What risks come with taking aspirin every day?
Daily aspirin can increase bleeding risk because it changes how platelets work and makes blood less likely to clot. The most important safety issues are:
- Stomach or intestinal bleeding (including ulcers)
- Bleeding in the brain (intracranial hemorrhage)
- Bruising and other minor bleeding that can become more serious over time
The risk is higher in people with a history of ulcers or gastrointestinal bleeding, uncontrolled high blood pressure, certain bleeding disorders, or those taking other medicines that raise bleeding risk (for example, other antiplatelet drugs, anticoagulants like warfarin, or frequent NSAID use).
Who should NOT take daily aspirin?
Daily aspirin is generally avoided (unless a clinician specifically recommends it for a particular reason) in people with higher bleeding risk and in groups where the risk-benefit balance is unfavorable. Common examples include:
- People with a prior gastrointestinal bleed or bleeding in the brain
- People with known bleeding disorders
- People taking blood thinners or multiple drugs that increase bleeding risk (without a clinician’s plan)
- Some people with aspirin allergy or NSAID-related asthma reactions
- Children and teens for viral illnesses like flu or varicella, because of the risk of Reye’s syndrome
When is daily aspirin considered “safe enough” to use?
Aspirin daily is sometimes recommended when the benefit is higher than the bleeding risk, such as for “secondary prevention” (preventing another event in people who already have cardiovascular disease). In these cases, clinicians may prescribe low-dose aspirin because it can reduce the risk of certain heart or stroke events.
If you do not already have cardiovascular disease, the decision is more individualized. Many people hear “take a baby aspirin every day,” but whether it helps can depend heavily on age, overall cardiovascular risk, and bleeding risk.
Does the dose matter?
Yes. Low-dose aspirin (often called “baby aspirin,” commonly 81 mg) is typically used when aspirin is prescribed for daily prevention, because it can provide antiplatelet effects with a lower bleeding risk than higher doses. Higher doses increase the chance of bleeding.
What side effects should you watch for?
If you or your doctor decide aspirin is appropriate, stop and get medical advice urgently for signs of serious bleeding, such as:
- Black/tarry stools or vomiting blood/coffee-ground material
- Severe or persistent abdominal pain
- Sudden severe headache, weakness, numbness, trouble speaking, or vision changes
- Unusual bleeding that is hard to stop (for example, nosebleeds or bleeding that keeps recurring)
How do other medicines affect aspirin safety?
Aspirin safety changes when you combine it with other drugs, especially:
- Anticoagulants (warfarin, apixaban, rivaroxaban, etc.)
- Other antiplatelet medications
- NSAIDs (ibuprofen, naproxen), particularly with frequent use
- Corticosteroids (which can raise GI bleeding risk)
- Some antidepressants (can increase bleeding risk, especially with GI bleeding)
If you’re taking any regular medications, it’s important to review the combination with a clinician or pharmacist.
Is there a safer alternative if you’re taking it for prevention?
Sometimes clinicians use alternatives depending on why aspirin was started. For example, controlling blood pressure, cholesterol management (statins), smoking cessation, and diabetes management can reduce cardiovascular risk without aspirin’s same bleeding concerns.
In certain people, other strategies (or no antiplatelet therapy) may be safer than daily aspirin.
What should you do if you already take aspirin daily?
Don’t change or stop aspirin on your own if it was prescribed for heart disease or prior stroke—suddenly stopping can increase risk of events for some people. If you take aspirin without a prescription, or you’re unsure why you started, discuss with a clinician to weigh your personal bleeding risk vs cardiovascular benefit.
If you tell me your age, whether you’ve ever had a heart attack, stent, stroke/TIA, or blood clot, and what dose you’re taking (plus any stomach ulcer history or blood thinners), I can help you think through the safety question more specifically.