ASA (acetylsalicylic acid)

What is ASA?

ASA is used to prevent blood clots in conditions such as Kawasaki disease, after heart surgery or after a stroke. It acts by keeping platelets in the blood from sticking together. ASA comes in a chewable tablet, regular tablet and enteric-coated tablet forms.

You may also hear ASA called by its brand name, Aspirin.

Before giving ASA

Tell your child's health-care provider if your child has:

• an allergy to ASA or other non-steroidal anti-inflammatory drugs (NSAIDs)
• asthma, rhinitis (inflammation of the inside of the nose) and nasal polyps
• chickenpox or flu-like symptoms

Talk with your child's health-care provider if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• a bleeding condition
• stomach ulcers
• liver disease
• kidney disease

How should you give your child ASA?

• If needed, you may cut the chewable or regular tablet in half or quarters to get the right dose for your child. You can use a tablet splitter to do this, which can be purchased at your pharmacy.
• If your child is taking chewable tablets:
• The tablets may be chewed or dissolved in the mouth. They may also be dissolved in a small amount of water (3 mL to 5 mL, or up to 1 teaspoon) and then given by mouth immediately.
• If your child is taking regular tablets:
• The tablets may be swallowed whole, crushed or chewed. Make sure your child drinks a glass of water or milk after taking the ASA.
• If your child is taking enteric-coated tablets (special coating to protect from stomach upset):
• The tablets should be swallowed whole with a glass of water, not crushed or chewed.
• To prevent stomach upset, give ASA with food or milk. For example, ASA can be given with or after breakfast.
• Give ASA exactly as your health-care provider tells you, even if your child seems better. Talk to your child's health-care provider before you stop giving ASA for any reason.
• Giving ASA at the same time(s) every day.

What should you do if your child misses a dose of ASA?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
  
• Do not give your child two doses to make up for one missed dose.

How long does it take ASA to work?

ASA works within a few hours to prevent platelets in the blood from sticking together. It is usually continued until the risk of blood clots has resolved. In children with Kawasaki disease, ASA is usually given for at least four to six weeks, or until their health-care team confirms it is safe to stop ASA at your child's follow-up appointment.

What are the possible side effects of ASA?

Your child may have some side effects while they take ASA. Usually, your child will not need to see a health-care provider about them.

These mild side effects may go away as your child's body gets used to ASA. Check with your child's health-care provider, and follow their instructions if your child has any of these signs or symptoms and they do not go away or they bother your child:

• a rash or itchy skin
• mild stomach cramps (usually happens shortly after taking a dose)
• upset stomach or throwing up

Call your child's health-care provider during office hours if your child has any of these side effects:

• severe or lasting stomach pain
• unusual bruising

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's health-care provider right away or take your child to the Emergency Department if your child has any of these side effects:

• blood in vomit, urine or stool (black tarry stools)
• prolonged, uncontrollable bleeding
• difficulty breathing
• problems seeing, blurred vision
• ringing in the ears, trouble hearing

What safety measures should you take when your child is using ASA?

There are some medicines that should not be taken together with ASA, or, in some cases, the dose of ASA or the other medicine may need to be adjusted. It is important that you tell your health-care provider if your child takes any other medications (prescription, over the counter or herbal), including:

• other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (also called Advil or Motrin) or naproxen (also called Aleve)
• blood thinners such as warfarin, enoxaparin and rivaroxaban
• valproic acid

What other important information should you know about ASA?

• ASA can be purchased at your local pharmacy without a prescription. Please speak to your pharmacist to purchase the right form (e.g., chewable tablets) for your child.
• If your child has any symptoms of a cold of flu-like symptoms such as runny nose, sneezing, stuffy nose, coughing or has been exposed to chickenpox, notify your child's health-care provider. Your ASA therapy may need to be changed to another medication.
• Before your child has any kind of surgery, even on the teeth, or emergency treatment, tell the doctor or dentist that your child is taking ASA. If they tell you to stop the ASA, speak to your child's doctor or dentist about when to start taking ASA again.
• Keep a list of all medications your child is on and show the list to the health-care provider.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Make sure you always have enough ASA to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep all appointments at the clinic or doctor's office so that the health-care provider can check your child's reaction to ASA.
• Keep ASA at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.

Keep ASA (acetylsalicylic acid) out of your child's sight and reach and locked up in a safe place. If your child takes too much ASA (acetylsalicylic acid), call the Ontario Poison Centre at one of these numbers. These calls are free.

• Call 416-813-5900 if you live in Toronto.
• Call 1-800-268-9017 if you live somewhere else in Ontario.
• If you live outside of Ontario, call your local Poison Information Centre.