Salsalate

Indications

Salsalate is used for: Rheumatoid arthritis, Osteoarthritis, Pain and fever

Adult Dose

Oral Osteoarthritis; Rheumatoid arthritis; Pain and fever Adult: Up to 3 g daily in divided doses.

Child Dose

Renal Dose

Administration

Should be taken with food. Take w/ food or milk.

Contra Indications

Haemophilia, haemorrhagic disorders, gout, hypersensitivity to aspirin or NSAIDs. Children <12 yr. Pregnancy (3rd trimester) and lactation. Severe renal or hepatic impairment.

Precautions

Peptic ulcers; asthma, allergic disorders. Impaired hepatic or renal function. Dehydrated patients; uncontrolled hypertension. May cause acute haemolytic anaemia in patients with G6PD deficiency.

Pregnancy-Lactation

Pregnancy Category: C Lactation: metabolite salicylate crosses into breast milk, use caution

Interactions

May increase risk of liver damage when used with gold compounds. GI effects may be enhanced with alcohol or concurrent use with corticosteroids. May increase activity of coumarin anticoagulants, sulfonylureas, zafirlukast, methotrexate, phenytoin and valproate. May decrease the activity of probenecid and sulfinpyrazone. Potentially Fatal: Increased risk of adverse effects when used with other NSAIDs.

Side Effects

Side effects of Salsalate : GI symptoms, hypersensitivity reactions, skin eruptions, angioedema, weakness, rhinitis and dyspnoea, hypoprothrombinaemia. Hepatotoxicity, renal impairment, iron-deficiency anaemia, occult bleeding. Local irritation (rectally); Reye's syndrome. Potentially Fatal: Paroxysmal bronchospasm, thrombocytopenia, leukopenia.

Mode of Action

Salsalate is a non-acetylated salicylic acid derivative with analgesic, anti-inflammatory and antipyretic actions similar to those of aspirin. It inhibits prostaglandin synthesis, acts on the hypothalamus heat-regulating center to reduce fever, blocks prostaglandin synthetase thus preventing thromboxane A2 formation.