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