I have been suffering with mild heartburn from dispersible aspirin since I stopped taking lansoprazole.
Some on here suggested taking (over the counter) coated aspirin to protect the stomach but I was wondering if it protects the heart in the same way as non coated/dispersible aspirin does.
Can anyone advise if they take it please?
C
my husband is prescribed enteric coated aspirin. This means I think that the stomach doesn’t digest the aspirin, it gets digested lower down. This is to protect the stomach as he had an ulcer 25 years ago - but still takes an “azole” As far as I’m aware it’s otherwise exactly the same as ordinary aspirin or dispersible aspirin.
Interesting because my gp tells me that the NHS state that there is no known advantage to coated so they prescribe dispersible (because its cheaper presumably). I was told I'd need to but it over the counter and that GPs do not prescribe it.
Your GP is right, it is a myth. One undesirable effect aspirin has is in affecting the production of mucus that protects the lining of the stomach. It is that which means the stomach becomes irritable, rather than the salicylic acid in the aspirin, which is much weaker than the stomach's own acid.
So it makes no difference which you take?
In theory no. I wouldn't rule out other reasons as to why some might get on better with one type than another, but certainly a coated aspirin won't "protect the stomach" any better than a dispersible one.
GP’s do prescribe it.
Well mine doesn't and I was told by her that the NHS do not see the benefit. Just going on what I was told. Maybe they prescribe it for people with known stomach problems but not as a general rule if not.
GP changed Ralph from dispersable once he could swallow and didn't need to inject through a rig.
I buy the coated aspirin from Home Bargains for less than £1 so if they can sell it at that price NHS should get it cheap as surel it’s more expensive prescribing a prazole drug and dispersible aspirin (which can also be bought cheap OTC)
I changed to an enteric coated aspirin too. The GP said it would be okay. But I do keep the dispersible aspirin at home - just in case of an emergency where one would need a quick absorbing aspirin. They must not be taken if the use by date has gone by though.
I was also prescribed enteric coated aspirin from the beginning. (I'm also on a stomach protector -- famotidine -- but that was originally for a hiatus hernia which pre-dated my heart issues.)
Interesting because my gp tells me that the NHS state that there is no known advantage to coated so they prescribe dispersible (because its cheaper presumably). I was told I'd need to but it over the counter and that GPs do not prescribe it. Maybe its because you already had issues. Who knows.
Thank you
Could also be that the HSE uses different guidelines than the NHS for this (I'm in Ireland).
I was initially prescribed coated aspirin due to my gastro issues, then the NHS bean counters in my area decided they would save a few pence out of the £150billion NHS budget and I was moved without consultation to dispersible. So I asked to be put back on coated and they grudgingly did so. There is apparently some evidence that coated is not quite as good as the dispersible for the job intended, but there isn't much in it, and as far as I am concerned if that is the case, so be it, I'd rather that than struggle with increased gastro issues. But if the bruising I get when I brush up against anything, or cuts that won't stop bleeding is anything to go by, the coated is doing its job.
I want to avoid going back on lansoprazole (which will also cost them money) but if you that the coated aren't as effective then I will do so.
Let it fully dissolve slowly in the mouth as much as possible so absorption occurs via the buccal/oral route minimalizing contact with the stomach.
That said it gives me terrible heartburn behind my breastbone if I'm at all 'risky' with my diet, I can't eat crisps for example or enjoy a glass of white wine like I used to since starting dispersible aspirin and my PPI has a reduced effectiveness too so despite it being a seemingly small little tablet it does seem to be fairly potent.
I have just started taking dispersible Aspirin, together with Lansoprazole for arrhythmia. At the moment I am tolerating them ok, but wondered why you are no longer taking Lansoprazole. Please don’t answer if you would rather not, I would fully understand.
I had a stent fitted fifteen months ago due to congested arteries. I wad on clopidogrel and aspirin but stopped the clopidogrel after a year and they stopped the lansoprazole too as the pharmacist said it was usually that that caused the stomach problems, if at all.
Thank you for saying
When on a 150mg dose of aspirin I was told to take lanzoprozole. Ie.first 3 months after op. Lanzoprozole gave me severe stomach cramps followed by liquid diarrhea and a very tender stomach so I didn't feel like eating. Having that 4 x per week left me weak dizzy and depressed. As soon as the dose of aspirin was reduced I stopped the lanzoprozole and got my life back.
I'm on 75mg aspirin. I'm suffering from heartburn at night since stopping lansoprazole (when I dropped clopidogrel).
Not a very nice experience for you - glad it has been sorted
You need to understand what the drugs do first to know why you’re on them. The aspirin helps your blood be, in layman’s terms, a bit thinner, which is great if you’ve had cardiac issues. There are, however, downsides to it. The claim is that it burns your stomach, which is why you should take it with food. That isn’t entirely accurate. It contains a component that, with excessive use (taking it every day for the rest of your life is actually excessive) prevents your stomach from producing the lining that protects itself. So, you have these literal patches in your stomach lining.
They want you to keep taking it, though (for obvious reasons), so as a workaround to the pain caused by the stomach acid burning your now unprotected stomach, is simply to reduce your stomach acid by over 90% by giving you a PPI. Sounds great, and may provide some relief. You’re not completely resolving the issue, because you’re still taking aspirin, which still leaves areas in your stomach unprotected, but you’ve now got 90% less acid in your stomach, so it’s not as bad.
Except, it actually is, because your stomach NEEDS acid. Reducing it by 90% means the food you eat no longer properly digests, which means your small intestines have to do work they weren’t designed to do, or your body just expels it on the loo. Your body is also now unable to break down essential vitamins and minerals such as C, calcium, B12, because they require stomach acid. So, you get now also have severe malabsorption long term.
It’s why PPIs should only be for short term use, but doctors keep people on them for years.
I have taken a PPI for well over 15 years for reflux disease. I get no side effects, and my digestion system works as normal, and I get all the nutrients I need it seems, and lead a normal life. If I stopped the taking the PPI my life would be a misery and more importantly the risk of stomach acid attacking the lining of my oesophagus would be significantly increased. I already have Barretts Oesophagus from before I started PPIs so the next step would possibly be the dreaded c word.
As with anything, YMMV, obviously. I just explained what is actually happening when you take aspirin and PPIs together, and how I used that to make my own informed decision. My solution has been to take coated aspirin instead, so I bypass the stomach entirely, and no longer have the need for PPIs anyway.
In your case, however, the oesophagitis isn’t good, I would agree, so needs the additional reduction of acid.
My GP prescribes coated aspirin and lanzoprozole to protect my stomach.
The regular aspirin is what causes the holes in your stomach. The PPI reduces the stomach acid that eats away at those holes, causing the pain. Coated aspirin doesn’t cause the holes, because it passes straight through your stomach and breaks down in your intestines, so ask your GP why you’re still on the PPI.
I did ask if I could come off the PPI but he said, 'stay on it, to be on the safe side'. To be fair, the hospital said the same thing. PPI is required, no matter what type of aspirin you're taking.
Did you have any pain or discomfort? I think we’re put on a LOT of unnecessary medication “to be on the safe side”, but never told about the long term consequences.
Does anyone dissolve the aspirin in water before taking it? And would that solve the issue?
Always, that’s how they gave me the aspirin in hospital.
That's what we are talking about... I was given dispersible (others weren't) and I wanted to know what (if any) the difference is. I've heard that the non dispersible/coated is easier on the stomach.
Oops! I think I’d better start dissolving mine rather than just swallowing whole!
So glad I read this topic! May have saved myself a whole heap of future trouble.
I found out last week that I have been taking diabetes tablets the wrong way for years!!!
the makers think
Delayed Release for Specific Uses – In some cases, a slower release might be beneficial, although this is debated when it comes to cardiovascular protection.
While studies suggest that enteric coating doesn’t significantly reduce serious stomach problems (like ulcers) and may delay absorption, the coated versions remain popular due to these factors. If people believe they experience fewer stomach issues with enteric-coated aspirin, they are more likely to continue taking it, which is still a win for both patient adherence and the companies selling it.
Why did you stop taking Lansoprazole?
Hi I stopped Lansoprazole by firstly tapering off. I checked with my GP , coated Asprin is fine as long as it's 75mg. 🤗
I was prescribed dispersible aspirin before my double CABG 25 years ago but was soon diagnosed with stomach erosions not long afterwards and changed to enteric coated aspirin. Which I’ve been on ever since. I’ve had no issues with my GP not prescribing it. I’ve been on Lansoprazole for several years now because of gastric issues and all the other medications I’m on.
The study concerning effectiveness of coated aspirin in preventing gastric problems is: pmc.ncbi.nlm.nih.gov/articl...
And this article puts it into easier language: mcgill.ca/oss/article/medic....
The advice is to take it with food to protect the stomach - this has always worked for me, but I am not a clinical study!
My cardiologist recommended not taking the coated ones as not as effective, I just take my regular soluble aspirin after my breakfast rather than on an empty stomach, seven years in and no problems so far, good luck with your ongoing journey, take care x
I've replaced Lansoprazole with a teaspoon or so of Gaviscon Advance (prescribed), taken on demand. Nearly 5 months after CABG X3 and no problems so far.
I recently switched to coated after being on regular for 6 years. It was only after I did my own research and figured out why I kept getting erosive gastritis, despite being on PPIs, was because a component of the aspirin dissolving in my stomach prevented it from producing the lining that protects it. So, you end up with whole unprotected areas in your stomach, and when the acid comes…
I’d stopped taking PPIs I was on for erosive gastritis and duodenitis because of what they did to my digestive system (IBS, malabsorption, etc) after 3 years, but randomly found I had I couldn’t swallow last year. Went for an endoscopy, and they found erosion again. Weird that I had no pain anywhere. Anyway, they said I had to take PPIs again. Knowing the hell they put me through, I did more research and somehow discovered coated aspirin: great stuff, it breaks down in the low pH of your intestines, instead of making holes in your stomach!
I took the PPI for a few weeks to try and heal the erosion, but have been doing well so far with the coated aspirin - and have again stopped the PPIs. They’re terrible drugs!
My GP suggested the enteric coated aspirin because the soluble type crucified my stomach. He said it worked just a little slower but was fine. Been on it 3 years now - no problems.
I take prescription coated aspirin. Got fed up having to dissolve non-coated 75 mg. It won’t hurt your stomach and is easy to take.
Make sure to take the aspirin with food so that the acid won't add to the stomach acid and cause irritation to the stomach lining. I take coated "enteric" aspirin off the shelf alternating with the doc prescribed ASA. I had an ulcer 20 yrs ago.
It’s a valid concern. The primary reason dispersible (or chewable) aspirin is often recommended for heart protection is that it gets absorbed more quickly into the bloodstream, which can be beneficial in cases like acute heart attacks. However, for long-term prevention, enteric-coated aspirin is still effective at reducing clot formation, though it may take longer to absorb.
The key issue with coated aspirin is that its absorption is delayed until it reaches the small intestine, whereas dispersible aspirin acts more quickly. That said, many cardiologists still prescribe enteric-coated aspirin for patients prone to stomach irritation, as it helps reduce the risk of gastrointestinal side effects.
If the heartburn is a problem, switching to enteric-coated aspirin could be a good option, but you might want to check with your doctor to ensure it’s still providing the necessary cardiovascular benefits. Alternatively, you could take dispersible aspirin with food to help buffer its effects on your stomach.
I take 75mg coated aspirin and Pantoprazole taken 0ne hour before breakfast and I take the aspirin after breakfast.
Hi. I have been taking enteric coated 75mg aspirin for several years now as prescribed by the heart consultant. I was started on this when clopidogrel (anti- clotting medication) was stopped a year after I had two stents inserted. I was also prescribed Omeprazole (similar to Lansoprazole) to protect my stomach because daily aspirin (even the low 75 mg) can apparently cause gastrointestinal problems. I couldn’t tolerate the Omeprazole at first and tried other similar medications before deciding to just carry on with the aspirin without the Omeprazole. After long term use of the Aspirin, I have developed some gastro symptoms although the consultant feels that this is not caused by the aspirin. I have tecently tried taking the Omeprazole again on the advice of my consultant and this time, for some reason, I have been able to tolerate it and my gastro problems seem to be a lot less severe now. You didn’t say why you stopped taking the Lansoprazole but, if it’s because you were getting side effects, then you should ask your consultant or GP for alternatives like Omeprazole or Esomeprazole.
I wasn't getting side effects from lansoprazole but my gp stopped it after a year when I stopped taking Clopidogrel which they told me was why I needed it.
I think you should check with your consultant or, perhaps, email the British Heart Foundation (BHF) nurses for an opinion. I do know many heart patients who take aspirin and have also been prescribed Lansoprazole to help protect their stomach just because they take aspirin. Everyone is individual so there mat be a reason why you've not been prescribed it.
I was prescribed it. They just took me off it when my clopidogrel stopped. I was only on that for a year.
I take coated, but ALWAYS eat something when I take my meds and have been on low dose aspirin going on 10 years, WITHOUT taking any PPIs or stomach problems.
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