To maximize the benefits and minimize the risks, take these steps:
Stick with low-dose 81-milligram (baby) aspirin. Research generally suggests that they're as effective as standard adult tablets (325 milligrams) and are less likely to harm the gut and cause other complications. The one exception is if you think you're having a heart attack. In that case, call 911, then chew and swallow a 325 mg tablet.
Protect your gut. If you have a history of stomach bleeding but your doctor says you need low-dose aspirin anyway, ask about adding a stomach-protecting drug such as misoprostol (Cytotec and generic) or omeprazole (Prilosec, Prilosec OTC, and generic). If you still can't tolerate aspirin or your risk of gastrointestinal bleeding is too high, ask him or her about using a different blood-thinning medication.
Don't stop on your own. Stopping abruptly eliminates the protective benefits of aspirin and might elevate risk beyond original levels by making the platelets in the blood more likely to form clots. If you do need to stop, possibly before surgery, for example, do so for as briefly as possible.
Don't combine aspirin with related pain relievers. Medications such as ibuprofen (Advil and generic) or naproxen (Aleve and generic) are chemically related to aspirin, so taken together they multiply the risk of stomach problems. So if you need pain relief, try acetaminophen (Tylenol and generic) or creams such as Zostrix that contain the topical anesthetic capsaicin. Moreover, ibuprofen and possibly naproxen can undermine aspirin's blood-thinning effect. If you do take aspirin and ibuprofen or naproxen, take the aspirin at least four hours before. That will give it a chance to do its job without having to compete against the other medication.