Wolowich William R, Hadley Carmen M, Kelley Michael T, Walson Philip D, Casavant Marcel J
Central Ohio Poison Center, Columbus, Ohio, USA.
J Toxicol Clin Toxicol. 2003;41(4):355-8. doi: 10.1081/clt-120022002.
Poison Control Centers follow the acetylsalicylic acid (ASA) treatment guideline to manage unintentional ingestions of topical methyl salicylate liniments. For example, one teaspoon of 30% methyl salicylate cream such as Ben Gay provides an "ASA equivalent dose" of 180 mg/kg for a 10 kg child. The ASA treatment guideline advises emesis with syrup of Ipecac and 24 h home followup for this dose. Both the ASA conversion factor to yield the ASA equivalent dose and the treatment guideline assume 100% bioavailability of the salicylate. The nature of this topical dosage product led the investigators to expect less than complete absorption of methyl salicylate.
To compare plasma concentrations of salicylate from ingested methyl salicylate cream with plasma concentrations of salicylate from ingested oil of wintergreen.
Four adult volunteers consented to an open label, four-way crossover design, with randomization to the following treatments: 1 mL Oil of Wintergreen, U.S.P., 6.7 g of Ben Gay 15% and 20 g of Ben Gay 15% and also to hold 5 g of Ben Gay 15% cream in the buccal cavity for 1 minute and then expectorate. Plasma was collected for salicylate determination, and the results analyzed with a noncompartmental pharmacokinetic model.
No plasma salicylate was detected after buccal treatment phase. Relative bioavailability for the low-dose treatment was 0.5 compared to oil of wintergreen.
Plasma salicylate concentrations from methyl salicylate cream are not equal to those achieved after ingestion of oil of wintergreen. Dosage formulation must be considered when predicting toxicity.
中毒控制中心遵循乙酰水杨酸（ASA）治疗指南来处理意外摄入外用的水杨酸甲酯搽剂。例如，一茶匙30%的水杨酸甲酯乳膏（如本盖止痛膏）对于一名10千克的儿童提供的“ASA等效剂量”为180毫克/千克。ASA治疗指南建议使用吐根糖浆催吐，并对该剂量进行24小时的家庭随访。用于得出ASA等效剂量的ASA转换因子以及治疗指南均假定水杨酸盐的生物利用度为100%。这种外用剂型产品的性质使研究人员预期水杨酸甲酯的吸收不完全。
比较摄入水杨酸甲酯乳膏后血浆中的水杨酸盐浓度与摄入冬青油后血浆中的水杨酸盐浓度。
四名成年志愿者同意采用开放标签、四交叉设计，并随机接受以下治疗：1毫升美国药典级冬青油、6.7克15%的本盖止痛膏、20克15%的本盖止痛膏，以及将5克1
