Salsalate

Oral
Osteoarthritis, Pain and fever, Rheumatoid arthritis

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

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

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

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.

PO: C (Avoid during 3rd trimester or near delivery)

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.

Glucose oxidase urinary glucose tests: False-negative results. Cupric sulfate method: False-positive. Interferes with Gerhardt test, vanillyl mandelic acid (VMA) determination; 5-hydroxy indole acetic acid (5-HIAA), xylose tolerance test and T₃ and T₄.

Description: 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.
Onset: Therapeutic: 3-4 days (continuous dosing).
Pharmacokinetics:
Absorption: Each molecule of salsalate is hydrolysed in the small intestines to 2 molecules of salicylic acid.
Excretion: About 13% of salsalate is excreted as glucuronide conjugates in the urine.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)