Aspirin and Cholesterol Medication: OK Together?

If you're taking a statin medication to lower your cholesterol and want to know whether you can also take aspirin, the answer is a bit mixed. Your doctor might recommend it, but there are also risks to be aware of.

​Read more:​ The 3 Major Causes of High Cholesterol Levels Are All Preventable

If it's pain relief you're seeking, the answer to your question is pretty direct: "Absolutely you can" take an aspirin, even though you're taking a cholesterol-lowering medication like a statin, says cardiologist Eugene Yang, MD, medical director of the University of Washington Medicine Eastside Specialty Center and professor of medicine at the University of Washington in Bellevue.

Of course, you should always follow safety guidelines for choosing and using over-the-counter pain relievers (more on that below). But, if you're talking about taking an aspirin every day to lower your risk for heart disease or stroke, then the answer is more complicated.

According to the Mayo Clinic, your doctor may recommend a statin plus daily aspirin if you've already had a heart attack, stroke or heart procedure such as bypass surgery or a stent placed in an artery leading to your heart. In these cases, says Dr. Yang, daily aspirin therapy is frequently recommended for what's called secondary prevention.

The aspirin thins your blood, notes the American Heart Association (AHA), and this can keep it from forming clots that could block blood vessels to your heart, causing a heart attack, or to your brain, causing a stroke.

If you haven't had a heart problem or stroke but are taking a statin to reduce your risk, your doctor is less likely to recommend daily aspirin therapy.

"That's primary prevention, where we're trying to optimize risk factors and prevent people from having a first heart attack or stroke," says Dr. Yang. "And that's where the data becomes a lot murkier and where we don't have the same level of evidence that taking an aspirin is beneficial in addition to taking a statin to lower the risk of heart attack or stroke."

Before recommending a daily aspirin, doctors weigh the potential benefits against the risks, which, according to the Mayo Clinic, include:

• Bleeding (or hemorrhagic) stroke, caused by a burst blood vessel.
• Bleeding in your digestive tract (this risk is increased if you also regularly drink alcohol).
• Allergic reaction.
  

The AHA advises against taking a daily aspirin without talking with your doctor first. Your doctor can weigh your individual risks and benefits and make a recommendation.

Dr. Yang says he typically recommends low-dose aspirin — commonly sold in 81 milligram dosage — for patients who take daily aspirin therapy. "It is just as effective as regular-strength aspirin in terms of reducing the risk of heart attack and stroke," he says. "We don't usually recommend higher-strength aspirin because it may increase the risk of bleeding, which we're trying to avoid."

For pain relief, you can also take ibuprofen, another over-the-counter medication, while taking a statin, says Dr. Yang. But, "similar to aspirin, it is a nonsteroidal anti-inflammatory medication and so, if taken in excess, can increase the risk of bleeding, can increase your blood pressure — it can sometimes cause kidney damage."

Dr. Yang says it's OK to take common medications like aspirin or ibuprofen — known as NSAIDs (nonsteroidal anti-inflammatory drugs) — intermittently for pain relief if necessary, but be aware of the potential risks associated with them.

The American Academy of Family Physicians recommends talking with your doctor before taking any kind of NSAID, including aspirin, if you:

• Are allergic to aspirin or other pain relievers.
• Drink three or more alcoholic beverages daily.
• Have high blood pressure or heart, liver or kidney disease.
• Have stomach ulcers or bleeding in the stomach or intestines.
• Take blood-thinning medicine or have a bleeding disorder.

​Read more:​ The Best Painkillers for Every Type of Pain — and How to Choose What's Best for You