by Sarah Millman

Created on: August 27, 2011   Last Updated: August 29, 2011

The word “enteric”, means relating to the small intestine. An enteric coating is a coating designed to protect a medication from being broken down in the stomach. These coatings are sometimes called “gastro-resistant” coatings, as they “resist” being broken down by the acids in the stomach. When the medication passes from the stomach into the small intestine where it is much less acidic, this change in acidity is the trigger that allows the enteric coating to break down; allowing for the absorption of the medication into the body.

There are some good reasons why it may not be desirable to have a medication being broken down in the stomach.

1. Some medications cause irritation to the stomach

A classic example of this is the non-steroidal anti-inflammatory drugs (NSAIDs). This class of drugs includes medications such as aspirin, naproxen, diclofenac to name a few. These drugs can cause irritation to the stomach which can cause symptoms such as nausea, vomiting, indigestion and reflux. Therefore, certain brands of these products are enteric coated, to prevent the breakdown of the tablets in the stomach which reduces the likelihood of the user experiencing these unpleasant side effects.

2. Some medications are destroyed by stomach acid

An example of this are a class of medications called the proton pump inhibitors (PPIs). These medications are used to treat stomach ulcers, reflux and heartburn.  An example from this class is a drug called omeprazole (Prilosec, Losec). Without an enteric coating, this drug gets easily destroyed by stomach acid, before it gets to where it is needed. With an enteric coating, the tablet remains in tact whilst in the stomach, and is readily broken down in the small intestine, allowing the drug to be absorbed effectively and get to where it is needed.

3. Depending on their purpose, some medications may require delayed release in the intestines

When a tablet starts breaking down in the stomach, this means absorption will start to occur quickly after taking a dose, which is important if a rapid effect is needed. For example, sulfasalazine is a drug used in rheumatoid arthritis for its anti-inflammatory properties, so a rapid effect is preferred. However, sulfasalazine is also used in Crohn’s disease, an inflammatory condition of the large intestine. In this case, it is preferred that the drug be released at the site of inflammation in the intestines. Therefore an enteric coated product is needed to prevent the product being broken down in the stomach, otherwise the drug won’t get to where it is needed.

Swallow whole, do not crush or chew

If you see this written on your medication label, there is a reason for it! For enteric coated products, the coating needs to remain in tact otherwise the product will not work effectively. If you have swallowing difficulties, let your doctor know as there is no point being prescribed a medication that has an enteric coating that you cannot crush or chew.

For more information on pill coatings, visit Swallowing Difficulties – Different Coatings.

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