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salsalate (Salflex, Disalcid, sasapyrine)
Tradenames: Salflex, Disalcid.
Indications:
1) temporary relief from minor aches & pains, fever & inflammation
2) rheumatoid arthritis
3) osteoarthritis
4) lowers hemoglobin A1c in diabetes mellitus type-2 [4]
Contraindications:
- may exacerbate asthma [5]
Dosage:
- 750 mg PO QID, max 3 g/day.
Tabs: 500, 750 mg.
Pharmacokinetics:
1) bioavailability is dependent upon dose form
2) drug eliminated primarily by the kidneys
Adverse effects:
1) common (> 10%)
- nausea, heartburn, epigastric pain, dyspepsia
2) less common (1-10%)
- weakness, tiredness, hemolytic anemia, rash, dyspnea, gastrointestinal ulceration, anaphylactic shock
3) uncommon (< 1%)
- insomnia, nervousness, jitters, leukopenia, thrombocytopenia, hepatotoxicity, bronchospasm, iron-deficiency anemia, renal insufficiency, occult bleeding, hepatotoxicity
4) other
- may be associated with Reye's syndrome when used by children or teenagers with influenza or chicken pox
- does not appear to affect platelet aggregation
Drug interactions:
1) corticosteroids
a) increase clearance of salicylates
b) may increase nephrotoxicity
2) ACE inhibitors: decreased antihypertensive effect
3) warfarin: minimal prolonged bleeding time
4) salsalate increases methotrexate levels & possible toxicity
Mechanism of action:
- analgesic, antipyretic, anti-inflammatory & anti-rheumatic effects
Interactions
drug interactions
drug adverse effects of NSAIDs
monitor with non steroidal anti-inflammatory agents (NSIADs)
General
non-steroidal anti-inflammatory agent (NSAID)
salicylate
Properties
INHIBITS: cyclooxygenase
MISC-INFO: elimination route KIDNEY
1/2life 1 HOURS
pregnancy-category C
safety in lactation ?
Database Correlations
PUBCHEM cid=5161
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Goldfine AB et al.
The effects of salsalate on glycemic control in patients with
type 2 diabetes: A randomized trial.
Ann Intern Med 2010 Mar 16; 152:346.
PMID: 20231565
- NEJM Knowledge+ Allergy/Immunology