Based on PubMed | Is it safe to take aspirin with coffee, or does caffeine increase the risk of stomach irritation or bleeding?

It can be okay for many people to drink coffee when taking occasional aspirin, but caffeine may modestly increase how quickly and how much aspirin is absorbed and could potentially add to stomach irritation in some individuals. ^[1] Aspirin itself is the main driver of stomach irritation and bleeding risk, and that risk goes up in certain situations regardless of coffee intake. ^[2]

How aspirin affects the stomach

Aspirin is a nonsteroidal anti‑inflammatory drug (NSAID) that can injure the protective lining of the gastrointestinal (GI) tract and increase the chance of stomach or intestinal bleeding. ^[2] The risk is higher with factors like older age, past ulcers or GI bleeding, and combining aspirin with other NSAIDs, corticosteroids, or blood thinners. ^[2]

What caffeine does in this mix

Caffeine can increase the rate at which aspirin’s active form (salicylate) appears in the bloodstream and can raise its peak level, which may enhance pain relief but also theoretically could nudge GI side‑effects for some people. ^[1] In classic animal studies, caffeine added to aspirin increased gastric erosions compared with aspirin alone, though animal findings do not always translate directly to people. ^[3] On the other hand, older human data suggest caffeine itself is probably not a direct cause of peptic ulcers, so the primary concern remains aspirin. ^[4]

Real‑world products that combine aspirin and caffeine

Several over‑the‑counter headache products intentionally combine aspirin with caffeine to improve pain relief, and they carry strong “stomach bleeding” warnings because of the aspirin component. ^[5] The bleeding warning emphasizes higher risk if you are 60 or older, have a history of ulcers or bleeding, or take blood thinners, steroids, or other NSAIDs. ^[5] These warnings apply even without extra coffee, since aspirin is the risk driver. ^[5]

Practical guidance

• Occasional use: For healthy adults without GI risk factors, having a cup of coffee with an occasional aspirin dose is unlikely to dramatically change bleeding risk, though sensitive individuals may notice more heartburn or stomach upset. ^[1]
• Higher‑risk situations: If you are over 60, have had ulcers or GI bleeding, or take blood thinners, steroids, or other NSAIDs, it would be safer to minimize additional GI irritants and consider limiting caffeine around aspirin. ^[2]
• Dose and timing: Using the lowest effective aspirin dose, taking it with food, and avoiding multiple GI irritants at once (e.g., alcohol plus high‑dose caffeine) may help reduce irritation. ^[2]
• Long‑term or daily aspirin: People on long‑term or daily aspirin for heart protection who have GI risk factors often benefit from a protective stomach medication such as a proton pump inhibitor, as advised by their clinician. ^[2]

When to seek help

Stop aspirin and seek medical care if you notice black or tarry stools, vomiting blood, persistent stomach pain, dizziness, or weakness, which can signal GI bleeding. ^[2] Over‑the‑counter combination labels also advise caution with heavy alcohol use and other interacting drugs because they raise bleeding risk. ^[5]

Bottom line

Caffeine can speed and slightly increase aspirin absorption, which may enhance pain relief but could also add to stomach irritation in some people. ^[1] The main bleeding risk comes from aspirin itself, and that risk is higher with age, prior ulcers or bleeding, and use of certain other medicines, regardless of coffee. ^[2] If you have any of those risk factors, it’s reasonable to limit caffeine with aspirin and talk with your clinician about safer strategies, including protective stomach medicines when appropriate. ^[2]