Influence of acetylsalicylic acid on the renal handling of a spironolactone metabolite in healthy subjects

L. E. Ramsay, I. R. Harrison, J. R. Shelton and C. W. Vose

View Related Documents

Abstract

The influence of 600 mg acetylsalicylic acid (ASA) on the renal excretion and clearance of canrenone, the principal unconjugated metabolite of spironolactone, was examined in a double-blind crossover study in six healthy subjects. ASA significantly reduced the urinary excretion, and the fractional excretion, of canrenone between 4 — 6 hours after administration of 50 mg spironolactone. The pharmacological activity of spironolactone, assessed simultaneously by alterations in fludrocortisone-induced urinary electrolyte changes, was slightly but not significantly reduced. The reductions in urinary canrenone excretion correlated with changes in the urinary log 10 Na/K ratio. The results suggest that canrenone may be actively secreted at the proximal renal tubule, and that secretion is blocked by ASA or its conjugates. This is a possible mechanism for the pharmacological interaction between ASA and spironolactone which has been described previously.

Key words  Spironolactone - acetylsalicylic acid - fludrocortisone - kinetics - pharmacology - interaction

Fulltext Preview

Image of the first page of the fulltext document