Salate

Indications

Salsalate is a pain reliever and anti-inflammatory medicine. It is used to relieve pain, swelling and stiffness in rheumatoid arthritis, osteoarthritis and related joint conditions.

How It Works

Salsalate is broken down in the body into Salicylic Acid, the same active substance that comes from Aspirin. Salicylic acid reduces the production of prostaglandins, chemicals that cause pain and inflammation. Unlike Aspirin, it has little effect on blood platelets and tends to irritate the stomach less.

Dosage and Administration

Take as prescribed. The usual adult dose is 3000 mg a day, divided into 2 or 3 doses (for example 1500 mg twice daily or 1000 mg three times daily), taken with food or milk and a full glass of water. Older people may need a lower dose. It can take a few days to give full benefit.

Interactions

Do not take with Aspirin or other NSAIDs such as Ibuprofen or Diclofenac, as stomach side effects increase. It can increase the effect of Warfarin and other blood thinners, and of Methotrexate and some diabetes medicines (sulfonylureas). It may reduce the effect of blood pressure medicines and diuretics. Antacids can lower salicylate levels. Tell your doctor about all medicines you use.

Contraindications

Do not take if you are allergic to Salsalate, Aspirin or other salicylates, or if Aspirin or NSAIDs have caused asthma, hives or swelling. Not for children and teenagers with viral illnesses such as flu or chickenpox (risk of Reye's syndrome), or in active stomach ulcers or bleeding.

Side Effects

Possible side effects include stomach upset, heartburn, nausea, ringing in the ears, reduced hearing, dizziness, headache and rash. Ringing in the ears is often a sign the dose is too high.

Get urgent medical help if you have black or bloody stools, vomit blood or material like coffee grounds, severe stomach pain, swelling of the face or lips, wheezing or difficulty breathing, a severe skin reaction, confusion, or very little urine.

Pregnancy and Lactation

Avoid in pregnancy unless your doctor advises it, and do not use in the last 3 months of pregnancy, as salicylates can harm the baby and affect labour. Salicylates pass into breast milk; ask your doctor before using while breastfeeding.

Precautions and Warnings

Use with care in kidney or liver disease, asthma, heart failure, high blood pressure, gout, and a history of stomach ulcers. Avoid alcohol, which raises the risk of stomach bleeding. Long-term use may need blood salicylate level checks. Stop before surgery if your doctor advises.

Overdose

Overdose can cause ringing in the ears, fast breathing, vomiting, sweating, fever, confusion, drowsiness and seizures, and can be life-threatening. Go to the nearest hospital straight away.

Therapeutic Class

Non-steroidal anti-inflammatory drug (NSAID), salicylate.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.