aspirin tablets, prevent a heart attack

When someone is experiencing classic symptoms of a heart attack (chest pain or pressure, pain spreading to the neck, jaw or arms, nausea or abdominal pain, shortness of breath, sweating, fatigue, dizziness), immediate action is called for.

An article in the Western Journal of Emergency Medicine (Dec. 2015) offers the evidence supporting the use of aspirin to improve the likelihood of surviving a heart attack:

“There is high-quality evidence demonstrating benefit of aspirin administration (162.5mg) in improving mortality among patients with an acute myocardial infarction (MI) [heart attack]. This reduction in long-term mortality is greatest when the aspirin is administered early.”

Fast Aspirin Action:

Q. Why isn’t there a soluble aspirin tablet available in the US? I carry two 325 mg tablets in my coin purse at all times and have read that one should take aspirin at the first sign of a heart attack, while simultaneously calling 911.

Is it better to dissolve the aspirin in my mouth or in water before ingesting it? Would soluble aspirin be more effective? Or is simply swallowing one or two aspirin with a glass of water equally effective?

A. We are not sure why soluble aspirin has never caught on in the United States the way it has it has in Europe, Australia and New Zealand (by the brand names Aspro and Disprin). Dissolvable aspirin is available in the U.S. only in combination products such as Alka-Seltzer or BC Powder.

You may be pleased to learn, however, that simply chewing a standard 325 mg aspirin tablet for 30 seconds and then swallowing it with four ounces of water is the best way to get its effects quickly (American Journal of Cardiology, Aug. 15, 1999). This technique produces measurable anti-clotting benefits within five minutes, compared to 12 minutes after swallowing an intact pill. Here is the conclusion:

“…many physicians and emergency medicine personnel have instructed patients with myocardial infarction to chew their initial dose of ASA [aspirin], and the 1996 ACC/AHA guidelines have encouraged this practice. The present pharmacokinetic/pharmacodynamic study now provides compelling scientific evidence to support this recent recommendation.”

If chewing regular aspirin is challenging, you can buy flavored chewable low-dose aspirin and achieve a similar effect. The recommendation of 162 mg would achieved with two baby aspirins (81 mg each).

Many people have enteric coated aspirin on hand. There are many brands that are designed to dissolve in the small intestine rather than the stomach. This is supposed to protect the stomach from irritation, but if such pills are swallowed whole, absorption will be delayed significantly. Chewing an enteric coated aspirin tablet, however, will speed things up considerably. A study from Japan found that chewed enteric coated aspirin tablets exerted an anti-clotting effect within 20 minutes (Journal of Pharmaceutical Sciences, Sept. 2011).

There is more information on aspirin in our free Guide to Key Aspirin Information.

Revised, February 18, 2016

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  1. Rita
    Reply

    My husband usually puts a regular aspirin tablet in tablespoon of water, lets it stay there for about 30 sec until it breaks down into powder and then drinks it with a glass of water, this will prevent the tablet sitting on your stomach.

  2. Ann
    Canada
    Reply

    Like Joan in Milwaukee, I am hoping for an answer regarding Warfarin, which I take every day. Are you there Joe? Thank you so much in advance

  3. Karen
    Washington state
    Reply

    Just wondering if you can get soluble or crystal aspirin in Canada.

  4. kkh
    Reply

    My local Walgreen’s carries BC powder, which is just powdered aspirin and a small bit of caffeine. I keep some in my car and my purse. Just dump in some water and drink it. Each dose is wrapped up in individual little wax paper bindles.

  5. joan
    Milwaukee, WI
    Reply

    My husband takes Warfarin so we have it on hand. Would it be effective for me to take one of those in case of heart attack symptoms?

  6. DJ
    Reply

    I’m confused. I would much rather chew 2 baby aspirin (because they would taste better). But that only comes to 162 mg. So, would the standard 325 mg. aspirin (even it tastes terrible) be the best to take if I were having heart attack symptoms. I am 68 yrs. old.

  7. Alton
    Reply

    How would you us BC power For heart attack?

    • kkh
      Reply

      Well, its just a powder, so put it in some water and down it! I have a box right here at the house. The powder is in individual little paper bindles. I put a couple in my purse and my car.

  8. Marianne
    Reply

    Great advice.

  9. Ellen
    upstate NY
    Reply

    I keep a small container filled with four baby aspirin at each of several places to which I am most likely to be near (purse, bedside dresser, computer desk, kitchen drawer, knitting basket). I discard all tablets near the expiration date and replace them with new ones.

  10. Cameron
    Reply

    I think this is very good to know.

  11. lou g
    Reply

    I can’t find a standard 325 mg aspirin in any pharmacy where I live. Aspirin has evolved into Enteric Coated for slow release. However, a few days ago, I asked a pharmacist and he suggested I buy chewable 81 mg aspirin, and chew 3 if I had a problem. Although I take an 81 mg EC aspirin daily, I now have a bottle of chewable in case.

  12. DH
    Reply

    I know I am strongly allergic to aspirin and all other of that type (all I can take is Tylenol) so should I take an aspirin if I believe I am having a heart attack….kind of a crazy question???
    PEOPLE’S PHARMACY RESPONSE: Not a crazy question at all. Doctors don’t all agree on this, but if your aspirin allergy involves not being able to breathe, most would probably say don’t risk it.

  13. Teri
    Reply

    To Joe H.– Yes, my mother always gave me Aspergum when I was a child. But I think I read some time ago that Aspergum does not contain aspirin.
    PEOPLE’S PHARMACY RESPONSE:
    As far as we can tell, Aspergum is no longer made in the USA. It did contain aspirin (227 mg).

  14. Pete W.
    Reply

    What about Bayer Quick Release Crystals? I keep a packet of them in a bedside drawer but have not started carrying them with me. It contains 850mg aspirin and 65mg caffeine. I am 80 years old, take no meds and have been having wonderful results with Essential Amino Acid therapy controlling my cardiovascular plaque. In fact, it has gone down over the last 3 years and my cardiologist had never seen that before. This is as a result of reading and following Dr. Louis J. Ignarro’s book NO More Heart Disease. NO refers to Nitric Oxide.

  15. dp
    Reply

    I handed a patient his aspirin tablet; He put it in his mouth and to my surprise, began chewing it. Seeing the startled look on my face, he said,”I don’t think its a good idea for aspirin to lay in one spot in my stomach and dissolve.” Made sense to me, I’ve done it ever since with my daily aspirin, followed with water. In an emergency, it’s nice to know one can take an aspirin if no water is available.

  16. LS
    Reply

    I have no problem finding aspirin tablet – which I crush up and use for an acne/aspirin facial.

  17. Joe H.
    Reply

    I rembember many years ago my mom having a gum by the name of Aspergum. I don’t know if it is still around. I will have to look for it and keep some around.
    Joe

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