Please check your internet connection and try again.
# Aspirin Enteric-Coated
## Overview
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) with analgesic, anti-inflammatory, and antipyretic properties. Enteric coating is designed to delay the release of aspirin until it reaches the small intestine, reducing gastric irritation.
## Primary Indications
* Pain relief (mild to moderate)
* Fever reduction
* Inflammation management
* Prevention of cardiovascular events (e.g., myocardial infarction, stroke) in certain patient populations.
## Adult Dosing
**Pain and Fever:**
* 325 mg to 650 mg orally every 4 to 6 hours as needed.
* Maximum dose: 4000 mg per day.
**Cardiovascular Prevention:**
* Dosing varies significantly based on indication (primary vs. secondary prevention). Common doses include 81 mg or 325 mg once daily. Consult specific guidelines for appropriate use.
## Pediatric Dosing
Aspirin is generally **not recommended** for children and teenagers due to the risk of Reye's syndrome, especially during viral illnesses like influenza or chickenpox.
## Dose Adjustments
* **Renal Impairment:** Use with caution. Dose adjustment may be necessary in severe renal impairment.
* **Hepatic Impairment:** Use with caution.
## Contraindications
* Hypersensitivity to aspirin, salicylates, NSAIDs, or any component of the formulation.
* History of aspirin-induced asthma, urticaria, or other allergic-type reactions.
* Active peptic ulceration or gastrointestinal bleeding.
* Children and teenagers with viral infections.
* Hemophilia and other bleeding disorders.
* Severe hepatic or renal insufficiency.
## Adverse Effects
* **Gastrointestinal:** Dyspepsia, heartburn, nausea, vomiting, abdominal pain, occult bleeding, peptic ulceration, perforation.
* **Hematologic:** Increased bleeding time, bruising, petechiae, epistaxis.
* **Hypersensitivity:** Bronchospasm, urticaria, angioedema.
* **Auditory:** Tinnitus, hearing loss (especially with higher doses).
* **Renal:** Renal insufficiency (especially in those with pre-existing renal disease).
* **Reye's Syndrome:** In children and adolescents with viral infections.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, heparin):** Increased risk of bleeding.
* **Other NSAIDs and Salicylates:** Increased risk of gastrointestinal bleeding and other adverse effects.
* **Corticosteroids:** Increased risk of gastrointestinal ulceration and bleeding.
* **Methotrexate:** Aspirin may increase methotrexate toxicity.
* **Antihypertensives (e.g., ACE inhibitors, ARBs, diuretics):** Aspirin may reduce their efficacy and increase risk of renal impairment.
* **Uricosuric agents (e.g., probenecid):** Aspirin can reduce the efficacy of uricosuric agents.
* **Alcohol:** Increased risk of gastrointestinal bleeding.
## Monitoring
* Signs and symptoms of bleeding (e.g., melena, hematemesis, bruising).
* Renal function (e.g., serum creatinine, BUN).
* Liver function (if indicated).
* Tinnitus or hearing changes (may indicate toxicity).
## Clinical Pearls
* Enteric-coated aspirin should not be crushed or chewed; it is designed to be swallowed whole to protect the stomach lining.
* For acute pain or fever, immediate-release aspirin formulations may be preferred for faster onset of action.
* Cardiovascular prevention dosing should be individualized based on risk assessment and patient history.
* Educate patients about the signs and symptoms of bleeding and to seek medical attention if they occur.
* Advise patients to avoid alcohol while taking aspirin to reduce the risk of GI bleeding.
***
*Disclaimer: This information is for educational purposes only and does not substitute for professional medical advice. Always consult the most current prescribing information and a qualified healthcare provider for any medication-related questions or before making any treatment decisions.*
