Drug General Information (ID: DDI5WHK7SB)
Drug Name			Acetazolamide		Drug Info		Choline salicylate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anticonvulsants				Salicylates
Structure

Mechanism of Acetazolamide-Choline salicylate Interaction (Severity Level: Major)
Competitive binding of plasma proteins Click to Show/Hide Mechanism Graph
Drug Name		Acetazolamide				Choline salicylate
Mechanism 1		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 Choline salicylate and Acetazolamide due to competitive binding of plasma proteins
Increased risk of metabolic acidosis Click to Show/Hide Mechanism Graph
Drug Name		Acetazolamide				Choline salicylate
Mechanism 2		Metabolic acidosis				Metabolic acidosis
Key Mechanism Factor 2
		Factor Name		Metabolic acidosis
		Factor Description		Metabolic acidosis is a clinical disorder defined as a pH below 7.35 and low HCO3 levels. Metabolic acidosis occurs when the body produces too much acid or the kidneys are unable to remove enough acid from the body. Symptoms vary depending on the underlying cause, but some common symptoms are as follows: shortness of breath, confusion, fatigue, shock, fruity taste of the patient's breath (diabetic ketoacidosis), rapid heartbeat, headache, weakness, and nausea.
Mechanism Description		Increased risk of metabolic acidosis by the combination of Acetazolamide and Choline salicylate

Recommended Action
Management		In general, concomitant use of antirheumatic doses of salicylates and oral CAIs is not recommended. If coadministration is necessary, careful monitoring of the patient's mental status and acid base balance is strongly recommended. Patients should be advised to promptly notify their physicians if they experience symptoms such as lethargy, tinnitus, confusion, nausea, vomiting, or hyperventilation.

References
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