Enteric coating can lead to reduced antiplatelet effect of low-dose acetylsalicylic acid

Basic Clin Pharmacol Toxicol. 2015 Mar;116(3):212-5. doi: 10.1111/bcpt.12362. Epub 2014 Dec 23.

Abstract

Low-dose acetylsalicylic acid (ASA) is widely used as antithrombotic prophylaxis. Enteric-coated ASA has been developed to decrease the risk of gastrointestinal side effects. The consequences of enteric coating on pharmacokinetics and antiplatelet effect of ASA have not systematically been assessed. This MiniReview demonstrates that data from clinical trials indicate that enteric coating can reduce the antiplatelet effect of ASA compared to plain ASA. This is possibly due to decreased bioavailability of ASA caused by prolonged solvation and absorption of the enteric-coated formulations. Therefore, low-dose enteric-coated ASA might not be bioequivalent to plain ASA, entailing the risk of insufficient cardiovascular prophylaxis.

Publication types

  • Review

MeSH terms

  • Aspirin / administration & dosage
  • Aspirin / pharmacokinetics
  • Aspirin / pharmacology*
  • Biological Availability
  • Blood Platelets / drug effects
  • Blood Platelets / metabolism
  • Clinical Trials as Topic
  • Humans
  • Platelet Aggregation / drug effects*
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / pharmacokinetics
  • Platelet Aggregation Inhibitors / pharmacology*
  • Tablets, Enteric-Coated

Substances

  • Platelet Aggregation Inhibitors
  • Tablets, Enteric-Coated
  • Aspirin