Salicylates Antacids

Food containing salicylate (curry powder, paprika, licorice, prunes, raisins, and tea) may increase the risk of adverse reactions. Coadministration of the salicylates with activated charcoal decreases the absorption of the salicylates. Antacids may decrease the effects of the salicylates. Coadministration with the carbonic anhydrase inhibitors increases the risk of salicylism. Aspirin may increase the risk of bleeding during... 

Not fully established. One idea is that these carbonic anhydrase inhibitors (acetazolamide, diclofenamide) affect the plasma pH, so that more of the salicylate exists in the un-ionised (lipid-soluble) form, which can enter the CNS and other tissues more easily, leading to salicylate toxicity. However, carbonic anhydrase inhibitors also make the urine more alkaline, which increases the loss of salicylate (see also Aspirin or other Salicylates + Antacids , p.l35). Animal studies confirm that carbonic anhydrase inhibitors increase the lethal toxicity of aspirin. An alternative suggestion is that because salicylate inhibits the plasma protein binding of acetazolamide and its excretion by the kidney, acetazolamide toxicity, which mimics salicylate toxicity, may occur. ... 

There is an increased risk of toxicity of MTX when administered with the NSAIDs, salicylates, oral antidiabetic drugs, phenytoin, tetracycline, and probenecid. There is an additive bone marrow depressant effect when administered with other drug known to depress the bone marrow or with radiation therapy. There is an increased risk for nephrotoxicity when MTX is administered with other drug that cause nephrotoxicity. When penicillamine is administered with digoxin, decreased blood levels of digoxin may occur. There is a decreased absorption of penicillamine when the dmg is administered with food, iron preparations, and antacids. 

Drugs that may affect mycophenolate include acyclovir, antacids, azathioprine, cholestyramine, ganciclovir, iron, probenecid, and salicylates. 

Peds. GERD 10 mg/kg PO bid in doses, 150 mg bid max T in renal impair Caution [B, +] Contra H2-Receptor antagonist sensitivity Disp Caps, sol SE Dizziness, HA, constipation, D Interactions t Effects OF salicylates, EtOH X effects W/ antacids, tomato/mixed veg juice EMS Concurrent salicylate use can t risk of salicylate tox smoking t gastric acid secretion which can aggravate Dz Sxs OD May cause cholinergic-type effects (SLUDGE) activated charcoal may be effective... 

Prednisolone [Corticosteroid] [See Steroids and Table VI-1] Interactions T Effects W/ clarithromycin, erythromycin, estrogen, ketoconazole, OCPs, troleandomycin X effects W/ antacids, aminoglutethimide, barbiturates, cholestyramine, colestipol, phenytoin, rifampin X effects OF anticoagulants, hypoglycemics, INH, salicylates, vaccine toxoids EMS Infxns may be masked OD May cause wt gain, T hair growth, acne, HTN, peripheral edema, and sore muscles symptomatic and supportive... 

Uses Acute chronic gout Action X Renal tubular absorption of uric acid Dose 100-200 mg PO bid for 1 wk, T PRN to maint of 200—400 mg bid max 800 mg/d take w/ food or antacids plenty of fluids avoid salicylates Caution [C (D if near term), /-] Contra Renal impair, avoid salicylates peptic ulcer blood dyscrasias, near term PRG, allergy Disp Tabs, caps SE N/V, stomach pain, urolithiasis, leukopenia Interactions T Effects OF oral anticoagulants, oral hypoglycemics, MTX X effects W/ ASA, cholestyramine, niacin, salicylates, EtOH X effects OF acetaminophen, theophylline, verapamil EMS T Effects of anticoagulants and oral hypoglycemic X effects of verapamil OD May cause N/V, loss of coordination, dyspnea, Szs symptomatic and supportive... 

Salt of Salicylic Acid. A large number of salts of salicylic acid have been prepared and evaluated for therapeutic or other commercial use. Sodium salicylate has analgesic, antiinflammatory, and antipyretic activities. Magnesium salicylate, an analgesic and antiinflammatory agent, appears to have exceptional ability to relieve backaches. It is also used for the symptomatic relief of arthritis. Bismuth subsalicylate is taken orally in combination with other ingredients for protective, antacid action as well as antidiaiiheal and antiseptic effects. 

Aspirin is often given in a buffered form. The addition of small amounts of antacids decreases GI irritation and increases the dissolution and absorption rate of the aspirin. Nonacetylated salicylates, including salsalate, sodium salicylate, choline salicylate, magnesium salicylate, and various salicylate combinations, are usually more expensive but can be effective. Although these aspirin substitutes provide less anti-inflammatory effects than aspirin, they exhibit minimal antiplatelet properties and have fewer GI side effects.They can therefore be useful for patients who cannot tolerate aspirin or other NSAIDs. 

Nonnarcotic analgesic combinations usually consist of one or more of the fitUowing agents acetaminophen, salicylates, salsalate, and saUcylamide. Some of the products contain barbiturates, meprobamate, or antihistamines to produce a sedative effect, and antacids may be included to minimize gastric upset associated with the salicylates. Caffeine, a traditional adjuvant in many analgesic combinations, may be beneficial in the treatment of certain vascular headache syndromes. Some belladonna alkaloids may be incorporated for their antispasmodic properties. Pamabrom, a diuretic, and cinnamedrine, a sympathomimetic amine, are sometimes included in products for premenstrual syndrome. 

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