Drug Information

Drug (ID: DG00548) and It's Reported Resistant Information

• Name: Aspirin
• Synonyms: Aspirin; ACETYLSALICYLIC ACID; 50-78-2; 2-Acetoxybenzoic acid; 2-(Acetyloxy)benzoic acid; O-Acetylsalicylic acid; Acetylsalicylate; o-Acetoxybenzoic acid; Acylpyrin; Easprin; Ecotrin; Acenterine; Acetophen; Polopiryna; Acetosal; Colfarit; Salicylic acid acetate; o-Carboxyphenyl acetate; Enterosarein; Aceticyl; Acetonyl; Acetosalin; Acetylin; Aspergum; Aspirdrops; Benaspir; Micristin; Pharmacin; Premaspin; Salcetogen; Temperal; Ecolen; Empirin; Endydol; Rhodine; Saletin; Rheumintabletten; Solprin acid; Acidum acetylsalicylicum; Benzoic acid, 2-(acetyloxy)-; Acetisal; Acetylsal; Aspirine; Bialpirina; Bialpirinia; Claradin; Clariprin; Entericin; Enterophen; Enterosarine; Globentyl; Measurin; Neuronika; Salacetin; Solpyron; Acesal; Acisal; Asagran; Asteric; Cemirit; Decaten; Duramax; Extren; Globoid; Helicon; Idragin; Levius; Pirseal; Rhonal; Solfrin; Adiro; Aspec; Aspro; Novid; Yasta; Acetosalic acid; 2-acetyloxybenzoic acid; Triple-sal; Spira-Dine; ZORprin; Bi-prin; Acetilum acidulatum; Acimetten; Delgesic; Entrophen; Persistin; 2-Carboxyphenyl acetate; Acetilsalicilico; Dolean pH 8; A.S.A. empirin; XAXA; Acido acetilsalicilico; Contrheuma retard; Acide acetylsalicylique; Endosprin; Kapsazal; Bayer; ASA; Acetylsalicylsaure; aspirin (acetylsalicylic acid); Solprin; Triaminicin; Asatard; Tasprin; Nu-seals aspirin; Salicylic acid, acetate; Acido O-acetil-benzoico; Kyselina acetylsalicylova; 2-Acetoxybenzenecarboxylic acid; St. Joseph Aspirin for Adults; A.S.A.; St. Joseph; Kyselina 2-acetoxybenzoova; SP 189; Acetard; AC 5230; Acetylsalicylsaeure; Azetylsalizylsaeure; S-211; UNII-R16CO5Y76E; ECM; CHEBI:15365; 2-(acetyloxy)benzoate; o-(Acetyloxy)benzoic acid; acide 2-(acetyloxy)benzoique; R16CO5Y76E; Aspirin form II; component of Midol; NSC27223; component of Synirin; MFCD00002430; NSC-27223; 8-hour Bayer; component of Zactirin; NSC-406186; component of Coricidin; component of Persistin; component of Robaxisal; o-Acetoxybenzoate; NCGC00015067-04; o-acetyl-salicylic acid; Acetysal; Istopirin; Magnecyl; Medisyl; Polopirin; Ronal; Bayer Buffered; DSSTox_CID_108; Aspro Clear; component of Ascodeen-30; Bayer Plus; WLN: QVR BOV1; Rheumin tabletten; AcetylsalicylicAcid; DSSTox_RID_75372; DSSTox_GSID_20108; Aspirina 03; Acetylsalycilic acid; acetyl salicylic acid; component of Darvon with A.S.A; Bayer Aspirin 8 Hour; Asaphen; Aspalon; Durlaza; Asprin; Bayer Children's Aspirin; Nu-seals; component of St. Joseph Cold Tablets; Aspir-Mox; Durlaza ER; Acetylsalicylsaure [German]; CAS-50-78-2; Acetoxybenzoic acid; Acetysalicylic acid; 11126-35-5; 1173022-25-7; AIN; SMR000059138; Ascoden-30; Benzoicacid, 2-(acetyloxy)-; Acetylsalicyclic acid; CCRIS 3243; HSDB 652; Acide acetylsalicylique [French]; Acido acetilsalicilico [Italian]; Kyselina acetylsalicylova [Czech]; Acido O-acetil-benzoico [Italian]; SR-01000075668; Kyselina 2-acetoxybenzoova [Czech]; Bayer Extra Strength Aspirin for Migraine Pain; EINECS 200-064-1; NSC 27223; Aspirin [USP:BAN:JAN]; Bayer Enteric 325 mg Regular Strength; BRN 0779271; Bay E4465; Aspropharm; Bayer Enteric 81 mg Adult Low Strength; Cardioaspirin; Cardioaspirina; Acetyonyl; Asacard; Ascolong; Bayer Enteric 500 mg Arthritis Strength; Colsprin; Miniasal; Salospir; Acesan; Toldex; AI3-02956; acetyl salicylate; 1oxr; 2-Acetoxybenzoate; 99512-66-0; Aspirin,(S); Aspalon (JAN); Durlaza (TN); Easprin (TN); acetyl-salicylic acid; Aspirin USP-26; acetyl salicyclic acid; o-(Acetyloxy)benzoate; Percodan (Salt/Mix); Ascriptin (Salt/Mix); Micrainin (Salt/Mix); 2-acetoxy benzoic acid; Acetylsalicylicum acidum; Spectrum_001245; 2-Acetylsalicyclic acid; Salicylic acid, acetyl-; CHEMBL25; Spectrum2_001899; Spectrum3_001295; Spectrum4_000099; Spectrum5_000740; Aspirin (JP17/USP); Lopac-A-5376; Salycylacetylsalicylic acid; benzoic acid, 2-acetoxy-; Epitope ID:114151; Percodan Demi (Salt/Mix); Soma Compound (Salt/Mix); ZINC53; EC 200-064-1; Acetylsalicylic acid, 99%; Aspirin USP (3080); cid_2244; Pravigard PAC (Salt/Mix); SCHEMBL1353; 2-(Acetyloxy)-benzoic acid; Aspirin USP (2080B); Bay-e-4465; Acetylsalicylic acid-[13C]; Lopac0_000038; KBioGR_000398; KBioGR_002271; KBioSS_001725; KBioSS_002272; 4-10-00-00138 (Beilstein Handbook Reference); MLS001055329; MLS001066332; MLS001336045; MLS001336046; Acetylsalicylic acid (who-ip); BIDD:GT0118; DivK1c_000555; SPECTRUM1500130; SPBio_001838; Acetylsalicylic acid, >=99%; GTPL4139; (non-d)Acetylsalicylic Acid-d3; O-Acetylsalicylic acid; Aspirin; DTXSID5020108; Acetylsalicylic acid-carboxy-14c; BDBM22360; HMS501L17; KBio1_000555; KBio2_001725; KBio2_002271; KBio2_004293; KBio2_004839; KBio2_006861; KBio2_007407; KBio3_002149; KBio3_002751; Empirin with Codeine (Salt/Mix); Acetylsalicylic acid, >=99.0%; cMAP_000006; component of Zactirin (Salt/Mix); NINDS_000555; HMS1920E13; HMS2090G03; HMS2091K13; HMS2233L18; HMS3260G17; HMS3372N15; HMS3656N14; HMS3715P19; HMS3866L03; HMS3885G03; Pharmakon1600-01500130; BCP21790; STR01551; ACETYLSALICYLIC ACID; ASPIRIN; Tox21_110076; Tox21_202117; Tox21_300146; Tox21_500038; CCG-39490; NSC406186; NSC755899; s3017; STL137674; AKOS000118884; component of Ascodeen-30 (Salt/Mix); Tox21_110076_1; BAY1019036; CS-2001; DB00945; LP00038; MCULE-3199019536; NSC-755899; PL-2200; SDCCGSBI-0050027.P005; BAY-1019036; IDI1_000555; Acetylsalicylic acid, analytical standard; NCGC00015067-01; NCGC00015067-02; NCGC00015067-03; NCGC00015067-05; NCGC00015067-06; NCGC00015067-07; NCGC00015067-08; NCGC00015067-09; NCGC00015067-10; NCGC00015067-11; NCGC00015067-12; NCGC00015067-13; NCGC00015067-14; NCGC00015067-24; NCGC00015067-26; NCGC00090977-01; NCGC00090977-02; NCGC00090977-03; NCGC00090977-04; NCGC00090977-05; NCGC00090977-06; NCGC00090977-07; NCGC00254034-01; NCGC00259666-01; NCGC00260723-01; Aspirin, meets USP testing specifications; H740; HY-14654; NCI60_002222; SBI-0050027.P004; DS-017139; UNM-0000306102; component of Darvon with A.S.A (Salt/Mix); EU-0100038; FT-0655181; FT-0661360; SW199665-2; A 5376; Acetylsalicylic Acid 1.0 mg/ml in Acetonitrile; C01405; D00109; Q18216; AB00051918-08; AB00051918_09; AB00051918_10; Arthritis Pain Formula Maximum Strength (Salt/Mix); SR-01000075668-1; SR-01000075668-4; SR-01000075668-6; Acetylsalicylic acid, Vetec(TM) reagent grade, >=99%; Aspirin, British Pharmacopoeia (BP) Reference Standard; F2191-0068; Z234893989; Aspirin, United States Pharmacopeia (USP) Reference Standard; D41527A7-A9EB-472D-A7FC-312821130549; Acetylsalicylic acid, European Pharmacopoeia (EP) Reference Standard; Acetylsalicylic acid, BioReagent, plant cell culture tested, >=99.0%; Acetylsalicylic acid for peak identification, European Pharmacopoeia (EP) Reference Standard; Aspirin (Acetyl Salicylic Acid), Pharmaceutical Secondary Standard; Certified Reference Material
• Indication:
  In total 3 Indication(s)
  Cardiovascular disease [ICD-11: BA00-BE2Z]; Approved; [1]
  Myocardial infarction [ICD-11: BA41]; Approved; [1]
  Pain [ICD-11: MG30]; Approved; [1]
• Drug Resistance Disease(s):
  Disease(s) with Clinically Reported Resistance for This Drug (5 diseases)
  Cerebral ischaemic stroke [ICD-11: 8B11]; [2]
  Dysmenorrhea [ICD-11: GA34]; [3]
  Heart failure [ICD-11: BD10]; [4]
  Myocardial infarction [ICD-11: BA41]; [5]
  Peripheral arterial disease [ICD-11: BD4Z]; [6]
• Target: HMG-CoA reductase (HMGCR); HMDH_HUMAN; [4]
• Target: Prostaglandin G/H synthase (COX); PGH1_HUMAN PGH2_HUMAN; [4]
• Formula: C9H8O4
• IsoSMILES: CC(=O)OC1=CC=CC=C1C(=O)O
• InChI: 1S/C9H8O4/c1-6(10)13-8-5-3-2-4-7(8)9(11)12/h2-5H,1H3,(H,11,12)
• InChIKey: BSYNRYMUTXBXSQ-UHFFFAOYSA-N
• PubChem CID: 2244
• ChEBI ID: CHEBI:15365
• TTD Drug ID: D0GY5Z
• VARIDT ID: DR00203
• INTEDE ID: DR1749
• DrugBank ID: DB00945

Type(s) of Resistant Mechanism of This Drug

  ADTT: Aberration of the Drug's Therapeutic Target

  IDUE: Irregularity in Drug Uptake and Drug Efflux

  UAPP: Unusual Activation of Pro-survival Pathway

Drug Resistance Data Categorized by Their Corresponding Diseases

ICD-11: Circulatory system diseases

Myocardial infarction [ICD-11: BA41]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Aberration of the Drug's Therapeutic Target (ADTT)

Key Molecule: Prostaglandin-endoperoxide synthase 1 (PTGS1) [1]

• Molecule Alteration: Missense mutation; p.C50T+p.A842G+p.A1676G
• Resistant Disease: Acute myocardial infarction [ICD-11: BA41.1]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: The following factors contribute to aspirin resistance: the COX-1 polymorphisms of C50T, -A842G, and A1676G; the COX-2 polymorphism of -765.

Heart failure [ICD-11: BD10]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Aberration of the Drug's Therapeutic Target (ADTT)

Key Molecule: Prostaglandin-endoperoxide synthase 1 (PTGS1) [4]

• Molecule Alteration: SNP; rs10306114
• Resistant Disease: Hypo-attenuated leaflet thickening [ICD-11: BD10.2]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: We thoroughly genotyped 34 SNPs and 8 SNPs that have been reported for clopidogrel and aspirin resistance. A total of 148 patients were enrolled. There were 15 patients demonstrating signs of HALT. Patients with HALT had a higher rate of atrial fibrillation (AF) pre-TAVR (33.3 vs. 7.5%, P = 0.01).

Key Molecule: Prostaglandin G/H synthase 2 (PTGS2) [4]

• Molecule Alteration: SNP; rs20417
• Resistant Disease: Hypo-attenuated leaflet thickening [ICD-11: BD10.2]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: We thoroughly genotyped 34 SNPs and 8 SNPs that have been reported for clopidogrel and aspirin resistance. A total of 148 patients were enrolled. There were 15 patients demonstrating signs of HALT. Patients with HALT had a higher rate of atrial fibrillation (AF) pre-TAVR (33.3 vs. 7.5%, P = 0.01).

Irregularity in Drug Uptake and Drug Efflux (IDUE)

Key Molecule: Multidrug resistance protein 1 (ABCB1) [4]

• Molecule Alteration: SNP; rs1045642
• Resistant Disease: Hypo-attenuated leaflet thickening [ICD-11: BD10.2]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: We thoroughly genotyped 34 SNPs and 8 SNPs that have been reported for clopidogrel and aspirin resistance. A total of 148 patients were enrolled. There were 15 patients demonstrating signs of HALT. Patients with HALT had a higher rate of atrial fibrillation (AF) pre-TAVR (33.3 vs. 7.5%, P = 0.01).

Unusual Activation of Pro-survival Pathway (UAPP)

Key Molecule: Thromboxane A2 receptor (TBXA2R) [4]

• Molecule Alteration: SNP; rs4523+rs1131882+rs768963+rs2238634+rs4806942
• Resistant Disease: Hypo-attenuated leaflet thickening [ICD-11: BD10.2]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: We thoroughly genotyped 34 SNPs and 8 SNPs that have been reported for clopidogrel and aspirin resistance. A total of 148 patients were enrolled. There were 15 patients demonstrating signs of HALT. Patients with HALT had a higher rate of atrial fibrillation (AF) pre-TAVR (33.3 vs. 7.5%, P = 0.01).

ICD-16: Genitourinary system diseases

Dysmenorrhea [ICD-11: GA34]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Aberration of the Drug's Therapeutic Target (ADTT)

Key Molecule: Prostaglandin G/H synthase 2 (PTGS2) [3]

• Molecule Alteration: SNP; rs20417
• Resistant Disease: Dysmenorrhea [ICD-11: GA34.3]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: Notably, rs20417 is a SNP in the promoter region of COX-2 associated with aspirin resistance. Further research is needed to determine if the identified SNP have a transcriptional effect contributing to NSAID-resistant dysmenorrhea.

Key Molecule: Prostaglandin-endoperoxide synthase 1 (PTGS1) [3]

• Molecule Alteration: SNP; rs10306114
• Resistant Disease: Dysmenorrhea [ICD-11: GA34.3]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: Genetic polymorphisms have been shown to disrupt COX-1 inhibition with aspirin. For example, Ulehlova et al demonstrated that COX-1 polymorphism rs10306114 was correlated with high platelet aggregation in aspirin-resistant individuals.

References

• Ref 1: Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI .Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221083674. doi: 10.1177/10760296221083674. 10.1177/10760296221083674
• Ref 2: Antiplatelet drug resistance is associated with early neurological deterioration in acute minor ischemic stroke in the Chinese population .J Neurol. 2016 Aug;263(8):1612-9. doi: 10.1007/s00415-016-8181-5. Epub 2016 Jun 3. 10.1007/s00415-016-8181-5
• Ref 3: Nonsteroidal antiinflammatory drug resistance in dysmenorrhea: epidemiology, causes, and treatment .Am J Obstet Gynecol. 2018 Apr;218(4):390-400. doi: 10.1016/j.ajog.2017.08.108. Epub 2017 Sep 6. 10.1016/j.ajog.2017.08.108
• Ref 4: Gene polymorphisms in dual antiplatelet therapy and the presence of hypo-attenuated leaflet thickening after transcatheter aortic valve replacement .J Thromb Thrombolysis. 2018 Apr;45(3):463-465. doi: 10.1007/s11239-018-1636-z. 10.1007/s11239-018-1636-z
• Ref 5: Drug resistance and pseudoresistance: an unintended consequence of enteric coating aspirin .Circulation. 2013 Jan 22;127(3):377-85. doi: 10.1161/CIRCULATIONAHA.112.117283. Epub 2012 Dec 4. 10.1161/CIRCULATIONAHA.112.117283
• Ref 6: Review of aspirin and clopidogrel resistance in peripheral arterial diseaseJ Vasc Surg. 2017 Nov;66(5):1576-1586. doi: 10.1016/j.jvs.2017.07.065.