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Relationship between Adverse Gastric Reactions and the Timing of Enteric-Coated Aspirin Administration

Weijun Guo1, Wenlin Lu2, Yujun Xu2

  • 1Department of Cardiology, Huaiyin Hospital, No.38, Beijing West Road, Huaiyin District, Huai'an, 223300, Jiangsu Province, China. hylucky289@163.com.

Clinical Drug Investigation
|October 28, 2016
PubMed

Insights

Taking enteric-coated aspirin before meals or before sleep significantly reduces adverse gastric effects. This timing optimizes drug release and minimizes stomach irritation for patients.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Clinical Medicine

Background:

  • Enteric-coated aspirin is widely prescribed for its anti-inflammatory and antiplatelet properties.
  • Adverse gastric effects are a common concern with aspirin use, potentially linked to administration timing.
  • Understanding optimal dosing schedules can improve patient safety and treatment adherence.

Purpose of the Study:

  • To investigate the association between the timing of enteric-coated aspirin administration and the occurrence of adverse gastric effects.
  • To determine if specific administration times (before meal, during meal, after meal, before sleep) influence gastric tolerability.
  • To correlate drug release profiles with observed clinical outcomes.

Main Methods:

  • A cohort of 572 patients (aged 45-84) received 100 mg enteric-coated aspirin daily at different times.
  • Patients were monitored for 6-9 months for gastric reactions and side effects, with gastroscopy performed as needed.
  • In vitro release tests using chromatography assessed tablet dissolution at varying pH levels.

Main Results:

  • Enteric-coated aspirin tablets demonstrated complete release (>99%) within 20-120 minutes at pH > 5.5.
  • Significantly fewer patients experienced recurring adverse stomach reactions and gastric lesions when aspirin was taken before meals or before sleep (p < 0.05).
  • No significant differences in damage to other organs were noted across groups.

Conclusions:

  • Administering low-dose enteric-coated aspirin before meals or before sleep is optimal for reducing gastric adverse events.
  • Increased gastric pH during and after meals may contribute to higher incidence of side effects with other administration timings.
  • This finding supports adjusting aspirin intake schedules to enhance gastrointestinal tolerability.
Abstract

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