Acetylsalicylic Acid Bluefish

What Is Acetylsalicylic Acid Bluefish and What Is It Used For?

Acetylsalicylic Acid Bluefish contains the active substance acetylsalicylic acid, commonly known as aspirin, at a dose of 75 mg per tablet. At this low dose, the primary therapeutic action is antiplatelet rather than analgesic or anti-inflammatory. The medication belongs to the non-steroidal anti-inflammatory drug (NSAID) class but is used specifically for its blood-thinning properties in cardiovascular medicine.

The mechanism of action centres on the irreversible inhibition of cyclooxygenase-1 (COX-1), an enzyme essential for the production of thromboxane A2 in platelets. Thromboxane A2 is a potent promoter of platelet aggregation and vasoconstriction. By blocking its synthesis, acetylsalicylic acid prevents platelets from clumping together, thereby reducing the likelihood of blood clot formation within arteries. Because platelets cannot synthesise new COX-1 enzyme (they lack a cell nucleus), this inhibition lasts for the entire lifespan of the platelet, approximately 7 to 10 days.

Acetylsalicylic Acid Bluefish 75 mg is indicated for the following conditions, as recommended by international guidelines including the European Society of Cardiology (ESC) and the American Heart Association (AHA):

• Secondary prevention of myocardial infarction (heart attack) — in patients who have already experienced a heart attack or have established coronary artery disease
• Secondary prevention of ischaemic stroke and transient ischaemic attacks (TIA) — reducing the risk of recurrent cerebrovascular events
• Unstable angina pectoris — as part of acute and long-term management to prevent progression to myocardial infarction
• Following coronary artery bypass graft (CABG) surgery — to maintain graft patency
• Following percutaneous coronary intervention (PCI) with stent placement — often in combination with a second antiplatelet agent (dual antiplatelet therapy, DAPT)
• Peripheral arterial disease (PAD) — to reduce the risk of cardiovascular events in patients with atherosclerotic disease of the limbs

It is important to understand that Acetylsalicylic Acid Bluefish 75 mg is primarily intended for secondary prevention, meaning it is prescribed for patients who already have established cardiovascular disease or have experienced a cardiovascular event. The use of low-dose aspirin for primary prevention (in individuals without known cardiovascular disease) has become more restricted in recent years, as the bleeding risks may outweigh the benefits in lower-risk populations. The ESC 2024 guidelines and AHA/ACC recommendations have narrowed the indications for primary prevention aspirin use.

What Should You Know Before Taking Acetylsalicylic Acid Bluefish?

Before starting treatment with Acetylsalicylic Acid Bluefish, your doctor will assess your individual risk–benefit profile. While low-dose aspirin provides significant cardiovascular protection for at-risk patients, it is not suitable for everyone. Understanding the contraindications, warnings, and precautions is essential for safe and effective use of this medication.

Contraindications

You must not take Acetylsalicylic Acid Bluefish if any of the following apply to you:

• Known hypersensitivity to acetylsalicylic acid, other salicylates, or any of the excipients — allergic reactions to aspirin can include urticaria, angioedema, bronchospasm, and in severe cases, anaphylaxis
• History of aspirin-induced asthma or aspirin-exacerbated respiratory disease (AERD) — also known as Samter’s triad (aspirin sensitivity, nasal polyps, and asthma)
• Active peptic ulcer disease — including gastric or duodenal ulcers, or a history of recurrent peptic ulceration
• Active gastrointestinal bleeding or any other active bleeding condition
• Haemophilia or other bleeding disorders — conditions that impair blood clotting, such as von Willebrand disease or thrombocytopenia
• Severe hepatic impairment — as aspirin metabolism may be significantly altered
• Severe renal impairment (GFR <30 mL/min) — increased risk of toxicity and reduced clearance
• Third trimester of pregnancy — risk of premature closure of the fetal ductus arteriosus and potential prolongation of labour
• Concomitant use with methotrexate at doses ≥15 mg/week — aspirin can increase methotrexate toxicity by reducing its renal clearance

Warnings and Precautions

Exercise particular caution and discuss with your doctor if you have any of the following conditions:

• History of gastrointestinal ulceration or bleeding — your doctor may prescribe a proton pump inhibitor (PPI) for gastric protection
• Uncontrolled hypertension — increases the risk of haemorrhagic stroke when combined with antiplatelet therapy
• Gout or hyperuricaemia — low-dose aspirin can reduce uric acid excretion, potentially precipitating gout attacks
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency — aspirin may trigger haemolytic anaemia in affected individuals
• Scheduled surgery or dental procedures — inform your surgeon or dentist that you are taking aspirin, as it may need to be temporarily discontinued
• Asthma or chronic respiratory disease — aspirin may trigger bronchospasm in sensitive individuals
• Liver disease — impaired metabolism may increase the risk of adverse effects
• Renal impairment — aspirin may further reduce renal blood flow, particularly in patients with pre-existing kidney disease

Pregnancy and Breastfeeding

The use of acetylsalicylic acid during pregnancy requires careful medical assessment. During the first and second trimesters, low-dose aspirin (75–150 mg daily) may be prescribed under specialist supervision for specific conditions, such as the prevention of pre-eclampsia in high-risk pregnancies. The WHO and the International Society for the Study of Hypertension in Pregnancy (ISSHP) recommend low-dose aspirin from 12 weeks of gestation in women at high risk of pre-eclampsia.

During the third trimester (from week 28 onwards), acetylsalicylic acid is contraindicated. At this stage, it may cause premature closure of the ductus arteriosus in the fetus, inhibit uterine contractions (prolonging labour), and increase the risk of maternal and neonatal bleeding. Regular doses of aspirin during late pregnancy can also lead to reduced amniotic fluid volume (oligohydramnios) and impaired fetal renal function.

Regarding breastfeeding, small amounts of acetylsalicylic acid and its metabolites pass into breast milk. Occasional use at low doses is generally considered compatible with breastfeeding, but regular use should be discussed with your doctor. The BNF (British National Formulary) advises that regular use of aspirin during breastfeeding should be avoided where possible, and the infant should be monitored for potential effects such as Reye’s syndrome.

How Does Acetylsalicylic Acid Bluefish Interact with Other Drugs?

Drug interactions are an important consideration when taking Acetylsalicylic Acid Bluefish. As aspirin affects platelet function and prostaglandin synthesis, it can interact with numerous classes of medications, either increasing the risk of bleeding, reducing the efficacy of other drugs, or altering its own therapeutic effect. The following table summarises the most clinically significant interactions.

Major Interactions

Minor Interactions

This list is not exhaustive. Always inform your doctor, pharmacist, or other healthcare professional about all medications you are currently taking, including prescription drugs, over-the-counter medicines, herbal supplements, and vitamins. Some herbal products, such as ginkgo biloba, garlic supplements, and fish oil, may also increase bleeding risk when combined with aspirin.

What Is the Correct Dosage of Acetylsalicylic Acid Bluefish?

The dosage of Acetylsalicylic Acid Bluefish should be determined by your prescribing physician based on your specific medical condition, risk factors, and other medications. The following provides general guidance based on international clinical recommendations.

Adults

Children

Acetylsalicylic Acid Bluefish is not recommended for children under 16 years due to the risk of Reye’s syndrome. In rare, specific paediatric conditions (e.g., Kawasaki disease), aspirin may be used under specialist supervision at doses determined by the treating paediatrician. The WHO and the American Academy of Pediatrics (AAP) have clear guidelines on this restricted use.

Elderly

Elderly patients are at increased risk of gastrointestinal bleeding and haemorrhagic stroke. The standard dose of 75 mg daily is generally appropriate, but the prescribing physician should carefully weigh the benefits against the bleeding risk. The NICE guidelines (CG181) recommend that elderly patients on long-term aspirin therapy should be regularly reviewed, and co-prescription of a proton pump inhibitor (PPI) should be considered for gastric protection, especially in those over 65 years or with additional risk factors for GI bleeding.

Missed Dose

If you forget to take a dose, take it as soon as you remember on the same day. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a forgotten tablet. Because aspirin’s antiplatelet effect lasts for the lifetime of the platelet (7–10 days), missing a single dose is unlikely to have significant clinical consequences. However, regular adherence is important for optimal protection.

Overdose

Aspirin overdose (salicylate poisoning) is a medical emergency. Symptoms of mild toxicity include tinnitus (ringing in the ears), hearing impairment, headache, dizziness, and confusion. Severe overdose may cause hyperventilation, metabolic acidosis, hyperthermia, seizures, coma, and cardiovascular collapse. If you suspect an overdose, seek emergency medical attention immediately. Treatment is supportive and may include activated charcoal (if within 1 hour of ingestion), intravenous sodium bicarbonate to enhance urinary excretion, and in severe cases, haemodialysis.

What Are the Side Effects of Acetylsalicylic Acid Bluefish?

Like all medicines, Acetylsalicylic Acid Bluefish can cause side effects, although not everybody gets them. At the low dose of 75 mg, the risk of side effects is generally lower than with higher analgesic or anti-inflammatory doses. However, because the medication is typically taken long-term, even infrequent side effects become clinically relevant over time. The side effects are classified below by frequency, according to MedDRA conventions.

If you experience any of the following symptoms, stop taking the medication and seek medical attention immediately: black or bloody stools, vomiting blood or material that looks like coffee grounds, severe stomach pain, signs of allergic reaction (swelling of face/throat, difficulty breathing, severe skin rash), unexplained bruising or prolonged bleeding, or ringing in the ears.

The risk of gastrointestinal adverse effects can be minimised by taking the tablet with or after food, using the lowest effective dose, and avoiding concomitant use with other gastrotoxic drugs. Your doctor may co-prescribe a proton pump inhibitor (PPI) such as omeprazole or pantoprazole if you are at elevated risk of GI complications. Risk factors for aspirin-associated GI bleeding include age over 65, history of peptic ulcer disease, concurrent use of anticoagulants or corticosteroids, and heavy alcohol consumption.

How Should You Store Acetylsalicylic Acid Bluefish?

Proper storage of Acetylsalicylic Acid Bluefish is essential to maintain the medication’s efficacy and safety throughout its shelf life. Aspirin is susceptible to degradation by heat and moisture, which can reduce its potency and lead to the formation of breakdown products such as salicylic acid and acetic acid (recognisable by a vinegar-like odour).

• Temperature: Store below 25°C (77°F). Do not freeze. Avoid storing in locations subject to temperature extremes, such as near radiators, in direct sunlight, or in humid bathrooms.
• Moisture protection: Keep the tablets in the original blister packaging until ready to take. Moisture can accelerate hydrolysis of aspirin, reducing its effectiveness.
• Light protection: Store in the original outer carton to protect from light.
• Child safety: Keep this medication out of the sight and reach of children. Aspirin overdose is particularly dangerous in young children.
• Expiry date: Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of that month.

Do not dispose of medications in household waste or down the drain. Return any unused or expired medications to your local pharmacy for safe disposal in accordance with local environmental regulations. This helps protect the environment and prevents accidental ingestion by others.

If your tablets have developed an unusual smell (particularly a vinegar-like odour), have changed colour, or appear damaged, do not take them. This may indicate that the aspirin has degraded and may no longer be effective or safe.

What Does Acetylsalicylic Acid Bluefish Contain?

Understanding the full composition of your medication is important, particularly if you have known allergies or intolerances to specific ingredients. Each Acetylsalicylic Acid Bluefish 75 mg tablet contains the following:

Active Ingredient

• Acetylsalicylic acid — 75 mg per tablet. This is the pharmacologically active component responsible for the antiplatelet effect.

Excipients (Inactive Ingredients)

The excipients used in the tablet formulation serve various purposes including binding, coating, and aiding disintegration. Common excipients found in low-dose aspirin formulations typically include:

• Microcrystalline cellulose — a filler and binder that provides structural integrity to the tablet
• Maize starch — used as a disintegrant to help the tablet break down in the gastrointestinal tract
• Colloidal anhydrous silica — a flow agent that improves manufacturing consistency
• Stearic acid — a lubricant that prevents the tablet from sticking to manufacturing equipment

Some formulations may include an enteric coating to reduce stomach irritation. The enteric coating is designed to prevent the tablet from dissolving in the acidic environment of the stomach, allowing it to pass through to the small intestine where it is absorbed. However, enteric-coated formulations may have delayed and variable absorption, and current evidence from the ADAPTABLE trial and other studies suggests that enteric coating does not provide clinically significant gastroprotection compared to non-coated aspirin at low doses.

If you have lactose intolerance, celiac disease, or other dietary sensitivities, check the specific product information leaflet for your batch, as excipient composition may vary between manufacturers and formulations. Consult your pharmacist if you have any concerns about specific inactive ingredients.