Aspirin has a "dual effect" on blood uric acid. Can people with gout still take it?

Aspirin is a familiar antiplatelet drug that can inhibit platelet aggregation and prevent thrombosis. Many people with potential risk of cardiovascular and cerebrovascular diseases need to take it for a long time. However, some problems may occur during the use of aspirin.

A friend left a message to Huazi, saying that his blood uric acid level exceeded the normal value, but he had not yet suffered from gout. If he took aspirin, would it affect his blood uric acid level and cause a gout attack?

1. Aspirin's "dual effect" on uric acid Hua Zi said that aspirin will have an impact on blood uric acid, and the impact is dual depending on the dosage. At low and medium doses (less than 2000 mg per day), it will inhibit the excretion of uric acid by the renal tubules; at high doses (more than 2000-3000 mg per day), it will inhibit the reabsorption of uric acid by the renal tubules, increasing uric acid excretion.

When taking aspirin in large doses, the risk of damage to the gastrointestinal mucosa and bleeding will increase significantly. However, except for patients with severe rheumatism, aspirin is rarely used in large doses. When preventing cardiovascular and cerebrovascular diseases, aspirin is usually used in small doses (75-150 mg per day), so it will have the effect of slightly increasing blood uric acid.

2. It is not recommended to stop taking aspirin for thrombosis prevention. Although aspirin can cause an increase in blood uric acid, it is not recommended to stop taking low-dose aspirin for people with potential cardiovascular and cerebrovascular disease risks. This is because compared with the increase in blood uric acid levels, the cardiovascular and cerebrovascular protective effect is undoubtedly more important. Therefore, "choose the lesser of two evils". Sometimes, for greater benefits, it is necessary to take some small risks.

Moreover, "it is nonsense to talk about toxicity without considering the dosage." Most people only need to take 100 mg of aspirin per day. After a small dose of aspirin enters the human body, it is metabolized and excreted very quickly, and has little effect on blood uric acid, so there is no need to worry about it.

3. Aspirin should not be used for pain relief during gout attacks. Aspirin is a non-steroidal anti-inflammatory drug. When used in medium and large doses, it has anti-inflammatory, analgesic and antipyretic effects. It is mostly used for fever caused by colds and flu, and can also relieve low and moderate pain such as toothache, headache, neuralgia, muscle pain and dysmenorrhea. However, aspirin should not be used for pain relief during acute gout attacks.

Because aspirin affects the excretion of uric acid, inhibits plasma glucocorticoids, increases insulin, etc., it causes uric acid to be retained in the body, leading to increased blood uric acid levels. Therefore, when gout attacks acutely, other non-steroidal anti-inflammatory drugs other than aspirin should be used to relieve pain.

4. How to deal with aspirin-induced increase in blood uric acid For patients who have not controlled their blood uric acid well and often suffer from gout, if they want to eliminate the effect of aspirin on blood uric acid, they can consider changing to other drugs. Aspirin is an antiplatelet drug that inhibits platelet aggregation. However, antiplatelet drugs are not just aspirin, and other drugs can be used to replace aspirin. However, the specific drug to be used should be decided by the doctor.

If it is not suitable to change aspirin, then you can consider combining it with a uric acid-lowering drug. Under the guidance of a doctor, you can combine it with a drug that inhibits uric acid production to counteract the effect of aspirin on raising uric acid. However, it is not advisable to combine it with a uric acid excretion drug, because such drugs will compete with aspirin for excretion channels and increase the side effects of the drug.

In summary, for people who want to prevent cardiovascular and cerebrovascular diseases, the effect of taking low-dose aspirin on blood uric acid levels is very small, so there is no need to worry too much, and it is not recommended to stop taking aspirin. Under the guidance of a doctor, replacing other antiplatelet drugs or combining them with drugs that inhibit uric acid production can also eliminate the effect of aspirin on blood uric acid. I am pharmacist Huazi, welcome to follow me and let me be your pharmacist.