What is salsalate, and how does it work (mechanism of action)?
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.
What brand names are available for salsalate?
Amigesic, Salflex, Argesic-SA, Marthritic, Salsitab, Artha-G
Is salsalate available as a generic drug?
GENERIC AVAILABLE: Yes
Do I need a prescription for salsalate?
Yes
What are the side effects of salsalate?
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.
What is the dosage for salsalate?
The usual dose of salsalate is 3000 mg daily given over 2-4 doses.
Salsalate should be taken with food to reduce stomach upset.
Which drugs or supplements interact with salsalate?
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.
QUESTION
The term arthritis refers to stiffness in the joints.
See Answer
Is salsalate safe to take if I’m pregnant or breastfeeding?
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 else should I know about salsalate?
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).