What is Salsalate
Salsalate is a non-acetylated, nonsteroidal anti-inflammatory agent. Salsalate (salicylsalicylic acid) is composed of two molecules of salicylic acid joined by an ester link.
The ester bond of salsalate occurs at the carboxyl group of one salicylic acid molecule and the hydroxyl group of another. Salsalate has analgesic properties, but clinical evidence of its effectiveness as an antipyretic is lacking.
Salsalate is used in the treatment of osteoarthritis, rheumatoid arthritis, and other inflammatory conditions.
It has fewer gastrointestinal effects than aspirin and has no clinically significant effect on platelet function. Salsalate was FDA-approved in 1977.
Brand Names
- Amigesic
- Argesic-SA
- Disalcid
- Mono Gesic
- Salflex
Indications
- osteoarthritis
- rheumatoid arthritis
Side Effects
- abdominal pain
- acneiform rash
- agranulocytosis
- anaphylactoid reactions
- anemia
- angioedema
- aplastic anemia
- azotemia
- bronchospasm
- confusion
- constipation
- dehydration
- diaphoresis
- diarrhea
- disseminated intravascular coagulation (DIC)
- dizziness
- drowsiness
- elevated hepatic enzymes
- encephalopathy
- erythema nodosum
- fever
- gastritis
- GI bleeding
- GI perforation
- hallucinations
- headache
- hearing loss
- hepatic necrosis
- hepatitis
- hyperbilirubinemia
- hyperglycemia
- hypernatremia
- hypertension
- hyperuricemia
- hyperventilation
- hypoglycemia
- hypokalemia
- hypoprothrombinemia
- jaundice
- lethargy
- leukocytosis
- leukopenia
- lichen planus-like eruption
- maculopapular rash
- metabolic acidosis
- myocardial infarction
- nausea
- pancytopenia
- peptic ulcer
- proteinuria
- pruritus
- pulmonary edema
- purpura
- pyrosis (heartburn)
- rash
- renal papillary necrosis
- renal tubular necrosis
- respiratory depression
- Reye’s syndrome
- seizures
- stroke
- thrombocytopenia
- thromboembolism
- tinnitus
- urticaria
- vertigo
- visual impairment
- vomiting
- wheezing
Monitoring Parameters
- glucose-6-phosphate dehydrogenase (G6PD) activity
- serum creatinine/BUN
- serum salicylate concentrations
- stool guaiac
Contraindications
- acid/base imbalance
- acute bronchospasm
- alcoholism
- anemia
- angina
- anticoagulant therapy
- ascites
- asthma
- bone marrow suppression
- breast-feeding
- cardiac disease
- cerebrovascular disease
- children
- coagulopathy
- coronary artery bypass graft surgery (CABG)
- corticosteroid therapy
- dehydration
- edema
- esophagitis
- G6PD deficiency
- gastritis
- geriatric
- GI bleeding
- GI disease
- GI perforation
- gout
- heart failure
- hemophilia
- hepatic disease
- hypertension
- hyperuricemia
- hypoprothrombinemia
- hypothyroidism
- hypovolemia
- immunosuppression
- infection
- influenza
- jaundice
- labor
- metabolic acidosis
- metabolic alkalosis
- myocardial infarction
- nasal polyps
- neutropenia
- NSAID hypersensitivity
- obstetric delivery
- peptic ulcer disease
- peripheral vascular disease
- pregnancy
- renal disease
- renal failure
- renal impairment
- respiratory acidosis
- respiratory alkalosis
- Reye’s syndrome
- salicylate hypersensitivity
- stroke
- systemic lupus erythematosus (SLE)
- thromboembolism
- thrombolytic therapy
- thrombotic thrombocytopenic purpura (TTP)
- tobacco smoking
- varicella
- viral infection
- vitamin K deficiency
Interactions
- Acetaminophen
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acetazolamide
- Acetohexamide
- Acidifying Agents
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Alkalinizing Agents
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Aminoglycosides
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Angiotensin-converting enzyme inhibitors
- Antithrombin III
- Antithymocyte Globulin
- Apixaban
- Ardeparin
- Ascorbic Acid, Vitamin C
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Atenolol; Chlorthalidone
- Azilsartan; Chlorthalidone
- Bacitracin
- Barbiturates
- Benazepril
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Benzhydrocodone; Acetaminophen
- Beta-blockers
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Bromocriptine
- Bumetanide
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Canagliflozin
- Canagliflozin; Metformin
- Candesartan; Hydrochlorothiazide, HCTZ
- Capreomycin
- Captopril
- Captopril; Hydrochlorothiazide, HCTZ
- Cefixime
- Cefotetan
- Celecoxib
- Chlorothiazide
- Chlorpropamide
- Chlorthalidone
- Chlorthalidone; Clonidine
- Cidofovir
- Citalopram
- Citric Acid; Potassium Citrate
- Citric Acid; Potassium Citrate; Sodium Citrate
- Citric Acid; Sodium Citrate
- Colchicine; Probenecid
- Colistimethate, Colistin, Polymyxin E
- Corticosteroids
- Cyclosporine
- Dabigatran
- Dalteparin
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Daratumumab; Hyaluronidase
- Deferasirox
- Dichlorphenamide
- Diclofenac
- Diclofenac; Misoprostol
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Drotrecogin Alfa
- Edoxaban
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Enalapril, Enalaprilat
- Enalapril; Felodipine
- Enalapril; Hydrochlorothiazide, HCTZ
- Enoxaparin
- Eprosartan; Hydrochlorothiazide, HCTZ
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Escitalopram
- Esomeprazole; Naproxen
- Ethacrynic Acid
- Ethanol
- Ethotoin
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Flavocoxid, Flavocoxid; Citrated Zinc Bisglycinate
- Fluoxetine
- Fluoxetine; Olanzapine
- Flurbiprofen
- Fluvoxamine
- Fondaparinux
- Foscarnet
- Fosinopril
- Fosinopril; Hydrochlorothiazide, HCTZ
- Fosphenytoin
- Furosemide
- Gallium Ga 68 Dotatate
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Griseofulvin
- Heparin
- Hyaluronidase
- Hyaluronidase, Recombinant; Immune Globulin
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone; Ibuprofen
- Ibritumomab Tiuxetan
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Immune Globulin IV, IVIG, IGIV
- Incretin Mimetics
- Indapamide
- Inotersen
- Insulins
- Ketoprofen
- Ketorolac
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole; Naproxen
- Linagliptin
- Linagliptin; Metformin
- Lisinopril
- Lithium
- Loop diuretics
- Low Molecular Weight Heparins
- Macimorelin
- Mannitol
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Meclofenamate Sodium
- Mefenamic Acid
- Meglitinides
- Meloxicam
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methazolamide
- Methotrexate
- Methyclothiazide
- Metolazone
- Moexipril
- Mycophenolate
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nateglinide
- Nitazoxanide
- Omeprazole; Sodium Bicarbonate
- Oxaprozin
- Paroxetine
- Penicillins
- Pentosan
- Perindopril
- Perindopril; Amlodipine
- Phentermine; Topiramate
- Phenytoin
- Photosensitizing agents (topical)
- Pioglitazone
- Piroxicam
- Polymyxins
- Potassium Bicarbonate
- Potassium Chloride
- Potassium Citrate
- Pramlintide
- Probenecid
- Psyllium
- Quinapril
- Ramipril
- Repaglinide
- Rituximab; Hyaluronidase
- Rivaroxaban
- Rosiglitazone
- Salicylic Acid
- Saxagliptin
- Selective serotonin reuptake inhibitors
- Serotonin norepinephrine reuptake inhibitors
- Sertraline
- Simvastatin; Sitagliptin
- Sitagliptin
- Sodium Bicarbonate
- Sodium Hyaluronate, Hyaluronic Acid
- Sodium Lactate
- Sodium Thiosulfate; Salicylic Acid
- Spironolactone
- Sulfinpyrazone
- Sulfonamides
- Sulfonylureas
- Sulindac
- Tacrolimus
- Telavancin
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thiazide diuretics
- Thiazolidinediones
- Thrombin Inhibitors
- Thrombolytic Agents
- Tinzaparin
- Tolazamide
- Tolbutamide
- Tolmetin
- Topiramate
- Torsemide
- Trandolapril
- Trandolapril; Verapamil
- Trastuzumab; Hyaluronidase
- Trazodone
- Treprostinil
- Triamterene
- Tromethamine
- Valproic Acid, Divalproex Sodium
- Vancomycin
- Varicella-Zoster Virus Vaccine, Live
- Vilazodone
- Vortioxetine
- Warfarin
