx?articleid=1558456

the article did not mention specifics (and haven't attempted to seriously dig deeper yet) but it would be interesting to know what dose they were taking and what we may be taking.

I'm supposedly meant to be taking 50mg daily, but unlike my warfarin am not as regular, so its probably 3 days a week of that.

Would be interested to know if anyone is on higher doses or knows any more about that study

 

[skeptic49]

Interesting...I hope that there is no causal relationship. I have been on a daily aspirin (325mg) for years on the advice of my doctors.

 

[Mom2izzy]

Aspirin - who's on regular and what dose?

325mg daily for me too.

 

[lance]

I took low dose 7mg aspirin for years for it's anti-platelet qualities until I related it to ringing in my years about two years ago. An MD on TV this a.m. Mentioned the study of age-related macular degeneration and aspirin. I was diagnosed with it about a year ago. It's very slight so I'm not aware of it. I don't know if one is related to the other or not but am very glad I stopped aspirin when I did. The MD mentioned the study might be flawed and referred to low dose taken daily or any sized dose taken more than three times a week is suspect.

 

[pellicle]

The MD mentioned the study might be flawed and referred to low dose taken daily or any sized dose taken more than three times a week is suspect.

yes, I think that the study may have issues too. There is a more through one in the making at the moment, which may be published in the next few years

mean time I'm surprised at the dose ranges already reported 7 ~ 325mg

 

[JiFaire]

Chris, I've been on 81mg/daily for 6 years now, and I AM very regular with dosage. My AVR Surgeon kept me on it after my recent surgery.

Haven't had any issues; will look up that study, though. Thanks!

Cheers,
Jim

PS - Interesting; there are a TON of links online, all about 18hrs old.

I liked this one: http://heartcenterutah.com/your-hea... Center Utah - EBSCO - Healthday News Sidebar

(just because it had a common-sense-sort of approach)

From another article, inquiring about causality vs correlation:

From a purely science-of-medicine perspective, the strength of evidence is not sufficiently robust to be clinically directive. These findings are, at best, hypothesis-generating that should await validation in prospective randomized studies before guiding clinical practice or patient behavior. However, from an art-of-medicine perspective, based on the limited amount of available evidence, there are some courses of action available to the thoughtful clinician. In the absence of definitive evidence regarding whether limiting aspirin exposure mitigates AMD risk, one obvious course of action is to maintain the status quo. This is currently the most prudent approach, especially in secondary prevention settings where the benefits of aspirin are indisputable and greatly exceed the risk.8 For primary prevention of cardiovascular disease, where the evidence is less certain,9 the decision to prescribe aspirin should be predicated on the balance of risks (bleeding and possibly AMD) and benefits (cardiovascular disease and possibly cancer). For guideline-eligible patients (the 10-year risk of myocardial infarction in men aged 45-79 years is >4%, and the 10-year risk of stroke in women aged 55-79 years is >3%, and in whom the bleeding risk is low),10 the presence or absence of strong risk factors for neovascular AMD might tilt treatment decisions in one direction or the other. For patients taking long-term aspirin for other indications (pain control), caution is warranted in light of these observations.

In the final analysis, decisions about aspirin use are best made by balancing the risks against the benefits in the context of each individual's medical history and value judgments.

 

[epstns]

I have been taking 81 mg aspirin daily for about 8 or 10 years. I only bump into big things in the dark - can't blame the aspirin for that.

My take on the current study is that while there may be some correlation between aspirin usage and macular degeneration, there is no cause-and-effect relationship shown at the present. Means that they are both present in the same patients, but they haven't seen anything to prove that the aspirin causes the degeneration.

I'll wait and see. . .

 

[Gail in Ca]

I also take 81 mg enteric coated aspirin daily along with my coumadin. (aspirin-am, coumadin-pm).

 

[Tirone]

Even if there was a causal relationship between macular degeneration and aspirin, what counts is the risk and benefit ratio. Aspirin is proven to especially reduce the arterial side of thrombosis. If one is affected by a cardiac disease the benefit of preventing a heart ischemia will be way higher then the risk of macular degeneration. As long as there are no potent alternatives this probably wont change. However, it might be appropriate to asses a preventive application of aspirin in a patient without proven cardiac disease carefully.

 

[ramjet]

Its very early days and very small numers of patients that have been studied in a single centre.

Let me explain.

The benefits of aspirin was demonstrated in a huge (nearly 20,000 patient study), conducted in a randomised, multi centre (over 400 hospitals) and in the event of am yopcardial infarction, mortality was shown to be reduced in those people who took aspirin by somewhere between 10 and 20%...a huge benefit, so much so that the resuklts were published in one of the most prestious, peer review journels, The Lancet.

The side eefct of macular degeneration has been detected in a study that looked ta just over 2,000 patients, and teh results should be look ed at with interest, but lots of caution.

My take is that the reduction isn risk of clots and heart atatcks and occlusive strokes by taking regular aspirin far outweigh the (so far) remote possibility of macular degeneration. I guess the message here is have regular health and eye checks, I know the last time I got my glasses from the optometrist, he checked for macular degeneration, and took a picture of my retina for future comparisons to monitor for the development of this condition.

Early days, small numbers, read with interest, but don't, whatever you do, stop taking aspirin without specific medical advice....in my humble opinion anyway.

 

[Sarah_Louise]

75mg daily for me
Sarah xxx

 

[lance]

Hi Sarah Louise,
75 mgs daily, are you sure?

 

[Sarah_Louise]

Hi Sarah Louise,
75 mgs daily, are you sure?

Yup i'm sure lol
i take:
75mgs asprin,
20,000 units of heparin over 2mls,
100mg of carvedilol (was told the other day that's twice the recommended dosage for the UK)
25mg lostartan,
30mg lanzoprazol,
40mg frusimide,
1g of metformin
daily, excuse my spelling lol,
JW, why did you ask?
Sarah xxx

 

[Protimenow]

I'm sure that he asked because Aspirin - at least in the United States - is not available in 75 mg doses. It's either 81 mg (which is about 1/4 of a standard dose) or 325 mg (a standard dose). Unless you sliced a specific amount off of an 81 mg pill, you wouldn't be able to get a 75mg. (I don't know if Aspirin from foreign sources may be available in different strengths) but I don't think you can even find 75 mg in North America.

Of course, it looks like you're in the UK, so perhaps they offer 75 and 300 mg doses. (Hey, if they can drive on the wrong side of the road, why couldn't they confuse things with a different aspirin dose, too?)

 

[njean]

After my first two surgeries in 1975, my heart doctors advised me NEVER to take an aspirin. It was like voodoo or taboo to ever take it. The only meds I took for 25 years were coumadin and Lanoxin.

Then after my 3rd OHS in 2006, the doctors sent me home with low dose aspirin (81mg) along with 16 other meds! Many heart patients that I talk to today, say that they too take aspirin, usually in a low dose.

 

[Garserin]

I was started on a 81mg aspirin tablet daily right after surgery and I'm still taking it. When I went to Germany last summer I forget to take my aspirin along and had to buy it there. Interestingly enough the 81mg dose was not available, they use a 100mg as a therapeutic dose.

 

[Protimenow]

I started taking 81mg, too, just to keep my platelets a bit more 'slippery.' I've stopped, when I saw something associating continuous aspirin use with tinnitus (ringing in the ears). I've been off the 81 mg aspirin for a few weeks, but haven't seen any change in the tinnitus.

(Also - some 'interns' who examined me a few months ago went bananas when I told them that I was taking 81 mg aspirin in addition to my warfarin. Apparently, they had a few hours of discussion on anticoagulation, so they knew more than this 'iggurant' patient did)

 

[ramjet]

I started taking 81mg, too, just to keep my platelets a bit more 'slippery.' I've stopped, when I saw something associating continuous aspirin use with tinnitus (ringing in the ears). I've been off the 81 mg aspirin for a few weeks, but haven't seen any change in the tinnitus.

(Also - some 'interns' who examined me a few months ago went bananas when I told them that I was taking 81 mg aspirin in addition to my warfarin. Apparently, they had a few hours of discussion on anticoagulation, so they knew more than this 'iggurant' patient did)

Aspirin and warfarin interaction is interesting, and the use of aspirin with warfarin for specific conditions has changed over time, with new evidence and further studies showing that in some instanes, for some indications, aspirin can indeed be taken safely with warfarin....but....BUT... it must be prescribed by your doctor who knows all about your warfaarin and condition being treated and they must know exactly what else you are taking and in what dosages.

Remember, people take warfarin for different conditions (temporarily fo tissue valve, long term for mechanical valves, sometime for pulmonary embolus or DVTs, sometimes for atrial fibrillation etc). Aspriin interacts with warfin protein binding and can increase the effect of warfarin and increase the risk of bleeding, but at prescribed doses and with INR checking etc, it can be very effective at preventing clots. The messgae is don't start taking aspirin or stop taking aspirin or change the dose of asprin without checking with your doctor.

It doesn't surprise me that the interns were worried about a patient taking aspirin, because they had probably heard about the interaction of aspirin and warfarin in their pharamcology lessons, and perhaps hadn't been right up to date with current best practice. However, if you had started taking the aspirin without telling your doctor, or before surgery, or without having your INR checked, I would absolutely expect them to be concerned about your health...and I would think they would "go bananas", and apples and oranges