Aspirin Article

[Missy]

I read in a magazine that research has now determinned that the low dosage aspirin regimen is now not enough. Also the enteric aspirin. Doctors have been prescribing the low dosage thinking that was the right thing to do to prevent strokes. Now find out it is too low. The article said that one should take a full strength regular aspirin.
I take the 81 mg. enteric time released Bayer. I am kind of worrying about this.
Has anyone else heard or read anything about this?
Thanks

 

[Ross]

There seems to be all sorts of conflicting reports. At this time, I'm just as confused as you are. Hopefully someone can straighten this out for us.

 

[hensylee]

I was taking the 81mg enteric - for 3 yrs. Then I read the same report and increased to 350mg enteric. Might as well not take chances and, like you say, the article said it is thought to help prevent strokes, as well as help the heart.

 

[Missy]

I wonder how this works along with coumadin. Might throw it off for awhile. There are two different effects from the two, I think. So which is more important or would it even be significant?

 

[JimL]

www.warfarinfo.com/aspirin-platelets.htm

There are other articles as well.

 

[Lorraine]

I didn't read the article, but I've been on 325mg coated aspirins since I had my surgery along with my Coumadin. I just had to buy a new bottle yesterday and thought of switching to the 325mg Enteric but I didn't know if I could or should use that kind. My INR has been stable for the last month so I was kind of afraid to even switch brands

 

[Guest]

Ross said it right. There is no correct answer. Too many conflicting results.

You can buy uncoated - might dissolve in the mouth, coated - designed to dissolve in the stomach and enteric coated - designed to not dissolve until they are past the stomach.

The real problem with warfarin is not throwing off the INR, it is eroding the lining of the stomach and causing bleeding.

For those of you who can remember BM (before Motrin) people used to take 12 to 16 aspirins per day for pain. It was the only non-prescription pain reliever. (Tylenol was still prescription then.) This caused significant bleeding and remember that they also used to keep warfarin levels very high back then too. So there was lots of bleeding.

So -- uncoated and coated work fast - like for a headache. But enteric coated works slowly. Which one you take for the action on platelets probably doesn't matter very much because you take one every day. Enteric coated might be better but nobody knows because no studies were ever done. Nobody ever will either because aspirin is cheap and there is little money to be made on it. This isn't what it was originally designed to do - it was invented to dissolve slowly and provide morning (taking it at bedtime) coverage for arthritics who were stiff when they got up.

One 325 mg tablet per day is unlikely to cause much bleeding, so it is probably OK to take that.

 

[Ross]

Aspirin?s anti-clotting effect doesn?t work in some cases
Tuesday, May 6, 2003 By CAROLYN SUSMAN Cox News Service

Millions of Americans rely on an aspirin a day to help keep heart attacks and strokes away. But a new study in the Journal of the American College of Cardiology shows that some people are resistant to the drug?s anti-clotting effect, and they may have a threefold higher risk of death, heart attack or stroke.

?Probably there has been no medicine that has had a greater impact in our field than aspirin, but we took for granted that it worked in everyone,? said Dr. Eric Topol of the Cleveland Clinic Foundation.

?We have to increasingly appreciate that aspirin resistance is real and not turn our backs on it,? he said. ?And we need to hunt this thing down: the cause, the specific ways to more rapidly screen for it, find its genetic basis ? which is only a theory at the moment ? and protect these patients. They are taking aspirin, but they are not deriving benefit from it. So there are a lot of people out there who have the illusion of being protected by aspirin.?

The researchers enrolled 326 patients between January 1997 and September 1999 who had a history of cardiovascular disease but were stable at the time they joined the study. Based on blood tests performed after each patient had been taking 325 mg of aspirin for at least a week, 17 patients (5.2 percent) were found to be resistant to the anti-clotting effect of aspirin. (Typical aspirin therapy uses 81 mg or 162 mg of aspirin daily.)

During an average follow-up period of almost two years, aspirin-resistant patients were more than three times as likely to die or suffer a heart attack or stroke.

If aspirin resistance is related to a genetic mutation, an inexpensive genetic screening test might be possible, but first researchers would need to find the right gene.

 

[Marty]

Aspirin resistant?

Aspirin resistant?

Ross, I have not read the original paper but your post states that 5.2% of the subjects were "aspirin resistant". This implies that 95% had a good effect on the platelets at low dose. Not bad odds. Having said this , I do not think 325 mgm is very dangerous. I have been peering into stomachs for many years and have never found any ulcers at this dose. As Al said, people used to munch 12, 16, and up full strength aspirin tablets a day and I used to see a lot of ulcers in those folks.