Drug General Information (ID: DDIFOPYLIU)
Drug Name			Sodium bicarbonate		Drug Info		Choline salicylate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidiarrheals				Salicylates
Structure

Mechanism of Sodium bicarbonate-Choline salicylate Interaction (Severity Level: Moderate)
Altered urine pH Click to Show/Hide Mechanism Graph
Drug Name		Sodium bicarbonate				Choline salicylate
Mechanism		Urine alkalinizer				Urine pH sensitive
Key Mechanism Factor 1
		Factor Name		Urine pH
		Factor Description		The normal range of urine pH is between 4.5 and 8, depending mainly on the hydrogen ion concentration. Changes in urine pH may significantly affect drug reabsorption and excretion.
Mechanism Description		Altered elimination of Choline salicylate caused by Sodium bicarbonate mediated altered urine pH

Recommended Action
Management		Patients treated chronically with urinary alkalinizers and large doses of salicylates (i.e. 3 g/day or more) should be monitored for potentially diminished or inadequate analgesic and anti-inflammatory effects, and the salicylate dosage adjusted if necessary.

References
1	Balali-Mood M, Prescott LF "Failure of alkaline diuresis to enhance diflunisal elimination." Br J Clin Pharmacol 10 (1980): 163-5. [PMID: 7426277]
2	Berg KJ "Acute acetylsalicylic acid poisoning: treatment with forced alkaline diuresis and diuretics." Eur J Clin Pharmacol 12 (1977): 111-6. [PMID: 21797]
3	Berg KJ "Acute effects of acetylsalicylic acid in patients with chronic renal insufficiency." Eur J Clin Pharmacol 11 (1977): 111-6. [PMID: 837963]
4	Brouwers JRBJ, Desmet PAGM "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet 27 (1994): 462-85. [PMID: 7882636]
5	Prescott LF, Balali-Mood M, Critchley JA, Johnstone AF, Proudfoot AT "Diuresis or urinary alkalinisation for salicylate poisoning?" Br Med J (Clin Res Ed) 285 (1982): 1383-6. [PMID: 6291695]