Plasma levels of acetylsalicylic acid and salicylic acid after oral ingestion of plain and buffered acetylsalicylic acid in relation to bleeding time and thrombocyte function.

Buffered acetylsalicylic acid (Alka Seltzer, B-ASA) and plain aspirin (P-ASA) tablets were compared as to their effects on bleeding time and platelet function in eight healthy male volunteers. Two doses (500 and 1000 mg) of each preparation were investigated in a cross-over design, each volunteer being his own control in each dose group (n=4). Both preparations disturbed platelet aggregation to the same extent. Bleeding time increased after both preparations, though significantly more after the buffered preparation than after plain acetylsalicylic acid, irrespective of the dosage. The 1000 mg dose prolonged bleeding time significantly more than the 500 mg dose, irrespective of the preparation. Kinetic analysis showed that B-ASA gave higher peak plasma levels of acetylsalicylic acid (ASA) and accordingly salicylic acid peak levels were also higher after the buffered preparation. It is concluded that B-ASA in equi-analgesic doses prolongs bleeding time more than the plain preparation. Since it is less agressive on the gastro-intestinal mucosa, its use may be advantageous in situations where acetylsalicylic acid induced loss of platelet aggregation is desired. However, the risk of prolonged bleeding--e.g. after tooth extractions--is probably higher after the buffered preparation.