Is there Evidence to Support the use of Enteric Coated (EC) Aspirin to Reduce Gastrointestinal Side Effects in Patients with Cardiovascular Disease?

Yuet Wan, Medicines Information Pharmacist, London and South East Regional Medicines InformationSource London and South East Regional Medicines InformationPublished

The enteric coated (EC) formulation of aspirin was developed and marketed in an effort to reduce GI adverse effects associated with aspirin therapy. There are reports however, that EC does not significantly reduce the risk of GI bleeding when compared to standard formulations of aspirin. There is also speculation that enteric coating may reduce the anti-platelet effect of aspirin due to a reduction in bioavailability, thereby reducing its clinical efficacy in prevention of cardiovascular events. This Q&A reviews the evidence on the use of EC aspirin to prevent GI damage, and also the effect of the enteric coating on the anti-platelet effect of aspirin.