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What are enteric-coated tablets?

Medically reviewed by Sally Chao, MD. Last updated on March 15, 2022.

Official answer

by Drugs.com

Enteric coated tablets are tablets that are coated with an enteric coating. Enteric coatings are polymers that are put on certain tablets to prevent them from dissolving in acid. Your stomach is very acidic, and some drugs need to be protected from the acid in your stomach in order to work properly in your body.

To understand how enteric coatings work, it is helpful to understand the pH scale. The pH scale is a tool that measures how acidic something is. It ranges from 0 to 14. Items with a pH of 0 are the most acidic, while items with a pH of 14 are the most basic. For reference, water has a pH of 7 and is considered to be neutral (neither acidic nor basic). The stomach is very acidic and has a pH around 1. The small intestine has a pH around 6.6, which is more basic, or alkaline, than the stomach.

An enteric coating stabilizes tablets

An enteric coating allows tablets to survive intact as they pass through the acidic stomach. They then dissolve in the less acidic small intestine to be absorbed.

Some examples of drugs that need to be protected from stomach acid include:

Erythromycin

Erythromycin is an antibiotic and comes as a delayed-release capsule. The capsule contains enteric-coated pellets that pass from the stomach into the small intestine to be absorbed.

Pancrelipase

Pancrelipase is an enzyme that’s given to help digestion when the pancreas isn’t working properly. It’s a delayed-release capsule containing enteric-coated spheres. This coating protects the inside of the mouth and throat from irritation and allows the medication to reach the small intestine. Brand name pancrelipase products include:

Proton pump inhibitors

Proton pump inhibitors (PPIs) are used to treat gastroesophageal reflux disease (GERD). Enteric-coated products include:

Protonix and Aciphex are enteric-coated tablets. Prilosec, Nexium and Prevacid contain enteric-coated sprinkles inside the delayed-release capsule.

Entocort EC

Entocort EC is a capsule used to treat Crohn’s disease, which causes inflammation in the small intestine. The capsule is filled with enteric-coated granules that dissolve at a pH greater than 5.5. This allows the medicine to reach the small intestine where it can dissolve and reduce swelling.

An enteric coating reduces side effects

Enteric coatings may also be used to protect the stomach lining from side effects such as irritation, nausea and bleeding. Drugs that can irritate the stomach lining include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). Enteric-coated versions of these include:

  • Ecotrin (aspirin)
  • Arthrotec (diclofenac sodium and misoprostol)
  • Azulfidine EN-tabs (sulfasalazine)
  • Alophen (bisacodyl)

Myfortic (mycophenolic acid) is prescribed to prevent organ rejection after kidney transplants. It’s an enteric-coated version of the drug Cellcept (mycophenolate mofetil). Myfortic was developed to decrease the gastrointestinal side effects of Cellcept.

Warning

Enteric-coated products should not be dissolved, cut in half, chewed or crushed prior to consumption. Damaging the coating allows the medicine to be dissolved by acid in the stomach.

References
  1. U.S. Food and Drug Administration (FDA). Naprosyn (naproxen) tablets, EC-Naprosyn (naproxen delayed-release tablets), Anaprox DS (naproxen sodium tablets), for oral use. April 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/017581s115,018164s065,020067s024lbl.pdf. [Accessed January 27, 2022].
  2. U.S. Geological Survey. Ph scale. Available at: https://www.usgs.gov/media/images/ph-scale. [Accessed January 31, 2022].
  3. Hsu M, Safadi AO, Lui F. Physiology, Stomach. [Updated 2021 Jul 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535425/.
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  5. U.S. National Library of Medicine DailyMed. Ecotrin-aspirin tablet, coated. July 16, 2012. Available at: https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=f950d4eb-39b9-4ef7-b5f3-0cf45d4d6bc0&type=pdf. [Accessed January 27, 2022].
  6. U.S. Food and Drug Administration (FDA). Arthrotec (diclofenac sodium and misoprostol delayed-release tablets), for oral use. August 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020607s039lbl.pdf. [Accessed January 27, 2022].
  7. U.S. Food and Drug Administration (FDA). Azulfidine EN-tabs (sulfasalazine delayed release tablets, USP. November 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/007073s130lbl.pdf. [Accessed January 27, 2022].
  8. U.S. Food and Drug Administration (FDA). Erythromycin Delayed-Release Capsules USP. April 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/050536s026lbl.pdf. [Accessed January 27, 2022].
  9. U.S. Food and Drug Administration (FDA). Creon (pancrelipase) Capsules, Delayed Release for Oral Use. 2009. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020725s000lbl.pdf. [Accessed January 27, 2022].
  10. Norman A, Hawkey CJ. What you need to know when you prescribe a proton pump inhibitor.Frontline Gastroenterol. 2011;2(4):199-205. http://dx.doi.org/10.1136/flgastro-2011-100006.
  11. U.S. Food and Drug Administration (FDA). Protonix (pantoprazole sodium) delayed-release tablets. May 2012. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020987s045lbl.pdf. [Accessed January 27, 2022].
  12. U.S. Food and Drug Administration (FDA). Aciphex (rabeprazole sodium) delayed-release tablets, for oral use. June 2018. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020973s039lbl.pdf. [Accessed January 27, 2022].
  13. U.S. Food and Drug Administration (FDA). Prilosec (omeprazole) Delayed-Release Capsules. September 2012. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/019810s096lbl.pdf. [Accessed January 27, 2022].
  14. U.S. Food and Drug Administration (FDA). Nexium (esomeprazole magnesium) delayed-release capsules, for oral use. December 2014. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/022101s014021957s017021153s050lbl.pdf. [Accessed January 27, 2022].
  15. U.S. Food and Drug Administration (FDA). Prevacid (lansoprazole) Delayed-Release Capsules. September 2012. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020406s078-021428s025lbl.pdf. [Accessed January 27, 2022].
  16. U.S. National Library of Medicine DailyMed. Entocort EC (budesonide) Capsules. December 13, 2021. Available at: https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=24f0312f-f768-42db-bf7c-4ba2ee4fc309&type=pdf. [Accessed January 27, 2022].
  17. U.S. National Library of Medicine DailyMed. Alophen (bisacodyl tablet, coated). April 2021. Available at: https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=622fda65-cead-ae70-0f7d-b202d49192af&type=pdf. [Accessed January 27, 2022].
  18. U.S. National Library of Medicine DailyMed. Myfortic-mycophenolic acid tablet, delayed release. July 13, 2021. Available at: https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=eed26501-890d-4ff6-88e7-6dbea4726e53&type=pdf. [Accessed January 27, 2022].
  19. Salvadori M, Holzer H, de Mattos A, et al. Enteric-coated mycophenolate sodium is therapeutically equivalent to mycophenolate mofetil in de novo renal transplant patients.Am J Transplant. 2004;4(2):231-236. https://doi.org/10.1046/j.1600-6143.2003.00337.x.
  20. Institute for Safe Medication Practices. Oral Dosage Forms That Should Not Be Crushed. February 21, 2020. Available at: https://www.ismp.org/recommendations/do-not-crush. [Accessed January 27, 2022].

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