Aspirin Poisoning

ByGerald F. O’Malley, DO, Grand Strand Regional Medical Center;
Rika O’Malley, MD, Grand Strand Medical Center
Reviewed/Revised May 2022 | Modified Sep 2022
VIEW PROFESSIONAL VERSION
GET THE QUICK FACTS

  • 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

aspirin

Gradual aspirin poisoning

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

Adults, many of them older, can develop poisoning gradually after several weeks of use.

coronary 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.

Did You Know...

  • The low dose of aspirin used for people with heart disease is too small to cause aspirin poisoning even when taken for a long time.

Poisoning with salicylates other than aspirin

aspirin. This amount can be fatal to young children .

Did You Know...

  • A young child can die from swallowing less than 1 teaspoonful of oil of wintergreen, which is found in liniments and solutions used in hot vaporizers.

In 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 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.

  • 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.

  • Activated charcoal

  • Sometimes hemodialysis

Activated charcoal is given as soon as possible and reduces aspirinaspirin 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.

  1. American Association of Poison Control Centers: Represents the US-based poison centers that provide free, confidential services (24/7) through the Poison Help Line (1-800-222-1222)

Drugs Mentioned In This Article
quizzes_lightbulb_red
Test your KnowledgeTake a Quiz!
Download the free Merck Manual App iOS ANDROID
Download the free Merck Manual App iOS ANDROID
Download the free Merck Manual App iOS ANDROID