Aspirin (Bayer Aspirin) alternatives: What can I take instead of aspirin?

Creator: SingleCare
Published: 2023-10-03T12:44:02-04:00

Aspirin (Bayer Aspirin) doesn't work for everyone. Other oral NSAIDs, COX-2 Inhibitors, topical NSAIDs, Tylenol, and platelet inhibitors are some aspirin alternatives. Get the full list here.

By Kristi C. Torres, Pharm.D. | Oct. 3, 2023

Aspirin is an inhibitor of thromboxane A2 (TXA2) and prostacyclin (PGI-2), and this action is responsible for vascular smooth muscle relaxation, vasodilation, and decreasing platelet aggregation (blood clots). For these reasons, aspirin is taken daily to help lower the risk of heart attacks and stroke prevention. Aspirin also decreases overall cardiovascular and heart disease risk. It can also treat or prevent angina pectoris or chest pain. Aspirin is useful in osteoarthritis, rheumatoid arthritis, joint pain, and other pain-related disorders.

What can I take in place of aspirin?

There are alternative options if aspirin is not the right choice. Other nonsteroidal anti-inflammatory drugs (NSAIDs) drugs, such as ibuprofen, naproxen, or diclofenac, may better treat acute pain and inflammation. Tylenol, or acetaminophen, is an effective fever reducer and is preferred in children for this purpose over aspirin. There are other options for cardiovascular protection as well. These include drugs like Plavix (clopidogrel) and Pletal (cilostazol).

The information below is not intended to be medical advice. Speak to a prescriber to determine the best treatment option for the condition.

Compare Aspirin alternatives
Drug name	Uses	Dosage	Savings options
Bayer Aspirin (aspirin)	Mild pain, fever, stroke prophylaxis, acute myocardial infarction, reduction in cardiovascular mortality	325 mg – 650 mg every 4 hours as needed for pain, or 81 mg by mouth daily for cardiovascular prophylaxis	Aspirin coupons
Motrin IB (ibuprofen)	Mild to moderate pain, osteoarthritis, rheumatoid arthritis, dysmenorrhea, fever, migraine	400 mg by mouth every 4 to 6 hours as needed	Motrin coupons
Naprosyn (naproxen)	Mild to moderate pain, osteoarthritis, rheumatoid arthritis, gout, dysmenorrhea, fever	250 mg to 500 mg by mouth twice daily as needed	Naprosyn coupons
Zipsor (diclofenac)	Mild to moderate pain	25 mg by mouth four times per day as needed	Zipsor coupons
Lodine (etodolac)	Mild to moderate pain, osteoarthritis, rheumatoid arthritis	200 mg to 400 mg by mouth every 6 to 8 hours as needed	Lodine coupons
Mobic (meloxicam)	Mild to moderate pain, osteoarthritis, rheumatoid arthritis	7.5 mg to 15 mg once daily	Mobic coupons
Celebrex (celecoxib)	Mild to moderate pain, osteoarthritis, rheumatoid arthritis, migraine, dysmenorrhea	100 mg by mouth twice daily or 200 mg by mouth once daily	Celebrex coupons
Voltaren gel (diclofenac)	Osteoarthritis	4 g applied topically four times daily (knee, ankle, foot) or 2 g applied topically four times daily (elbow, wrist, hand joint)	Voltaren gel coupons
Tylenol (acetaminophen)	Mild to moderate pain, fever, headache	325 mg to 650 mg every 4 to 6 hours	Tylenol coupons
Plavix (clopidogrel)	Myocardial infarction prophylaxis, stroke prophylaxis, thrombosis prophylaxis	75 mg by mouth once daily	Plavix coupons
Brilinta (ticagrelor)	Myocardial infarction prophylaxis, stroke prophylaxis, reduction of risk after myocardial infarction	180 mg loading dose, then 90 mg by mouth twice daily (specific dosing dependent on indication)	Brilinta coupons
Effient (prasugrel)	Arterial thromboembolism prophylaxis	60 mg loading dose, then 10 mg by mouth once daily	Effient coupons
Aggrenox (aspirin/ dipyridamole)	Secondary stroke prophylaxis	25 mg ASA/ 200 mg dipyridamole by mouth twice daily	Aggrenox coupons
Pletal (cilostazol)	Thromboembolism prophylaxis, treatment of claudication associated with peripheral vascular disease (PVD)	100 mg by mouth twice daily	Pletal coupons

Other alternatives to aspirin

Aleve (naproxen)
Indocin (indomethacin)
Relafen (nabumetone)
Feldene (piroxicam)
Toradol (ketorolac)
Ansaid (flurbiprofen)
Pennsaid (diclofenac)

Top 5 aspirin alternatives

The following are some of the most common alternatives to aspirin.

1. Other oral NSAIDs

For some types of pain and inflammation, aspirin may not provide the desired symptom relief. Other NSAIDs offer both COX-1 and COX-2 inhibition to varying degrees. Some last longer and do not have to be dosed as often as aspirin for inflammation and pain. Aspirin is available over the counter without a prescription, and Advil, Motrin, and Aleve are as well. Other NSAIDs require a prescription order. Long-term use of NSAIDs should only be done under the advice and supervision of a healthcare professional.

Examples: Motrin (ibuprofen), Naprosyn (naproxen), Cataflam (diclofenac), Lodine (etodolac), Toradol (ketorolac)

2. COX-2 Inhibitors

COX-1 inhibition is responsible for some of the adverse events related to the gastrointestinal system that NSAIDs cause. These can include intestinal lining irritation or ulcers (more common with long-term use). There is a generation of NSAIDs known as COX-2 inhibitors which avoid action on the COX-1 pathway. This provides anti-inflammatory effects and pain relief with a much lower risk of gastrointestinal side effects. This group of drugs is prescription only and typically dosed once or twice daily.

Examples: Celebrex (celecoxib), Mobic (meloxicam)

3. Topical NSAIDs

If oral NSAID therapy is not desired or there is concern over potential systemic adverse events, there are topical NSAID preparations that have minimal systemic risk with topical application. These are appropriate for joint and muscle pain related to inflammation. Most products in this class contain diclofenac as the active ingredient. There are various application types, such as gels, solutions, and patches. Some items are prescription-only, while others are available over the counter without a prescription.

Examples: Voltaren gel (diclofenac), Pennsaid solution (diclofenac), Flector patch (diclofenac)

4. Tylenol

In treating fever, Tylenol is an excellent alternative to aspirin and other NSAIDs. It is the preferred product in children due to the potential for Reye’s syndrome. Tylenol is not an anti-inflammatory drug, but it does have some analgesic properties and can be useful for some pain types, such as arthritis and headaches. Tylenol is available without a prescription.

Examples: Tylenol (acetaminophen)

5. Platelet inhibitors

Aspirin causes platelet inhibition, slowing and decreasing the formation of clots in the blood. This makes it useful in treating and preventing stroke and other cardiac conditions. For patients who need this protection but are not good candidates for aspirin therapy, other platelet inhibitors do not carry the NSAID-related risk profile of aspirin. These other platelet inhibitors are available by prescription. All platelet inhibitors carry some risk with the potential for serious bleeding and blood loss, bruising, and bleeding gums.

Examples: Plavix (clopidogrel), Effient (prasugrel), Pletal (cilostazol)

Natural alternatives to aspirin

Some natural supplements have anti-inflammatory properties. Fish oil (omega-3 fatty acids) is a natural blood thinner and may reduce cholesterol. White willow bark, curcumin (turmeric), and green tea are other natural alternatives. As mentioned previously, aspirin is derived from the white willow bark. It is a non-selective inhibitor of COX-1 and COX-2, functioning similarly to aspirin.

Green tea is a natural antioxidant used for its cardioprotective properties to reduce the risk of cardiovascular diseases. Magnesium has been assumed to have blood thinning properties, but clinical data shows that effect to be very small and only clinically impactful at high doses.

How to switch to an aspirin alternative

Whether one has a drug allergy to aspirin or another NSAID, is concerned about potential or existing side effects, or has another reason for wanting an aspirin alternative, the first step is to speak to a healthcare provider. Let the provider know if conditions such as stomach ulcers or high blood pressure exist, as aspirin may not be the right choice. The primary consideration in finding an aspirin alternative is determining what indication it will be used to treat and then looking at appropriate and safe alternatives for that indication.

Switching therapies should not be done alone, even between two over-the-counter options. Consult a prescriber or pharmacist to get acceptable alternatives. If switching to a prescription-only drug, it would be best to consult the insurance formulary while deciding. The formulary status of the drug will determine out-of-pocket costs. If uninsured, consult the SingleCare webpage to compare the discounted cash prices SingleCare offers across multiple pharmacies at once.