Low-dose aspirin, an anti-platelet drug, is an excellent choice for many. Aspirin is classed as a non-steroidal anti inflammatory drug. This means that it reduces inflammation but does not contain steroids.
Aspirin is a drug that is very familiar to most people. It’s a medication that most of us have taken at one time or another for fever or a headache. But aspirin also has other qualities. It’s a drug that has been shown by research to reduce the chances of a heart attack or stroke.
Aspirin is often prescribed by haematologists for people with MPNs, because it reduces the risk of clots. This treatment does have some side effects, but it is safe for most people. Aspirin is available in tablet form and dispersible form (dissolves in water), some tablets are enteric coated.
Why take this drug
Aspirin is one of the most effective drugs with the fewest side effects that we have available to treat all MPNs: essential thrombocythaemia (ET), polycythaemia vera (PV) and myelofibrosis (MF).
While aspirin isn’t appropriate for everyone, this treatment is an excellent choice for many people. If your MPN is low risk and you have a low risk of clots, you may be able to take 75 mg low-dose aspirin (or in the US 81 mg) and in some cases you may not need any additional treatment. If you have PV you may be able to combine aspirin therapy with your phlebotomy treatments.
If you have more risk factors or if your platelet count is higher, your haematologist may recommend that you take aspirin in conjunction with other medications such as hydroxycarbamide. The two drugs work in different ways to help reduce your risk of clots such as heart attack or stroke.
Aspirin may not be suitable if you have low platelets and if you suffer from bleeding. It is also known to increase the risk of developing asthma.
Sometimes aspirin is given with a second so-called antiplatelet drug such as clopidogrel or Plavix.
How it works
Aspirin is a drug that acts on platelets in your body. It blocks a platelet enzyme, this reduces the ability of platelets to form clumps or clots. Aspirin makes the platelets less ““sticky””, so that they are less likely to stick together. Research shows that aspirin is very effective at reducing risks of heart attacks and strokes in many people with different levels of risk.
Minor side effects
Low-dose aspirin does have some side effects. The most common side effects of this drug are bleeding and indigestion. You may find that you bruise more easily and that you bleed for a long time if you cut yourself. It can help to keep a supply of sterile bandages on hand so that you can apply pressure to any small cuts or wounds. If you develop indigestion or worsening indigestion on aspirin it is important to inform your doctor.
More serious side effects
In rare cases aspirin can have more serious side effects. Some people are allergic to aspirin. Aspirin can also cause gastric irritation and bleeding in the stomach and contribute to ulcers. You may also need to be checked if you develop stomach pain or bleeding. Aspirin is also known to increase the risk of developing asthma.
Your haematologist will tell you if aspirin is safe for your particular situation. He or she may suggest similar medications such as dipyridamole and clopidogrel if you suffer from side effects when taking this drug.
If you are planning surgery, your doctor may advise that you stop aspirin therapy temporarily to prevent bleeding problems.
Can I eat and drink normally? We recommend that you eat a normal, healthy diet and drink plenty of water. If you experience any stomach distress or burning, you may need to reduce consumption of tea, coffee, spicy and peppery foods and other foods that may upset your stomach. Your haematologist or GP can offer dietary advice.
Can I drink alcohol? Alcohol can cause stomach upset, so it may help to reduce your consumption of alcohol if you are on aspirin therapy. While it is safe to drink alcohol in moderation whilst taking aspirin, we recommend you do not exceed the recommended weekly limits of 14 units of alcohol per week for men and women. Alcohol can cause dehydration, and it is important to avoid becoming dehydrated if you have an MPN. Please ask your nurse or doctor if you require more information regarding alcohol consumption.
What if I want to have a child? Aspirin is generally safe until late in pregnancy. Please see our mpns in pregnancy section for more information on pregnancy in MPNs.
Who will prescribe aspirin for me? Low-dose aspirin can be purchased in any chemists or pharmacy. You may find that coated aspirin is easier for you to take and minimises stomach distress. Your doctor, specially-trained nurse, hospital pharmacist or sometimes your GP will prescribe your medication.
What if I need an operation or dental procedure? You may be advised to stop taking aspirin for at time before your surgery or procedure to avoid excessive bleeding. Always talk with your haematologist to get his or her advice before surgery or any procedure, no matter how minor.
What about use of other painkillers? When taking aspirin, it is not advisable to take other anti-inflammatory painkillers such as ibuprofen. Ask your consultant of GP for advice and remind your consultant that you are taking other painkillers they may ask you to stop the aspirin or give different instructions for taking it.
If you’d like more information you can download our leaflets about MPN medications.