They won't advise the use of aspirin for long term use here for fear of the stomach problems you state. I just assumed that was the same everywhere.
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?? why?
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It would, and I may be wrong in my 'recollection'. Mind you, if it were true it would not be the first time a medicine had been found to lose efficacy if the dose increased beyond some threshold!
However, there is no doubt that sub-analgesic doses of aspirin are effective as 'anti-thrombotic' treatment, and since even lowish doses of aspirin can cause gastric problems in some people, it makes sense to take as small a dose as is possible if one only wants the anti-thrombotic activity. That is generally taken to be 75mg - 150mg per day, which contrasts with the 3,000+ mg per day commonly used for the treatment of pain and/or elevated temperature.
It's a question of practicalities. As you say, long-term use of aspirin is discouraged for that reason - but, as I have said, much the same (or equally potentially problematical complications) is true of nearly all the alternatives.
Some patients with diseases like rheumatoid arthritis have to take extremely high doses of drugs of this type (far higher doses than recommended for the non-prescription products) in order to control their symptoms, and they will often be given 'anti-ulcer' medicines as well to reduce the possible effects on their stomachs.
More generally, of course, almost any non-prescription medicine will come with advice that it should not be taken 'long-term' without seeking medical advice (and that 'long term' is often stated as being just 'more than a few days').
By long term, I meant for ever.
As I've said, no medicine should be taken 'for ever' other than with appropriate medical advice and monitoring - and the instructions that come with non-prescription medicines should (and nearly always do) reflect that.
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Or become too effective. A couple of grams of diamorphine for example would be an extremely effective, and long-lasting, analgesic....
I never had any gastric problems from aspirin, but then I was never a long-term user of it. I had no concerns about taking 300mg (or whatever they usually are) tablets for a few days before a flight. It never occurred to me that that might be too much for it to work as an anti-thrombotic.
Now I'm on Rivaroxaban I'd rely on that - one of it's approved uses is to prevent DVT or pulmonary embolisms after knee or hip surgery.
Its not the one known as Apixaban is it? or is that something else?
These medical names for stuff is often more tricky the Electrics stuff!
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No - that's something else, but it's also an anti-coagulant, alternative to Warfarin, used for the same/similar reasons.
IHNI what subtle differences there are between that, Rivaroxaban, Dabigatran, Edoxaban (thanks, Wikipedia).
And their pronunciations.
I've always gone with "as in river" for Rivaroxaban, but I've heard some people pronounce it as in "arrive".
I take Lercanidipine for blood pressure, so is that "pine" as in the tree, or "peen"? And where the hell do any syllable emphases go?
Fun fact - one can tell (or at least those who know the code can tell) what a drug does by how it's name ends (or sometimes starts). https://en.wikipedia.org/wiki/Drug_nomenclature#List_of_stems_and_affixes
And how did we get here from
?
Well, yes, but that's a little on the silly side
AsI said, it's far from unknown. It's essentially an example of the phenomenon known as "hormesis", which results in an 'inverted U-shaped' dose-response curve, and usually relates to a situation in which a substance has a beneficial effect ion something at lowish doses, but a (at least partially) 'cancelling' detrimental effect on the same 'something' at high doses.
More generally, it's most often seen in terms of environmental and dietary 'substances' (including 'supplements') - for almost everything one 'consumes' there is an ideal 'happy medium' - with 'far too little' or 'far too much' causing problems. In terms of deficiencies/supplements there are several vitamins and minerals for which this is the case during pregnancy - with both Vitamin A and magnesium (and probably other things, both 'too high' and 'too low' levels of these substances in the mother's body are associated with an increased risk of congenital malformations in her baby.
In terms of medicines, the ones that come immediately to mind are some cannabis derivatives and substances (such as buprenorphine) used as 'opiate substitutes' in managing those addicted to opioids.
The documentation for rivaroxaban says the following, which suggests that you perhaps should be taking aspirin (acetylsalicylic acid) as well as the rivaroxaban ...
Due to having been on a first aid course many years ago I was familiar with the proper name for Aspirin and one pedantic twerp once asked me "Do you know the proper name for Aspirin?" I answered "yes", he then said "What is it?" I said "Why, do you not know it?" he said "I bet you dont know it!" I said "I do" he then announced "It is Salicylic acid!" I said "no it is not! It is not! It is Acetylsalicylic acid!" didnt stop him habitually comment out with his other stupid statements either though such as "You cant say half a metre! It is 0.5 of a metre!" and a whole host of other stupid statements he was famous for. I do miss him though, even though he was the laugh (sometimes the Scourge) of his workmates he was actually a very well meaning person but such a twerp - he emigrated (I wonder how he`s getting on with the locals ? ) Sorely missed
That's now my prescribed anticoag. I have been through the lot and the riva was the only one not to cause itchy lumps and generally irritated skin. Before this I was prescribed low dose aspirin (TIA's 25yrs ago) until advice was changed.
Very much so
As I wrote above, it's interesting to see that the manufacturer's documentation for rivaroxaban say that when used as prophylaxis against "atherothrombotic events" (such as TIAs), it should be given together with aspirin - but I don't know how many prescribers follow that advice.
Try him with paracetamol, particularly if he has any American tendencies
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