Which medicines can interact with aspirin?
Aspirin can interact with several common drug types, mainly by increasing bleeding risk or raising stomach irritation.
Other blood thinners/antiplatelet drugs
Taking aspirin with other agents that thin the blood can raise the chance of bleeding. This can include:
- Warfarin
- Heparin
- Direct oral anticoagulants (for example, apixaban, rivaroxaban, dabigatran)
- Other antiplatelet drugs (for example, clopidogrel, prasugrel, ticagrelor)
If you’re on any blood-thinning medicine, you should not add aspirin without clinician guidance.
NSAIDs (ibuprofen, naproxen, and similar)
Using aspirin alongside other NSAID pain relievers can increase stomach bleeding/irritation risk. It can also interfere with aspirin’s specific anti-platelet effect in some cases, depending on timing and dose.
Certain antidepressants
Some antidepressants—especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)—can raise bleeding risk when combined with aspirin.
What about supplements—what shouldn’t be mixed with aspirin?
Some supplements can also increase bleeding risk. People often ask about these, especially before dental work or surgery. Common examples include:
- Fish oil (high doses)
- Vitamin E (high doses)
- Garlic supplements (high doses)
Because supplement contents vary by brand and dose, it’s safest to ask a pharmacist or clinician what applies to your specific products.
What should you avoid if you’re taking aspirin for heart protection?
If you take aspirin daily for heart or stroke prevention, avoid adding pain relievers or other “heart medications” without checking first—particularly:
- Other NSAIDs (unless your clinician says it’s fine)
- Additional antiplatelet or anticoagulant drugs
Timing matters when NSAIDs are involved, so ask how to space doses.
What increases aspirin harm from the stomach?
Aspirin can irritate the stomach lining. You should be extra careful (or seek advice before using) if you also use:
- Alcohol (raises GI bleeding risk)
- Other ulcer- or gastritis-provoking meds (especially additional NSAIDs)
People with a history of stomach ulcers or GI bleeding generally need individualized guidance.
When to get urgent help
Stop and get urgent medical advice if you have signs of serious bleeding, such as:
- Black/tarry stools
- Vomiting blood or material that looks like coffee grounds
- Unusual bruising, severe weakness, or dizziness
- Severe abdominal pain
If you tell me which aspirin dose you’re taking (81 mg vs 325 mg), why you take it (pain vs heart), and the other medicines/supplements you’re on, I can narrow down the specific “do not take together” items.