Drug General Information (ID: DDI12TLW9Z)
Drug Name			Phenytoin		Drug Info		Salsalate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anticonvulsants				Antiinflammatory Agents
Structure

Mechanism of Phenytoin-Salsalate Interaction (Severity Level: Minor)
Competitive binding of plasma proteins Click to Show/Hide Mechanism Graph
Drug Name		Phenytoin				Salsalate
Mechanism		Competition for plasma protein binding sites				Competition for plasma protein binding sites
Key Mechanism Factor 1
		Factor Name		Plasma protein binding
		Factor Description		Plasma protein binding refers to the degree of binding of a drug to proteins in the blood, and the lower the degree of binding, the more efficiently the drug can cross cell membranes or diffuse. Plasma protein binding alters the distribution and therapeutic characteristics of the drugs.
Mechanism Description		Increased plasma concentration of Salsalate and Phenytoin due to competitive binding of plasma proteins

References
1	Fraser DG, Ludden TM, Evens RP, Sutherland EW "Displacement of phenytoin from plasma binding sites by salicylate." Clin Pharmacol Ther 27 (1980): 165-9. [PMID: 7353334]
2	Leonard RF, Knott PJ, Rankin GO, et al "Phenytoin-salicylate interaction." Clin Pharmacol Ther 29 (1981): 56-60. [PMID: 7460475]
3	Lunde PK, Rane A, Yaffe SJ, Lund L, Sjoqvist F "Plasma protein binding of diphenylhydantoin in man: interaction with other drugs and the effect of temperature and plasma dilution." Clin Pharmacol Ther 11 (1970): 846-55. [PMID: 4394754]
4	Neuvonen PJ, Lehtovaara R, Bardy A, Elomaa E "Antipyretic analgesics in patients on antiepileptic drug therapy." Eur J Clin Pharmacol 15 (1979): 263-8. [PMID: 314381]
5	Paxton JW "Effects of aspirin on salivary and serum phenytoin kinetics in healthy subjects." Clin Pharmacol Ther 27 (1980): 170-8. [PMID: 7353335]