Sodium salicylate Chlorpropamide

The blood glucose-lowering effects of chlorpropamide and sodium salicylate were found to be additive in 5 healthy subjects. A further study in 6 healthy subjects found that chlorpropamide 1(X) mg given with sodium salicylate 1.5 g lowered blood glucose levels by the same amount as either chlorpropamide 2(X) mg or sodium salicylate 3 g alone. ... 

Richardson T, Foster J, Mawer GE. Enhancement by sodium salicylate of tiie blood glucose lowering effect of chlorpropamide - drug interaction or summation of similar effects BrJ Clin Pharmacol (1986) 22, 43-48. 

Oral administration of bicarbonate may decrease the absorption of ketoconazole. Increased blood levels of quinidine, flecainide, or sympatiiomimetics may occur when these agents are administered with bicarbonate There is an increased risk of crystalluria when bicarbonate is administered with the fluoroquinolones. Fbssible decreased effects of lithium, methotrexate, chlorpropamide, salicylates, and tetracyclines may occur when these drag s are administered with sodium bicarbonate. Sodium bicarbonate is not administered within 2 hours of enteric-coated drugs the protective enteric coating may disintegrate before the drug reaches the intestine. 

Urine alkalinization is a treatment modality that increases elimination of poisons by the intravenous administration of sodium bicarbonate to produce urine with a pH of more than or equal to 7.5 and must be supported by high urine flow. This technique might be useful for the elimination of drugs with an acid pKa such as salicylates (but not recommended for phenobarbital intoxication for which multiple-dose activated charcoal is better), chlorpropamide, 2,4-dichlorophenoyacetic acid, diflunisal, fluoride, mecoprop, methotrexate. Complications include severe alkalemia, hypokalemia, hypocalcemia and coronary vasoconstriction. 

---