Low‐dose misoprostol for the prevention of low‐dose aspirin‐induced gastroduodenal injury

Introduction: The harmful effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the gastric mucosa and the prophylactic effects of misoprostol are both dose-dependent. Aim: To investigate whether a low-dose of misoprostol is sufficient to prevent gastric mucosal injury caused by low-dose aspirin. Methods: We conducted a double-blind placebo controlled parallel group endoscopic study in 32 evaluable volunteers. The main outcome measure was erosive injury (ulcers and superficial erosions) in the gastric mucosa over 28 days. Results: Most subjects developed erosions on aspirin 300 mg daily. This was significantly reduced by misoprostol 100 μg daily. (Odds ratio 0.18, 95% CI: 0.07–0.48). There were no drug-related or gastrointestinal adverse events in subjects receiving misoprostol. Conclusion: Misoprostol 100 μg daily can prevent low-dose aspirin induced gastric mucosal injury without causing identifiable adverse effects.