Coated v dispersible aspirin?

[Heartmum56]

Getting conflicting advice from GP and pharmacist. Have recently come off ticagrelor and wanting to come off lansaprazole too ( for malabsorption reasons). Suggested to GP I move to coated aspirin and drop lansaprazole and she said fine. Not sure how much she thought about it. On checking with pharmacist she said there is evidence that coated doesn't work as well for heart patients and said better to stick with dispersible and just make sure I take it on full stomach if stopping the lansaprazole. Anyone any thoughts or experience of this?

[Happyrosie]

my husband was told to have enteric coated aspirin, and that dispersible was not the same.

[Heartmum56 in reply to Happyrosie]

So the opposite of what my pharmacist said?

[Happyrosie in reply to Heartmum56]

I’m told: Enteric coated means that stomach acids don’t affect the aspirin until it’s gone further down the alimentary canal, so it doesn’t cause stomach problems. Dispersible just means that it’s been dispersed into water or the stomach contents straight away.

If this was your docs pharmacist, you could ask the dispensing pharmacy instead. If it was the dispensing pharmacy you could ask the pharmacist that’s attached to your doc’s group of surgeries.

Certainly I’d believe a pharmacist over a doctor as they are the experts.

Or that’s my view,

[annpavitt250448]

I came of disposable aspirin and Sent on to enteric coated as was having reflux problems. Have mild produce gastritis anyway so feel safer for stomach taking coated ones

[Lowerfield_no_more]

Apparently there is some medical evidence to suggest that coated aren't quite as good at their intended job as dispersible. But there isn't much in it. So try dispersible and if it gives you problems you have good reason to move to coated. But as someone who has had stomach bleeds caused by NSAIDs (which includes aspirin) that is the reason I take coated, and if my blood anti-platelet is down a notch or two so be it.

[Swim2fitness]

I was on coated and they got changed to dispersible. I prefer coated to dispersible so at my next appointment asked to change to coated. I even offered to pay as I wanted them. Dr said no worries they had only changed because dispensable were cheaper but as coated were only 20p more expensive for NHS Dr was happy for me to change back.

[JennyRx]

I’m a pharmacist. There IS evidence that dispersible aspirin is more effective than coated as an antiplatelet. But how more effective isn’t clear in terms of definitive outcomes in terms of reduction of events However I choose to have coated so I don’t have to take Omeprazole all the time. Omeprazole has links with osteoporosis and also disturbs the gut flora My choice. But it’s wise to carry aspirin dispersible 300mg with you as this is the first thing to take straight in the mouth if having a heart attack.

[Barre01 in reply to JennyRx]

I have carried 300mg dispersible for heart attacks for some years. Have used them twice in anger in that time - once on myself after call handler advised me to.

[Stentsandrun in reply to JennyRx]

Could I just ask, is it still worth taking the 300mg dispersible if you are on regular 75mg daily? Would they make much difference?

[JennyRx in reply to Stentsandrun]

If you have a heart attack, aspirin dispersible 300mg should be used even if you’re on 75mg daily. We’re in a whole different scenario by then.

[ChoochSiesta in reply to JennyRx]

I am guessing that 4 x 75mg if needed, would do the same job?

[JennyRx in reply to ChoochSiesta]

Well if you have time or the wherewithal to push out 4 tablets from its packaging when you’re having a heart attack I’d be surprised. It’s possible you might need 2x300mg. That’s eight tablets.

[Stentsandrun in reply to JennyRx]

I always take a few out with me, been told you can take 2. Might help someone else as well.

[GnomeHA in reply to JennyRx]

Presumably chewing coated aspirin would help get them into the system quicker, if they were the only available option. Just wondering, as I've never used dispersible before.I'll be buying a packet now though for emergencies !

[CyclingTime]

The dispersible gets absorbed in to your gut much better and more quickly, my doctor was clear it was by far the best for me

[phoebewhite]

I've always been on enteric coated Aspirin, it's what was prescribed right from the start.

[topbook]

Does this mean if you take the coated you can drop the Lansoprazole I'm taking that to protect the stomach whilst taking aspirin?

[JennyRx in reply to topbook]

It depends. E/c aspirin doesn’t affect the stomach in the same way. Discuss with GP.

[Richdirich]

I’ve had a burst stomach ulcer in 2022 and Im on pantoprazole 40mg which I take first thing. I’m also on Ticagrelor 90mg. I was advised by the hospital to chew my dispensable aspirin 75mg so it does sit on the stomach lining abd cause damage. I always carry aspirin 300mg with me in case of HA.

[Chris_Williams]

I'm on 75mg dispersible aspirin daily for life post-OHS. I always take it with food and have never had any stomach issues. I've had conflicting advice on my 15mg daily lansoprazole dose; pharmacist saying take it, senior reg on cardiac ward saying ok to stop. I'm keen to reduce to a minimum any drug, preferably stop completely if not absolutely needed, as virtually everything has a side-effect. If the negative side effects on the stomach of aspirin can be effectively mitigated by always taking it with food can I stop the lansoprazole? Seeing GP this week, but my faith in them is pretty low and I trust the pharmacist more as they have the specialist knowledge.

[Lowerfield_no_more in reply to Chris_Williams]

You won't really know how dropping lansoprazole will affect you so why not suggest to your GP that you stop taking it on a trial basis to see how you get on, perhaps with coated instead of dispersible. We are all different and so is our response to medication.

[Cruise1]

I dropped the dispersible and Lanzaprazole and now buy coated aspirin at my local supermarket.

[Traveldreams in reply to Cruise1]

Can I ask did you manage to get 75mg coated? I’m currently on dispersable and omeprazole and interested about alternatives.

[Cruise1 in reply to Traveldreams]

Yes got it from Morrisons. Home Bargains stock them too.

[Traveldreams in reply to Cruise1]

Thank you

[Drummer20]

I’m on disperseable aspirin to protect my new aortic valve.I didn’t want to take lanzoprazole after careful consideration.The cardiologist was ok with me not having the lanzoprazole.I’ve had no gastric problems at all.I take the disperseable aspirin after breakfast.

[Chris_Williams in reply to Drummer20]

It was explained to me as a reason for taking lansoprazole that gastric bleeds are often asymptomatic. However I'm with you, the list of side effects in the lansoprazole paperwork is enough to make me question it. I just wish there was a definitive answer, but it's clear from all these responses that there just isn't. Personal choice I suppose unless you have symptoms.

[Benfin4]

I had a similar situation.I was told they no longer advise prescribing coated aspirin and just take aspirin on a full stomach.I was offered lansoprazole .I've got my medication down to 3 pills from 12 and would like to keep it that way .Good luck getting meds sorted out .

[fishonabike]

this paper from last year indicates that both are equally effective: jamanetwork.com/journals/ja...

it also says: While it is not known what level of aspirin-induced platelet inhibition is needed to decrease cardiovascular events, this finding implies that enteric coating did not limit the effectiveness of aspirin in providing cardiovascular protection in this patient population.

Acid-reducing medications, such as proton pump inhibitors and histamine type 2 receptor antagonists, used to buffer aspirin within the stomach, have been shown to affect dissolution of the enteric formulations of aspirin by altering the pH, composition, and ionic strength in the stomach.

ie - taking a PPI with coated aspirin reduces how well it dissolves

[Harefieldfan]

I take enteric coated cause it’s easier. Can’t remember if I was having gastrointestinal problems with dispersable but enteric suits me. Good luck!

[Corriefan33]

I’ve been taking dispersible aspirin for over 5 years following my HA and HF. I also take Omeprazole. I’ve never been able to tolerate Aspirin but my doctor (who I really trust) says it’s by far the best option for me. I have to be really careful what I eat and drink otherwise I end up in agony. I really only drink water plus one weak cup of coffee a day although I abandon this when I’m in pain. I’ve had gastroscopy etc. to check I have no other issues. Despite all this I’m sticking with the aspirin as I respect the doctors advice that this is the most effective treatment for my heart.

[Qualipop]

I had to change to enteric coated after the soluble one gave me an ulcer. I was told it works slower but would offer the same protection. When I was in hospital they continued to give me enteric coated and made no comment about it. I can't take the "azoles" , I take famotidine instead but I wouldn't stop it even though the aspirin has been changed. I had to see the gP only yesterday about bad stomach pain. She doubled my famotidine but said there's nothing I take that should cause stomach problems. I take only simvastatin, famotidine, the coated aspirin ,oxycodone and laxido.

[Kazzie68]

I was told by my cardiology consultant that I should stick to the non-coated version as evidence indicated it was more effective. I don’t take a stomach protector but eat something before I take it. Seven years along and no problems to report stomach wise. I wish you well, take care x

[topbook in reply to Kazzie68]

Good to hear from someone who's been on a regime for a long time.

[polenta]

I take a coated aspirin at bed time and eat a little something before I take any of my medication, even if its just a few crackers. If you have been on the lazaprazole for a long time, you really should wean off of it slowly. I was told it could cause extra stomach acid and upset if stopped suddenly making you think you NEED it. If you look up PPIs it will also advice to wean off of them slowly.

[Smitty1956]

Hi, Heartmum56,

Enteric (coated) aspirin is much easier on your stomach (since it is meant to dissolve in your intestines rather than in your stomach). This can be important when low-dose aspirin is taken daily. So, when aspirin is taken as a possible preventative, or maintenance, drug daily, coated aspirin might prevent stomach bleeding and upset.

On the other hand, if you are experiencing some type of cardiac event, doctors/paramedics have suggested taking up to 350 mg. of fast-dissolving aspirin as soon as possible.

You might want to discuss the aspirin issue with your doctor before trying something different.

Best wishes! ❤️

[Heartmum56]

Thank you all for your replies. I think my conclusion is that I will try and stay on the dispersible if I can but take with plenty of food and still try and wean off the lansaprazole. That in itself sounds quite tricky but will start alternating my current 30mg with 15mg for a few weeks then 15 every other day for a bit and see how I get on. Have read some stuff where people literally open the capsules and take one extra granule out each day. Hoping it won't come to that!