Salsalate

Salsalate

What is Salsalate?

Salsalate (brand names Amigesic®, Salflex®, Argesic-SA®, Marthritic®, Salsitab®, Artha-G®) is a non-steroidal anti-inflammatory drug (NSAID) that works by stopping the body’s production of an enzyme, cyclooxygenase, which makes prostaglandins, hormone-like substances that affect inflammation, muscle relaxation/contraction, and blood vessel contraction and dilation in the body. Salsalate is converted in the body to salicylic acid, which is closely related to aspirin and is the drug’s active form.

Why is it prescribed?

Salsalate is prescribed to treat pain, swelling, inflammation and fever. It is usually prescribed to treat the symptoms such as pain, swelling of joints and tenderness) caused by inflammation due to rheumatoid arthritis, osteoarthritis, and other similar conditions. It is also often used for tendinitis and bursitis.

What is the dosage?

Salsalate comes as a tablet of either 500 mg. or 750 mg., to be taken by mouth. The usual dose is a total 3000 mg. daily, spread over 2-4 times a day. Salsalate should be taken with food or milk to protect the stomach, and doses should be taken each day at around the same time. The lowest effective dose should be used, as side effects are dose-related.

It may take three to four days until the medication takes full effect.

Contraindications

Do not use Salsalate if you have previously had an allergic reaction to it, aspirin or other NSAIDs such as naproxen (Aleve®, Naprosyn®) or ibuprofen (Advil®, Motrin®), etc. Also be sure to let your doctor know about any other allergies you may have to either foods or medicines.

Before taking salsalate, consult your doctor or pharmacist if you have:

• Asthma, particularly if caused by aspirin (stuffy/runny nose after taking aspirin is one symptom)
• Kidney disease
• Liver disease
• Diabetes
• Gastrointestinal problems (bleeding, ulcers, recurring heartburn)
• Heart disease, history of heart attack or congestive heart disease.
• High blood pressure
• History of stroke
• Swelling of the hands, feet or ankles
• Dehydration
• Blood disorders or bleeding/clotting problems
• Polyps in the nose
• Certain genetic conditions (G-6-PD deficiency, for example)

Because this medication is similar to aspirin, children and teenagers should not take this medication if they have chickenpox, influenza, or an undiagnosed illness, or if they have just been given a vaccine, without first talking to a doctor, due to the risk of Reye’s syndrome.

Also tell your doctor if you smoke or drink alcoholic beverages. If you are planning on having surgery of any kind, tell your doctor you are taking Salsalate.

Interactions

Salsalate may interact with the following drugs. Please let your physician know if you are taking any of these drugs before starting Salsalate.

• Warfarin (Coumadin®), heparin or other blood thinners
• Anti-platelet drugs (e.g., cilostazol, clopidogrel)
• Corticosteroids, e.g. prednisone
• Cidofovir
• Cyclosporine
• Gout medications (such as probenecid)
• Lithium
• Methotrexate (Rheumatrex®)
• Oral biphosphonates (such as alendronate, a.k.a. Fosamax®)
• Pemetrexed
• SSRI antidepressants such as fluoxetine (Prozac®) or sertraline
• Tenofovir
• Diuretics such as furosemide (Lasix®), hydrochlorothiazide
• Drugs for seizures such as phenytoin (Dilantin®) or valproic acid (Depakote®)
• Aspirin and other NSAIDs
• Antacids
• Over-the-counter drugs containing salicylates , such as Pepto-Bismol® and Kaopectate® and Doan’s® pills.
• ACE (Angiotensin-Converting Enzyme) inhibitors, such as enalapril (Vasotec®) and benazepril (Lotensin®)
• ARBs (Angiotensin Receptor Blockers), such as valsartan (Diovan®)
• Beta-blockers such as metoprolol (Toprol®) or atenolol (Tenormin®)
• Oral medications for diabetes
• Thyroid medications

Side Effects

Diarrhea and dizziness are two common side effects of this medication. Call your doctor if they become severe or persistent.

Notify your doctor immediately and stop taking Salsalate if you have any of the following serious side effects. These symptoms may indicate an allergic reaction, an overdose, liver or kidney problems, heart problems or gastrointestinal bleeding.

• Stomach pain
• Heartburn
• Hearing changes/ringing in the ears
• Unexplained sudden weight gain
• Fever or chills
• Cough
• Sweating or flushing
• Muscle or joint pain
• Chest pain
• Pale/cold skin
• Blisters, rash, hives or itching
• Swelling of the tongue, throat, eyes or face
• Edema in the hands, arms or lower extremities
• Difficulty breathing or swallowing
• Dizziness
• Sore throat
• Tachycardia (fast heartbeat)
• Severe tiredness, no energy
• Unusual bleeding or bruising
• Feeling as if you have the flu
• Jaundice (a yellow color to the skin or eyes)
• Dark urine or cloudy/bloody urine
• Nausea or vomiting
• Abdominal pain
• Back pain
• Change in amount of urine

Salsalate and other NSAIDs may cause a higher risk of heart attack and stroke among those taking them, especially over long periods of time. Be sure to mention any heart-related symptoms to your doctor immediately.

References:

http://www.medicinenet.com/salsalate-oral/article.htm

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682880.html