Can Aspirin Cause Heart Palpitations and How to Cope

Aspirin does not commonly cause heart palpitations on its own at typical pain-relief doses, but palpitations and fast heart rate (tachycardia) have been reported with certain aspirin combination products and in the setting of salicylate toxicity (aspirin overdose). ^[1] Palpitations are specifically listed among the possible heart rhythm side effects for products that combine aspirin with dipyridamole, and tachycardia may occur with salicylate toxicity. ^{[2] [3]}

What the evidence shows

• Palpitations and tachycardia appear in the adverse event listings for aspirin plus dipyridamole capsules (often used for stroke prevention). ^[2] This indicates that some users may experience noticeable heartbeats or a rapid pulse. ^[4]

• In overdose or toxicity from salicylates (the drug class that includes aspirin), symptoms can include restlessness, dizziness, drops in blood pressure, and tachycardia. ^[3] These effects are part of the body’s response to high salicylate levels and can feel like pounding or racing heart. ^[5]

• Some aspirin combination products also list tachycardia as a possible adverse effect, reinforcing that a fast heart rate can occur in certain contexts. ^[1]

• Standard aspirin monographs emphasize serious gastrointestinal and bleeding risks more than palpitations, suggesting palpitations are uncommon with plain aspirin at usual doses. ^[6] Still, any new or worrisome heart symptoms should be checked promptly. ^[7]

Bottom line: Palpitations are uncommon with plain aspirin but can occur with aspirin combinations (like aspirin/dipyridamole) or with overdose/toxicity. ^{[2] [3] [1]}

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Why palpitations can happen

• Dipyridamole-related effects: Dipyridamole can cause vasodilation (widening blood vessels) leading to flushing and a drop in blood pressure, which the body may counter by increasing heart rate felt as palpitations. ^{[8] [9]}

• Salicylate toxicity: High levels of aspirin can disturb acid–base balance and electrolytes, triggering symptoms including tachycardia. ^{[3] [5]}

In these situations, the sensation of a racing or pounding heart may be a secondary effect of blood pressure changes or metabolic stress. ^{[8] [3]}

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Who might be more at risk

• People taking aspirin in combination with dipyridamole for stroke prevention. ^[2]
• Anyone taking more than the recommended aspirin dose or using multiple salicylate-containing products, which raises the risk of toxicity. ^{[5] [6]}

Older adults or those with multiple medications may be more susceptible to side effects and interactions, so careful dosing and monitoring matter. ^[6]

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Practical steps to cope safely

1) Check your product and dose

• Verify whether you’re on plain aspirin or an aspirin combination (e.g., aspirin/dipyridamole). Palpitations are more often noted with the combination. ^[2]
• Review your total daily aspirin intake, including over-the-counter products, to avoid excessive dosing that could lead to salicylate toxicity. ^{[6] [5]}

If you realize you’re exceeding recommended doses or using multiple salicylate products, reduce to labeled doses and seek medical guidance. ^{[6] [5]}

2) Monitor your symptoms

• Track when palpitations occur, how long they last, and whether they are accompanied by dizziness, chest pain, shortness of breath, or fainting. These paired symptoms warrant urgent medical attention. ^[7]

3) Adjust timing and supportive measures

• If palpitations seem linked to aspirin/dipyridamole, discuss with your clinician whether dosing time adjustments or gradual titration could help reduce hemodynamic effects. ^[8]
• Maintain hydration and avoid stimulants (like high caffeine) that can worsen palpitations.

4) Discuss alternatives with your clinician

• If palpitations persist on aspirin/dipyridamole, your clinician may consider alternative antithrombotic strategies based on your risk profile. Never stop a prescribed antiplatelet medication without medical advice. ^[2]

5) Know when to seek urgent care

• Seek immediate medical help for severe or new-onset palpitations with chest pain, shortness of breath, fainting, or suspected overdose. Suspected overdose requires prompt assessment and management. ^{[5] [9]}

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Red flags and emergency guidance

• Signs like black, tarry stools, vomiting blood, severe stomach pain, or symptoms of shock require urgent evaluation, as they can be serious aspirin-related effects. ^{[7] [6]}
• In cases of real or suspected overdose, contact emergency services or a Poison Control Center immediately. Early medical management is essential. ^{[9] [5]}

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Key takeaways

• Palpitations are uncommon with plain aspirin but have been reported with aspirin/dipyridamole and with salicylate toxicity. ^{[2] [3]}
• Verify your medication and dose, monitor symptoms, and consult your clinician if palpitations occur. ^[6]
• Treat any severe or accompanying symptoms as urgent, especially if overdose is suspected. ^{[5] [7]}