lUNLICENSED USENot licensed for use in children under
16 years.
lCONTRA-INDICATIONSActive peptic ulceration.bleeding
disorders (antiplatelet dose).children under 16 years (risk
of Reye’s syndrome).haemophilia.previous peptic
ulceration (analgesic dose).severe cardiac failure
(analgesic dose)
CONTRA-INDICATIONS, FURTHER INFORMATION
▶Reye’s syndromeOwing to an association with Reye’s
syndrome, aspirin-containing preparations should not be
given to children under 16 years, unless specifically
indicated, e.g. for Kawasaki disease.
lCAUTIONSAllergic disease.anaemia.asthma.
dehydration.G6PD deficiency.preferably avoid during
fever or viral infection in children (risk of Reye’s
syndrome).previous peptic ulceration (but manufacturers
may advise avoidance of low-dose aspirin in history of
peptic ulceration).thyrotoxicosis.uncontrolled
hypertension
lINTERACTIONS→Appendix 1 : aspirin
lSIDE-EFFECTS
▶Common or very commonDyspepsia.haemorrhage
▶UncommonDyspnoea.rhinitis.severe cutaneous adverse
reactions (SCARs).skin reactions
▶Rare or very rareAplastic anaemia.asthmatic attack.
bronchospasm.erythema nodosum.gastrointestinal
haemorrhage (severe).granulocytosis.haemorrhagic
vasculitis.intracranial haemorrhage.menorrhagia.
nausea.thrombocytopenia.vomiting
▶Frequency not knownFluid retention.gastrointestinal
disorders.headache.hearing impairment.hepatic failure
.hyperuricaemia.iron deficiency anaemia.renal
impairment.sodium retention.vertigo
OverdoseThe main features of salicylate poisoning are
hyperventilation, tinnitus, deafness, vasodilatation, and
sweating. Coma is uncommon but indicates very severe
poisoning.
For specific details on the management of poisoning, see
Aspirin, under Emergency treatment of poisoning p. 832.
lALLERGY AND CROSS-SENSITIVITYAspirin iscontra-
indicatedin history of hypersensitivity to aspirin or any
other NSAID—which includes those in whom attacks of
asthma, angioedema, urticaria, or rhinitis have been
precipitated by aspirin or any other NSAID.
lPREGNANCYUse antiplatelet doses with caution during
third trimester; impaired platelet function and risk of
haemorrhage; delayed onset and increased duration of
labour with increased blood loss; avoid analgesic doses if
possible in last few weeks (low doses probably not
harmful); high doses may be related to intra-uterine
growth restriction, teratogenic effects, closure of fetal
ductus arteriosus in utero and possibly persistent
pulmonary hypertension of newborn; kernicterus may
occur in jaundiced neonates.
lBREAST FEEDINGAvoid—possible risk of Reye’s syndrome;
regular use of high doses could impair platelet function
and produce hypoprothrombinaemia in infant if neonatal
vitamin K stores low.
lHEPATIC IMPAIRMENTAvoid in severe impairment—
increased risk of gastro-intestinal bleeding.
lRENAL IMPAIRMENTUse with caution; avoid in severe
impairment; sodium and water retention; deterioration in
renal function; increased risk of gastro-intestinal bleeding.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Aspirin for prevention of blood
clotswww.medicinesforchildren.org.uk/aspirin-prevention-
blood-clots- 0lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: capsule, oral suspension, oral solution
Gastro-resistant tablet
CAUTIONARY AND ADVISORY LABELS5, 25, 32
▶Aspirin (Non-proprietary)
Aspirin 75 mgAspirin 75 mg gastro-resistant tablets| 28 tabletp
£ 0. 52 DT = £ 0. 52 | 56 tabletp£ 1. 04 – £ 1. 66
Aspirin 300 mgAspirin 300 mg gastro-resistant tablets|
100 tabletP£ 20. 34 DT = £ 20. 34
▶Micropirin(Dexcel-Pharma Ltd)
Aspirin 75 mgMicropirin 75 mg gastro-resistant tablets|
28 tabletp£ 1. 45 DT = £ 0. 52 | 56 tabletp£ 2. 87
▶Nu-Seals(Alliance Pharmaceuticals Ltd)
Aspirin 75 mgNu-Seals 75 gastro-resistant tablets| 56 tabletp
£ 3. 12
Tablet
CAUTIONARY AND ADVISORY LABELS21, 32
▶Aspirin (Non-proprietary)
Aspirin 75 mgAspirin 75 mg tablets| 28 tabletP£ 1. 13 DT =
£ 1. 12
Aspirin 300 mgAspirin 300 mg tablets| 100 tabletP£ 1. 12 –
£ 10. 47
Suppository
CAUTIONARY AND ADVISORY LABELS 32
▶Aspirin (Non-proprietary)
Aspirin 150 mgAspirin 150 mg suppositories| 10 suppositoryp
£ 18. 67 DT = £ 18. 67
Aspirin 300 mgAspirin 300 mg suppositories| 10 suppositoryp
£ 35. 89 DT = £ 35. 89
Dispersible tablet
CAUTIONARY AND ADVISORY LABELS13, 21, 32
▶Aspirin (Non-proprietary)
Aspirin 75 mgAspirin 75 mg dispersible tablets| 1000 tabletP
£ 11. 79 – £ 18. 57
Aspirin 300 mgAspirin 300 mg dispersible tablets| 32 tabletP
sDT = £ 0. 66 | 100 tabletP£ 2. 06 DT = £ 2. 06
▶Danamep(Ecogen Europe Ltd)
Aspirin 75 mgDanamep 75 mg dispersible tablets| 28 tabletP
£ 0. 50 DT = £ 0. 33Dipyridamole
lINDICATIONS AND DOSE
Kawasaki disease (initiated under specialist supervision)
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 1 month–11 years: 1 mg/kg 3 times a day
Prevention of thrombus formation after cardiac surgery
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 1 month–11 years: 2. 5 mg/kg twice daily
▶Child 12–17 years: 100 – 200 mg 3 times a daylUNLICENSED USENot licensed for use in children.
lCAUTIONSAortic stenosis.coagulation disorders.heart
failure.hypotension.left ventricular outflow obstruction.
may exacerbate migraine.myasthenia gravis (risk of
exacerbation)
lINTERACTIONS→Appendix 1 : dipyridamole
lSIDE-EFFECTS
▶Common or very commonAngina pectoris.diarrhoea.
dizziness.headache.myalgia.nausea.skin reactions.
vomiting
▶Frequency not knownAngioedema.bronchospasm.
haemorrhage.hotflush.hypotension.tachycardia.
thrombocytopenia
lPREGNANCYNot known to be harmful.
lBREAST FEEDINGManufacturers advise use only if
essential—small amount present in milk.
lDIRECTIONS FOR ADMINISTRATIONInjection solution can
be given orally.92 Blood clots BNFC 2018 – 2019
Cardiovascular system2