aspirin

Synonyms in a broader sense

ASA, acetylsalicylic acid, (COX inhibitors, NSAIDs, non-steroidal anti-inflammatory drugs, non-steroidal analgesics, non-opioid analgesics, English NSAID’s = non-steroidal anti-inflammatory drugs).

Explanation / definition

The name of the synthetically produced active ingredient usually contained in Aspirin®, "acetylsalicylic acid", comes from the origin of the parent substance "salicylic acid" from the leaves and flowers of plants - the main source is the scientifically known as "salix" . The analgesic and antipyretic (medicinally: antipyretic) effect of willows has been known since ancient times. B. Teutons and Celts used it by chewing the bark of the tree. However, the mechanism of action was not clarified until 1970, about seventy years after the first synthesis was successful (1896, by Felix Hoffmann).

With 13,000 tons per year, Aspirin® is the most commonly used pain reliever worldwide.

General

Aspirin® belongs to the group of analgesics, i.e. the drugs that suppress or relieve pain sensation (from the Greek algos, der pain).
To be more precise, they are so-called non-steroidal analgesics, as Aspirin® and related drugs are not chemically like those that belong to the steroids Cortisone are built up (this also has an analgesic and anti-inflammatory effect).
With around 70 million prescriptions per year and sales of almost € 2 billion, analgesics take the top position among drugs in Germany.
They are therefore used even more frequently than Medication for the treatment of high blood pressure (medical: arterial hypertension) and medicinal substances for the treatment of mental ailments and illnesses (psychotropic drugs). The term "anti-inflammatory drugs", which is also often used, refers to the effect of Aspirin®, which not only inhibits pain but also inhibits inflammation (from the Greek phlogizein = to kindle or phlogistos = inflammable / inflammable).

Application / indication

aspirin® is prescribed to treat various pain conditions, such as: B. tooth - and a headache. It will also be at migraine used.
Furthermore, the fever-lowering effect of Aspirin® is used; in children, however Paracetamol (Trade name: e.g. ben-u-ron) and ibuprofen (trade name e.g.: Aktren) to be preferred, as these are also available as suppositories (Paracetamol) or as juice and Aspirin® for children Not may be used (see below).
In the form of a combined preparation Aspirin® Complex often used for colds.

Another application of Aspirin® is the treatment of tumor pain. Only when the analgesic effect of this "non-opioid analgesic" is no longer sufficient will weakly effective opiates (e.g.Codeine or tramadol), then on highly effective opiates (Morphine, Levomethadone).
In lower doses than necessary for the analgesic effect, Aspirin® is used to prevent disorders of the Blood clotting, how thrombosis and embolism.
These blood clots can form a blood vessel in the lungs (pulmonary embolism) brain (stroke) clog.
Against rheumatic diseases like Rheumatoid arthritis or osteoarthritis, Aspirin® is only rarely used, as the anti-inflammatory effect only occurs when taking high doses, but the undesirable effects of Aspirin® are also very pronounced.
Therefore, for the basic treatment of rheumatic diseases, preference is given to coxibs (see below, e.g. Celebrex), Diclofenac (Trade name e.g .: Voltaren) or Ibuprofen (Trade name e.g .: Aktren) is used.
(For long-term treatment, glucocorticoids such as cortisone, methotrexate, which is also used in cancer therapy, and other cytostatics are used.)

application areas

Typical areas of application for Aspirin® are:

• Pain
• a headache
• migraine
• fever
• flu

Aspirin® as a blood thinner

Aspirin® also has a blood thinning effect. The reason for this is an inhibition of the blood platelets or thrombocytes. These usually stick together at the beginning of blood clotting and thus create an initial clot. To do this, however, they have to be activated by several signal substances. This also includes the so-called thromboxane A2. Aspirin inhibits the enzyme required for the formation of thromboxane A2, the COX 1. The inhibition is irreversible. Platelets are unable to form new COX 1, so the inhibition persists for a longer period of time. Ibuprofen or diclofenac only reversibly inhibit the COX enzymes and are therefore not used for long-term anticoagulation.

You might also be interested in this topic: blood thinner

Aspirin® for migraines

Aspirin® can also be used to treat migraines. It has been shown to be particularly effective against headache caused by migraines. It is important to take Aspirin® early in the event of a migraine attack. In the course of migraines, gastrointestinal disorders can occur, which can impair the absorption of the active ingredient. Therefore, Aspirin® should be taken with sufficient water, especially if you have a migraine. This will likely make it easier to pass through the stomach. Aspirin® is particularly effective in treating mild to moderate migraine attacks.

Also read: Therapy for migraines

Aspirin® for headaches

When treating headaches, one mainly uses the analgesic effect of Aspirin®. The most important thing here is the correct dosage. While doses that are too low (e.g. 100 mg) do not provide adequate pain relief, doses that are too high can lead to more severe undesirable effects. Aspirin® has been used for headache relief for years and has therefore been well tested. Side effects mainly occur with regular consumption of high doses. Taking it to treat acute headaches is therefore relatively low in side effects. Exceptions to this are, for example, hypersensitivity reactions.

Aspirin® against hangovers

Theoretically, a sufficient dose of Aspirin® also works against the headache that typically occurs in a hangover. This has even been proven in studies. It should be noted, however, that both alcohol and Aspirin® can damage the gastric mucosa if taken frequently. In general, Aspirin® should not be taken prophylactically as a hangover drug, i.e. before a party. There is little objection to a single intake in the case of a very bad hangover, but regular intake can have severe undesirable effects.

Also read our topic: Hangover After Alcohol - What To Do?

Mode of action

The pain-relieving effect of Aspirin® is based on the inhibition of the formation of messenger substances (so-called mediators), which are responsible for transmitting the pain stimulus from the location of the damage to the brain.
Pain itself arises as a reaction to tissue damage, but ultimately it is a sensation that is generated by the brain (more precisely: by the central nervous system, which includes the spinal cord and the brain).
Pain is therefore an endogenous reaction, the function of which is a “warning signal” for the body.
The pain needs treatment if it goes beyond the normal level, persists for too long (chronic pain, phantom pain) or is very excruciating.
Medically speaking, pain is the result of an inflammatory process, i.e. the body's natural response to the penetration of pathogens, foreign substances or the destruction of tissue.

The messenger substances known as prostaglandins, the formation of which is inhibited by Aspirin®, cause the unpleasant symptoms typical of inflammation in the body:

Damaged tissue turns red as a result of increased blood flow (hyperemia) and widening of the vessels (vasodilation). The tissue swells because on the one hand cell fluid escapes due to the cell damage, on the other hand due to the increased permeability of the vessels, which should allow the immune cells circulating in the blood to migrate into the tissue. The classic four characteristics of inflammation, already known in antiquity, also include the

Overheating of the tissue around the injury. Last but not least, the messenger substances are responsible for creating the impression of pain.
The signaling substances are formed in immune cells, especially in white blood cells (the so-called leukocytes, from Greek leukos = white). Attracted and activated by foreign bodies or pathogens, the white blood cells themselves release messenger substances in order to activate further immune cells and to recruit them to the scene. This phenomenon is known as chemotaxis.

Aspirin® intervenes in this process by inhibiting the most important enzyme required by the immune cells to form the messenger substances, the so-called cyclooxygenase (COX for short). From a chemical point of view, the active ingredient in Aspirin® acetylsalicylic acid acetylates the cyclooxygenase, which permanently, i.e. irreversible, inactivated.
It is important that this enzyme occurs in two different forms in the body: The COX 1 occurs in all body cells and fulfills important (vital) functions there: It promotes the formation of mucus and alkaline bicarbonate, which occur in the sensitive mucous membrane of the stomach the aggressive hydrochloric acid required for digestion protects.

ASA also inhibits the enzyme phospholipase A2, which is responsible for releasing the fatty acid arachidonic acid from phospholipids and is an important precursor in the synthesis of prostaglandins. Read our article on this: Phospholipase

It also directly reduces hydrochloric acid production. The blood circulation-promoting effect also contributes to the protection of the gastric mucosa (medical: mucosa), since cell-damaging radicals can be transported away through the bloodstream.

Another, desirable effect of the COX 1 is to promote blood flow to the kidneys.
The prostaglandins formed by the enzyme are responsible for all the positive effects of COX 1 mentioned above. The preventive use against embolism in heart attack patients is based on the occurrence of COX 1 in blood platelets (thrombocytes):
There, with the help of the enzyme, the blood coagulation-promoting thromboxanes are formed. By inhibiting COX 1, the coagulation in the body is inhibited.
A related enzyme, cyclooxygenase 2, called Cox 2, occurs only in specialized inflammatory cells and only comes into action when it is activated by the inflammatory messenger substances.
Aspirin® is also called "unselective COX inhibitor“Because it cannot differentiate between the two forms of cyclooxygenase. Newer pain relievers have been developed specifically with a view to inhibiting only the COX 2 in order to obtain the desired function of the COX 1.
These new drugs are called "coxibs". A few examples of selective COX 2 inhibitors are melecoxib, which is the prototype but in practice has no fewer side effects than conventional analgesics, as well as rofecoxib (better known under the trade name Vioxx .
As a precaution, the preparation was withdrawn from the market because a clinical study showed increased side effects in the cardiovascular system.
It is now accepted that this risk could be minimized by the simultaneous administration of Aspirin® in low doses or another platelet inhibitor.
The first injectable COX-2 selective drug used for the treatment of post-operative pain is parecoxib (trade name: Dynastat).

The formation of prostaglandins by the COX-2 can also take place in the central nervous system. The cell messenger substances formed by immune cells (not permanently active, but) for example by cell toxins, bacterial components or similar foreign substances set a cascade of different reactions in motion, the end point of which is the formation of fever-inducing substances (these are called endogenous, i.e. coming from within, “pyrogens " designated).
The fever-inducing substances are the trigger for the formation of prostaglandin in the brain (for those interested: formation takes place in a structure called the organum vasculosum laminae terminalis, or OVLT, adjacent to the hypothalamus (region in the brain)).
The prostaglandins cause a dysregulation of the temperature balance in the hypothalamus: The body increases the desired normal temperature (the target value), which manifests itself as a fever, i.e. a state of elevated body temperature. Again, by inhibiting prostaglandin synthesis, Aspirin® has a strong fever lowering effect.

In addition to the analgesic, antipyretic and anti-inflammatory effects, another property of Aspirin® is used in medicine:
By inhibiting cyclooxygenase, the production of a messenger substance is also inhibited, which is required for blood coagulation by promoting platelet aggregation - thromboxane, which is chemically structurally related, such as prostaglandins (see above) among the eicosanoids.

Read more on the subject at: Prostaglandins

Metabolism

What happens to Aspirin® in the body?
Aspirin® is given orally, i.e. taken as a tablet. The uptake into the blood (resorption) begins in the stomach, which explains the early onset of action compared to other analgesics:
The highest concentration in the blood is reached after just 25 minutes. The reason for this lies in the chemical structure of Aspirin® as an acid, which is responsible for the accumulation in the mucous membrane cells of the stomach.
Due to its own acidic character, Aspirin® is also present in the acidic environment of the gastric mucosa to a greater extent in its non-charged form (ie chemically: it is less dissociated), which is able to overcome the cell membrane and settle in the Accumulate gastric mucosal cells.
In the not acidic, of course, but a more neutral one PH value of 7 inside cells, however, Aspirin® is more strongly present as a charged particle (i.e. as an ion) that cannot penetrate the cell membrane. This principle of trapping charged particles within cells is also known as the “ion trap” and explains not only the early onset of action, but also those that are strong in high doses unwanted effects of the Aspirin®.
After absorption from the stomach and intestines, the Aspirin® is processed into its breakdown products by the enzymes of the cell metabolism.
A not inconsiderable part of 30% is already metabolized before the Aspirin® could develop its effect as a COX inhibitor, so that only the remaining part of 70% is responsible for the desired analgesic, antipyretic and anti-inflammatory effects.
This not 100% "bio-availability" must be taken into account when dosing the aspirin. In the course of the metabolism, the COX inhibitor is also effective Salicylic acid educated. It is not broken down as quickly as Aspirin®, which is already half eliminated after 15 minutes, and thus ensures that the effect of Aspirin® lasts longer than would be expected after its occurrence in the blood.
The salicylic acid itself remains in the blood for a long time, especially when high doses of Aspirin® have been administered (half of it is still detectable after 30 hours), until it is directly above the kidney is excreted in the urine, partly also through the liver is converted into more easily eliminated end products.

Side effects

The most important side effects of Aspirin® are gastrointestinal complaints:
It can lead to reflux, heartburn and nausea, in more severe cases to erosions (superficial damage to the gastric mucous membrane) and ulcers (deeper epithelial defects that extend into the muscles and can even break through (rupture) to the outside.
Another consequence is a prolongation of the bleeding time, caused by the inhibition of the thromboxane synthesis.
The increased occurrence of asthmatic complaints after taking Aspirin® led to the designation of "analgesic asthma". This form of asthma accounts for about 10% of all asthma sufferers, but only occurs with a corresponding predisposition (disposition), i.e. if there is an increased sensitivity to the messenger substances known as leukotrienes, which are related to the prostaglandins (see above).
(The leukotrienes are messenger substances that are formed from the same starting substance as the prostaglandins - arachidonic acid, which consists of twenty carbon atoms. The messenger substances formed from arachidonic acid are therefore called "eicosanoids", from the Greek eikos = twenty).
This parent substance of the prostaglandins is increasingly available for cyclooxygenase inhibition. Therefore, when taking Aspirin®, more leukotrienes are formed at the same time (there is a leukotriene shift).
Asthma as a respiratory disease characterized by constriction of the bronchi is based on precisely this effect of the leukotrienes, so-called spasms, i.e. causing violent contractions of the bronchial muscles.
These express themselves as the main symptom of asthma, i.e. the attack-like, typically strongly trigger-related, shortness of breath.
The treatment of this side effect again consists in the administration of drugs that inhibit the effect (in this case not the formation) of the leukotrienes by blocking the point of attack of the messenger substance on the body cells (the receptor): As an example, this is also according to his Mechanism of action known as “leukotriene antagonist” called montelukast (trade name: Singulair).
Further information on this topic can also be found at: Bronchial asthma

Reye's syndrome is one of the rarer side effects of Aspirin®, the cause of which is still unknown.
It occurs only in children up to the age of 15 who are being treated for a viral infection with a fever (e.g. chickenpox).
Reye's syndrome is a very serious clinical picture that is associated with symptoms such as vomiting, fever and drowsiness. Coma can result, with a fatal outcome in 25 to 50% of patients.
Further information is available under our topic: Reye syndrome

Side effect headache

Usually Aspirin® relieves headaches. However, headaches can sometimes occur while taking Aspirin®. This is likely a side effect. The exact reasons are still relatively unexplored. It should also be noted that the long-term use of excessive amounts of painkillers can lead to a so-called drug overuse headache, or MÜK for short. This is a chronic headache.

Side effect diarrhea

Diarrhea can also occur as a side effect of Aspirin®. The bowel movement is influenced by so-called prostaglandins, among other things. These are also formed by the COX 1/2 enzymes. Aspirin® inhibits this prostaglandin formation. This also impairs the control of bowel movements, which can lead to diarrhea. Diarrhea is one of the more harmless gastrointestinal side effects. A doctor should be consulted if blood is mixed in with the diarrhea. Since Aspirin® primarily damages the gastric mucosa, long-term use can lead to dangerous bleeding. If there is bleeding in the upper part of the gastrointestinal tract, the blood changes through the gastrointestinal passage. It comes to the so-called tar stools. This is a black coloration of the stool, which can often be accompanied by diarrhea. A doctor should be consulted immediately.

Side effect nausea

In addition to non-bloody diarrhea, nausea is one of the most common side effects of the gastrointestinal tract when taking Aspirin®. As with most of the side effects of Aspirin®, nausea often occurs with long-term use of high doses. However, side effects can occur even with the first use. Since everyone can react slightly differently to different drugs such as Aspirin®, some people quickly complain of nausea, while others take Aspirin® for months without being impaired.

Interactions

Aspirin® interactions, i.e. Interactions with other drugs result from competition for transport proteins in the blood.
This is especially true for those drugs that, like Aspirin®, are mainly transported by binding to such proteins in the blood:
Examples here are oral Antidiabetic drugs (Medicines against the Diabetes mellitus, the most widespread are the so-called. Sulfonylureas (e.g. Euglucon) and Metformin (e.g. Glucophage) and oral anticoagulants (i.e. drugs used to prevent blood clotting, such as phenprocoumon and warfarin. Marcumar and Coumadin) to call.
Are e.g. aspirin® and Marcumar taken at the same time, Marcumar is bound to the transport proteins to a lesser extent and the active levels in the blood rise - without a corresponding dose adjustment there is a risk of bleeding due to overdose of Marcumar.
The same applies to antidiabetic drugs, which, if taken at the same time as Aspirin®, pose the risk of potentially lethal hypoglycaemia (low blood sugar levels). Taking them together with glucocorticoids (e.g. Cortisone) intensifies the damaging effect of Aspirin® on the gastric mucosa.

Contraindications

Aspirin® must not be taken in the last third (trimester) of pregnancy, as the prostaglandins formed by cyclooxygenase, etc. for keeping the so-called open Ductus Arteriosus Botalli of the unborn child.
An inhibition of prostaglandin synthesis would lead to its premature closure with fatal consequences for the child.
(The Ductus Arteriosus Botalli is a vascular connection between the trunk of the pulmonary arteries, medically called truncus pulmonalis, and the main body artery, the aorta.
This so-called shunt represents a short-circuit in the blood vessels: the blood is drawn directly from the right heart, bypassing the child's blood that is not yet needed and enabled for gas exchange lung in the Body circulation forwarded. Only at birth does the flow reversal and closure of the Ductus Botalli occur due to various messenger substances and changes in the pressure conditions in the child's heart. In adults, the rudimentary vascular connection is still preserved as a connective tissue band, medically known as the ligamentum arteriosum.)
On the other hand, exactly this effect, which is undesirable before birth, is used after the birth: If the ductus botalli does not close, will Cyclooxygenase inhibitors used to suppress the formation of the prostaglandins responsible for the failure to occlude.

Another contraindication of Aspirin® is unspecific and psychological pain. With regular use, especially higher doses, the undesirable side effects predominate and there is a risk of the drug accumulating, e.g. in cells of the stomach lining.

May not be used aspirin® generally in children, as there is a risk of a rare but very dangerous side effect - Reye's syndrome (see below).

With severe Kidney or liver dysfunction the dose must be reduced because the aspirin® is excreted mainly via the kidneys after metabolism in the liver.
Even if there is an increased risk of bleeding (the diseases causing them are medically referred to as so-called hemorrhagic diatheses), Aspirin® should not be administered due to its bleeding effect hemophilia (Hemophilia, is based on a defect in the blood coagulation factor 8) or that von Willebrand syndrome (a genetic deficiency of the von Willebrand factor, which is important for hemostasis, which is required for the binding of blood platelets to one another and for the closure of damaged vessels)

dosage

The dosage of Aspirin® depends on the desired effect. Higher doses have more pain relieving, anti-inflammatory and antipyretic effects. However, the number and severity of side effects increases, especially with long-term use. This is important, for example, with blood thinning with Aspirin®. The tablets must be taken daily for months, sometimes years. Fortunately, even small amounts of around 100 mg per day are sufficient for effective anticoagulation. The reason for this is that the ASA contained in Aspirin® enters the blood immediately after it has been absorbed from the intestine and irreversibly inhibits the platelets here. The remaining ASA flows with the blood to the liver, where it is quickly broken down before it reaches the body's circulation. Since Aspirin® is broken down very quickly by the liver and other tissues, higher doses are required to relieve pain or reduce inflammation. Usually tablets with 500 mg are used here. If the pain is severe, two tablets may be taken at once. The daily dose should not exceed 3000 mg, and breaks of more than four hours should be observed if the dose is taken several times. If Aspirin® is used against rheumatic-inflammatory diseases, the highest doses are necessary. The single dose here is often more than 1000 mg, the daily dose over 3000 mg.

Aspirin® and alcohol

The simultaneous intake of Aspirin® and alcohol can lead to undesirable side effects, some of which can be associated with dangerous consequences for the person concerned. In particular, the risk of gastric ulcers and gastric bleeding, known side effects when taking aspirin, can be intensified by the simultaneous consumption of alcohol.

Irritation of the gastric mucosa, gastric bleeding and gastric ulcers can become noticeable through a variety of typical symptoms. Gastric bleeding is characteristically accompanied by jet black stools and bloody or coffee grounds-like vomiting. Excessive bleeding can result in significant blood loss and associated symptoms. Chronic stomach ulcers can lead to changes in the gastric outlet, causing digestive problems and vomiting. Stinging abdominal pain, which is particularly pronounced after eating, is typical.

Read more on this topic at: Aspirin® and alcohol

When do you have to stop Aspirin® before an operation?

The active ingredient in Aspirin®, ASA, has an anticoagulant effect. Therefore, Aspirin® should be discontinued especially before major operations where there is a risk of bleeding. This is not absolutely necessary, especially for minor interventions. Since Aspirin® only wears off in its anticoagulant effect several days after you stop taking it, a period of five to ten days is often recommended. Recent studies show that platelet function can return to normal after just three days. However, due to its anticoagulant effect, Aspirin® is often used specifically as a blood thinner. In this case, a break in the medication with Aspirin® can be dangerous for the patient. Therefore, when taking Aspirin®, you should always consult your doctor before you discontinue Aspirin®.

Aspirin® and pill - are they compatible?

Basically, the metabolism of the pill is not or only insignificantly influenced by Aspirin®. The effectiveness of the pill is usually unaffected. However, since there are so many different types of pill on the market, it is difficult to make a general statement. Most pharmacies, however, can use databases to check drug interactions.There are also programs for laypeople, so-called interaction checks, free of charge on the Internet. Aspirin® can also cause diarrhea or vomiting. Both can affect the absorption of the pill in the gastrointestinal tract.

Aspirin® poisoning - how do you recognize it and what can you do about it?

The acute poisoning with Aspirin® leads to a stimulation of the respiratory center with subsequent hyperventilation (increased breathing).

As more acidic carbon dioxide is exhaled, alkaline substances accumulate in the body. If the body tries to balance the alkalization by increasing the formation of acids (including lactic acid and a sugar breakdown product, pyruvic acid), this leads to over-acidification.
The metabolic acidification of the body (medical: metabolic acidosis) manifests itself through Respiratory paralysis, Overheating (hyperthermia) and may lead to unconsciousness.
Doses of 10 g can be fatal. If it is recognized early, treatment can include measures to normalize the acid-base balance by infusing an alkaline liquid (sodium hydrogen carbonate) to neutralize the acid and by increasing the excretion of Aspirin® by means of diuretics (diuretics, e.g. Furosemide- Trade name: Lasix®) respectively.
If there is danger to life, attempts are also made to remove the Aspirin® by means of artificial washing of the blood (medical: hemodialysis).

Chronic and excessive abuse of Aspirin® and related analgesics (e.g. Paracetamol; Trade name: ben-u-ron) causes severe kidney damage: hence the name "Analgesics kidney“.
The reason for this lies in the insufficient blood flow to the kidney tissue, for which the prostaglandins, which are inhibited in their formation by Aspirin®, are required.

price

Since there is always talk of cost pressure in the healthcare sector, I think it is important to also find out prices for drugs:

Aspirin® 500 mg 20 tablets (N1) € 2.43

Aspirin® 500 mg 100 tablets (N3) € 7.63

Status: Jan. 2010 (Internet query)

Aspirin® preparations

Aspirin® Complex

Aspirin® Complex is a combination preparation of two active ingredients. Aspirin® Complex is primarily intended to be used to treat a cold or a flu-like infection. On the one hand, it contains the eponymous Aspirin® or ASS (acetylsalicylic acid). The second active ingredient is pseudoephedrine. Pseudoephedrine is often used as a cold remedy. It increases the release of adrenaline and noradrenaline. This narrows vessels. The mucous membranes swell. This makes it easier to breathe, especially if the nose was previously blocked. However, it is a purely symptomatic treatment. Together with the anti-inflammatory, anti-fever and pain-relieving aspirin, Aspirin® Complex is intended to provide relief, especially when you have a cold. Aspirin® Complex is sold as granules. This is a coarse powder in a sachet. It should be dissolved in water before ingestion and then drunk. It should be noted that in addition to the side effects of Aspirin®, additional undesirable effects can occur due to the added pseudoephedrine. These include dry mouth or a racing heart. For this reason, Aspirin® Complex should not be used, for example, with severe high blood pressure or coronary heart disease. In addition, interactions with certain active ingredients such as MAO inhibitors (including antidepressants) are possible.

Further information on this topic can be found at: Aspirin®Complex

Aspirin® Plus C

Aspirin® Plus C also contains two effective substances. In addition to the eponymous Aspirin®, every tablet contains vitamin C. Since the Aspirin® it contains has analgesic, anti-inflammatory and fever-lowering effects, Aspirin® Plus C can be used almost like pure Aspirin®. The additionally contained vitamin C is supposed to strengthen the immune system. Whether vitamin C can provide relief from a cold has been debated in science since its discovery in the 1930s. While regular intake of vitamin C does not seem to prevent the occurrence of a cold, a recovery-promoting effect has been proven several times. In addition, vitamin C is almost free of side effects and, with a few genetic exceptions, is only poorly tolerated in extremely high doses. Therefore, the side effects of Aspirin® Plus C are very similar to those of pure Aspirin®.

Aspirin® Protect

Aspirin® Protect contains a smaller amount of active ingredient than normal Aspirin®. It is not used as a pain reliever, to lower fever or to reduce inflammation, but mainly serves as a precaution against the risk of heart attacks or strokes. Both diseases are caused by blood clots. Aspirin® inhibits the activation of so-called thrombocytes, the blood platelets. These usually clump together during blood clotting and thus block an injured blood vessel. However, if this happens within a healthy vessel, it can lead to an obstruction of the blood flow and thus to an insufficient supply of the tissue - the infarct. Small amounts of the active ingredient are sufficient to inhibit platelets, as the ASA contained in it enters the blood immediately after it has been absorbed from the intestine and is first effective there. Side effects are limited in this way.

You may also be interested in this topic: Heart attack risk

Aspirin® Effect

Aspirin® Effect is also a granulate. The only active ingredient is ASA. Similar to the usual Aspirin® tablets, one dose contains 500 mg of the active ingredient. The granulate is packed in ready-made bags. The contents of the bag can simply be poured into your mouth. It dissolves in saliva and can then be swallowed. If necessary, it can then be rinsed with water, for example. Since the active ingredient is aspirin, both the effect and side effects are very similar to a normal Aspirin® tablet.

Aspirin® Direct

Aspirin® Direkt is a chewable tablet. As in all Aspirin® tablets, the active ingredient is acetylsalicylic acid. It has an analgesic, anti-inflammatory and antipyretic effect. The advantage of the chewable tablet is that it is easy to take. No water is needed to wash it down. Instead, simply chew the tablet before swallowing it. However, drinking water is likely to facilitate gastrointestinal passage and thus absorption. The side effects of Aspirin® Direct are the same as those of ordinary Aspirin®.