All you ever wanted to know about aspirin medication

February 6, 2002

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USP DI® Volume II, Advice for the Patient.

SALICYLATES (Systemic)

Table Of Contents:

Brand Names

Category

Analgesic—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered;

Aspirin, Buffered; Choline and Magnesium Salicylates; Choline Salicylate;

Magnesium Salicylate; Salsalate; Sodium Salicylate

Anti-inflammatory, nonsteroidal—Aspirin; Aspirin and Caffeine; Aspirin and

Caffeine, Buffered; Aspirin, Buffered; Choline and Magnesium Salicylates;

Choline Salicylate; Magnesium Salicylate; Salsalate; Sodium Salicylate

Antipyretic—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered;

Aspirin, Buffered; Choline and Magnesium Salicylates; Choline Salicylate;

Magnesium Salicylate; Salsalate; Sodium Salicylate

Antirheumatic, nonsteroidal anti-inflammatory—Aspirin; Aspirin and Caffeine;

Aspirin and Caffeine, Buffered; Aspirin, Buffered; Choline and Magnesium

Salicylates; Choline Salicylate; Magnesium Salicylate; Salsalate; Sodium

Salicylate

Antithrombotic—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine,

Buffered; Aspirin, Buffered

Myocardial infarction prophylactic—Aspirin; Aspirin and Caffeine; Aspirin

and Caffeine, Buffered; Aspirin, Buffered

Myocardial reinfarction prophylactic—Aspirin; Aspirin and Caffeine; Aspirin

and Caffeine, Buffered; Aspirin, Buffered

Platelet aggregation inhibitor—Aspirin; Aspirin and Caffeine; Aspirin and

Caffeine, Buffered; Aspirin, Buffered

Description

Salicylates are used to relieve pain and reduce fever. Most salicylates are

also used to relieve some symptoms caused by arthritis (rheumatism), such as

swelling, stiffness, and joint pain. However, they do not cure arthritis and

will help you only as long as you continue to take them.

Aspirin may also be used to lessen the chance of heart attack, stroke, or

other problems that may occur when a blood vessel is blocked by blood clots.

Aspirin helps prevent dangerous blood clots from forming. However, this

effect of aspirin may increase the chance of serious bleeding in some

people. Therefore, aspirin should be used for this purpose only when your

doctor decides, after studying your medical condition and history, that the

danger of blood clots is greater than the risk of bleeding. Do not take

aspirin to prevent blood clots or a heart attack unless it has been ordered

by your doctor .

Salicylates may also be used for other conditions as determined by your

doctor.

The caffeine present in some of these products may provide additional relief

of headache pain or faster pain relief.

Some salicylates are available only with your medical doctor's or dentist's

prescription. Others are available without a prescription; however, your

medical doctor or dentist may have special instructions on the proper dose

of these medicines for your medical condition.

These medicines are available in the following dosage forms:

Oral

Aspirin

Tablets (U.S. and Canada)

Chewable tablets (U.S. and Canada)

Chewing gum tablets (U.S. and Canada)

Delayed-release (enteric-coated) tablets (U.S. and Canada)

Extended-release tablets (U.S. and Canada)

Aspirin and Caffeine

Capsules (Canada)

Tablets (U.S. and Canada)

Buffered Aspirin

Tablets (U.S. and Canada)

Buffered Aspirin and Caffeine

Tablets (U.S. and Canada)

Choline Salicylate

Oral solution (U.S.)

Choline and Magnesium Salicylates

Oral solution (U.S.)

Tablets (U.S. and Canada)

Magnesium Salicylate

Tablets (U.S. and Canada)

Salsalate

Capsules (U.S.)

Tablets (U.S. and Canada)

Sodium Salicylate

Tablets (Canada)

Delayed-release (enteric-coated) tablets (U.S.)

Rectal

Aspirin

Suppositories (U.S. and Canada)

Before Using This Medicine

If you are taking this medicine without a prescription, carefully read and

follow any precautions on the label. For salicylates, the following should

be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic

reaction to aspirin or other salicylates, including methyl salicylate (oil

of wintergreen), or to any of the following medicines:

Diclofenac (e.g., Voltaren)

Diflunisal (e.g., Dolobid)

Etodolac (e.g., Lodine)

Fenoprofen (e.g., Nalfon)

Floctafenine (e.g., Idarac)

Flurbiprofen, oral (e.g., Ansaid)

Ibuprofen (e.g., Motrin)

Indomethacin (e.g., Indocin)

Ketoprofen (e.g., Orudis)

Ketorolac (e.g., Toradol)

Meclofenamate (e.g., Meclomen)

Mefenamic acid (e.g., Ponstel)

Nabumetone (e.g., Relafen)

Naproxen (e.g., Naprosyn)

Oxaprozin (e.g., Daypro)

Oxyphenbutazone (e.g., Tandearil)

Phenylbutazone (e.g., Butazolidin)

Piroxicam (e.g., Feldene)

Sulindac (e.g., Clinoril)

Suprofen (e.g., Suprol)

Tenoxicam (e.g., Mobiflex)

Tiaprofenic acid (e.g., Surgam)

Tolmetin (e.g., Tolectin)

Zomepirac (e.g., Zomax)

Also tell your health care professional if you are allergic to any other

substances, such as foods, preservatives, or dyes.

Diet—Make certain your health care professional knows if you are on a

low-sodium diet. Regular use of large amounts of sodium salicylate (as for

arthritis) can add a large amount of sodium to your diet. Sodium salicylate

contains 46 mg of sodium in each 325-mg tablet and 92 mg of sodium in each

650-mg tablet.

Pregnancy—Salicylates have not been shown to cause birth defects in humans.

Studies on birth defects in humans have been done with aspirin but not with

other salicylates. However, salicylates caused birth defects in animal

studies.

Some reports have suggested that too much use of aspirin late in pregnancy

may cause a decrease in the newborn's weight and possible death of the fetus

or newborn infant. However, the mothers in these reports had been taking

much larger amounts of aspirin than are usually recommended. Studies of

mothers taking aspirin in the doses that are usually recommended did not

show these unwanted effects. However, there is a chance that regular use of

salicylates late in pregnancy may cause unwanted effects on the heart or

blood flow in the fetus or in the newborn infant.

Use of salicylates, especially aspirin, during the last 2 weeks of pregnancy

may cause bleeding problems in the fetus before or during delivery or in the

newborn infant. Also, too much use of salicylates during the last 3 months

of pregnancy may increase the length of pregnancy, prolong labor, cause

other problems during delivery, or cause severe bleeding in the mother

before, during, or after delivery. Do not take aspirin during the last 3

months of pregnancy unless it has been ordered by your doctor .

Studies in humans have not shown that caffeine (present in some aspirin

products) causes birth defects. However, studies in animals have shown that

caffeine causes birth defects when given in very large doses (amounts equal

to those present in 12 to 24 cups of coffee a day).

Breast-feeding—Salicylates pass into the breast milk. Although salicylates

have not been reported to cause problems in nursing babies, it is possible

that problems may occur if large amounts are taken regularly, as for

arthritis (rheumatism).

Caffeine passes into the breast milk in small amounts.

Children—Do not give aspirin or other salicylates to a child or a teenager

with a fever or other symptoms of a virus infection, especially flu or

chickenpox, without first discussing its use with your child's doctor . This

is very important because salicylates may cause a serious illness called

Reye's syndrome in children and teenagers with fever caused by a virus

infection, especially flu or chickenpox.

Some children may need to take aspirin or another salicylate regularly (as

for arthritis). However, your child's doctor may want to stop the medicine

for a while if a fever or other symptoms of a virus infection occur. Discuss

this with your child's doctor, so that you will know ahead of time what to

do if your child gets sick.

Children who do not have a virus infection may also be more sensitive to the

effects of salicylates, especially if they have a fever or have lost large

amounts of body fluid because of vomiting, diarrhea, or sweating. This may

increase the chance of side effects during treatment.

Older adults—Elderly people are especially sensitive to the effects of

salicylates. This may increase the chance of side effects during treatment.

Other medicines—Although certain medicines should not be used together at

all, in other cases two different medicines may be used together even if an

interaction might occur. In these cases, your doctor may want to change the

dose, or other precautions may be necessary. When you are taking a

salicylate, it is especially important that your health care professional

know if you are taking any of the following:

Anticoagulants (blood thinners) or

Carbenicillin by injection (e.g., Geopen) or

Cefamandole (e.g., Mandol) or

Cefoperazone (e.g., Cefobid) or

Cefotetan (e.g., Cefotan) or

Dipyridamole (e.g., Persantine) or

Divalproex (e.g., Depakote) or

Heparin or

Inflammation or pain medicine, except narcotics, or

Pentoxifylline (e.g., Trental) or

Plicamycin (e.g., Mithracin) or

Ticarcillin (e.g., Ticar) or

Valproic acid (e.g., Depakene)—Taking these medicines together with a

salicylate, especially aspirin, may increase the chance of bleeding

Antidiabetics, oral (diabetes medicine you take by mouth)—Salicylates may

increase the effects of the antidiabetic medicine; a change in dose may be

needed if a salicylate is taken regularly

Ciprofloxacin (e.g., Cipro) or

Enoxacin (e.g., Penetrex) or

Itraconazole (e.g., Sporanox) or

Ketoconazole (e.g., Nizoral) or

Lomefloxacin (e.g., Maxaquin) or

Norfloxacin (e.g., Noroxin) or

Ofloxacin (e.g., Floxin) or

Tetracyclines (medicine for infection), taken by mouth—Buffered aspirin,

choline and magnesium salicylates, and magnesium salicylate may keep these

medicines from working properly if taken too close to them

Methotrexate (e.g., Mexate) or

Vancomycin (e.g., Vancocin)—The chance of serious side effects may be

increased

Probenecid (e.g., Benemid)—Salicylates can keep probenecid from working

properly for treating gout

Sulfinpyrazone (e.g., Anturane)—Salicylates can keep sulfinpyrazone from

working properly for treating gout; also, taking a salicylate, especially

aspirin, with sulfinpyrazone may increase the chance of bleeding

Urinary alkalizers (medicine that makes the urine less acid, such as

acetazolamide [e.g., Diamox], calcium- and/or magnesium-containing antacids,

dichlorphenamide [e.g., Daranide], methazolamide [e.g., Neptazane],

potassium or sodium citrate and/or citric acid, sodium bicarbonate [baking

soda])—These medicines may make the salicylate less effective by causing it

to be removed from the body more quickly

Other medical problems—The presence of other medical problems may affect the

use of salicylates. Make sure you tell your doctor if you have any other

medical problems, especially:

Anemia or

Overactive thyroid or

Stomach ulcer or other stomach problems—Salicylates may make your condition

worse

Asthma, allergies, and nasal polyps (history of) or

Glucose-6-phosphate dehydrogenase (G6PD) deficiency or

High blood pressure (hypertension) or

Kidney disease or

Liver disease—The chance of side effects may be increased.

Gout—Salicylates can make this condition worse and can also lessen the

effects of some medicines used to treat gout

Heart disease—The chance of some side effects may be increased. Also, the

caffeine present in some aspirin products can make some kinds of heart

disease worse

Hemophilia or other bleeding problems—The chance of bleeding may be

increased, especially with aspirin

Proper Use of This Medicine

Take this medicine after meals or with food (except for enteric-coated

capsules or tablets and aspirin suppositories) to lessen stomach irritation.

Take tablet or capsule forms of this medicine with a full glass (8 ounces)

of water . Also, do not lie down for about 15 to 30 minutes after swallowing

the medicine. This helps to prevent irritation that may lead to trouble in

swallowing.

For patients taking aspirin (including buffered aspirin and/or products

containing caffeine) :

Do not use any product that contains aspirin if it has a strong,

vinegar-like odor . This odor means the medicine is breaking down. If you

have any questions about this, check with your health care professional.

If you are to take any medicine that contains aspirin within 7 days after

having your tonsils removed, a tooth pulled, or other dental or mouth

surgery, be sure to swallow the aspirin whole. Do not chew aspirin during

this time.

Do not place any medicine that contains aspirin directly on a tooth or gum

surface. This may cause a burn.

There are several different forms of aspirin or buffered aspirin tablets. If

you are using:

chewable aspirin tablets , they may be chewed, dissolved in liquid, crushed,

or swallowed whole.

delayed-release (enteric-coated) aspirin tablets , they must be swallowed

whole. Do not crush them or break them up before taking.

extended-release (long-acting) aspirin tablets , check with your pharmacist

as to how they should be taken. Some may be broken up (but must not be

crushed) before swallowing if you cannot swallow them whole. Others should

not be broken up and must be swallowed whole.

To use aspirin suppositories :

If the suppository is too soft to insert, chill it in the refrigerator for

30 minutes or run cold water over it before removing the foil wrapper.

To insert the suppository: First remove the foil wrapper and moisten the

suppository with cold water. Lie down on your side and use your finger to

push the suppository well up into the rectum.

To take choline and magnesium salicylates (e.g., Trilisate) oral solution :

The liquid may be mixed with fruit juice just before taking.

Drink a full glass (8 ounces) of water after taking the medicine.

To take enteric-coated sodium salicylate tablets :

The tablets must be swallowed whole. Do not crush them or break them up

before taking.

Unless otherwise directed by your medical doctor or dentist:

Do not take more of this medicine than recommended on the label, to lessen

the chance of side effects.

Children up to 12 years of age should not take this medicine more than 5

times a day.

When used for arthritis (rheumatism), this medicine must be taken regularly

as ordered by your doctor in order for it to help you . Up to 2 to 3 weeks

or longer may pass before you feel the full effects of this medicine.

Dosing—The dose of these medicines will be different for different patients.

Follow your doctor's orders or the directions on the label . The following

information includes only the average doses of these medicines. If your dose

is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets or teaspoonfuls of solution that you take

depends on the strength of the medicine. Also, the number of doses you take

each day, the time allowed between doses, and the length of time you take

the medicine depend on whether you are taking a long-acting or a

short-acting form of the medicine and the medical problem for which you are

taking the salicylate .

For aspirin

For short-acting tablet, chewable tablet, and delayed-release

(enteric-coated) tablet oral dosage forms:

For pain or fever:

Adults and teenagers—325 to 500 milligrams (mg) every three or four hours,

650 mg every four to six hours, or 1000 mg every six hours as needed.

Children up to 2 years of age—Dose must be determined by your doctor.

Children 2 to 4 years of age—160 mg every four hours as needed.

Children 4 to 6 years of age—240 mg every four hours as needed.

Children 6 to 9 years of age—320 to 325 mg every four hours as needed.

Children 9 to 11 years of age—320 to 400 mg every four hours as needed.

Children 11 to 12 years of age—320 to 480 mg every four hours as needed.

For arthritis:

Adults and teenagers—A total of 3600 to 5400 mg a day, divided into several

smaller doses.

Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound)

of body weight a day, divided into several smaller doses.

For preventing a heart attack, stroke, or other problems caused by blood

clots:

Adults—Most people will take 81, 162.5, or 325 mg a day or 325 mg every

other day. Some people taking aspirin to prevent a stroke may need as much

as 1000 mg a day.

Children—Use and dose must be determined by your doctor.

For chewing gum tablet dosage form:

For pain:

Adults and teenagers—2 tablets every four hours as needed.

Children up to 3 years of age—Dose must be determined by your doctor.

Children 3 to 6 years of age—1 tablet (227 mg) up to three times a day.

Children 6 to 12 years of age—1 or 2 tablets (227 mg each) up to four times

a day.

For long-acting oral dosage forms (extended-release tablets):

For pain:

Adults and teenagers—1 or 2 tablets twice a day.

Children—The long-acting aspirin tablets are too strong for use in children.

For arthritis:

Adults and teenagers—1 or 2 tablets twice a day, at first. Your doctor will

then adjust your dose as needed.

Children—The long-acting aspirin tablets are too strong for use in children.

For rectal dosage form (suppositories):

For pain or fever:

Adults and teenagers—325 to 650 mg every four hours as needed.

Children up to 2 years of age—Dose must be determined by your doctor.

Children 2 to 4 years of age—160 mg every four hours as needed.

Children 4 to 6 years of age—240 mg every four hours as needed.

Children 6 to 9 years of age—325 mg every four hours as needed.

Children 9 to 11 years of age—325 to 400 mg every four hours as needed.

Children 11 to 12 years of age—325 to 480 mg every four hours as needed.

For arthritis:

Adults and teenagers—A total of 3600 to 5400 mg a day, divided into several

smaller doses.

Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound)

of body weight a day, divided into several smaller doses.

For aspirin and caffeine

For oral capsule dosage form:

For pain or fever:

Adults and teenagers—325 to 500 milligrams (mg) of aspirin every three or

four hours, 650 mg of aspirin every four to six hours, or 1000 mg of aspirin

every six hours as needed.

Children up to 6 years of age—Aspirin and caffeine capsules are too strong

for use in children up to 6 years of age.

Children 6 to 9 years of age—325 mg every four hours as needed.

Children 9 to 12 years of age—325 to 400 mg every four hours as needed.

For arthritis:

Adults and teenagers—A total of 3600 to 5400 mg of aspirin a day, divided

into several smaller doses.

Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound)

of body weight a day, divided into several smaller doses.

For preventing a heart attack, stroke, or other problems caused by blood

clots:

Adults—325 mg a day or every other day. People who take smaller doses of

aspirin will have to use a different product. Some people taking aspirin to

prevent a stroke may need as much as 1000 mg a day.

Children—Use and dose must be determined by your doctor.

For oral tablet dosage form:

For pain or fever:

Adults and teenagers—325 to 500 mg of aspirin every three or four hours, 650

mg of aspirin every four to six hours, or 1000 mg of aspirin every six hours

as needed.

Children up to 9 years of age—Aspirin and caffeine tablets are too strong

for use in children up to 9 years of age.

Children 9 to 12 years of age—325 to 400 mg every four hours as needed.

For arthritis:

Adults and teenagers—A total of 3600 to 5400 mg of aspirin a day, divided

into several smaller doses.

Children—A total of 80 to 100 mg per kg (32 to 40 mg per pound) of body

weight a day, divided into several smaller doses.

For preventing a heart attack, stroke, or other problems caused by blood

clots:

Adults—325 mg a day or every other day. People who take smaller doses of

aspirin will have to use a different product. Some people taking aspirin to

prevent a stroke may need as much as 1000 mg a day.

Children—Use and dose must be determined by your doctor.

For buffered aspirin

For oral dosage form (tablets):

For pain or fever:

Adults and teenagers—325 to 500 milligrams (mg) of aspirin every three or

four hours, 650 mg of aspirin every four to six hours, or 1000 mg of aspirin

every six hours as needed.

Children up to 2 years of age—Dose must be determined by your doctor.

Children 2 to 4 years of age—One-half of a 325-mg tablet every four hours as

needed.

Children 4 to 6 years of age—Three-fourths of a 325-mg tablet every four

hours as needed.

Children 6 to 9 years of age—One 325-mg tablet every four hours as needed.

Children 9 to 11 years of age—One or one and one-fourth 325-mg tablets every

four hours as needed.

Children 11 to 12 years of age—One or one and one-half 325-mg tablets every

four hours as needed.

For arthritis:

Adults and teenagers—A total of 3600 to 5400 mg of aspirin a day, divided

into several smaller doses.

Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound)

of body weight a day, divided into several smaller doses.

For preventing a heart attack, stroke, or other problems caused by blood

clots:

Adults—325 mg a day or every other day. People who take smaller doses of

aspirin will have to use a different product. Some people taking aspirin to

prevent a stroke may need as much as 1000 mg a day.

Children—Use and dose must be determined by your doctor.

For buffered aspirin and caffeine

For oral dosage form (tablets):

For pain or fever:

Adults and teenagers—325 or 421 milligrams (mg) of aspirin every three or

four hours, 650 mg of aspirin every four to six hours, or 842 mg of aspirin

every six hours as needed.

Children up to 2 years of age—Dose must be determined by your doctor.

Children 2 to 4 years of age—One-half of a 325-mg tablet every four hours as

needed.

Children 4 to 6 years of age—Three-fourths of a 325-mg tablet every four

hours as needed.

Children 6 to 9 years of age—One 325-mg or 421-mg tablet every four hours as

needed.

Children 9 to 11 years of age—One or one and one-fourth 325-mg tablets every

four hours as needed.

Children 11 to 12 years of age—One or one and one-half 325-mg tablets, or

one 421-mg tablet, every four hours as needed.

For arthritis:

Adults and teenagers—A total of 3600 to 5400 mg of aspirin a day, divided

into several smaller doses.

Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound)

of body weight a day, divided into several smaller doses.

For preventing a heart attack, stroke, or other problems caused by blood

clots:

Adults—162.5 or 325 mg (one-half or one 325-mg tablet) a day or 325 mg every

other day. People who need smaller doses of aspirin will have to use a

different product. Some people taking aspirin to prevent a stroke may need

as much as 1000 mg a day.

Children—Use and dose must be determined by your doctor.

For choline salicylate

For oral dosage form (oral solution):

For pain or fever:

Adults and teenagers—One-half or three-fourths of a teaspoonful every three

hours, one-half or one teaspoonful every four hours, or one or one and

one-half teaspoonfuls every six hours as needed.

Children up to 2 years of age—Dose must be determined by your doctor.

Children 2 to 4 years of age—1.25 milliliters (mL) (one-fourth of a

teaspoonful) every four hours as needed. This amount should be measured by a

special dropper or measuring spoon.

Children 4 to 6 years of age—1.66 mL every four hours as needed. This amount

should be measured by a special dropper or measuring spoon.

Children 6 to 11 years of age—2.5 mL (one-half of a teaspoonful) every four

hours as needed. This amount should be measured by a special measuring

spoon.

Children 11 to 12 years of age—2.5 to 3.75 mL (one-half to three-fourths of

a teaspoonful) every four hours as needed. This amount should be measured by

a special measuring spoon.

For arthritis:

Adults—A total of five and one-half to eight teaspoonfuls a day, divided

into several smaller doses.

Children—A total of 0.6 to 0.7 mL per kilogram (kg) (0.25 to 0.28 mL per

pound) of body weight a day, divided into several smaller doses.

For choline and magnesium salicylates

For oral dosage forms (oral solution or tablets):

For pain or fever:

Adults and teenagers—A total of 2000 to 3000 milligrams (mg) a day, divided

into two or three doses.

Children weighing up to 37 kilograms (kg) (about 89 pounds)—A total of 50 mg

per kg (20 mg per pound) of body weight a day, divided into two doses.

Children weighing more than 37 kg (90 pounds or more)—2200 mg a day, divided

into two doses.

For inflammation or arthritis:

Adults and teenagers—A total of 3000 mg a day, divided into two or three

doses, to start. Your doctor will then adjust your dose as needed.

Children weighing up to 37 kg (about 89 pounds)—A total of 50 mg per kg (20

mg per pound) of body weight a day, divided into two doses.

Children weighing more than 37 kg (90 pounds or more)—2200 mg a day, divided

into two doses.

For magnesium salicylate

For oral dosage form (tablets):

For pain:

Adults and teenagers—2 regular-strength tablets every four hours, up to a

maximum of 12 tablets a day, or 2 extra-strength tablets every eight hours,

up to a maximum of 8 tablets a day.

Children—Dose must be determined by your doctor.

For salsalate

For oral dosage forms (capsules or tablets):

For arthritis:

Adults and teenagers—500 to 1000 milligrams (mg) two or three times a day,

to start. Your doctor will then adjust your dose as needed.

Children—Dose must be determined by your doctor.

For sodium salicylate

For oral dosage forms (tablets or delayed-release [enteric-coated] tablets):

For pain or fever:

Adults and teenagers—325 or 650 milligrams (mg) every four hours as needed.

Children up to 6 years of age—This medicine is too strong for use in

children younger than 6 years of age.

Children 6 years of age and older—325 mg every four hours as needed.

For arthritis:

Adults and teenagers—A total of 3600 to 5400 mg a day, divided into several

smaller doses.

Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound)

of body weight a day, divided into several smaller doses.

Missed dose—If your medical doctor or dentist has ordered you to take this

medicine according to a regular schedule and you miss a dose, take it as

soon as you remember. However, if it is almost time for your next dose, skip

the missed dose and go back to your regular dosing schedule. Do not double

doses.

Storage—To store this medicine:

Keep out of the reach of children. Overdose is very dangerous in young

children.

Store away from heat and direct light.

Do not store tablets or capsules in the bathroom, near the kitchen sink, or

in other damp places. Heat or moisture may cause the medicine to break down.

Keep liquid forms of this medicine from freezing.

Store aspirin suppositories in a cool place. It is usually best to keep them

in the refrigerator, but keep them from freezing.

Do not keep outdated medicine or medicine no longer needed. Be sure that any

discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Check the labels of all nonprescription (over-the-counter [OTC]) and

prescription medicines you now take. If any contain aspirin or other

salicylates (including bismuth subsalicylate [e.g., Pepto-Bismol] or any

shampoo or skin medicine that contains salicylic acid or any other

salicylate), check with your health care professional . Taking or using them

together with this medicine may cause an overdose.

If you will be taking salicylates for a long time (more than 5 days in a row

for children or 10 days in a row for adults) or in large amounts, your

doctor should check your progress at regular visits .

Check with your medical doctor or dentist:

If you are taking this medicine to relieve pain and the pain lasts for more

than 10 days (5 days for children) or if the pain gets worse, if new

symptoms occur, or if redness or swelling is present. These could be signs

of a serious condition that needs medical or dental treatment.

If you are taking this medicine to bring down a fever, and the fever lasts

for more than 3 days or returns, if the fever gets worse, if new symptoms

occur, or if redness or swelling is present. These could be signs of a

serious condition that needs treatment.

If you are taking this medicine for a sore throat, and the sore throat is

very painful, lasts for more than 2 days, or occurs together with or is

followed by fever, headache, skin rash, nausea, or vomiting.

If you are taking this medicine regularly, as for arthritis (rheumatism),

and you notice a ringing or buzzing in your ears or severe or continuing

headaches. These are often the first signs that too much salicylate is being

taken. Your doctor may want to change the amount of medicine you are taking

every day.

For patients taking aspirin to lessen the chance of heart attack, stroke, or

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