How risky is it to take aspirin?

Do they sell aspirin in the underground market? No, because it’s legal, regulated, and there aren’t any restrictions to access. There are also no sin taxes on aspirin, which helps make it cheap. But how safe is aspirin (or any NSAID)?

http://www.reuters.com/article/2007/05/09/us-risks-idUSN0737156120070509

For 50-year-old men, taking a full-sized, 325 mg aspirin every day to prevent heart disease and stroke carries a risk of 10.4 deaths per 100,000 men per year over and above their overall death risk.

Using Vioxx for arthritis pain carried a risk of 76 deaths per 100,000 people per year. Merck and Co withdrew Vioxx in September 2004 after it was shown to double the risk of heart attack and stroke.

“The finding that taking Vioxx for a year is much more risky than a year of car travel, swimming or being a firefighter suggests that greater scrutiny of drug risks may be warranted,” the researchers wrote.

Using Tysabri, known generically as natalizumab, to treat multiple sclerosis raises the death rate by 65 per 100,000 people a year…

https://www.propublica.org/article/tylenol-mcneil-fda-behind-the-numbers

Data compiled by the U.S. Food and Drug Administration has linked as many as 980 deaths in a year to drugs containing acetaminophen. In addition, FDA reports of death associated with acetaminophen have been increasing faster than those for aspirin, ibuprofen and many other common over-the-counter pain medicines.

Data obtained from the U.S. Centers for Disease Control and Prevention show that more than 300 people die annually as a result of acetaminophen poisoning.

Beginning in 2006, according to the CDC, the number of people who died after accidentally taking too much acetaminophen surpassed the number who died from intentionally overdosing to commit suicide…

Why the large differences? Because each organization’s data has strengths and weaknesses.

The FDA relies primarily on individual case reports, called FDA Adverse Event Reports, submitted by drug makers, consumers and doctors. Drug makers must submit information about any cases they learn about involving side effects linked to their drugs, while reports by consumers and healthcare workers are voluntary. The reports often lack key information. By some estimates, the FDA system captures from 1 percent to 10 percent of adverse events involving drugs.

Most important, the reports do not demonstrate a causal connection between a person’s death and a particular drug, just an association. This is a crucial issue for acetaminophen, because that drug is often combined with other drugs into one medication. For example, the prescription painkiller Vicodin combines acetaminophen with the powerful opioid painkiller hydrocodone. If a person dies after taking Vicodin, the FDA report does not say whether it was caused by hydrocodone or acetaminophen, or even some other drug. So the FDA data only allows one to say a drug is linked to or associated with the death…

But the quality of the reports depends upon the judgments of the local officials who review medical files, conduct autopsies and ultimately fill out death certificates…

After examining the data sets and checking the numbers with the CDC and AAPCC, ProPublica has generally relied upon the CDC figures as a primary source of information. We judged that the death certificate information, while imperfect, represented the most rigorous collection of data. (And yes, we are aware of the series we did pointing out the flaws of death investigations in America.)…

All we can say is that only a tiny fraction of people who take acetaminophen appear to suffer injuries or fatalities as a result. Adding up the highest estimates of injuries and deaths linked to acetaminophen would result in a total of a little over 110,000 incidents annually. About 27 billion doses were sold in 2009, the most recent year for which figures are publicly available. If all the pills were consumed, that would mean about one injury for every quarter million doses. In actuality, that almost certainly lowballs the rate of injuries, but by how much, nobody knows.

http://www.ncbi.nlm.nih.gov/pubmed/9715832

(1998) Recent considerations in nonsteroidal anti-inflammatory drug gastropathy.

Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated…

Analysis of these data indicates that: (1) osteoarthritis (OA) and rheumatoid arthritis (RA) patients are 2.5-5.5 times more likely than the general population to be hospitalized for NSAID-related GI events; (2) the absolute risk for serious NSAID-related GI toxicity remains constant and the cumulative risk increases over time; (3) there are no reliable warning signals- >80% of patients with serious GI complications had no prior GI symptoms; (4) independent risk factors for serious GI events were age, prednisone use, NSAID dose, disability level, and previous NSAID-induced GI symptoms; and (5) antacids and H2 antagonists do not prevent NSAID-induced gastric ulcers, and high-risk NSAID users who take gastro-protective drugs are more likely to have serious GI complications than patients not taking such medications. Currently, limiting NSAID use is the only way to decrease the risk of NSAID-related GI events…

5 thoughts on “How risky is it to take aspirin?

  1. 300 people in one (we dont know which one, of course) year die from tylenol poisoning….wow, that is such a huge number! we have to stop this acetominiphen death train now!! get it out of the stores, stop prescribing it, for god’s sake, its a plague of death!! i mean what? a tylenol crisis? what about car wrecks, strokes, heart attacks? don’t those things kill more people each individually in a given year, than these tylenol deaths? next report : how ingrown toenails cause 25 people to die each year! what can we do to prevent this? healthcare experts say sometimes removing the toe is the best answer. RIDICULOUS!!!!!

    Liked by 1 person

    • I think the point is that we don’t really know how many people die from tylenol poisoning, or from many other drugs either. When someone dies from a heart attack, is it because he took tylenol every day or because he didn’t take tylenol every day? When someone dies from an overdose, what is it intentional or not? There are lots of things that all this data doesn’t say, and lots of things that it will never be able to say.

      Liked by 1 person

      • the point i was making was now the new epidemic, tylenol overdoses & deaths, is the NEW pain med epidemic that the public must be saved from. chronic use of tylenol, the full 2000mg/day, may, just may, lead to liver dysfunction by the time you are in your 70’s or older (usually older). If you want to overdose on it, you would have to do more than just swallow a bunch of tylenol. 1 bottle is not gonna kill you. you’d have to take 3 or more bottles of extra strength tylenol at once –and keep them all down–without being sick—and even then, dying is only a maybe. even if you take that much and keep it down, if you add C02 poisoning (car in garage) you probably still won’t die before anyone finds you, even overnight. it is a lot harder to develop chronic tylenol poisoning that happens earlier than your 70’s or to intentionally poison oneself with it than it would be to just choose another method.

        i worked in geriatric care as a Nurse Aide, and one of the big topics of the educational meetings we had to take was all about overuse of tylenol for patients’ entire lives was now maybe causing some liver issues, and there was discussion on whether or not to let these elderly people continue to take tylenol. Of course, we continued to give it and no one died of it either.

        and i have had a couple of friends who have tried tylenol overdose, and all it did was make for an excruciatingly painful recovery with really awful tasting medicine. my advice, keep giving tylenol and –its not an epidemic.

        Liked by 1 person

  2. also, this article was speaking about Both tylenol (acetominephin) and aspirin (salicylic acid) and NSAIDS . i was replying regarding the section about tylenol and its dangers.

    Liked by 1 person

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