Chewing enteric-coated acetylsalicylic acid accelerated absorption and significantly decreased serum thromboxane B2 and platelet aggregation within 20 minutes, equivalent to buffered ASA.
RCT
Single-blind
Crossover
Does chewing enteric-coated or buffered acetylsalicylic acid accelerate absorption and platelet inhibition in healthy volunteers?
Chewing enteric-coated aspirin accelerates its absorption and antiplatelet action to match that of buffered aspirin, providing pharmacokinetic evidence supporting the guideline recommendation to chew aspirin in suspected acute myocardial infarction.
In the initial treatment of acute myocardial infarction, it is important to administer oral low-dose acetylsalicylic acid (ASA) within 10 min of arrival at the hospital. However, ASA is supplied as an enteric-coated tablet or buffered tablet to prevent gastric irritation. Although current guidelines recommended that patients should chew their initial dose of ASA, there is little evidence as to whether this is efficacious. Therefore, we aimed to make a direct comparison of the pharmacokinetics and pharmacodynamics of ASA after ingestion of intact and chewed nonenteric-coated buffered ASA tablet (NBA) and enteric-coated ASA tablet (ECA) in a quadruple crossover study in healthy volunteers. Chewing ECA accelerated tmax of ASA absorption, which became equivalent to that after ingestion of intact or chewed NBA. A significant decrease in serum thromboxane B2 was observed 20 min after ingestion of chewed ECA, or intact or chewed NBA, and inhibition of platelet aggregation was also observed within 20 min. Thus, chewing of the ECA appears to result in a similar timing of ASA action to that in the case of chewed or unchewed NBA. © 2011 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci Copyright © 2011 Wiley-Liss, Inc.
Sai et al. (Thu,) conducted a rct in Healthy volunteers. Chewed and unchewed low-dose acetylsalicylic acid (ASA) vs. Intact vs chewed nonenteric-coated buffered ASA (NBA) and enteric-coated ASA (ECA) was evaluated on Pharmacokinetics (tmax) and pharmacodynamics (serum thromboxane B2 and platelet aggregation). Chewing enteric-coated acetylsalicylic acid accelerated absorption and significantly decreased serum thromboxane B2 and platelet aggregation within 20 minutes, equivalent to buffered ASA.