Metabolic acidosis can occur in those taking high-dose salicylates if they are given carbonic anhydrase inhibitors (e.g. acetazolamide).
Carbonic anhydrase inhibitors should probably be avoided in those taking high- dose salicylates. If they are used, the patient should be well monitored for any evidence of toxicity (confusion, lethargy, hyperventilation, tinnitus). In this context NSAIDs or paracetamol (acetaminophen) may be safer alternatives. It is not known whether eye drops interact similarly; there appear to be no reports of an interaction.
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