Episode 215: 215. Enteric coated or uncoated aspirin, which is better or safer?
Questioning Medicine20 Des 2023

Episode 215: 215. Enteric coated or uncoated aspirin, which is better or safer?

Effectiveness and Safety of Enteric-Coated vs Uncoated Aspirin in Patients With Cardiovascular Disease: A Secondary Analysis of the ADAPTABLE Randomized Clinical Trial | Clinical Pharmacy and Pharmacology | JAMA Cardiology | JAMA Network

Enteric coating of aspirin delays the breakdown of the tablet until it is in the higher pH of the duodenum and has been shown to reduce gastric erosion5 but has not been shown to reduce gastrointestinal bleeding. We say take enteric coated but no study has shown that enteric coated formulation is safer then uncoated aspirin

post hoc secondary analysis of 10 678 participants with atherosclerotic cardiovascular disease from the ADAPTABLE randomized clinical trial—a reminder, (Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-term Effectiveness). In that trial they randomized 15,000 patients with coronary artery disease to take 81 mg or 325 mg of aspirin daily.

Roughly half of the pts using 81mg and half of the pts using 325mg were on enteric coated aspirin and half on regular uncoated aspirin. - Median follow-up was ≈2 years

primary outcomes were death, hospitalization for myocardial infarction, or hospitalization for stroke and the primary safety outcomes was major bleeding -- (hospitalization for a bleeding event with use of a blood product or intracranial hemorrhage).---between enteric-coated aspirin and uncoated aspirin among participants

and the answer was there was no difference so when your patient that needs aspirin for secondary prevention ask you should I take enteric-coated aspirin or uncoated aspirin

You can answer

Sound affect

At this time it appears the best available evidence that there likely is no difference between enteric-coated aspirin and uncoated aspirin just make sure you are taking your aspirin

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