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Published: Saturday, 8/10/2002

Aspirin has long history as miracle drug

Woe to the movie mogul who uses aspirin's true-life story in some miracle-drug film.

Stick to the facts, and you get a preposterous plot so unbelievable that audiences would leave the theater in disgust.

How could any drug reign as the world's best-selling medicine for more than 100 years and work on diseases ranging from headaches to heart attacks, yet cost almost nothing? And get this. We owe it all to a loving son who wanted to help Dad.

In 1897, German chemist Felix Hoffmann began looking for a drug to ease his father's arthritis pain without causing the bad stomach irritation that happened with sodium salicylate. Sodium salicylate then was the best anti-arthritis drug. People could thank the ancient Greek physician Hippocrates. Around 400 BC, Hippocrates used the bark and leaves of the willow tree to relieve pain and fever.

Scientists eventually discovered the active ingredient in willow bark and leaves - a substance called salicin.

By Hoffmann's time, doctors used it in the form of sodium salicylate. Like Hoffmann's father, however, many patients had to stop treatment due to stomach upsets and stomach bleeding.

Hoffmann tinkered with its chemical skeleton and made acetylsalicylic acid, modern aspirin. He worked for Friedrich Bayer & Co., which named the new substance aspirin. Bayer used the “a” in acetyl; “spir” from spirea, a plant containing salicin, and “in,” a common suffix for drug names.

Aspirin hit the market in 1899, and quickly became the world's best-selling medicine.

Its medical role should have expanded in 1948, when an obscure California doctor noticed that male patients who took aspirin regularly rarely had heart attacks. The finding, however, went unnoticed for years.

In the 1970s, aspirin joined the battle against cardiovascular disease, due to its ability to hinder blood clotting. Blood clots cause most heart attacks and many strokes.

Doctors started recommending it to prevent strokes in people with warning signs, and second heart attacks in those who had a previous heart attack. The U. S. Food and Drug Administration (FDA) officially approved both uses in the 1980s.

Aspirin quickly carved out a role in preventing first heart attacks as well. Studies have shown that a quarter aspirin tablet daily brings a 28 percent reduction in risk.

Millions of people are now taking small daily doses. They work just as well as large doses, and cause fewer side effects. Get the doctor's OK first. Regular use can cause problems, especially in people with a history of stomach and certain other disorders.

The FDA in 1996 approved aspirin as an emergency treatment during a heart attack.

Aspirin's perpetual challenger, acetaminophen (as in Tylenol and other products) spares the stomach, but lacks one of aspirin's key actions. Aspirin relieves pain, inflammation, and fever. Acetaminophen relieves just pain and fever. In addition, it does not prevent blood clots.

New high-tech, high-priced challengers also have appeared. Celebrex and Vioxx became superstars by claiming to work just as well as aspirin - not better - while sparing the stomach. In June, however, the FDA said Celebrex must carry a label warning that it too can cause stomach irritation.

Another aspirin challenger - the blood thinner Plavix - stumbled in June. Researchers found Plavix only slightly better than aspirin in preventing blood clots and questioned whether Plavix is worth the price.

What about prices? One generic aspirin tablet may cost a couple cents. Celebrex fetches about $1.35 per capsule; Vioxx about $2.40, and Plavix, about $3.20.

And there is growing evidence that small regular doses of aspirin might help prevent other diseases, including colon cancer, Type-2 diabetes, and Alzheimer's disease.

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