Also, salicylates may depress the concentration of prothrombin in the plasma. Salicylates may potentiate sulfonylurea hypoglycemic agents. Large doses of salicylates may have a hypoglycemic action, and thus, affect the insulin requirements of diabetics. Although salicylates in large doses are uricosuric agents, smaller amounts may depress uric acid clearance, and thus, decrease the uricosuric effects of probenecid, sulfinpyrazone and phenylbutazone. Sodium excretion produced by spironolactone may be decreased in the presence of salicylates.
Salicylates also retard the renal elimination of methotrexate.
Caution is necessary when cefamandole, cefoperazone, cefotetan, moxalactam, plicamycin or, valproic acid are prescribed concurrently with ASA as these medications may cause hypoprothrombinemia. Codeine should be given with caution to patients with severe respiratory depression. The depressant effect of codeine may be enhanced by the concurrent administration of sedatives and tranquilizers. The potential for habituation may occur. Severe cases may show fever, hemorrhage, bloody urine, excitement, confusion, hallucinations, severe nervousness, convulsions or coma, and respiratory failure.