Salsalate

(sal-suh-late)

Trade/other name(s): disalicylic acid, Amigesic, Argesic SA, Disalcid, Mono-Gesic, Salflex, Salsalate, Salsitab, and others

Why would this drug be used?

Salsalate is used to help relieve pain, fever, or inflammation. It may also be prescribed for other uses.

How does this drug work?

Salsalate is a non-opioid pain medicines, meaning that it is not in the same family as morphine or codeine. It belongs to the general class of drugs called salicylates, which fall within a larger category called non-steroidal anti-inflammatory drugs (NSAIDs). It helps block the body from making prostaglandins. (Prostaglandins are substances made by most of the cells in the body. They have a role in many body functions, including pain and inflammation.) Salsalate helps prevent pain receptors from passing the pain message to the brain. This drug reduces inflammation and also reduces fever by helping the body expand blood vessels so that heat is lost from the body. Salsalate is similar to aspirin, but has fewer side effects.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• If you have any medical conditions such as asthma, nasal polyps, allergies, high blood pressure, kidney disease, liver disease (including hepatitis), stroke, high cholesterol, diabetes, or heart disease. These conditions increase the risk of side effects from or reactions to salsalate.
• If you have ulcers or other stomach problem. Salsalate can worsen these conditions.
• If you drink more than 3 alcoholic drinks per day. This can increase your risk of side effects while taking salsalate.
• If you have gout. Salsalate may worsen it and also decrease the effects of some medicines used to treat gout.
• If you have congestive heart failure or fluid retention (swelling, usually of the legs and feet). Salsalate may worsen this problem.

If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. There may be an increased risk of harm to the fetus if a woman takes this drug during pregnancy, especially during the last few months.

• If you are breast-feeding. Salsalate passes into breast milk and can affect the baby.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Taking salsalate while using "blood thinners" (such as warfarin and heparin) can increase your risk of serious bleeding.

If you take salsalate while taking lithium, your lithium level may go up. This can increase your risk of toxic effects from lithium. You may need more frequent checking of lithium levels while on salsalate.

Taking salsalate along with other non-steroidal anti-inflammatory drugs that are used for pain, inflammation, or fever, such as ibuprofen, naproxen, diclofenac, fenoprofen, indomethacin, and ketaprofen, can increase your risk of bleeding or other side effects.

Taking salsalate along with other salicylates (or medicines containing salicylates) such as aspirin, trisalicylate, bismuth subsalicylate, etc., can result in a dangerous overdose of salicylates. See "Precautions" section for more details.

Medicines for gout may not work properly while taking salsalate.

Alcohol may increase your risk of stomach irritation or bleeding while taking salsalate. Steroids such as prednisone may also increase this risk.

Pills that are used for diabetes (oral hypoglycemic drugs) may have more effect if taken with salsalate. This can increase your risk for low blood sugar.

If you are taking medicine to make your urine less acid, salsalate may not work as well because it will be removed from the body more quickly.

If salsalate is taken with antacids or drugs that block stomach acid, it may absorb too quickly and cause stomach irritation.

Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Salsalate is a tablet or capsule, which is usually taken by mouth with food and a full glass (8 oz.) of water or milk. Do not take with antacids.

The dose depends on why you are taking it and how well it works for you. It is most often taken 2 or 3 times per day. Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you.

Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.

Precautions

If you are allergic to aspirin, you may also react to salsalate, which is a salicylate very similar to aspirin. Talk to your doctor before use.

Avoid aspirin and other salicylates while on salsalate. Aspirin is often added to other medicines (prescription and non-prescription). To avoid overdosing on salicylates, ask your doctor, pharmacist, or nurse if aspirin or another salicylate is in any of your medicines before you start taking salsalate. Read the ingredient list on all non-prescription remedies for headache, sinus, cold, flu, diarrhea, and other problems before taking them. If you are not sure, ask your pharmacist.

Avoid salsalate if you have a stomach or duodenal ulcer. It can cause severe bleeding or holes in the intestine.

If you have ever had trouble breathing, rash, itching, or swelling in the mouth or throat after taking aspirin or other anti-inflammatory drugs, do not take salsalate.

Your doctor may want to check your lab work and blood pressure more often if you are taking salsalate for more than a few weeks. This is to help find problems early, before they worsen.

Call your doctor or nurse right away if you have bleeding from the stomach or intestines, such as vomiting blood or coffee-ground material, blood in your stool, or black, tarry stools. Stop taking salsalate until after you talk with your doctor.

Call your doctor or nurse right away if you have dizziness, ringing in your ears, nausea, vomiting, headache, or sweating. These symptoms usually occur when too much salicylate is taken. Stop taking salsalate until you talk to your doctor or nurse.

Salsalate can increase your risk of heart attack and stroke. If you develop shortness of breath, chest pain, weakness in one part or on one side of the body, or slurred speech, get help right away.

If you think that you or anyone else may have taken an overdose of salsalate, or of salicylates, get emergency help right away. Symptoms of overdose include dizziness, ringing or buzzing in the ears (tinnitus), decreased hearing, nausea, vomiting, diarrhea, mental confusion, headache, sweating, fast breathing, and sleepiness or drowsiness. Be careful not to take more than the recommended doses.

Do not give salsalate or other salicylates to a child or teen with a fever or other symptoms of viral infection without first discussing it with the child's doctor. It may cause a serious illness called Reye's syndrome in children and teens with viral infections, especially flu and chickenpox.

Possible side effects

Most of the following side effects probably will not occur. Your doctor or nurse will want to discuss specific care instructions with you. They can help you understand these side effects and help you deal with them.

Less common

• nausea
• heartburn
• liver damage (which usually improves when the medicine is stopped)
• loss of appetite
• increased risk of peptic ulcer*
• ringing in the ears (tinnitus)*
• vomiting
• diarrhea
• confusion*
• feeling sleepy or drowsy*
• headache
• sweating

Rare

• decreased hearing (usually improves when the medicine is stopped)
• allergic reaction, with swelling of the face, eyes, mouth or throat, itchy skin welts, dizziness, or shortness of breath*
• increased bleeding time*
• low white blood cell count with increased risk of infection
• low platelet count with increased risk of bleeding
• bleeding in the stomach or intestine
• rash
• stroke*
• heart attack*

*See the "Precautions" section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved before 1984 (FDA cannot verify dates of drugs approved before 1984.)

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.