Aspirin
An anti-platelet medication used in selected stroke, retinal vascular, and cardiovascular prevention situations when bleeding risk is acceptable.
Drug Class: Cardiovascular
Aspirin is an anti-platelet medication that helps prevent blood clots. In neuro-ophthalmology, it's used for vascular conditions and prevention of stroke after transient vision loss.
Key Takeaways
- Prevents blood clots
- Used after transient vision loss from vascular causes
- Part of stroke prevention
- Low dose (81 mg) usually sufficient
- Increases bleeding risk
Common Uses
- After transient vision loss (amaurosis fugax)
- After retinal artery occlusion
- Microvascular cranial nerve palsy
- Secondary stroke/TIA prevention when recommended
- Established cardiovascular disease prevention when recommended; not routine primary heart disease prevention because bleeding risk may outweigh benefit
How It Works
- Inhibits platelet clumping
- Reduces blood clot formation
- Prevents vessel blockage
- Single dose effect lasts days (platelets affected for their lifespan)
Typical Dosing
- Low dose: 81 mg daily (baby aspirin)
- Sometimes 325 mg
- Take with food to reduce stomach upset
- Consistent daily dosing important
Side Effects
Common
- Stomach upset
- Heartburn
- Easy bruising
- Minor bleeding
Serious
- GI bleeding
- Hemorrhagic stroke (rare)
- Allergic reactions
Precautions
Do not give aspirin to children or teenagers with a viral illness - risk of Reye syndrome
Aspirin given during or shortly after a viral illness (flu, chickenpox, COVID, common cold) in anyone under about 19 has been linked to Reye syndrome, a rare but life-threatening condition that causes liver failure and brain swelling. For fever or pain in children and teens, use acetaminophen or ibuprofen instead, and ask your child's clinician before giving any aspirin-containing product (including some Pepto-Bismol formulations).
Avoid if:
- Active GI bleeding
- Bleeding disorder
- Known aspirin or NSAID allergy / aspirin-exacerbated respiratory disease (AERD: nasal polyps + asthma + aspirin sensitivity)
- Before certain surgeries (per surgeon's instructions)
- Children and teens with a viral illness (Reye syndrome risk, above)
Use Caution if:
- History of ulcers or GI bleeding
- On other blood thinners (warfarin, DOACs, clopidogrel)
- Kidney disease
- Asthma - about 7% of adults with asthma have aspirin sensitivity (closer to 14% in severe asthma) - known as aspirin-exacerbated respiratory disease (AERD)
- Pregnancy - high-dose aspirin in the third trimester is generally avoided
Drug Interactions
- Other blood thinners (increased bleeding)
- Ibuprofen (may reduce aspirin effect if taken first)
- NSAIDs (increased GI bleeding)
Important Points
- Don't stop suddenly before surgery without medical advice
- Tell all doctors and dentists you take aspirin
- Report unusual bleeding
- Prescription medications may replace aspirin for some patients
Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice.
References
For current U.S. drug labeling, contraindications, boxed warnings, pregnancy/lactation language, and formulation-specific dosing, check the official label databases and your prescriber's instructions.