Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Optimal aspirin dose

The Annals of Internal Medicine has published the results of a post-hoc observational analysis of a randomised controlled trial to assess the optimal dose of aspirin as an anti-thrombotic.

The review assessed the benefits and risks of aspirin at doses of less the 100mg daily and more than 100mg daily. The review found no differences between the two dose classifications in terms of the primary efficacy or primary safety endpoints. In patients who were also taking clopidogrel, there was a trend towards reduced efficacy and increased harm in patients taking more than 100mg of aspirin daily although these results were not statistically significant.

The authors conclude that higher doses of aspirin are associated with "no clear benefit in patients taking aspirin only and possibly with harm in patients taking clopidogrel".

Action: Clinicians should ensure that aspirin is given at a daily dose of 75mg when intended for use as an anti-thrombotic. Higher doses should be used cautiously after careful assessment of potential risks and benefits.

Thanks to Kevin Ashworth for spotting this article

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