Salicylates drug interactions

Although acid-base and electrolyte disturbances were not reported in the clinical trials, these disturbances have been reported with oral CA inhibitors and have, in some instances, resulted in drug interactions (eg, toxicity associated with high-dose salicylate therapy). 

Many drugs interact with folate to affect its absorption, antagonize its biochemical activity, or increase its loss from the body. These drugs include ethanol, phenytoin, and oral contraceptives. Salicylates can compete with foUc acid for plasma protein binding. Methotrexate, a cytotoxic agent, is a folate antagonist that inhibits the biosynthesis of this coenzyme. 

Multiple drug interactions, including alcohol and salicylates... 

Drug interactions NSAIDs Salicylates Sulfonamides Chloramphenicol Probenecid Coumarins MAO inhibitors Beta-blockers Thiazides and other diuretics Corticosteroids Phenothiazines Thyroid products Estrogens Oral contraceptives Phenytoin Nicotinic acid Sympathomimetic Calcium channel blockers Isoniazid Miconazole... 

Drug interactions May decrease antihypertensive effects of ACE inhibitors, angiotensin II antagonists. May decrease antihypertensive and diuretic effects of thiazide and loop diuretics May decrease absorption of vitamin B,2 Effects decreased by barbiturates, phenytoin, and rifampin decreases effect of salicylates and vaccines Decreases clearance of beta-lactams Risk for hypersensitivity increased in patients who are on thiazides or ACE inhibitors and allopurinol... 

Mention of salicylate overdose is made here, even though its popularity seems to be in decline. Its treatment, presuming hemodialysis is not indicated, includes a classic type of beneficial drug interaction that is different from that of a specific antidote (cf. A -acetylcysteine, above). Furthermore, the combination of respiratory alkalosis... 

Drug Interactions. Enzyme inducers, such as carbamazepine and phenytoin, increase tiagabine clearance and decrease the half-life. Food decreases the rate but not the extent of absorption. Tiagabine is displaced from protein by naproxen, salicylates, and valproate. However, tiagabine does not displace phenytoin, valproic acid, amitrypty-line, tolbutamide, or warfarin. ... 

Lau, A.H. Chang, C.W. Schlesinger, P.K. Evaluation of a potential drug interaction between sucralfate and aspirin. Clin.Pharmacol.Ther, 1986, 39, 151-155 [plasma pharmacokinetics extracted metabolites, salicylic acid, salicyluric acid a-phenylcinnamic acid (IS) gradient column temp 30] Mamolo, M.G. Vio, L. Maurich, V. Higb-pressure liquid chromatographic analysis of paracetamol, caffeine and acetylsalicylic acid in tablets. Salicylic acid quantitation. Farmaco.[Prat]., 1985, 40, 111— 123 [tablets simultaneous ac etcuninophen, caffeine, phenazone, salicylic acid]... 

Drug interactions mainly with first-generation drugs ->t hypoglycemia with cimetidine, insulin, salicylates, sulfonamides... 

Salicylates are highly bound to plasma protein albumin, with binding being concentration dependent. At low therapeutic concentrations of 100 pg/mL, approximately 90% of aspirin is plasma protein bound, whereas at higher concentrations of approximately 400 pg/mL, only 76% binding is observed. Plasma protein binding is a major factor in the drug interactions observed for salicylates. 

Lindquist B, Jensen KH Johansson H, Hansen T. Effect of concurrent administration of aspirin and indomediacin on serum concentrations. Clin Pharmacol Ther (1974) 15,247-52. Barraclough DRE, Muirden KD, Laby B. Salicylate therapy and drug interaction in rheumatoid arthritis. AustNZJMed 97S) 5, 518-23. 

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. 

About 10% of asthmatics are hypersensitive to aspirin, and in some individuals life-threatening bronchoconstriction can occur. This is not a drug-drug interaction but an adverse response of asthmatic patients to aspirin, whether taking an anti-asthmatic drug or not. The reasons are not fully understood. Those known to be sensitive to aspirin may also possibly react to other NSAIDs, in particular the acetylated salicylates, the indole and indene acetic acids, and the propionic acid derivatives (see Table 6.1 , (p.l34)). The fenamates, oxicams, pyrazolones and pyrazolidinediones are better tolerated. The nonacetylated salicylates (sodium salicylate, salicylamide, choline magnesium trisalicylate) are normally well tolerated. Aspirin-sensitive individuals are also less likely to react to nimesulide. ... 

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