From the Guidelines
Enteric-coated (EC) aspirin should be taken with food to minimize stomach irritation and ensure effective absorption. When considering the administration of EC aspirin, it's crucial to understand that the enteric coating is designed to prevent the aspirin from dissolving in the stomach, allowing it to pass into the small intestine where it can be absorbed effectively. However, the presence of food can aid in this process by helping to buffer stomach acid and reduce the potential for stomach irritation [ 1 ]. The evidence from recent guidelines suggests that while enteric-coated aspirin may have reduced absorption compared to non-enteric coated formulations [ 1 ], taking it with food can help mitigate some of these issues. Key points to consider include:
- The importance of minimizing stomach irritation to improve patient compliance and reduce gastrointestinal side effects.
- The role of food in buffering stomach acid and potentially enhancing the absorption of enteric-coated aspirin.
- The recommendation to avoid high-dose aspirin (≥160 mg) due to increased bleeding risk without improved outcomes [ 1 ]. Given these considerations, taking EC aspirin with food is recommended to balance the need for effective antiplatelet therapy with the minimization of gastrointestinal side effects. If patients experience persistent stomach pain, heartburn, or nausea, they should consult their healthcare provider for further guidance [ 1 ].
From the Research
Enteric-Coated Aspirin Administration
- Enteric-coated aspirin can be taken with or without food, but its effectiveness and potential for gastrointestinal side effects may vary depending on the circumstances.
- Studies have shown that enteric coating can reduce the antiplatelet effect of aspirin compared to plain aspirin, possibly due to decreased bioavailability 2.
- The enteric coating is designed to reduce gastrointestinal side effects, but research suggests that it may not be entirely effective in doing so 3, 4.
Gastrointestinal Side Effects
- Enteric-coated aspirin may cause less minor gastrointestinal lesions compared to plain aspirin, but it does not seem to have a significant effect on the incidence of dyspepsia or gastrointestinal bleeding 3.
- Low-dose enteric-coated aspirin can still cause significant gastric endoscopic lesions and may even predict mortality due to progression of gastrointestinal disorders 5.
- However, one study found that enteric-coated aspirin reduced acute gastric mucosal injury to placebo levels, despite its inhibition of prostaglandin synthesis 6.
Food Interaction
- There is no clear evidence to suggest that taking enteric-coated aspirin with food significantly affects its absorption or efficacy.
- However, it is generally recommended to take aspirin with food to reduce the risk of gastrointestinal side effects.
- More research is needed to fully understand the interaction between food and enteric-coated aspirin 2, 3, 4, 5, 6.