Side Effects of aspirin and omeprazole: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Major research findings

Aspirin is commonly prescribed for secondary prevention of cardiovascular disease, but its optimal dosage and how to minimize side effects remain uncertain. 2 、 20 Aspirin can cause gastrointestinal side effects, especially in long-term users or patients with pre-existing gastrointestinal conditions. 14 、 22 Some studies suggest that combining aspirin with omeprazole, a proton pump inhibitor, might reduce gastrointestinal side effects. 22 、 20 However, there are concerns that combining aspirin and omeprazole may increase the risk of cardiovascular events. 4 However, more recent research does not support this concern. 18

Reasons for side effects

Aspirin can cause gastrointestinal side effects by inhibiting the production of prostaglandins, which protect the stomach lining. Aspirin can also increase stomach acid secretion, directly damaging the stomach lining. 3 Combining aspirin with omeprazole, which reduces stomach acid, may help to mitigate these side effects. 22

Common side effects

Digestive System

The most common side effects of aspirin are digestive problems. 14 、 22 、 These can include stomach pain, nausea, indigestion, stomach ulcers, peptic ulcers, and bleeding. 、 13 These side effects are more likely to occur with long-term use and in older individuals. 3 Combining aspirin with omeprazole may reduce these side effects. 22

Other side effects

Besides digestive issues, side effects such as tinnitus, hearing loss, headache, dizziness, and rash can occur, although these are relatively uncommon. 1

Countermeasures for side effects

Countermeasures for digestive side effects

To minimize gastrointestinal side effects, aspirin can be taken with food, or combined with stomach acid suppressants like omeprazole. 13 、 Aspirin use might also be stopped, or a lower dose of aspirin can be considered. PA32540, a combination drug with aspirin and omeprazole, has been developed and might offer a way to reduce gastrointestinal side effects while maintaining the secondary prevention benefits of aspirin. 22

Countermeasures for other side effects

If you experience tinnitus, hearing loss, headache, or other side effects, consult your doctor. 1 Depending on the situation, you may need to discontinue aspirin use or switch to a different medication.

Comparison of studies

Common points of research

Multiple studies agree that aspirin can cause gastrointestinal side effects. 2 、 14 、 22 、 Additionally, a few studies have suggested that using stomach acid suppressants such as omeprazole alongside aspirin might decrease these side effects. 22 、 20

Differences in research

Some studies have observed a potential increase in the risk of cardiovascular events when aspirin and omeprazole are combined. 4 However, more recent research has not supported this concern. 18 PA32540, a fixed-dose combination of aspirin and omeprazole, has been developed and shows promise in potentially reducing gastrointestinal side effects while maintaining the secondary prevention benefits of aspirin. 22

Caution in applying to real life

Aspirin is an effective medication for secondary prevention of cardiovascular disease. 20 However, it has the potential to cause gastrointestinal side effects. 14 It is crucial to discuss aspirin use with your doctor and understand the risks and benefits before taking it. If you have concerns about gastrointestinal side effects, you should discuss appropriate measures with your doctor, such as combining aspirin with a stomach acid suppressant or lowering the dose of aspirin. 22

Current research limitations

The long-term effects of combining aspirin and omeprazole are not fully understood. 4 Further research is needed to assess the effectiveness of PA32540, which combines aspirin and omeprazole. 22

Future research directions

Studies are necessary to evaluate the long-term effects of combining aspirin and omeprazole. 4 Clinical trials are also needed to determine the effectiveness and safety of PA32540, the fixed-dose combination of aspirin and omeprazole. 22

Conclusion

Aspirin is a valuable drug for secondary prevention of cardiovascular disease, but it can cause gastrointestinal side effects. 20 、 14 Consulting your doctor and understanding the risks and benefits of aspirin before taking it is essential. If you are concerned about gastrointestinal side effects, discuss with your doctor about appropriate measures, such as combining aspirin with a stomach acid suppressant or lowering the dose of aspirin. 22

Literature analysis of 24 papers
Positive Content
19
Neutral Content
3
Negative Content
2
Article Type
5
0
1
11
24
1.

Measurement of side effects of drugs.

Author: HuskissonE C, WojtulewskiJ A

Check list interference

Using a check list to collect side effects in a clinical trial may interfere with the reporting of known and unknown symptoms.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Anti-platelet effects of 100 mg alternate day oral aspirin: a randomized, double-blind, placebo-controlled trial of regular and enteric coated formulations in men and women.

Author: RidkerP M, HennekensC H, ToflerG H, LipinskaI, BuringJ E

Cardiovascular benefit
Reduced gastrointestinal symptoms

Further research is needed to determine the optimal dose of aspirin to produce a cardiovascular benefit while minimizing side effects, particularly in women.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Nonsteroidal antiinflammatory drugs and the gastrointestinal tract.

Author: HirschowitzB I

Analgesic
Anti-inflammatory
Antithrombotic
Esophagitis
Gastrointestinal bleeding
Peptic ulcer

This study discussed the risks and benefits of nonsteroidal antiinflammatory drugs (NSAIDs), particularly the potential for gastrointestinal side effects. The authors emphasized the importance of rational use and the need for effective preventive and treatment strategies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Esomeprazole and aspirin fixed combination for the prevention of cardiovascular events.

Author: SylvesterKatelyn W, ChengJudy Wm, MehraMandeep R

Reduced ulcer development
Gastrointestinal bleeding

Adding esomeprazole to low-dose aspirin therapy in patients at high risk of developing gastric ulcers significantly reduced their risk of ulcer development. The combination can be recommended for these patients, but not for those at lower risk.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Mechanisms of nonsteroidal anti-inflammatory drug-induced gastric damage. Actions of therapeutic agents.

Author: IveyK J

Reduced gastric damage
Gastric mucosal damage

NSAIDs, including aspirin, were found to cause gastric mucosal damage through various mechanisms, highlighting the importance of considering their potential gastrointestinal side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Upper gastrointestinal haemorrhage complicating antiplatelet treatment with aspirin and/or clopidogrel: where we are now?

Author: LiberopoulosEvangelos N, ElisafMoses S, TselepisAlexandros D, ArchimandritisAthanasios, KiskinisDimitris, CokkinosDennis, MikhailidisDimitri P

Antiplatelet therapy
Bleeding risk reduction
Bleeding complications

This review discusses the use of proton-pump inhibitors (PPIs) in patients receiving antiplatelet therapy. PPIs can reduce the risk of gastrointestinal bleeding, particularly in patients with a history of bleeding.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Double-blind trial of omeprazole and amoxicillin in the cure of Helicobacter pylori infection in gastric ulcer patients. The Ulcer Study Group, Germany.

Author: MeiningA, HöchterW, WeingartJ, SommerA, KlannH, SimonT, HuberF, BolleK H, HatzR, FischerG, LehnN, StolteM, BayerdörfferE

Omeprazole/amoxicillin effective
NSAIDs/ASA reduce efficacy

Omeprazole and amoxicillin effectively cured Helicobacter pylori infection in gastric ulcer patients not taking NSAIDs/aspirin. Efficacy was reduced in patients taking NSAIDs/aspirin.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

Nonsteroidal anti-inflammatory drug and phospholipid prodrugs: combination therapy with antisecretory agents in rats.

Author: LichtenbergerL M, UlloaC, RomeroJ J, VanousA L, IllichP A, DialE J

Improved therapeutic activity
Reduced GI side effects

Combination therapy of antisecretory agents and NSAIDs, chemically associated with phospholipids, has distinct advantages with regard to both low gastrointestinal toxicity and restored therapeutic activity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

14.

Inhibition of Aspirin-Induced Gastrointestinal Injury: Systematic Review and Network Meta-Analysis.

Author: ZhangWan-Tong, WangMiao-Ran, HuaGuo-Dong, LiQiu-Yan, WangXu-Jie, LangRui, WengWei-Liang, XueChun-Miao, ZhuBao-Chen

Aspirin-induced GI injury
Gastrointestinal injury

Omeprazole plus rebamipide was found to be the most effective treatment for aspirin-induced gastrointestinal injury compared to other treatments, including placebo, in a network meta-analysis of 10 randomized controlled trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Evaluation of the anti-ulcer activity of NR-ANX-C (a polyherbal formulation) in aspirin & pyloric ligature induced gastric ulcers in albino rats.

Author: NairVinod, ArjumanAlbina, GopalakrishnaH N, DorababuP, MirshadP V, BhargavanDivya, ChatterjiDipsanker

Anti-ulcer efficacy

A polyherbal formulation with potent antioxidant activity was found to be effective in treating gastric ulcers in rats.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Enteric-Coated Aspirin and the Risk of Gastrointestinal Side Effects: A Systematic Review.

Author: KedirHanan Muzeyin, SisayEskinder Ayalew, AbiyeAlfoalem Araba

Cardiovascular disease prevention
Gastrointestinal toxicity

Aspirin is commonly used to prevent cardiovascular disease, but it can cause gastrointestinal (GI) toxicity, ranging from mucosal damage to death.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Does concurrent use of clopidogrel and PPIs increase CV risk in patients with ACS?

Author: ShehataSandy, BakerJason, KelsbergGary, SafranekSarah

Cardiovascular events

Adding a proton pump inhibitor to antiplatelet medications does not increase the risk of cardiovascular events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

19.

Usefulness of PA32540 in Protecting the Gastric Layer While Providing Secondary Prevention for Coronary Artery Disease.

Author: KagolanuDeepthi, SayedyNajia, HaseebSyed, ShahShivani, LamPaul, MunnangiSwapna, ViswanathanPrakash, StephensonKent

Cardiovascular event prevention
Reduced GI bleeding

Aspirin is a common treatment for preventing heart attacks. However, it can cause stomach problems. PA32540 is a new combination pill that contains aspirin and omeprazole, which protects the stomach. This study looked at the safety and effectiveness of PA32540 in three different clinical trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

20.

PA32540 for the secondary prevention of cardiovascular disease in patients at risk for aspirin-associated gastric ulcers.

Author: DuffyDanielle, RooneyBridget, AdamsSuzanne, WhellanDavid J

Cardiovascular disease prevention
Bleeding
Gastrointestinal side effects

Aspirin is widely used to prevent cardiovascular disease but comes with risks of bleeding and gastrointestinal problems. A polypill containing aspirin and a proton pump inhibitor, PA32540, shows promising safety and efficacy in preliminary trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Omeprazole ameliorates aspirin-induced gastroduodenal injury.

Author: ScheimanJ M, BehlerE M, LoefflerK M, EltaG H

Reduced gastric injury
Gastroduodenal injury

Omeprazole effectively prevented gastroduodenal injury caused by aspirin in healthy volunteers. It significantly decreased aspirin-induced gastric mucosal injury and protected 85% of subjects from extensive erosions or ulceration. No subject taking omeprazole developed duodenal injury.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

22.

Yosprala: A Fixed Dose Combination of Aspirin and Omeprazole.

Author: VeltriKeith T

Aspirin adherence
Cardiovascular prevention
Gastrointestinal side effects

Yosprala, a fixed-dose combination of delayed-release aspirin and immediate-release omeprazole, offers a new therapeutic option for improving adherence to daily aspirin therapy in patients at risk of cardiovascular events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Aspirin chemoprevention of gastrointestinal cancer in the next decade. A review of the evidence.

Author: JankowskaHelena, HooperPatricia, JankowskiJanusz A

Cancer prevention
Gastric side effects

This review discusses the potential of aspirin as a chemopreventive agent for gastrointestinal cancers, highlighting its cost-effectiveness, safety, and efficacy in reducing cancer risk.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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