Aspirin Discontinuation/Tapering

[Kyle Bigman]

I have been taking low dose aspirin for 2 weeks now for a blood clot in my arm and was going to start tapering off but don't want to cause any further issues. I have read some articles about aspirin causing a "rebound" effect, or residual effect that causes side-effects, where there is also a dramatic rise in cardiac events or stroke.

Have any of you discontinued aspirin? Did you just stop cold-turkey or did you taper? And do you have advice as to how to taper?

Thanks

 

[TeaRex14]

I take anywhere between 325 and 650 milligrams a day, occasionally I'll forget to take it for a day. Never noticed any problems, to be clear though I'm not dealing with any coronary issues either. I just take it for the pro-metabolic effects. Tapering won't hurt if you want to be cautious. Not sure what your dose is but just half it and take that for a few days.

 

[Whichway?]

I take anywhere between 325 and 650 milligrams a day, occasionally I'll forget to take it for a day. Never noticed any problems, to be clear though I'm not dealing with any coronary issues either. I just take it for the pro-metabolic effects. Tapering won't hurt if you want to be cautious. Not sure what your dose is but just half it and take that for a few days.

Forgetting it for a day won't bother you as the anti-clotting effect takes 10 days to wear off.

I have been taking low dose aspirin for 2 weeks now for a blood clot in my arm and was going to start tapering off but don't want to cause any further issues. I have read some articles about aspirin causing a "rebound" effect, or residual effect that causes side-effects, where there is also a dramatic rise in cardiac events or stroke.

Have any of you discontinued aspirin? Did you just stop cold-turkey or did you taper? And do you have advice as to how to taper?

Thanks

If you want to be super safe taper down every 10 days, so that your blood clotting factors have time to adjust fully to each dose reduction.

I would step down to 3/4 initial dose. then 1/2, then either stop or do 1/4 dose depending on what your initial dose was. If by low dose you mean 100mg/day then I doubt that NOT doing the 1/4 dose would be that harmful. You could take the 1/4 dose every second day for two weeks, then stop.

The studies where people have had heart attacks and strokes after stopping are when they have quit cold turkey from doses of 200mg/day or more.

 

[Braveheart]

How to Stop Aspirin Safely

There appears to be a rebound from reversing the “blood thinning” effects of aspirin when it is stopped suddenly. Over three times the expected risk of stroke occurs in patients with a previous history of heart disease when they suddenly stop taking aspirin.13 A similar increase in risk of heart attack has been reported when aspirin was stopped.

No one has determined a safe regime for discontinuing this therapy. I suggest that people needing to stop long-term use of aspirin should do so slowly. Since as little as 30 mg (1/3 of a baby aspirin) will deactivate all of the body’s platelets, slow withdrawal should begin at about this level. Cut a baby aspirin into quarters (now 20 mg). Take 20 mg then wait for 4 days to take the next 20 mg dose. Increase the interval between 20 mg doses by one day until a 10-day interval between doses is reached, and then stop taking the aspirin. This is not an easy task since the tablets are so small. Reduction or discontinuation should be done after obtaining a doctor’s advice on the risks and benefits for each individual patient. Even before reducing the aspirin, patients should change to the McDougall Diet in order to most effectively reduce their risk of strokes and heart attacks.

Report of McDougall Advanced Study Weekend - February 2010

 

[Kyle Bigman]

Forgetting it for a day won't bother you as the anti-clotting effect takes 10 days to wear off.



If you want to be super safe taper down every 10 days, so that your blood clotting factors have time to adjust fully to each dose reduction.

I would step down to 3/4 initial dose. then 1/2, then either stop or do 1/4 dose depending on what your initial dose was. If by low dose you mean 100mg/day then I doubt that NOT doing the 1/4 dose would be that harmful. You could take the 1/4 dose every second day for two weeks, then stop.

The studies where people have had heart attacks and strokes after stopping are when they have quit cold turkey from doses of 200mg/day or more.

So, take 3/4 dose every day for ten days, then reduce to 1/2, and so on...

 

[Kyle Bigman]

You can combine the Mcdougall protocol with Wichway's protocol but it would be a long-drawn out process. You could do 3/4 for ten days, then 1/2 for ten, and then 1/4 for ten. And then skip 4 days, take another 1/4 dose, and then add a day to the interval until you reach 10 days.... and then stop.

 

[walterex]

I am sticking 100% with Ray ( and Haidut) I have been taking 2.7g and day for over 5 years (9x300mg), with food and milk, and a little K2.
Mainstream recommend 3g for osteo. and arther:

Usual Adult Dose for Osteoarthritis
Initial dose: 3 g orally per day in divided doses
Maintenance: Adjust dose as needed for anti-inflammatory efficacy

Comments:
-Dosing should be individualized.
-Target plasma salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response while plasma salicylate levels greater than 200 mcg/mL are associated with a higher incidence of toxicity.

Uses: For the relief of the signs and symptoms of rheumatoid arthritis, osteoarthritis, and arthritis and pleurisy associated with systemic lupus erythematous.

Usual Adult Dose for Rheumatoid Arthritis
Initial dose: 3 g orally per day in divided doses
Maintenance: Adjust dose as needed for anti-inflammatory efficacy

Comments:
-Dosing should be individualized.
-Target plasma salicylate levels of 150 to 300 mcg/mL are associated with anti-inflammatory response while plasma salicylate levels greater than 200 mcg/mL are associated with a higher incidence of toxicity.

Uses: For the relief of the signs and symptoms of rheumatoid arthritis, osteoarthritis, and arthritis and pleurisy associated with systemic lupus erythematous.

Usual Adult Dose

 

[Kyle Bigman]

Just to clarify, my blood clot was a superficial clot caused by an I.V. So, it's not like I just had a spontaneous DVT form.

But now I have to go on this long plane flight and am actually concerned that if I go off of aspirin too soon I will get a real blood clot due to some residual effects. It sounds absurd but that's why I wanted to get information regarding tapering or discontinuing it. There's really no information out there on the internet besides the Mcdougall protocol.

 

[Kyle Bigman]

For future people who care, I developed this taper protocol, which combines the Mcdougal taper with the advice of my own doctor.

I go straight to 1/2 a baby aspirin (~40mg) because the research shows that platelet aggregation is as reduced at 40mg as at 80mg. So, I thought reducing to 3/4 of a pill was unnecessary, but if you are at a higher dose maybe start with 3/4 of that dose, as Wichway suggested above, and work your way down to this.

Taper Protocol:

1/2 aspirin EOD for one week,

1/2 aspirin 2x per week for 2 weeks – or indefinitely if you want to remain on low dose aspirin.

If you want to discontinue completely, take:

——————————————————

1/2 aspirin every 5 days, 6 days, and again every 7 days. Then drop to

1/4 aspirin 2x per week for 2 weeks

(make sure your last dose was four days ago before next step)

1/4 aspirin after 5 days, then 6, increasing interval of 1/4 dose until at 10 days, then stop.