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# Ecospirin (Aspirin Enteric-Coated)
## Overview
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with analgesic, antipyretic, and anti-inflammatory properties. The enteric coating is designed to delay absorption and reduce gastrointestinal irritation.
## Primary Indications
* Pain relief
* Fever reduction
* Inflammation reduction
* Prevention of cardiovascular events (e.g., myocardial infarction, stroke) in specific patient populations.
## Adult Dosing
* **Analgesia/Antipyresis/Anti-inflammatory:** 325 mg to 650 mg orally every 4 to 6 hours as needed. Maximum daily dose typically 4 grams.
* **Cardiovascular Prevention:** Dosing varies based on indication and risk stratification. Common doses include 81 mg or 325 mg once daily. Specific protocols should be followed.
## Pediatric Dosing
Aspirin is generally **not recommended** for children and teenagers due to the risk of Reye's syndrome, especially during viral illnesses like influenza or chickenpox.
## Dose Adjustments
No dose adjustments are typically required for renal or hepatic impairment, but caution is advised. Monitor for signs of toxicity.
## Contraindications
* Known hypersensitivity to aspirin, salicylates, NSAIDs, or any component of the formulation.
* History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
* Children and teenagers with viral infections.
* Active peptic ulceration or gastrointestinal bleeding.
* Severe hepatic impairment.
* Severe renal impairment.
* Perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
## Adverse Effects
* **Gastrointestinal:** Dyspepsia, heartburn, nausea, vomiting, abdominal pain, gastritis, occult bleeding, ulceration, perforation.
* **Hematologic:** Increased bleeding time, bruising, epistaxis, petechiae.
* **Hypersensitivity:** Bronchospasm, urticaria, angioedema.
* **Other:** Tinnitus (especially with higher doses), dizziness, confusion.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, heparin, DOACs):** Increased risk of bleeding.
* **Other NSAIDs and COX-2 Inhibitors:** Increased risk of gastrointestinal toxicity and bleeding.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Methotrexate:** Aspirin can increase methotrexate toxicity.
* **Antihypertensives (e.g., ACE inhibitors, ARBs, diuretics, beta-blockers):** Aspirin may reduce their efficacy.
* **Uricosuric agents (e.g., probenecid):** Aspirin can reduce their uricosuric effect.
* **Alcohol:** Increased risk of gastrointestinal irritation and bleeding.
## Monitoring
* Signs and symptoms of gastrointestinal bleeding (e.g., melena, hematemesis, abdominal pain).
* Signs and symptoms of bleeding elsewhere (e.g., prolonged bleeding from cuts, bruising, epistaxis).
* Renal function and electrolytes, especially with long-term use or in patients with pre-existing renal disease.
* Liver function tests, particularly with high-dose or long-term therapy.
* Auditory symptoms (tinnitus) which may indicate toxicity.
## Clinical Pearls
* The enteric coating allows aspirin to pass through the stomach and be absorbed in the small intestine, which can reduce gastric irritation compared to non-enteric coated formulations. However, it does not eliminate the risk of gastrointestinal bleeding or ulceration.
* For acute pain or fever, immediate-release aspirin may provide faster relief.
* Patients should be advised to take enteric-coated aspirin with a full glass of water and avoid lying down for 30 minutes after administration.
* Always consult the most current prescribing information and local protocols for specific indications, dosing, and administration.
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*Disclaimer: This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the current prescribing information and your healthcare provider for any health concerns or before making any decisions related to your health or treatment.*
