Dose effects of aspirin on gastric prostaglandins and stomach mucosal injury

Ann Intern Med. 1994 Feb 1;120(3):184-9. doi: 10.7326/0003-4819-120-3-199402010-00002.


Objective: To determine if a dose of aspirin exists that might inhibit thromboxane-dependent platelet function without causing gastric mucosal injury, we studied the effects of a wide range of doses of aspirin (3 mg/d to 2600 mg/d) on gastric juice prostaglandins (PGE2 and PGF2 alpha), on serum thromboxane B2, and on stomach mucosal injury as reflected by gastric juice hemoglobin and DNA concentrations.

Design: A randomized, placebo-controlled study.

Setting: Research laboratory at a Veterans Affairs medical center.

Participants: 16 healthy volunteers (5 men and 11 women).

Intervention: In the first part of the study, volunteers received placebo; aspirin, 324 mg/d; 1300 mg/d; or 2600 mg/d for 2 days. In the second part, volunteers received placebo; aspirin, 3 mg/d; 10 mg/d; 30 mg/d; or 81 mg/d for 8 days.

Measurements: Gastric juice PGE2 and PGF2 alpha, hemoglobin and DNA concentrations; gastric juice volume and acidity; and serum salicylate and thromboxane B2 concentrations.

Results: In the first part, significant and similar (approximately 50%) inhibition of gastric juice prostaglandin output was observed with daily aspirin doses of 324 to 2600 mg. However, a significant increase in gastric juice hemoglobin output occurred only with 2600 mg/d. In the second part, significant inhibition (approximately 50%) of gastric PGE2 output was noted at a daily aspirin dose of 30 mg. Lower aspirin doses did not reduce PGE2 output significantly, although these doses did significantly reduce serum thromboxane B2 in a dose-related manner.

Conclusions: Aspirin can significantly reduce serum thromboxane B2 at doses of 3 mg/d or 10 mg/d, which are significantly below the threshold dose for significant gastric prostaglandin inhibition and acute stomach mucosal injury.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aspirin / adverse effects*
  • Aspirin / blood
  • DNA / drug effects
  • Dinoprost / metabolism
  • Dinoprostone / metabolism
  • Dose-Response Relationship, Drug
  • Female
  • Gastric Acidity Determination
  • Gastric Juice / metabolism
  • Gastric Mucosa / drug effects*
  • Gastric Mucosa / pathology
  • Hemoglobins / drug effects
  • Humans
  • Male
  • Middle Aged
  • Prostaglandins / metabolism*
  • Reference Values
  • Thromboxane B2 / blood


  • Hemoglobins
  • Prostaglandins
  • Thromboxane B2
  • DNA
  • Dinoprost
  • Dinoprostone
  • Aspirin