Aspirin and related medications called salicylates, a common ingredient in many prescription and over-the-counter medications, is safe in normal doses, but severe overdose can cause severe symptoms and rarely death.
Aspirin poisoning can occur rapidly after taking a single high dose or develop gradually after taking lower doses for a long time.
Symptoms may include ringing in the ears, nausea, vomiting, drowsiness, confusion, and rapid breathing.
The diagnosis is based on blood tests and the person's symptoms.
Treatment involves giving activated charcoal by mouth or stomach tube, giving fluids and bicarbonate by vein, and, for severe poisoning, undergoing hemodialysis.
(See also Overview of Poisoning.)
Acute aspirin poisoning
Swallowing of aspirin and similar medications (salicylates) can lead to rapid (acute) poisoning due to an overdose. The dose necessary to cause acute poisoning, however, is quite large. A person weighing about 150 pounds (68 kg) would have to consume more than 30 325-milligram aspirin tablets to develop even mild poisoning. An acute aspirin overdose, therefore, is seldom accidental, but concentrated salicylate products intended to be applied to the skin, such as oil of wintergreen (methyl salicylate), do cause accidental poisonings.overdose, therefore, is seldom accidental, but concentrated salicylate products intended to be applied to the skin, such as oil of wintergreen (methyl salicylate), do cause accidental poisonings.
Gradual aspirin poisoning
Gradual aspirin poisoning can develop unintentionally if people take normal or slightly higher than normal doses of aspirin for a long time. Children with fever who are given only slightly higher than the prescribed dose of aspirin for several days may develop poisoning, although children are rarely given aspirin to treat fever because they could develop Reye syndrome. None of the over-the-counter cough and cold preparations sold in the United States for children contains aspirin; most contain either acetaminophen or ibuprofen. ; most contain either acetaminophen or ibuprofen.
Adults, many of them older, can develop poisoning gradually after several weeks of use.
The low dosage of aspirin recommended for people with The low dosage of aspirin recommended for people withcoronary artery disease to reduce the risk of heart attack (1 baby aspirin, ½ of an adult aspirin, or 1 full adult aspirin daily) is too small to cause aspirin poisoning even when taken for a long time.
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Poisoning with salicylates other than aspirin
Oil of wintergreen (methyl salicylate) is a very concentrated salicylate that is a component of many commercial products such as liniments and solutions used in hot vaporizers. One teaspoon (5 mL) of pure oil of wintergreen is equivalent to about 7000 milligrams (22 adult tablets) of Oil of wintergreen (methyl salicylate) is a very concentrated salicylate that is a component of many commercial products such as liniments and solutions used in hot vaporizers. One teaspoon (5 mL) of pure oil of wintergreen is equivalent to about 7000 milligrams (22 adult tablets) ofaspirin. This amount can be fatal to young children.
Far less toxic are over-the-counter products containing bismuth subsalicylate (used to treat infections of the digestive tract), which can cause poisoning after several doses.Far less toxic are over-the-counter products containing bismuth subsalicylate (used to treat infections of the digestive tract), which can cause poisoning after several doses.
Did You Know...
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Symptoms of Aspirin Poisoning
In acute aspirin poisoning, the first symptoms are usually:
Nausea and vomiting
Rapid or deep breathing
Ringing in the ears
Sweating
Later, if poisoning is severe, the person can develop light-headedness, fever, drowsiness, hyperactivity, confusion, seizures, destroyed muscle tissue (rhabdomyolysis), kidney failure, and difficulty breathing.
In gradual aspirin poisoning, symptoms develop over days or weeks. The most common symptoms are:
Drowsiness
Subtle confusion
Hallucinations
Light-headedness, rapid breathing, shortness of breath, fever, dehydration, low blood pressure, a low oxygen level in the blood (hypoxia), a buildup of lactic acid in the blood (lactic acidosis), fluid in the lungs (pulmonary edema), seizures, and brain swelling can develop.
Diagnosis of Aspirin Poisoning
Blood tests
A blood sample is taken to measure the precise level of aspirin in the blood. Measurement of the blood pH (amount of acid in the blood) and the level of carbon dioxide or bicarbonate in the blood also can help doctors determine the severity of poisoning. Tests are usually repeated several times during treatment to reveal whether the person is recovering.
Treatment of Aspirin Poisoning
Activated charcoal
Sodium bicarbonate with potassium, given by veinSodium bicarbonate with potassium, given by vein
Sometimes hemodialysis
Activated charcoal is given as soon as possible and reduces aspirin absorption. For moderate or severe poisoning, fluids containing sodium bicarbonate are given by vein. Unless there is kidney damage, potassium is added to the fluid. This mixture moves absorption. For moderate or severe poisoning, fluids containing sodium bicarbonate are given by vein. Unless there is kidney damage, potassium is added to the fluid. This mixture movesaspirin from the bloodstream into the urine. If the person’s condition is worsening despite other treatments, hemodialysis (which uses an artificial kidney [dialyzer] to filter the poisons) can remove aspirin, other salicylates, and acids from the blood. Other symptoms such as fever or seizures are treated as necessary.
More Information
The following is an English-language resource that may be useful. Please note that The Manual is not responsible for the content of this resource.
America's Poison Centers: Represents the United States-based poison centers that provide free, confidential services (24/7) through the Poison Help Line (1-800-222-1222)
