Aspirin and Seizures: What to Know and How to Cope

Aspirin does not typically cause seizures at standard doses, but seizures can occur in rare situations most notably with overdose and in children with Reye’s syndrome after viral illness. ^[1] Serious neurological symptoms, including seizures, are listed among possible adverse effects in drug information sources, usually in the context of toxicity or unusual reactions. ^[2]

When Can Aspirin Lead to Seizures?

• Overdose (salicylate toxicity): Taking a large amount of aspirin can lead to progressive toxicity with fast breathing, confusion, hyperthermia (very high fever), and seizures, and can be life‑threatening. ^[1] Overdose symptoms span multiple body systems and include agitation, coma, and seizures as toxicity worsens. ^[3]
• Children and Reye’s syndrome: In children and teenagers who have a viral illness (like flu or chickenpox), aspirin use has been strongly associated with Reye’s syndrome, a rare but severe condition that can cause brain and liver injury and may present with seizures or loss of consciousness. ^[4] Warnings about aspirin in children highlight behavior changes, repeated vomiting, and neurological symptoms as red flags for Reye’s syndrome. ^[5]
• Combination products: Some aspirin-containing combinations (for example, with codeine) carry an added seizure risk because of the non‑aspirin ingredient (codeine). ^[6] In such combination capsules, codeine can increase seizure frequency in those with seizure disorders and in other seizure‑prone settings. ^[7]

How Common Is This?

Aspirin has been widely used for decades and seizures are considered rare and usually tied to toxicity or special circumstances rather than routine dosing. ^[1] Consumer and professional drug monographs list seizures among serious adverse effects, but these are uncommon outside overdose or pediatric Reye’s syndrome contexts. ^[2]

Warning Signs to Watch For

• Possible toxicity: Fast or deep breathing, ringing in the ears, confusion, high fever, vomiting, and seizures warrant urgent care. ^[1] Severe overdose can progress to coma, seizures, and respiratory failure. ^[3]
• In children after viral illness: Repeated vomiting, unusual sleepiness, sudden behavior changes, seizures, or loss of consciousness are emergencies. ^[4] If a child on aspirin develops behavior changes with nausea/vomiting, contact a clinician right away due to Reye’s syndrome risk. ^[5]

What To Do If Seizures Occur

• Seek emergency care immediately: Seizures after aspirin use, especially with signs of overdose or in a child with recent viral illness, need urgent evaluation. ^[1] Delays in treating overdose raise the risk of seizures, high fevers, and death. ^[1]
• Provide details: Bring information on dose, timing, and any combination products (e.g., aspirin with codeine). ^[6] Combination products may change the risk profile, as codeine can increase seizure risk. ^[7]

Managing Salicylate Toxicity (Clinical Approach)

• Decontamination and supportive care: Standard management for salicylate toxicity focuses on preventing further absorption and correcting fluid and electrolyte imbalances; there is no specific antidote. ^[8] Care teams may use gastrointestinal decontamination and careful correction of acid‑base and electrolyte disturbances. ^[9]
• Monitor severity: Clinicians assess salicylate levels; early signs like tinnitus occur near certain plasma concentrations, and severe toxicity is associated with higher levels. ^[10] Hyperthermia and low blood volume are major immediate threats in severe cases. ^[10]

Safer Use Tips

• Avoid aspirin in children/teens with viral illnesses: Choose alternatives like acetaminophen (paracetamol) unless a clinician specifically advises aspirin. ^[4] Product labeling warns about Reye’s syndrome risk and advises caution in pediatric use. ^[11]
• Stick to recommended doses: Do not exceed package or clinician‑directed dosing; accidental overdosing raises seizure risk. ^[1] Much lower amounts can seriously affect children compared with adults. ^[12]
• Check combination products: Be cautious with aspirin combined with other drugs (e.g., codeine), especially if you have a seizure disorder. ^[6] People with known seizure disorders should be regularly evaluated when using such combinations. ^[7]
• Know red flags: New confusion, agitation, severe headache, vomiting, fast breathing, fever, or seizures should prompt urgent care. ^[3] Loss of responsiveness or collapse are emergency symptoms. ^[3]

Who Is at Higher Risk?

• Children and adolescents with recent viral illness: Due to Reye’s syndrome risk when aspirin is used. ^[4] Behavior changes, vomiting, and neurological signs in this setting need immediate attention. ^[5]
• People taking high doses or with access to large quantities: Overdose risk is higher and can progress to seizures. ^[1] Severity depends on how much aspirin is absorbed and how quickly treatment begins. ^[1]
• Users of certain combinations: Aspirin with codeine may raise seizure risk in susceptible people. ^[6] This added risk applies both to those with seizure disorders and some other clinical settings. ^[7]

Bottom Line

Aspirin can be linked to seizures primarily in overdose and in children with Reye’s syndrome, and rarely via certain combination products; routine adult dosing is unlikely to cause seizures on its own. ^[1] Recognizing warning signs and using aspirin appropriately especially avoiding it in children with viral illnesses can significantly reduce risk. ^[4] If seizures or severe symptoms occur after aspirin use, seek emergency medical care immediately. ^[1]