Despite its relatively safe nature and medicinal history that traces back to the ancient Greek physician Hippocrates in the 5^th Century B.C., aspirin and other NSAIDs cause up to 15,000 deaths and 100,000 hospitalizations each year. Most famously, perhaps, actor and American martial artist Bruce Lee’s untimely death at the age of 32 was attributed to an acute reaction to the combination drug, Equagesic, which features aspirin as a primary ingredient.

Aspirin overdoses may be intentional or accidental and may be acute – the result of ingesting too much aspirin over a short period of time or chronic – the result of taking too much aspirin over a prolonged period of time. About 5 percent of severe aspirin poisoning cases can result in fatalities, either a result of cardiac arrest or brain damage.

What Causes an Overdose?

Some patients intentionally ingest large amounts of aspirin as an attempt at suicide, either as an outcry or as a deliberate attempt to take one’s life. Other patients deliberately give children large doses of aspirin as an effort to abuse or harm children. These cases are less common than unintentional overdoses, which can happen for many reasons.

Acute Overdoses

Aspirin poisoning used to be the most common cause of accidental poisoning in children – in the days before child-resistant aspirin bottles. Inappropriate dosing in young children or the elderly is also a common cause of aspirin poisoning in the United States. This can be the result of giving a child too large a dose, despite warnings against giving children aspirin. Elderly patients may forget that they’ve taken a dose of aspirin and double up, or a patient inadvertently may take multiple combination medications that contain aspirin. This long-term inappropriate dosing is common in elderly patients who have chronic health problems, according to the New York Times.


Chronic Overdoses

Chronic overdoses can occur when aspirin levels build up in the body over time as a result of a daily aspirin regimen. Chronic overdoses are especially common in the elderly during hot seasons and in patients who have kidneys that don't function at their full capacity.

What Are the Symptoms?

The earliest symptoms of aspirin poisoning can include tinnitus, or a ringing in the ears, as well as potential hearing loss. They also may include an upset stomach or stomach pain, and nausea or vomiting. However, more serious overdoses can result in significant symptoms that may include:

·      Hyperventilation

·      Hyperactivity or drowsiness

·      Dehydration

·      Fever

·      Vision impairment

·      Dizziness or faintness

In acute aspirin poisoning cases, symptoms can include drowsiness or mental impairment, which can include confusion, agitation and hallucinations and can lead to seizures, loss of consciousness or coma.


What Can I Do?

If you or a loved one has been taking aspirin or if you suspect that the patient has accessed aspirin (such as in the case of a child who has had access to a medicine cabinet), seek immediate emergency medical treatment. If the person is not yet showing symptoms, you can call the American Association of Poison Control Centers at 800-222-1222 for information on the steps to take.  

Call 911 if the person has become delirious or lost consciousness. Provide emergency personnel with as much information as you have, which may include the brand or brands of medication the person took and the dosage, how many pills are missing or believed to be missing from any containers, and any information about underlying medical conditions of which you’re aware.

Once at an emergency care center, a doctor can check for signs of aspirin poisoning and organ system damage and measure aspirin levels in the blood. Because an aspirin overdose can affect the ability to breathe, it’s important to be in a facility where breathing can be monitored, and oxygen can be administered. Further, because aspirin levels can continue to rise over time (especially when the overdose is the result of coated tablets), it’s important that a doctor be able to monitor those levels.

How Can I Avoid an Overdose?

In 2014, the FDA reversed its position on using daily aspirin as a primary prevention method in patients who have not had a heart attack, stroke or cardiovascular problems. Because new evidence suggests that the benefits for these patients, who have not been diagnosed with a condition and prescribed an aspirin regimen by their physicians, do not outweigh the risks, the FDA does not recommend this type of preventive therapy. Regular aspirin use can increase the risk of brain or stomach bleeding, as well as the risk of developing ulcers, certain gastrointestinal (GI) infections, diverticular disease and inflammatory bowel disease (IBD), among others.

If you or a loved one has been prescribed a daily aspirin regimen, you should take a few steps to ensure that you don’t develop a chronic overdose:


-       Stay Hydrated. Make sure that you or the patient drinks plenty of fluid throughout the day and increase fluid intake during hot seasons or travel in hot climates.

-       Be Cautious of Kidney Problems. If you have or suspect you may have kidneys that don't function properly, make an appointment to see a specialist. If you have been diagnosed with a kidney disorder, make sure you share this with your cardiologist and follow any specific instructions he or she may provide regarding your aspirin intake.

-       Read Labels Carefully. Many combination drugs contain aspirin as an active ingredient, so you should be sure that you carefully read active ingredient labels and avoid doubling up on a dose if you are on an aspirin regimen.

An Important Note About Aspirin and Children

Aspirin is generally not the pain reliever of choice for use in children unless specifically prescribed by a physician. Not only is there a high risk for overdose, but aspirin also has been linked to a potentially deadly condition in children. Reyes Syndrome, according to Mayo Clinic, is a rare but serious condition that causes swelling of the brain and liver in teenagers and children. This condition is most often seen in children and teens who are recovering from viral infections, such as the flu or chickenpox, so it is essential that children who have such infections not be given aspirin as a pain reliever or fever reducer.

As with all medications, aspirin should be stored in a child-resistant container and out of reach of young children to avoid an accidental, acute overdose. If an overdose is suspected, you should seek immediate, emergency medical care for your child to avoid permanent consequences, such as organ failure or death.