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2D Structure
Also known as: 4-amino-2-hydroxybenzoic acid, 65-49-6, Aminosalicylic acid, P-aminosalicylic acid, Rezipas, Para-aminosalicylic acid
Molecular Formula
C7H7NO3
Molecular Weight
153.14  g/mol
InChI Key
WUBBRNOQWQTFEX-UHFFFAOYSA-N
FDA UNII
5B2658E0N2

An antitubercular agent often administered in association with ISONIAZID. The sodium salt of the drug is better tolerated than the free acid.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
4-amino-2-hydroxybenzoic acid
2.1.2 InChI
InChI=1S/C7H7NO3/c8-4-1-2-5(7(10)11)6(9)3-4/h1-3,9H,8H2,(H,10,11)
2.1.3 InChI Key
WUBBRNOQWQTFEX-UHFFFAOYSA-N
2.1.4 Canonical SMILES
C1=CC(=C(C=C1N)O)C(=O)O
2.2 Other Identifiers
2.2.1 UNII
5B2658E0N2
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 4 Aminosalicylic Acid

2. Acid, Aminosalicylic

3. Alumino 4 Aminosalicylic Acid

4. Alumino-4-aminosalicylic Acid

5. Aminosalicylic Acid

6. P Aminosalicylic Acid

7. P Aminosalicylic Acid Monolithium Salt

8. P Aminosalicylic Acid Monopotassium Salt

9. P Aminosalicylic Acid Monosodium Salt

10. P-aminosalicylic Acid

11. P-aminosalicylic Acid Monolithium Salt

12. P-aminosalicylic Acid Monopotassium Salt

13. P-aminosalicylic Acid Monosodium Salt

14. P-aminosalicylic Acid, Aluminum (2:1) Salt

15. P-aminosalicylic Acid, Calcium (2:1) Salt

16. P-aminosalicylic Acid, Monosodium Salt, Dihydrate

17. Pamisyl

18. Para Aminosalicylic Acid

19. Para-aminosalicylic Acid

20. Rezipas

2.3.2 Depositor-Supplied Synonyms

1. 4-amino-2-hydroxybenzoic Acid

2. 65-49-6

3. Aminosalicylic Acid

4. P-aminosalicylic Acid

5. Rezipas

6. Para-aminosalicylic Acid

7. Aminopar

8. Pamisyl

9. Parasal

10. Paser

11. Parasalindon

12. Deapasil

13. Apacil

14. Gabbropas

15. Paramycin

16. Parasalicil

17. Pasnodia

18. Aminox

19. Benzoic Acid, 4-amino-2-hydroxy-

20. Entepas

21. Osacyl

22. Pamacyl

23. Pasalon

24. Pasara

25. Pasdium

26. Pasmed

27. Pasolac

28. Propasa

29. Pasem

30. Pasa

31. 2-hydroxy-4-aminobenzoic Acid

32. Apas

33. Pask

34. Para-pas

35. Sanipirol-4

36. Para-amino Salicylic Acid

37. Hellipidyl

38. Pascorbic

39. Pas-c

40. Pas (acid)

41. 4-aminosalicylate

42. Pas

43. Kyselina P-aminosalicylova

44. Aminosalicylate

45. Salicylic Acid, 4-amino-

46. 3-hydroxy-4-carboxyaniline

47. Amino-pas

48. Sanipriol-4

49. Nih 2939

50. Nsc 2083

51. Mfcd00007789

52. 4-asa

53. Aminosalicylate Sodium

54. Aminosalicylic Acid [usp]

55. A 1909

56. Benzoic Acid, 4-aminohydroxy-

57. 4-amino-2-hydroxy-benzoic Acid

58. P-amino Salicylic Acid

59. 4-amino Salicylic Acid

60. Nsc-2083

61. Mls000069418

62. Chebi:27565

63. Nsc2083

64. 5b2658e0n2

65. Aminosalyl

66. Helipidyl

67. Smr000059110

68. Paser Granules

69. Aminosalicylic Acid (usp)

70. Paskalium

71. Mls000069579

72. Pas (van)

73. 4-aminosalicylicacid

74. Aminosalicylic Acid Resin Complex

75. Hsdb 3203

76. 4-amino-salicylic Acid

77. Kyselina P-aminosalicylova [czech]

78. Sr-01000002990

79. Smr000058830

80. Einecs 200-613-5

81. Brn 0473071

82. P.a.s

83. Aminosalicylic

84. Granupas

85. Ai3-50142

86. Unii-5b2658e0n2

87. Salicylic Acid Usp

88. Isonicotinic Acid Hydrazide P-aminosalicylate Salt

89. Pamisyl (tn)

90. Paser (tn)

91. 4-aminosalicyclic Acid

92. Spectrum_000042

93. .gamma.-aminosalicylate

94. (mixture Of Tautomers)

95. Opera_id_614

96. Spectrum2_000001

97. Spectrum3_000297

98. Spectrum4_000145

99. Spectrum5_000804

100. Para-amino-salicyclic Acid

101. Wln: Zr Cq Dvq

102. Salicyclic Acid, 4-amino-

103. Schembl2262

104. Chembl1169

105. Bspbio_001834

106. Kbiogr_000590

107. Kbioss_000422

108. Zinc922

109. 4-14-00-01967 (beilstein Handbook Reference)

110. Mls001148121

111. 4-aminosalicylic Acid, 99%

112. Bidd:gt0175

113. Divk1c_000350

114. 4-amino-2-hydroxobenzoic Acid

115. Spbio_000001

116. P-aminosalicylic Acid Standard

117. Dtxsid2022591

118. Bdbm48319

119. Hms501b12

120. Kbio1_000350

121. Kbio2_000422

122. Kbio2_002990

123. Kbio2_005558

124. Kbio3_001334

125. 4-azanyl-2-oxidanyl-benzoic Acid

126. Cid_11988145

127. Ninds_000350

128. Aminosalicylic Acid [hsdb]

129. Hms2090i07

130. Hms2093l14

131. Hms2236i04

132. Hms3371a17

133. Hms3715m08

134. Kuc106682n

135. Aminosalicylic Acid [vandf]

136. P-aminosalicylic Acid [mi]

137. Aminosalicylic Acid [mart.]

138. Amy31099

139. Bcp18565

140. Hy-i0447

141. Aminosalicylic Acid [usp-rs]

142. Aminosalicylic Acid [who-dd]

143. Ccg-39969

144. S5211

145. Stl163955

146. Akos000121200

147. Cs-w023102

148. Db00233

149. Pb47849

150. 4-amino,2-hydroxy-benzoic Acid

151. Idi1_000350

152. Aminosalicylic Acid [orange Book]

153. Ncgc00018110-01

154. Ncgc00018110-02

155. Ncgc00018110-03

156. Ncgc00018110-04

157. Ac-12894

158. As-11043

159. Sy001079

160. Aminosalicylic Acid [usp Monograph]

161. Ksc-11-207-13

162. Sbi-0051279.p003

163. Sbi-0051279.p004

164. Db-054818

165. Mesalazine Impurity E [ep Impurity]

166. A0420

167. Ft-0617609

168. Ft-0689453

169. C02518

170. D00162

171. Neopasalate Component Aminosalicylic Acid

172. P17508

173. Ab00051913-20

174. Aminosalicylic Acid Component Of Neopasalate

175. Q229924

176. Q-200437

177. Sr-01000002990-4

178. Sr-01000002990-6

179. 4-aminosalicylic Acid, Vetec(tm) Reagent Grade, 99%

180. Z90121065

181. F2191-0245

182. Para-aminosalicylic Acid;aminosalicylic Acid;4-aminosalicylate

183. Aminosalicylic Acid, United States Pharmacopeia (usp) Reference Standard

184. 4-aminosalicylic Acid, Pharmaceutical Secondary Standard; Certified Reference Material

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 153.14 g/mol
Molecular Formula C7H7NO3
XLogP31.3
Hydrogen Bond Donor Count3
Hydrogen Bond Acceptor Count4
Rotatable Bond Count1
Exact Mass153.042593085 g/mol
Monoisotopic Mass153.042593085 g/mol
Topological Polar Surface Area83.6 Ų
Heavy Atom Count11
Formal Charge0
Complexity160
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NamePaser
PubMed HealthAminosalicylic Acid (By mouth)
Drug ClassesAntitubercular
Drug LabelPASER granules are a delayed release granule preparation of aminosalicylic acid (p-aminosalicylic acid; 4-aminosalicylic acid) for use with other anti-tuberculosis drugs for the treatment of all forms of active tuberculosis due to susceptible strains...
Active IngredientAminosalicylic acid
Dosage FormGranule, delayed release
RouteOral
Strength4gm/packet
Market StatusPrescription
CompanyJacobus

2 of 2  
Drug NamePaser
PubMed HealthAminosalicylic Acid (By mouth)
Drug ClassesAntitubercular
Drug LabelPASER granules are a delayed release granule preparation of aminosalicylic acid (p-aminosalicylic acid; 4-aminosalicylic acid) for use with other anti-tuberculosis drugs for the treatment of all forms of active tuberculosis due to susceptible strains...
Active IngredientAminosalicylic acid
Dosage FormGranule, delayed release
RouteOral
Strength4gm/packet
Market StatusPrescription
CompanyJacobus

4.2 Therapeutic Uses

Antitubercular Agents

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)


EXPTL USE: LIPID LOWERING AGENT. 6 G GIVEN FOR 4 WK. IT WAS CONCLUDED THAT IT LOWERS ELEVATED SERUM TRIGLYCERIDE LEVELS AS WELL AS ELEVATED SERUM CHOLESTEROL LEVELS.

VESSBY ET AL; PARA-AMINOSALICYLIC ACID AS A LIPID LOWERING AGENT; CLIN PHARMACOL THER 23 (JUN) 651-7 (1978)


USED ALONE, IT CAN SOMETIMES SUCCESSFULLY MANAGE /TUBERCULOSIS/...BUT RESISTANCE EMERGES & ALSO TOXICITY LIMITS THE DOSE. THEREFORE, PAS IS NEARLY ALWAYS USED IN COMBINATION WITH 1 OR 2 OTHER ANTITUBERCULAR DRUGS. ...PAS SUPPORTS THE OTHER DRUGS & DELAYS THE EMERGENCY OF RESISTANCE.

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 1150


AMINOSALICYLIC ACID...HAS POTENT HYPOLIPIDEMIC ACTION & REDUCES BOTH CHOLESTEROL & TRIGLYCERIDES. HOWEVER IT HAS NOT BEEN WELL TOLERATED BECAUSE OF GI REACTION.

American Medical Association, AMA Department of Drugs, AMA Drug Evaluations. 3rd ed. Littleton, Massachusetts: PSG Publishing Co., Inc., 1977., p. 161


For more Therapeutic Uses (Complete) data for P-AMINOSALICYLIC ACID (15 total), please visit the HSDB record page.


4.3 Drug Warning

UNDER NO CIRCUMSTANCES USE SOLN IF ITS COLOR IS DARKER THAN THAT OF FRESHLY PREPD SOLN. ... PREPARE SOLN OF CALCIUM, /POTASSIUM, & SODIUM SALTS/ WITHIN 24 HR OF ADMIN.

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 1149


FOR THE VARIOUS DEFECTS /FOR EXAMPLE, DEFICIENCY IN ERYTHROCYTE GLUCOSE-6-PHOSPHATE DEHYDROGENASE/ THAT SEEM TO BE SPECIFIC TO PARTICULAR RACES, DIFFERENT DRUGS ELICIT HEMOLYSIS. MOST IMPORTANT OF THESE ARE NITROFURANTOIN, AMINOSALICYLIC ACID...

The Chemical Society. Foreign Compound Metabolism in Mammals. Volume 1: A Review of the Literature Published Between 1960 and 1969. London: The Chemical Society, 1970., p. 429


IN PT WITH IMPAIRMENT OF KIDNEY OR OTHER MECHANISMS FOR CONTROLLING PLASMA CONCN, THE DRUG CAN CAUSE HYPERCALCEMIA. IT MAY ALSO CONTRIBUTE TO UROLITHIASIS. /CA SALT/

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 1149


The most frequent adverse effects of aminosalicylic acid or its salt are GI disturbances including nausea, vomiting, abdominal pain, diarrhea, and anorexia. Rarely, aminosalicylic acid has caused peptic ulcer and gastric hemorrhage. Adverse GI effects may be minimized in some patients by administering the aminosalicylates with meals; however, symptoms may be severe enough to require discontinuation of the drugs. Malabsorption of vitamin B12 folic acid, iron, and lipids has also occurred occasionally in patients receiving aminosalicylic acid or its salt, possibly as the result of increased peristalsis. The manufacturer states that maintenance therapy with vitamin B12 should be considered in patients receiving aminosalicylic acid for longer than 1 month.

McEvoy G.K. (ed.). American Hospital Formulary Service-Drug Information 96. Bethesda, MD: American Society of Health-System Pharmacists, Inc. 1996 (Plus Supplements)., p. 400


For more Drug Warnings (Complete) data for P-AMINOSALICYLIC ACID (12 total), please visit the HSDB record page.


4.4 Drug Indication

For the treatment of tuberculosis


Granupas is indicated for use as part of an appropriate combination regimen for multi-drug resistant tuberculosis in adults and paediatric patients from 28 days of age and older when an effective treatment regimen cannot otherwise be composed for reasons of resistance or tolerability (see section 4. 4).

Consideration should be given to official guidance on the appropriate use of antibacterial agents.


5 Pharmacology and Biochemistry
5.1 Pharmacology

Aminosalicylic acid is an anti-mycobacterial agent used with other anti-tuberculosis drugs (most often isoniazid) for the treatment of all forms of active tuberculosis due to susceptible strains of tubercle bacilli. The two major considerations in the clinical pharmacology of aminosalicylic acid are the prompt production of a toxic inactive metabolite under acid conditions and the short serum half life of one hour for the free drug. Aminosalicylic acid is bacteriostatic against Mycobacterium tuberculosis (prevents the multiplying of bacteria without destroying them). It also inhibits the onset of bacterial resistance to streptomycin and isoniazid.


5.2 MeSH Pharmacological Classification

Antitubercular Agents

Drugs used in the treatment of tuberculosis. They are divided into two main classes: "first-line" agents, those with the greatest efficacy and acceptable degrees of toxicity used successfully in the great majority of cases; and "second-line" drugs used in drug-resistant cases or those in which some other patient-related condition has compromised the effectiveness of primary therapy. (See all compounds classified as Antitubercular Agents.)


5.3 ATC Code

J04AA01


J - Antiinfectives for systemic use

J04 - Antimycobacterials

J04A - Drugs for treatment of tuberculosis

J04AA - Aminosalicylic acid and derivatives

J04AA01 - 4-aminosalicylic acid


5.4 Absorption, Distribution and Excretion

BIOAVAILABILITY STUDIES ON P-AMINOSALICYLIC ACID & ITS SALTS IN 12 SUBJECTS. COLORIMETRIC ASSAY INDICATED THAT PEAK BLOOD LEVELS OCCURRED @ 0.5, 0.75, 1.5, & 3 HR FOR SODIUM, POTASSIUM, & CALCIUM SALTS & P-AMINOSALICYLIC ACID, RESPECTIVELY.

WAN ET AL; J PHARMACOKINET BIOPHARM 2 (FEB): 1-12 (1974)


URINE EXCRETION DATA SHOWED ABSORPTION TO BE ESSENTIALLY COMPLETE ALTHOUGH RATES OF ABSORPTION DIFFERED.

WAN ET AL; J PHARMACOKINET BIOPHARM 2 (FEB): 1-12 (1974)


Aminosalicyclic acid is readily absorbed from the gastrointestinal tract. A single oral dose of 4 g of the free acid produces maximal concentrations in plasma of about 75 ug/ml within 1.5 to 2 hours. The sodium salt is absorbed even more rapidly. The drug appears to be distributed throughout the total body water and reaches high concentrations in pleural fluid and caseous tissue. However, values in CSF are low, perhaps because of active outward transport.

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1164


Over 80% of the drug is excreted in the urine; more than 50% is in the form of the acetylated compound. The largest portion of the remainder is made up of the free acid.

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1164


For more Absorption, Distribution and Excretion (Complete) data for P-AMINOSALICYLIC ACID (8 total), please visit the HSDB record page.


5.5 Metabolism/Metabolites

Hepatic.


ACETYLATION IS MAJOR ROUTE FOR INACTIVATION OF MANY DRUGS SUCH AS ... P-AMINOSALICYLIC ACID... ENZYMES WHICH CATALYSE THESE REACTIONS, ACETYL COENZYME A:N-ACETYLTRANSFERASES (EC2.3.1.5), ARE LOCATED IN LIVER CYTOSOL.

The Chemical Society. Foreign Compound Metabolism in Mammals Volume 3. London: The Chemical Society, 1975., p. 545


WHEN ADMIN ORALLY TO MAN IT IS RAPIDLY ABSORBED, & IS EXCRETED IN URINE AS UNCHANGED P-AMINOSALICYLIC ACID & AS ACETYL GLUCURONYL, GLYCYL & GLUTAMINYL CONJUGATES.

Parke, D. V. The Biochemistry of Foreign Compounds. Oxford: Pergamon Press, 1968., p. 176


YIELDS 5-AMINO-2-CARBOXYPHENYL-BETA-D-GLUCURONIDE IN MAN. 4-AMINOCATECHOL IN PSEUDOMONAS. 4-AMINOSALICYLOYLGLUTAMINE & 4-AMINOSALICYLOYLGLYCINE IN MAN. /TABLE/

Goodwin, B.L. Handbook of Intermediary Metabolism of Aromatic Compounds. New York: Wiley, 1976., p. A-52


Blood from tuberculosis patients was cultured before, during, and after withdrawal of therapy involving five different drug combinations if isoniazid, thiacetazone, p-aminosalicyclic acid, and streptomycin. The approaches used to detect DNA damage were chromosome aberrations and sister chromatid exchanges (SCEs). A total of 179 subjects were analyzed. In combo these drugs showed synergistic, additive, and antagonistic effects, though they were found to be nonclastogenic individually. Four of the drug combinations, isoniazid plus thiacetazone, isoniazid plus p-aminosalicyclic acid, isoniazid plus thiacetazone plus streptomycin, and isoniazid plus p-aminosalicyclic acid plus streptomycin, induced a significant incr in the frequency of aberrations, whereas isoniazid plus streptomycin did not induce aberrations. In fact, streptomycin appeared to reduce the frequency of aberrations. SCEs were incr in only two patients: one treated with isoniazid plus thiacetazone and the other with isoniazid plus p-aminosalicyclic acid. The frequency of aberrations after withdrawal of therapy was decr; it was slightly higher than the controls, though it was insignificant. The return to normalcy could be due to elimination of damaged cells or the repair of DNA in lymphocytes. Though the drug-induced aberrations do not persist after withdrawal of therapy, the chromosome damaging combo of drugs should be used with caution, because the possibility of meiotic chromosome damage in germ cells (during therapy), which might be passed on to the next generation, cannot be ruled out.

PMID:6205465 Jaju M et al; Teratog Carcinog Mutagen 4 (3): 261-72 (1984)


For more Metabolism/Metabolites (Complete) data for P-AMINOSALICYLIC ACID (9 total), please visit the HSDB record page.


5.6 Biological Half-Life

The drug has a half life of about 1 hour, and concentrations in plasma are negligible within 4 to 5 hours after a single conventional dose.

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1164


5.7 Mechanism of Action

There are two mechanisms responsible for aminosalicylic acid's bacteriostatic action against Mycobacterium tuberculosis. Firstly, aminosalicylic acid inhibits folic acid synthesis (without potentiation with antifolic compounds). The binding of para-aminobenzoic acid to pteridine synthetase acts as the first step in folic acid synthesis. Aminosalicylic acid binds pteridine synthetase with greater affinity than para-aminobenzoic acid, effectively inhibiting the synthesis of folic acid. As bacteria are unable to use external sources of folic acid, cell growth and multiplication slows. Secondly, aminosalicylic acid may inhibit the synthesis of the cell wall component, mycobactin, thus reducing iron uptake by M. tuberculosis.


The antimicrobial activity of aminosalicylic acid is highly specific, and microorganisms other than Mycobacterium tuberculosis are unaffected. Most nontuberculous mycobacteria are not inhibited by the drug.

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1164


Aminosalicyclic acid is a structural analog of paraaminobenzoic acid, and its mechanism of action appears to be very similar to that of the sulfonamides. Since the sulfonamides are ineffective against Mycobacterium tuberculosis, and aminosalicyclic is inactive against sulfonamide susceptible bacteria, it is probable that the enzymes responsible for folate biosynthesis in various microorganisms may be quite exacting in their capacity to distinguish various analogs from the true metabolite.

Hardman, J.G., L.E. Limbird, P.B. Molinoff, R.W. Ruddon, A.G. Goodman (eds.). Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996., p. 1164