Effect of salicylic acid on the plasma protein binding and pharmacokinetics of misoprostol acid

Abstract

The in vitro serum protein binding and erythrocyte uptake of [3H]misoprostol acid ([3H]MPA; SC-30695), an active metabolite of the prostaglandin E1 (PGE1) analogue misoprostol, was determined in the blood of young (20-40 years) and elderly subjects (64 years or older) at concentrations ranging between 20 and 5000 pg/mL. The effect of selected other drugs on the displacement of [3H] MPA from the binding sites was also investigated. [3H]MPA serum binding (between 81 and 89 %) was similar and concentration independent in the young and elderly subjects and the erythrocyte partitioning coefficient was about 1, indicating the absence of a significant accumulation of MPA in red blood cells. Both the plasma and serum protein binding of [3H] MPA were substantially reduced in the presence of high (> 100 microg/mL) concentrations of salicylic acid. In an in vivo study, the single-dose pharmacokinetics of MPA did not change significantly when misoprostol (200 microg) was given alone or concomitantly with 975 mg of aspirin. These findings indicate that MPA is displaced from its protein binding sites only by high concentrations of salicylic acid and that this displacement is unlikely to be of clinical significance with the usual therapeutic doses of aspirin.