Aspirin Dosage Guide For Travel: Tablet Sizes And Recommendations

Long-distance travel, especially by air, is a risk factor in the development of blood clots, also known as deep vein thrombosis (DVT). While the absolute risk of developing DVT is small, it is recommended that travellers take precautions to prevent blood clots from forming. One such precaution that is often considered is taking aspirin before a long flight. However, the verdict is still out on whether this is effective or not. While some doctors do not recommend taking aspirin prior to a long flight, others are not completely against it, as long as the patient doesn't have any health issues that could be negatively affected by aspirin use.

The verdict on aspirin preventing blood clots

Aspirin has been proven to prevent blood clots by reducing the ability of the blood to clump together. Blood clots are the leading cause of heart attacks and strokes, and aspirin's "blood-thinning" quality can help prevent these clots from forming. However, it is important to note that aspirin use also increases the risk of bleeding. This is especially true for individuals with a history of gastrointestinal ulcers, bleeding, or gastritis, kidney failure, severe liver disease, or bleeding/clotting disorders.

Some studies have shown that low-dose aspirin can be an effective way to prevent potentially deadly blood clots in patients who have had previous blood clots. The ASPIRE study, for example, found that low-dose aspirin prevented about one-third of recurrent blood clot events. The results suggest that for every 1000 patients treated for one year, aspirin can prevent 20 to 30 episodes of recurrent major thrombotic events at the cost of about three significant bleeding episodes.

Despite the benefits, the use of aspirin for preventing blood clots is not without controversy. Previous guidelines from the United States Preventive Services Task Force warned against taking aspirin for the primary prevention of heart disease unless the individual is at elevated risk. Additionally, there is insufficient data to accurately predict the absolute risk of deep vein thrombosis (DVT) in specific individuals, and there is a lack of evidence on the efficacy of aspirin in long-distance travel.

In conclusion, while aspirin has been shown to be effective in preventing blood clots, it is important to carefully weigh the risks and benefits before recommending its use. Individuals should consult with their doctors to assess their risk level and determine if low-dose aspirin therapy is right for them.

Deep vein thrombosis (DVT)

The symptoms of DVT include throbbing pain, swelling, and redness or discolouration of the skin in the affected area. However, DVT can also occur without noticeable symptoms, making it difficult to diagnose. Certain factors can increase the risk of developing DVT, such as age, lack of movement, injury, surgery, pregnancy, birth control pills, hormone replacement therapy, obesity, smoking, cancer, and a family history of DVT.

To prevent DVT, it is recommended to maintain a healthy weight, stay active, drink plenty of fluids, avoid sitting still for long periods, and refrain from crossing your legs while sitting. When travelling for extended periods, it is important to wear loose clothing, stay hydrated, and walk around frequently to promote blood circulation.

While aspirin has been recommended as a preventive measure for DVT during air travel, there is limited evidence to support its efficacy. It is always advisable to consult a doctor before taking any medication, especially when considering it for preventative purposes.

Risk factors for DVT

Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs. DVT can be serious because blood clots in the veins can break loose, travel through the bloodstream, and get stuck in the lungs, blocking blood flow (pulmonary embolism). When DVT and pulmonary embolism occur together, it's called venous thromboembolism (VTE).

There are a variety of risk factors that contribute to the development of DVT. These include:

• Surgeries, particularly of the hip, leg, or abdomen
• Trauma or bone fracture
• A long period of bed rest or sitting for a long time (e.g. on an airplane or in a car)
• Birth control pills or hormone replacement therapy
• Age (over 60)
• Inherited tendency to form blood clots
• Pregnancy
• Prior thromboembolism
• Malignancies
• Chronic medical conditions, such as cardiac issues, renal problems, hematological disorders, rheumatological conditions, gastrointestinal issues, infections, respiratory problems, and endocrine disorders
• Smoking
• Obesity
• Cancer
• Heart failure
• Inflammatory bowel disease
• Personal or family history of DVT or pulmonary embolism
• Genetics, including DNA changes that cause the blood to clot more easily, such as factor V Leiden

Preventative measures for DVT

Deep-vein thrombosis (DVT) is a blood clot that forms in the veins, most commonly in the leg. It can be life-threatening if the clot breaks free and travels to major organs such as the lungs. While the link between DVT and air travel is not fully understood, preventative measures are often recommended for those at risk. Here are some preventative measures to reduce the likelihood of developing DVT:

General Precautions:

• Maintain a healthy weight by exercising regularly and eating a balanced diet rich in fruits and vegetables. Walking, swimming, and bicycling are excellent forms of physical activity.
• Quit smoking. Nicotine replacement therapies and support groups can aid in smoking cessation.
• Monitor your blood pressure regularly and follow your doctor's instructions regarding medication.
• Stay hydrated by drinking plenty of water, especially when travelling. Avoid coffee and alcohol, as they can lead to dehydration.
• Wear loose-fitting clothing, especially when travelling, to promote blood flow and comfort.
• Avoid wearing short, tight socks, and try not to cross your legs frequently.

During Travel:

• Move around at least once every hour, especially on long journeys (plane, train, bus, or car trips). If you are unable to move about, perform heel-toe exercises or circle your feet to promote blood flow.
• When driving, make sure to stop at least every two hours to get out and stretch your legs.
• On flights longer than four hours, take advantage of the opportunity to walk and stretch between connecting flights as well.
• Consider wearing compression stockings to enhance blood flow and reduce swelling.

Medical Advice:

• Consult your doctor about your risk factors for DVT, especially if you are taking hormones, using birth control pills, undergoing hormone replacement therapy, or are pregnant.
• If advised by your doctor, consider taking "blood thinners" (anticoagulants) or wearing compression stockings to prevent clots.
• Follow your doctor's recommendations for managing any existing health conditions, such as heart failure or diabetes.

Contraindications for taking aspirin

Aspirin is a salicylate that works by reducing substances in the body that cause pain, fever, and inflammation. It is typically used to treat pain, reduce fever or inflammation, and sometimes to treat or prevent heart attacks, strokes, and chest pain (angina). However, there are several contraindications and precautions to consider before taking aspirin. Here are some detailed instructions and factors to consider:

• Coexisting medical conditions: If you are 60 or older or have a history of gastrointestinal (GI) problems, taking aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of serious GI events such as stomach bleeding and ulcers. Aspirin and NSAIDs may also modestly increase blood pressure, which can be clinically significant in elderly patients with hypertension. For individuals with liver cirrhosis or liver disease, aspirin and NSAIDs are metabolized in the liver and can pose additional risks. Similarly, those with renal abnormalities should exercise caution as aspirin and NSAIDs may contribute to chronic kidney disease and adverse renal events. Finally, aspirin and NSAIDs that inhibit COX-1 can aggravate asthma in some adults.
• Concomitant medications and potential interactions: Antiplatelet medications, including low-dose aspirin, carry risks of GI complications and bleeding. Adding another NSAID can compound these risks. Concomitant use of anticoagulants and NSAIDs also increases the likelihood of GI bleeding. If you are on antihypertensive medications, aspirin may diminish their effects and modestly increase blood pressure. For patients on aspirin heart therapy, ibuprofen can reduce its cardioprotective benefits, and taking any NSAID alongside aspirin increases the risk of GI bleeding.
• Allergies and other considerations: If you are allergic to aspirin or any other pain reliever/fever reducer, you should refrain from taking aspirin. Additionally, consuming three or more alcoholic drinks daily while taking aspirin increases the chance of GI bleeding. Pregnant or breastfeeding individuals should also avoid aspirin, as it can cause complications during pregnancy and be harmful to the nursing baby.

Frequently asked questions