para-aminosalicylate; PAS; 4-aminosalicylate (Pamisyl, Paser)
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Indications
- adjunctive treatment of tuberculosis
- Crohn's disease, ulcerative colitis[3]
Contraindications
Warnings:
- avoid use in patients with:
- hepatic or renal dysfunction
- gastric bleeding disorders
- glucose-6-phosphate dehydrogenase (G6PD) deficiency
Dosage
- adults: 12-15 g/day divided TID-QID
- children: 240-360 mg/kg/day divdided TID-QID
- take with food
- avoid exposing drug to moisture, extreme heat or direct sunlight
Tabs: 500 mg, Granules
Pharmacokinetics
- oral dose readily absorbed
- widely distributed to tissues
- protein binding 50-70%
- peak concentration within 1-4 hours
- 1/2life 1 hour
elimination via intestine
elimination via liver
elimination via kidney
1/2life = 1 hour
protein binding = 50-70 %
Adverse effects
- not common (1-10%)
- uncommon (< 1%)
- fever, skin eruptions, leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, goiter with or without myxedema, jaundice, hepatitis, vasculitis
- other
- hypersensitivity[4]
- hypothyroidism, especially when used in combination with ethionamide[4]
Drug interactions
- PAS interferes with rifampin absorption
- PAS displaces phenytoin from albumin, thus raising free phenytoin levels
- probenecid can increase PAS levels
- drug interaction(s) of direct oral anticoagulants (DOAC) with NSAIDs
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) of antibiotics with warfarin
- drug interaction(s) of cholinesterase inhibitors with NSAIDs
- drug interaction(s) of lithium carbonate with NSAIDs
- drug interaction(s) of beta-adrenergic receptor antagonists with salicylate
- drug interaction(s) of salicylates with sulfonylureas
- drug interaction(s) of NSAIDs with oral contraceptive
- drug interaction(s) of NSAIDs with SSRIs
- drug interaction(s) of NSAIDs with antidepressants
- drug interaction(s) of aspirin with NSAIDs
- drug interaction(s) of apixaban with NSAIDs
- drug interaction(s) of warfarin with NSAIDs
- drug interaction(s) of NSAIDs with beta blockers
- drug interaction(s) of NSAIDs with ARBs
- drug interaction(s) of NSAIDs with aldosterone antagonis
- drug interaction(s) of NSAIDs with glucocorticoid
- drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
- drug interaction(s) of NSAIDs with ACE inhibitors
- drug interaction(s) of NSAIDs & antihypertensives
- drug interaction(s) of NSAIDs & loop diuretics
- drug interaction(s) of NSAIDs & aspirin
Test interactions
- false positive reactions with copper sulfate urine glucose test