Adjusting the dose of aspirin may reduce bleeding risk

Aspirin is a potent drug that is still widely prescribed since the days of Hippocrates in its willow bark tea form. Recently, it has been reported that older people are at high risk of gastric bleeds when taking low dose aspirin (
The Pharmaceutical Journal 2017;298:327). Perhaps this is specifically related to dosage. Taking 75mg of aspirin daily certainly has risks. However, those could possibly be avoided with as much as 90% of aspirin’s efficacy retained after reviewing the researchers’ findings.

If it has not been done, I suggest a simple further analysis of the data. With no adjustment of dose to body weight it would not surprise me if most of the gastric haemorrhages occurred within smaller subjects with fewer statistically significant cases in larger people. If that proves to be the case then perhaps 25mg enteric-coated aspirin should be made available to facilitate doses tailored to body weight.

Gerald Alan Fox

Dunstable, Bedfordshire