The effect of intra‐articular steroids on plasma salicylate concentrations.

Edelman, J.L.; Jm, Potter; Hackett, L.P.

doi:10.1111/j.1365-2125.1986.tb05194.x

Cited by 27 publications

(5 citation statements)

References 15 publications

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“…However, given a significance level of 0.05 and a 1 value of 0.8, this study with six subjects should have been able to detect at least a 20% increase in the clearance of salicylate induced by corticosteroids (Dobson, 1984). An increase in salicylate clearance of the order of 25-59% was anticipated from data reported in previous studies (Graham et al, 1977;Kiinenberg & Miller, 1965;Koren et al, 1987;Edelman et al, 1986). However, since most of the subjects had decreases in clearance of 10% or less, it would seem most unlikely that increasing patient numbers would unmask a substantial and significant increase in salicylate clearance.…”

Section: Discussionmentioning

confidence: 72%

“…Salicylate concentrations in plasma increased markedly when corticosteroid dosage was tapered in patients with rheumatoid arthritis (Klinenberg & Miller, 1965;Muirden & Barraclough, 1976) and, correspondingly decreased when prednisone was commenced (Koren et al, 1987). In addition, it was noted that salicylate concentrations were substantially lower when corticosteroids were taken concurrently (Graham et al, 1977;Bardare et al, 1978) while, in a recent communication, it was reported that even intra-articular corticosteroids decreased the plasma concentrations of salicylate during chronic salicylate therapy (Edelman et al, 1986). Klinenberg & Miller (1965) reported that corticosteroids enhanced the renal clearance of salicylate in some patients but their assay method was non-specific and salicylate could not be distinguished from its major urinary metabolite, salicylurate, which is found in high concentration in the urine (Levy et al, 1972).…”

Section: Introductionmentioning

confidence: 99%

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Interaction of salicylate and corticosteroids in man.

Day

Harris

Brown

et al. 1988

Brit J Clinical Pharma

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Corticosteroids have been reported to decrease the plasma concentrations of salicylate when salicylates have been administered chronically at high doses. In the present study, two single, oral doses of sodium salicylate, 10 mg kg-1 were administered to six adult subjects with a variety of inflammatory conditions both before and during treatment with daily oral doses of prednisone (12-60 mg). Concomitant prednisone therapy did not increase the whole body clearance of single doses of salicylate in these subjects (0.0275 + 0.081 kg-' h-1 before prednisone; 0.0247 ± 0.031 kg-' h-1 during prednisone therapy; P > 0.05). These results indicate that corticosteroids do not alter the clearance of single doses of salicylate in man.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Interaction of salicylate and corticosteroids in man.

Day

Harris

Brown

et al. 1988

Brit J Clinical Pharma

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“…According to Edelman et al (38) prednisolon, DEX and methylprednisolon as well as other glucocorticoids (39,40) decreased the serum salicylate concentrations as a result of increased salicylic clearance caused by glucocorticoids. Klinenberg and Miller (41) supposed that glucocorticoids increased glomerula filtration of salicylates.…”

Section: Discussionmentioning

confidence: 99%

Effects of acetysal, dexamethasone and their combination on drug metabolizing enzyme systems in rat liver microsomes

Tantcheva

Rangelova

Stoytchev

1995

European Journal of Drug Metabolism and Pharmacokinetics

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After 4 days of acetysal treatment (160 mg/kg body weight orally), the following were established: a higher acute toxicity of acetysal, an inducing effect on amidopyrin N-demethylase and analgin N-demethylase activity and increases in cytochrome P-450 and cytochrome b5 content. Aniline hydroxylase activity decreased, thiopental sleeping time was prolonged and UDP-glucuronyltransferase activity was not changed. Dexamethasone, at a dose of 5 mg/kg body weight p.o. for 4 days, did not change acetysal acute toxicity but at a dose of 100 mg/kg i.p. increased it. Thiopental sleeping time was shortened by dexamethasone (100 mg/kg i.p.) but was not changed by dexamethasone at 5 mg/kg p.o., alone or in combination. Dexamethasone at 5 mg/kg increased analgin N-demethylase and UDP-glucuronyltransferase activities, did not change cytochrome P-450 content and decreased aniline hydroxylase activity. The combination with 5 mg/kg dexamethasone increased the activity of amidopyrin N-demethylase, analgin N-demethylase and UDP-glucuronyltransferase and decreased those of amitriptyllin N-demethylase and aniline hydroxylase and cytochrome P-450 content. Ethylmorphine N-demethylase, benzphetamine N-demethylase, NADPH-cytochrome c reductase and glutathione S-transferase activities were not affected significantly by acetysal, dexamethasone or their combination. Hepatic carboxyl esterase was depressed by dexamethasone (5 mg/kg) and was increased by the combination. Lipid peroxidation was not changed by dexamethasone (5 mg/kg) but was decreased by acetysal and the combination.

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“…Corticosteroids Concurrent administration of aspirin or salicylic acid with a glucocorticoid (orally or via intraarticular injection) leads to increased salicylate clearance accompanied by a significant reduction Drug Safety 8 (2) 1993 in plasma salicylate concentrations (Baer et al 1987;Edelman et al 1986;Koren et al 1987). Further support for this interaction derives from reports that plasma salicylate concentrations rise proportionately with a reduction in the daily dose of corticosteroids when both drugs are coadministered (Klinenberg & Miller 1965;Muirden & Barraclough 1976).…”

Section: Cholestyraminementioning

confidence: 93%

Adverse Drug Interactions with Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

1993

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The prevalence and incidence of adverse drug interactions involving nonsteroidal anti-inflammatory drugs (NSAIDs) remains unknown. To identify those proposed drug interactions of greatest clinical significance, it is appropriate to focus on interactions between commonly used and/or commonly coprescribed drugs, interactions for which there are numerous well documented case reports in reputable journals, interactions validated by well designed in vivo human studies and those affecting high-risk drugs and/or high-risk patients. While most interactions between NSAIDs and other drugs are pharmacokinetic, NSAID-related pharmacodynamic interactions may be considerably more important in the clinical context, and prescriber ignorance is likely to be a major determinant of many adverse drug interactions. Prescribing NSAIDs is relatively contraindicated for patients on oral anticoagulants due to the risk of haemorrhage, and for patients taking high-dose methotrexate due to the dangers of bone marrow toxicity, renal failure and hepatic dysfunction. Combination NSAID therapy cannot be justified as toxicity may be increased without any improvement in efficacy. Where lithium or anti-hypertensives are coprescribed with NSAIDs, close monitoring is mandatory for lithium toxicity and hypertension, respectively, and aspirin (acetylsalicylic acid) or sulindac are preferred. Phenytoin or oral hypoglycaemic agents may be administered with NSAIDs other than pyrazoles and salicylates provided that patients are monitored carefully at the initiation and cessation of NSAID treatment. Digoxin, aminoglycosides and probenecid may be coprescribed with NSAIDs, but close monitoring is required, particularly for high-risk patients such as the elderly. Indomethacin and triamterene should be avoided due to the risk of renal failure. High dose aspirin should be replaced by naproxen in patients on valproic acid (sodium valproate) and care is required when corticosteroids are administered to patients taking salicylates long term in high dosage. Interactions between NSAIDs and antacids or cholestyramine are generally avoidable. Adverse drug interactions involving NSAIDs may be limited by rational prescribing and by careful monitoring, particularly for high-risk patients, drugs and therapy periods.

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The effect of intra‐articular steroids on plasma salicylate concentrations.

Cited by 27 publications

References 15 publications

Interaction of salicylate and corticosteroids in man.

Interaction of salicylate and corticosteroids in man.

Effects of acetysal, dexamethasone and their combination on drug metabolizing enzyme systems in rat liver microsomes

Adverse Drug Interactions with Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

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