Daily aspirin therapy: Understand the benefits and risks


By Mayo Clinic Staff




How can aspirin prevent a heart attack?




Should you take a daily aspirin?


  • You've already had a heart attack or stroke.
  • You've never had a heart attack, but you're at high risk of having one.
  • You have diabetes and at least one other heart disease risk factor — such as smoking or high blood pressure — and you're a man older than 50 or a woman older than 60. The use of aspirin to prevent heart attacks in people with diabetes but no other risk factor is controversial.

The U.S. Preventive Services Task Force recommends daily aspirin therapy if you're age 50 to 59, you're not at increased bleeding risk, and you have an increased risk of heart attack or stroke of 10 percent or greater over the next 10 years. If you're age 60 to 69, you aren't at increased bleeding risk, and you have a high risk of heart attack or stroke of 10 percent or greater over the next 10 years, talk to your doctor about daily aspirin therapy.

More research is needed to determine the benefits and risks of daily aspirin use in adults younger than age 50 and older than age 70 before a recommendation can be made for or against aspirin use to prevent cardiovascular disease and colorectal cancer for these age groups.



Guidelines are varied between organizations, but they're evolving as more research is done. The benefits of daily aspirin therapy don't outweigh the risk of bleeding in people with a low risk of heart attacks. The higher your risk of heart attack, the more likely it is that the benefits of daily aspirin outweigh the risk of bleeding.




  • A bleeding or clotting disorder (bleeding easily)
  • Aspirin allergy, which can include asthma caused by aspirin
  • Bleeding stomach ulcers

What's the best dose of aspirin to take?

Your doctor will discuss what dose is right for you. Very low doses of aspirin — such as 75 to 150 milligrams (mg), but most commonly 81 mg — can be effective. Your doctor will usually prescribe a daily dose anywhere from 75 mg — the amount in an adult low-dose aspirin — to 325 mg (a regular strength tablet).

If you have had a heart attack or have had a heart stent placed, it's very important to take aspirin and any other blood-thinning medications exactly as recommended.

What happens if you stop taking aspirin every day?



Can you take aspirin if you regularly take ibuprofen or another nonsteroidal anti-inflammatory drug (NSAID) for another condition?

Both aspirin and nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen (Motrin IB, Advil, others) and naproxen sodium (Aleve), reduce the clotting action of blood platelets. Regular use of nonsteroidal anti-inflammatory medications can increase your bleeding risk.

Some NSAIDs can increase the risk of heart attacks on their own. Additionally, some NSAIDs can adversely interact with aspirin, increasing the risk of bleeding even more.

If you need only a single dose of ibuprofen, take it two hours after the aspirin. If you need to take ibuprofen or other NSAIDs more often, talk to your doctor about medication alternatives that won't interfere with daily aspirin therapy.

What are the possible side effects of daily aspirin therapy?

Side effects and complications of taking aspirin include:


If you're taking aspirin and need a surgical procedure or dental work, be sure to tell the surgeon or dentist that you take daily aspirin and how much. Otherwise you risk excessive bleeding during surgery. Don't stop taking aspirin without talking to your doctor, however.

People who regularly take aspirin and drink alcohol can have an increased risk of stomach bleeding. Talk to your doctor about how much alcohol is safe to drink. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

What are possible drug interactions with daily aspirin therapy?

If you're already taking an anticoagulant, such as warfarin (Coumadin, Jantoven), apixaban (Eliquis), dabigatran (Pradaxa) or rivaroxaban (Xarelto) for another condition, combining it with aspirin may greatly increase the risk of major bleeding complications. However, there may be some conditions for which combining a low dose of aspirin with warfarin or another anticoagulant is appropriate. But, this therapy always needs to be carefully discussed with your doctor.


  • Heparin
  • Ibuprofen (Advil, Motrin IB, others), when taken regularly
  • Corticosteroids
  • Clopidogrel (Plavix)
  • Some antidepressants (clomipramine, paroxetine, others)


  • Bilberry
  • Capsaicin
  • Cat's claw
  • Danshen
  • Evening primrose oil
  • Ginkgo
  • Kava
  • Ma-Huang
  • Omega-3 fatty acids (fish oil)



The operator may advise you to chew an aspirin, but will first ask questions to make sure you're not allergic to aspirin or you don't have any other health conditions that would make taking an aspirin during a heart attack too risky. It's OK to chew an aspirin if your doctor has previously told you to do so if you think you're having a heart attack — but call 911 or emergency medical services first.

Should you take a coated aspirin?

Enteric-coated aspirin is designed to pass through your stomach and not disintegrate until it reaches your small intestine. It may be gentler on the stomach and may be appropriate for some people who take a daily aspirin, especially in those with a history of gastritis or ulcers.

However, some researchers think there's no evidence that taking an enteric-coated aspirin decreases your chance of developing gastrointestinal bleeding. In addition, some research has found that coated aspirin may not be as effective as plain aspirin when taken at the time of a possible heart attack. Talk to your doctor if you're concerned about ways to decrease your bleeding risk.

Jan. 09, 2019 See more In-depth

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