salsalate

Salsalate is a nonsteroidal anti-inflammatory 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 produced by the body 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.

Amigesic, Salflex, Argesic-SA, Marthritic, Salsitab, Artha-G

GENERIC AVAILABLE: Yes

Yes

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 (high blood pressure), and heart failure also have been associated with the use of NSAIDs.

The usual dose of salsalate is 3000 mg daily given over 2-4 doses. Salsalate should be taken with food to reduce stomach upset.

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, Lithobid) 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 aminoglycoside antibiotics (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 more side effects from methotrexate or aminoglycosides.

Individuals taking oral blood thinners or anticoagulants, for example, warfarin (Coumadin), should avoid NSAIDs because NSAIDs also thin the blood, and excessive blood thinning may lead to bleeding.

Persons who have more than 3 alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking NSAIDs.

There are no adequate studies of salsalate in pregnant women.

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.

What preparations of salsalate are available?

Tablets: 500 and 750 mg

How should I keep salsalate stored?

Salsalate should be stored at room temperature, 15 C (59 F - 86 F).