Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: salsalate
BRAND NAME: Amigesic, Salflex, Argesic-SA, Marthritic, Salsitab, Artha-G, (Note: Disalcid is no longer available in the U.S.)
DRUG CLASS AND MECHANISM: Salsalate is a
nonsteroidal antiinflammatory drug
(NSAID) that is used for treating fever, pain, and inflammation in the body.
Salsalate is converted in the body to salicylic acid which is its active form
and is closely related to aspirin. Other NSAIDs include ibuprofen (Motrin),
indomethacin (Indocin), nabumetone (Relafen), naproxen (Aleve) and several
others. They work by reducing the levels of prostaglandins, chemicals that are
responsible for pain, fever, and inflammation. Salsalate blocks the enzyme that
makes prostaglandins (cyclooxygenase), resulting in lower concentrations of
prostaglandins. As a consequence, inflammation, pain and fever are reduced.
Salsalate is as strong as aspirin in reducing inflammation but has less effect
on blood clotting than aspirin.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 500, 750 mg
STORAGE: Salsalate should be stored at room temperature 15-0 C (59-86 F).
PRESCRIBED FOR: Salsalate is used for treating rheumatoid arthritis and
osteoarthritis. It also is used for the treatment of inflammation and pain
resulting from soft tissue injuries,
tendinitis, bursitis, and similar
conditions.
DOSING: The usual dose of salsalate is 3000 mg daily given over 2-4 doses.
Salsalate should be taken with food to reduce stomach upset.
DRUG INTERACTIONS: Salsalate, like aspirin, is converted to salicylic acid.
Therefore, adding aspirin to salsalate can cause salicylic acid toxicity.
NSAIDs may increase the blood levels of lithium (Eskalith) by reducing the
excretion of lithium by the kidneys. Increased levels of lithium may lead to
lithium toxicity.
NSAIDs may reduce the blood pressure lowering effects of blood pressure
medications. This may occur because prostaglandins play a role in the regulation
(lowering) of blood pressure.
When NSAIDs are combined with methotrexate (Rheumatrex, Trexall) or aminoglycosides (for
example, gentamicin) the blood levels of methotrexate or aminoglycoside may
increase, presumably because the elimination of methotrexate or aminoglycosides
is reduced. This may lead to side effects from methotrexate or aminoglycosides.
PREGNANCY: There are no adequate studies of salsalate in
pregnant women.
NURSING MOTHERS: Salicylic acid appears in
breast milk at levels close to
maternal blood levels. This may cause adverse effects in the infant. Nursing
women should avoid nursing while taking salsalate or use alternate drugs.
SIDE EFFECTS: Most patients benefit from salsalate and other NSAIDs with few
side effects. However, serious side effects can occur and generally tend to be
dose-related (are more common at higher doses). Therefore, it is advisable to
use the lowest effective dose to minimize side effects. The most common side
effects of salsalate involve the gastrointestinal system and ringing in the ears
(tinnitus). It can cause ulcerations of the stomach and intestines, abdominal
pain, cramping, nausea,
vomiting, gastritis, and even serious gastrointestinal
bleeding and liver toxicity. Sometimes, ulceration and bleeding may occur
without any abdominal pain.
Black tarry stools, weakness, and dizziness upon
standing (orthostatic hypotension) may be the only signs of internal
bleeding.
Patients who develop tinnitus may need to reduce the dose of salsalate. Rash,
kidney impairment, vertigo, and lightheadedness also may occur. Fluid
retention, blood clots, heart attacks,
hypertension, and heart failure also have
been associated with the use of NSAIDs.
Reference: FDA Prescribing Information
Last Editorial Review: 3/27/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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