Effect of food on the absorption of enteric-coated aspirin: correlation with gastric residence time.

The Heidelberg capsule is an indigestible indicator of gastrointestinal pH, which was used to evaluate the relationship between gastric residence time (GRT) and variability in aspirin absorption from enteric-coated tablets. In a crossover study, eight healthy subjects (four men and four women) received an enteric-coated aspirin (648 mg) together with a Heidelberg capsule while fasting or with food (breakfast, followed 4 hours later by lunch). Salicylic acid and salicyluric acid concentrations in plasma and urine were measured by HPLC. The mean (+/- SD) GRT was significantly delayed by food (0.8 +/- 0.5 vs. 5.9 +/- 3.3 hours; P less than 0.005). The mean (+/- SD) lag time (TL) and time to peak concentration (expressed as salicylic acid equivalents) were markedly prolonged after the fed regimen (2.7 +/- 0.8 vs. 8.9 +/- 3.7 hours [P less than 0.005] and 8.3 +/- 2.9 vs. 13.8 +/- 4.5 hours [P less than 0.025]). For the combined data from the fasting and fed evaluations, an excellent correlation existed between TL and GRT of the capsule (TL = 1.0 GRT + 1.95; n = 16; r = 0.94; P less than 0.0001). Women demonstrated greater delays in GRT and TL than did men. The delay in aspirin absorption from an enteric-coated tablet is directly related to its GRT, which is gender related and greatly affected by food.