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Tell your doctor if you are taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor). Taking any of these drugs while you are also use rectal aspirin may cause you to bruise or bleed easily.

Before using rectal aspirin, tell your doctor if you are using any of the following drugs:

• alprostadil (Caverject, Edex);

• epitifibatide (Integrilin);

• tirofiban (Aggrastat);

• probenecid (Benemid);

• divalproex (Depakote) or valproic acid (Depacon, Depakene);

• an antacid or laxative;

• a blood thinner such as heparin or warfarin (Coumadin);

• cancer medicine such as abciximab (Reopro), methotrexate (Folex, Rheumatrex, Folex), plicamycin (Mithracin);

• insulin or diabetes medicine you take by mouth;

• an antibiotic such as cefemandole (Maxipime), cefoperazone (Cefobid), cefotetan (Cefotan), ciprofloxacin (Cipro), demeclocycline (Declomycin), doxycycline (Doryx, Periostat, Vibramycin), enoxacin (Penetrex), itraconazole (Sporanox), ketoconazole (Nizoral), mezlocillin (Mezlin), minocycline (Dynacin, Minocin), norfloxacin (Noroxin), ofloxacin (Floxin), piperacillin (Pipracil), tetracycline (Broadspec, Panmycin, Sumycin), ticarcillin (Ticar), vancomycin (Vancocin);

• medication used to prevent blood clots, such as alteplase (Activase), anistreplase (Eminase), clopidogrel (Plavix), dipyridamole (Persantine), streptokinase (Kabikinase, Streptase), ticlopidine (Ticlid), and urokinase (Abbokinase);

• salicylates such as Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal; or

• NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene).

This list is not complete and there may be other drugs not listed that can interact with aspirin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using rectal aspirin and call your doctor at once if you have any of these serious side effects:

• black, bloody, or tarry stools;

• blood in your urine;

• coughing up blood or vomit that looks like coffee grounds;

• pale skin, easy bruising or bleeding;

• wheezing, chest tightness, trouble breathing;

• decreased hearing or ringing in the ears;

• seizure (convulsions); or

• dizziness, confusion, or hallucinations.

Less serious side effects may include:

• nausea, vomiting, stomach pain; or

• rectal irritation.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.