Over the Counter Aspirin for Pregnant Women at Risk of Pre-eclampsia

Dawn O'Shea

May 27, 2020

Pre-eclampsia remains the leading cause for iatrogenic prematurity in the UK and a significant cause of maternal morbidity and inpatient antenatal care. Despite National Institute for Health and Care Excellence recommendations on screening and managing women at risk of pre-eclampsia, more than 50 per cent of mothers-to-be who are eligible for low-dose aspirin never start it.

Writing in an editorial in the  Drug and Therapeutics Bulletin , consultant obstetrician Dr Joanna Girling of West Middlesex University Hospital in London, asks: Is there an option of buying low-dose aspirin over the counter?

“The cost of low-dose aspirin bought from a pharmacy is less than £5 for a 6-month supply and much less costly than the equivalent supply of unnecessary branded pregnancy-related nutrients and supplements that many women chose to buy. However, pharmacists cannot legally sell aspirin for pre-eclampsia prevention as there is no product with UK marketing authorisation for this indication,” Dr Girling writes.

While some may be concerned that this suggests the treatment is unsafe, she says the absence of marketing authorisation is more likely to be a commercial decision.

“It does not make medical, financial or human (common) sense to disempower those pregnant women whose midwives have followed evidence-based national guidelines to recommend low-dose aspirin, from obtaining it alongside their other pharmacy purchases,” writes Dr Girling.

“If we are serious about increasing uptake of a nationally recommended evidence-based life-saving low-cost intervention, how about developing a national PGD to allow community pharmacists to supply low-dose aspirin to women who are at risk of pre-eclampsia?”

Girling J. Low-dose aspirin for prevention of pre-eclampsia: when over the counter just isn't. Drug Ther Bull. 2020 May 21 [Epub ahead of print]. doi: 10.1136/dtb.2020.000003. PMID: 32439654. 

This article originally appeared on Univadis, part of the Medscape Professional Network.

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