title: Aspirin absorption rates and platelet inhibition times with 325-mg buffered aspirin tablets (chewed or swallowed intact) and with buffered aspirin solution.
abstract: Large clinical trials such as the second International Study of Infarct Survival routinely gave patients with myocardial infarction a chewed aspirin, yet there are no data to show whether chewing of aspirin is better, or worse, than swallowing a whole tablet. We performed a randomized, placebo-controlled study to determine whether chewing aspirin or administering it in solution accelerates its absorption and antiplatelet activity. On separate days, 12 fasting volunteers ingested 325 mg of buffered aspirin, either by chewing a tablet for 30 seconds before swallowing it with 4 ounces of water, swallowing a whole tablet with 4 ounces of water, or drinking 4 ounces of Alka Seltzer. Frequent blood samples were obtained for serum aspirin, salicylate, and thromboxane B2 (TxB2) concentrations. With all formulations of aspirin, serum TxB2 decreased 50% when the plasma aspirin concentration reached approximately 1,000 ng/ml. A 50% and 90% decrease in serum TxB2 occurred more quickly after chewing a tablet than after a tablet was swallowed whole. For example, the t 50% for serum TxB2 inhibition was 5.0 +/- 0.6 minutes with the chewed tablet versus 12.0 +/- 2.3 minutes when the tablet was swallowed (p = 0.01). A 50% decrease in serum TxB2 occurred 7.6 +/- 1.2 minutes after Alka Seltzer solution (p = 0.04 vs chewing a tablet; p = 0.13 vs swallowing a whole tablet). Chewing an aspirin tablet is the most effective way of accelerating absorption of aspirin into the blood and shortening the time required for an antiplatelet effect.
authors.affiliation: Dallas Department of Veterans Affairs Medical Center and Department of Internal Medicine, University of Texas Southwestern Medical School, 75216, USA. mark.feldman@med.va.gov
authors.forename: M
authors.initials: M
authors.lastname: Feldman
authors.forename: B
authors.initials: B
authors.lastname: Cryer
mesh_terms: D000042:Absorption; D000284:Administration, Oral; D000328:Adult; D001241:Aspirin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002021:Buffers; D002851:Chromatography, High Pressure Liquid; D002951:Citrates / Q000008:administration & dosage; D018592:Cross-Over Studies; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000517:prevention & control; D004366:Nonprescription Drugs / Q000008:administration & dosage; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics*; D011446:Prospective Studies; D011863:Radioimmunoassay; D017693:Sodium Bicarbonate / Q000008:administration & dosage; D013929:Thromboxane B2 / Q000097:blood
chemical_list: D002021:Buffers; D002951:Citrates; D004338:Drug Combinations; D004366:Nonprescription Drugs; D010975:Platelet Aggregation Inhibitors; C002931:sodium acetylsalicylate, sodium bicarbonate, sodium citrate drug combination; D013929:Thromboxane B2; D017693:Sodium Bicarbonate; D001241:Aspirin