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Review
. 2025 Apr;398(4):3297-3320.
doi: 10.1007/s00210-024-03521-w. Epub 2024 Nov 15.

Review on recent advancements in understanding acetylsalicylic acid-induced gastrointestinal injury: mechanisms, medication, and dosage refinement

Jiahui Zhou  1   2   3   4 , Na Li  1   2   3   4 , Xinzhong Li  1   2   3   4 , Jingxue Ye  5   6   7   8 , Min Wang  9   10   11   12 , Guibo Sun  13   14   15   16
Affiliations
Review

Review on recent advancements in understanding acetylsalicylic acid-induced gastrointestinal injury: mechanisms, medication, and dosage refinement

Jiahui Zhou et al. Naunyn Schmiedebergs Arch Pharmacol. 2025 Apr.

Abstract

Acetylsalicylic acid (ASA) is a clinical drug with multiple effects, including prevention of cardiovascular adverse events and anti-cancer effects. However, gastrointestinal side effects, such as gastrointestinal ulcers and bleeding, limit the use of ASA and reduce patient compliance. Various studies have investigated the mechanisms of ASA-induced gastrointestinal injury, and many medicines have been reported to be effective in preventing and treating the adverse gastrointestinal effects of ASA. New formulations of ASA have demonstrated milder gastrointestinal injury than ASA alone. In this article, we summarized the mechanisms of ASA-induced gastrointestinal injury, drugs that resist gastrointestinal side effects of ASA, and progress in research on formulation improvement of ASA to help resolve the clinical dilemma of ASA usage.

Keywords: Acetylsalicylic acid; Formulation; Gastrointestinal injury; Mechanism.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

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