Hypersensitivity reactions: Acetylsalicylic acid and other NSAIDs may cause hypersensitivity reactions (including asthma attacks, rhinitis, angioedema or urticaria). The risk is higher in subjects who have experienced a hypersensitivity reaction in the past after using this type of drug, as well as in subjects who have allergic reactions to other substances (eg, skin reactions, pruritus, urticaria). In patients with asthma and/or rhinitis (with or without nasal polyposis) and/or urticaria, reactions may be more frequent and severe. In rare cases, reactions can be very serious and potentially fatal. In the following cases, the administration of the drug requires the appointment of a doctor after a thorough assessment of the risk/benefit ratio: subjects with an increased risk of developing hypersensitivity reactions; with an increased risk of damage to the gastrointestinal tract. Acetylsalicylic acid and other NSAIDs can cause serious gastrointestinal side effects (bleeding, ulcer, perforation). For this reason, these drugs should not be used in persons suffering from gastrointestinal ulcers or gastrointestinal bleeding. It is advisable that even those who have suffered from gastrointestinal ulcers or gastrointestinal bleeding in the past should avoid using it. The risk of gastrointestinal injury is a dose-dependent effect, as gastric injury is greater in subjects using higher doses of acetylsalicylic acid. Even subjects who have a habit of drinking large amounts of alcohol are more at risk of gastrointestinal injury (particularly bleeding). Subjects with coagulation defects or receiving anticoagulants: In individuals suffering from clotting disorders or taking anticoagulants, acetylsalicylic acid and other NSAIDs can cause a serious decrease in hemostatic capacity, putting them at risk of bleeding. Subjects with impaired renal, cardiac, or hepatic function: Acetylsalicylic acid and other NSAIDs may cause a critical decrease in renal function and water retention; the risk is higher in subjects receiving diuretics. This can be especially dangerous for older people and people with impaired kidney, heart, or liver function. People with asthma: Acetylsalicylic acid and other NSAIDs can aggravate asthma. Geriatric age (especially over 75): The risk of serious side effects is higher in older people. Subjects over 70 years of age, especially in the presence of concomitant therapy, should use the medicine only after consulting a physician. Do not use in the pediatric population. Preparations containing acetylsalicylic acid should not be used in children and adolescents under 16 years of age with viral infections, regardless of the presence or absence of fever. Some viral illnesses, especially influenza A, influenza B, and chickenpox, are at risk of Reye’s syndrome, a very rare but life-threatening illness that requires immediate medical attention. The risk may increase with the simultaneous use of acetylsalicylic acid, although a causal relationship has not been proven. Persistent vomiting in patients with these diseases may be a sign of Reye’s syndrome. Subjects with hyperuricemia/gout: acetylsalicylic acid may interfere with the excretion of uric acid: high doses have a uricosuric effect, while (very) low doses may reduce its excretion. It should also be borne in mind that acetylsalicylic acid and other NSAIDs can mask the symptoms of gout, delaying its diagnosis. An antagonistic effect with uricosuric drugs is also possible. Subjects with a predisposition to calcium oxalic nephrolithiasis (kidney stones) or with recurrent nephrolithiasis. Vitamin C effervescent tablets: Vitamin C (ascorbic acid) should be used with caution in individuals with a predisposition to calcium oxalic nephrolithiasis (kidney stones) or with recurrent nephrolithiasis. The combination of drugs is not recommended or requires special precautions or dosage adjustments. The use of acetylsalicylic acid in combination with certain drugs may increase the risk of serious side effects. Do not use acetylsalicylic acid together with another NSAID or, under no circumstances, use more than one NSAID at the same time.
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