Gastric toxicity of antiplatelet therapy with low-dose aspirin

Low-dose aspirin is widely employed as antiplatelet therapy for cardiovascular disorders. However, even in the dosages usually employed for that purpose (75 to 325 mg daily), the drug maintains its ability to damage the gastric mucosa by inducing bleeding ulcers and/or erosions. Pharmacological protection is therefore necessary. Specific long term studies with histamine H-2 receptor antagonists or sucralfate are lacking, but data from trials on the prevention of gastric damage by other nonsteroidal anti-inflammatory drugs (NSAIDs) are discouraging. Recent preliminary data suggest that misoprostol, in keeping with its ability to protect both gastric and duodenal mucosa from long term NSAID treatment, seems to be effective also against long term low-dose aspirin therapy in this setting.