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Many people take 80-300mg a day of aspirin for cardiovascular reasons; while, from what I've seen online, arthritis patients take up to 3000mg a day (is this correct?). But what are the increased risks associated with such a high daily intake? At what daily dose does aspirin become dangerous?

I've found many accounts of acute poisoning, but no quantitative studies on the chronic effects over time, as a function of dosage -- it's surprisingly hard to find information on this (I've tried every keyword combination under the sun).

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  • Sorry I can’t answer your question, but I am wondering the exact same thing. I have extensive arthritis and have found hot (Bikram) Yoga to be extremely beneficial. Sometimes, though, I’ll overdo it and aspirin helps with the resulting pain. I’d like to take a couple of full strength aspirin every night, but maybe I should take something else that won’t cause bleeding. I hope someone does have a real answer to your question.
    – Lawrence W. Nelson
    Commented Jan 15, 2018 at 12:17

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Aspirin, just like all NDSAIDs, affects enzymes associated with pain transmission; they are COX-1 and COX-2 (cyclooxygenase-1 and 2). COX-1 helps protect the stomach and intestinal lining from the acids the stomach produces 1. Since NSAIDs inhibit the production of these enzymes, they also leave your stomach and intestinal lining somewhat unprotected from acids. This is what can cause damage from long-term use of NSAIDs. It's not so much that they burn a hole in your stomach, but that they reduce the protection offered by the COX-1 enzyme. Of course, the higher the dose, the greater the effect on these enzymes, and the longer NSAIDs are taken, the greater the gastrointestinal risk. Except for low-dose aspirin, NSAIDs should not be taken longer than necessary.

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1. https://www.rxlist.com/cox-2_inhibitors/drugs-condition.htm

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  • Lacks citations.
    – Carey Gregory ♦
    Commented Jan 16, 2018 at 18:33
  • Did you see my footnote (superscript)?
    – BillDOe
    Commented Jan 17, 2018 at 0:14
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    Oh wow, sorry, no, I didn't. Too tiny. Probably not the best way to add links but I'm reversing my downvote. (I had to make a trivial edit of adding a space to allow me to reverse it.)
    – Carey Gregory ♦
    Commented Jan 17, 2018 at 2:54
  • Thanks. Sometimes I use a footnote style link where a regular hyperlink just doesn't fit. I don't use it often.
    – BillDOe
    Commented Jan 17, 2018 at 19:05
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Aspirin is a platelet inhibitor. As such it has a number of bleeding risks - including GI bleeding as described above. Risks also include increased bleeding risk from injury including cuts, bruising, or hitting your head and having a brain bleed. And actually, even without head trauma, an intracranial hemorrhage risk increases with the dose of aspirin. The same dose of aspirin is not safe for everyone.

This does NOT mean that aspirin is too risky to take for primary or secondary prevention of heart disease, ischemic stroke, etc - it means you need to have a discussion with your doctor on the risks and benefits of whether daily (or even as-needed) aspirin is right for your personal situation and if so, what dose. And you/your doctor need to know what other medications you take daily and what others you might take when you need it - because some interact with aspirin. Again you need a doctor to advise you on what daily dose is right for you.

Arthritis pain has many possible treatments. Your doctor can help develop a specialized treatment plan.

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Commonly prescribed dose of aspirin for certain types of arthritis can be as high as 4 g/day (Drugs.com).

For angina pectoris and heart attack prevention, even low doses (75-325 mg/day) can result in gastrointestinal bleeding (PubMed).

According to one study (PubMed):

Mini-dose aspirin...(75 mg/day), caused significant changes in renal function and uric acid handling within 1 week in a group of elderly inpatients...

Surely, side effects depend on the dose and treatment duration but also on an individual's susceptibility. So, I think it would be irresponsible to mention any specific aspirin dose as "safe dose".

The recommendations about "Safe Daily Use of Aspirin" by the US Food and Drug Administration FDA.gov do not mention any aspirin dose at all.

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