Drug Interaction:
+ Salicylates
Activated charcoal
coadmin. decreases aspirin absorption depending on charcoal dose
Ammoniun chloride/ Ascorbic acid / Methionine
urinary acidifiers decrease salicylate excretion
Antacids & urinary alkalinizers
decrease the pharmacologic effects of salicylates
Urinary alkalinization increases renal excretion of salicylic acid
due to decreased tubular reabsorption of un-ionized drug
Carbonic acid inhibitors
salicylates intoxification occurred after coadministration of these
agents. Salicylic acid renal renal elimination increased if
urine is kept alkaline
Corticosteroids
increase salicylate clearance and decrease serum levels
Salicylate +
Nizatidine
increased serum salicylate levels ocurred in patients receiving
high dose of aspirin ( 3.9g/day ) and concurrent nizatidine
Alcohol
the risk of GI ulceration increase when salicylates are given
concomittantly. Ingestion of alcohol during salicylate therapy may also
prolong bleeding time.
ACE inhibitors
antihypertensive effectiveness of these agents decreased by
concurrent salicylate admin. due to prostagladin inhibition.
Consider discontinuing salicylates if problems occur
Anticoagulants , oral
therapeutic aspirin has an additive hypoprothombimiemic effect.
Impaired platelet function may prolong bleeding time. Use caution
Betablockers
may have their antihypertensive action blunted by concurent salicylate
admin. due to prostagladin inhibition.Consider discontinuing
salicylates if problems occur
Heparin
asprin can increase bleeding risk in heparin anticoagulant patients
Loop diuretics
less effective when given with salicylates in patients with
compromised renal function or with cirhhosis with ascites.
Methotrexate
salicylates increase drug levels causing toxicity by interfering with
protein binding and renal elimination of antimetobolite
Nitroglycerin
when taken with aspirin, result in unexpected hypotension.
If hypotension occurs, reduce nitroglycerin dose
NSAIDs
aspirin decrease NSAID serum conc. Concomittant use offers
no advantage and significantly increase incidence of GI effects
Probenecid and Sulfinpyrazone
salicylates antagonize the uricosuric effect. While salicylates in large
doses ( > 3g/day ) have a uricosuric effect, smaller amounts may
reduce the urocosuric effect of these agents
Spironolactone
salicylates inhibit the diuretic effects. antihypertensive action
does not appear altered. Effects depend on dose of spirololactone
Sulfonylureas and exogenous insulin
salicylates in dose greater than 2g/day have a hypoglycemic
action, perhaps by altering pancreatic beta cell function.They
may potentiate the glucose lowering effect of these drugs
Valproic acid
aspirin displaces the drug from its protein binding sites and may
decrease its total body clearance, thus increasing the pharmacological
effect
Indication:
U.S FDA APPROVED DRUGS FROM 01-01-08 TO 31-12-08
Drug name Indication Date of Approval
33. Salicylic acid 10mg/20mg 28-01-08
(Foaming facewash solution)
For the treatment of acne vulgaris
242. Salicylic acid + 17-11-08
Coal Tar (3%+ 1%) solution
For scaling of seborrhea, seborrheic dermatitis,
psoriasis of scalp
243. Salicylic acid + 17-11-08
Coal Tar+
Precipitated Sulphur
For the treatment of psoriasis
263. Salicylic acid 18-12-08
+ Acetyl Alcohol
+ Stearyl Alcohol (2%+2.65%+0.26%) Lotion
For treatment of scaly dermatoses
Mild to moderate pain,fever.
New Drugs Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
1.Salicylic acid 18-12-2008
+ Cetyl alcohol
+ Stearyl Alcohol (2%+2.65%+ 0.26%)
For the treatment of scaly dermatoses
2.Salicylic Acid 17-11-2008
+ Coal tar (3%+1%)
For scaling of Seborrhea, Seborrheic Dermatitis, Psoriasis of scalp
3.Salicylic Acid 17-11-2008
+ Coal tar
+ Precipitated Sulphur
(3%+1%+3%) ointment
For the treatment of Psoriasis and Fungal Skin Infections
4. Salicylic acid 10mg/20mg 28-01-2008
Foaming Face wash solution
For the treatment of Acne Vulgaris
Adverse Reaction:
Salicylate intoxification and death(increased risks with large dose, young children high dose frequency, presence of occlusion either dressing or natural skin folds).
Dermititis, allergic response, Irritation, inflammation. Systemic absorption causes nausea, thirst, sweating, fatigue, fever and confusion.
Contra-Indications:
Hypersens
Special precautions:
Neonates,lactation,pregnancy.
Dosages/ Overdosage Etc:
Indications:
Mild to moderate pain,fever.
Dosage:
325 to 625 mg every 4 hours as needed. Juvenille rheumatoid arthritis- 60 to 110 mg/kg/day in divided doses every 6 to 8 hours..
Drug/Lab interactions: Serum acid uric levels are elevated by salicylates less than 10 mg/dl; and decreased by levels greater than 10 mg/dl.
Combinations with phenylbutazone and salicylates decrease uric acid secretion and may increase serum uric acid by an average of 2mg/dl.: Salicylates compete with thyroid hormone for binding sites and increases protein bound iodine (PBI). salicylates in the urine result infalsely elevated VMA(vanilylmandelic acid). .
Patient Information:
ASPIRIN- SALICYLATES Includes- salicylates, choline salicylate, sodium salicylates
Refer - ASPIRIN
1. May cause GI upset; take with food or after meals.
2. Do not crush or chew sustained release preparations.
3.Patients allergic to tartrazine dye should avoid aspirin.
4. Do not use Asprin if it has a strong vinegar-like odor.
5. Allergies- tell your doctor if you have ever had any unusual or allergic reaction to salicylates including methyl salicylates. Also tell your doctor if you are allergic to any other substances, such as foods, presevatives or dyes.
6.Pregnancy - studies on birth defects in human has not been done. However, salicylates caused birth defects in animal studies.
7.Breast feeding- salicylates pass into the breast milk. Although salicylates have not been reported to cause problems in nursing babies, it is possible that problems may occur if large amounts are taken as for arthiritis
8.Children- do not give aspirin ot other salicylates to child or a teenager with a fever or other symptoms of virus infection especially flu or chickenpox without first discussing its use with your child doctor. This is important because salicylates may cause a serious illnesss called Reys syndrome.
9.Elderly- are more sensitive to salicylates. This may increase the chance of side effects.
10. Other medicines - Anticoagulants or Carbenicilin or Cefamandole or Cefoperazone or Cefotetan or Dipyridamole or Divalproex or Heparin or Infalmmation or pain medicine Pentoxyfylline or Plicamycin or Ticarcillin or Valproic acid - taking these medicines together with salicylate especially aspirin, may increase the chance of bleeding.
Antidiabetics- salicylates may increase the efects of antidiabetic medicine, a change in dose may be needed Ciprofloxacin or Enoxacin or Itraconazole or Ketoconazole or Lomefoxacin Oflaxacin or Tretracycline - bufered aspirin, choline and magnesioum salicylates may keep these medicines from working properly it taken too close to them. Methotrexate Vancomycin - chance of serious side effects may be increased
Probenecid - salicylates can keep probenecid from working properly fot treating gout Sulfinpyrazole - salicylates can keep sulfinpyrazole from working properly for treating gout, also taking salicylate especially aspirin with sulfinpyrazole may increase chance of bleeding. Urinary alkaliners- these medicines may make the salicylates less effective by causing it to be removed from the body quickly.
10. Other medical problems - Tell your doctor if you have any other medical problems especially - Anemia or Overactive thyroid or Stomach ulcer -salicylates may make your conditions worse.
Asthma or Glucose-6-PD deficiency or High blod pressure or Kidney diseasse or Liver disease - chance of side effects may be increased
Gout- salicylates can make condition worse also lessen effects of the medicine Heart diseasse - chance of side effects may be increased. Caffeine present in some aspirin products can make some heart diseasse worse. Hemopliia or bleeding problems- chance of bleeding may be increased especially with aspirin.
11. Missed dose - If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time for the next dose, skip the missed dose. Do not double doses.
12. Storage - Keep out of reach of children. Store away from heat or direct sunlight. Do not store the capsule in bathroom, near the kitchen sink, or in other damp places.
13. Outdated medicines - Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of reach of children.
Pharmacology/ Pharmacokinetics:
Pharmacology:
Salicylates have analgesic, antipyretic, anti-inflammatory and anti-rheumatic effects.Salicylates lower elevated body temperature through vasodilatation of peripheral vessels, thus enhancing dissipation of excess heat. The anti-inflammatory and analgesic activity may be mediated through inhibition of prostaglandin synthetase enzyme complex.
Pharmacokinetics:
Salicylates are rapidly and completely absorbed after oral use. Aspirin is partially hydrolysed to salicylic acid during absorption and distributed to all bodytissues and fluids. Salicylic acid is eliminated by renal excretion,and hasa a half-life of 15 to 20 minutes.
Interaction with Food:
Not significant.
Pregnancy and lactation:
Aspirin may produce adverse maternal effects. Avoid using Aspirin especially during third trimester Lactation: Salicylates are excreted in breast milk, and considered a potential risk.