Salsalate
DISALCID
What it isSalicylate that is NOT converted to acetylsalicylic acid; arthritis.
Why this oneIt does not inhibit platelets and, unlike other NSAIDs, does not raise serum lithium.
What limits itTinnitus is the first sign of salicylate excess. GI and renal risk persist at higher doses.
FDA-approved for
- rheumatoid arthritis / osteoarthritis
FDA label
Read the full label on DailyMed ↗
BOXED WARNING NSAID cardiovascular thrombotic risk (contraindicated for peri-operative CABG pain) and serious GI bleeding/ulceration/perforation risk
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Rheumatoid arthritis, osteoarthritis, related rheumatic disorders | Adult | 3000 mg/day divided | 3000 mg/day divided BID–TID | 3000 mg/day |
Renal Undefined
Hepatic Undefined
Instructions
- Use the lowest effective dose for the shortest duration
- Elderly may need a lower dose; full benefit may take 3–4 days at steady-state
Contraindications
- Asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs
- Peri-operative pain in the setting of CABG surgery
Cautions
- Serious cardiovascular thrombotic events (MI, stroke)
- Serious GI bleeding, ulceration, perforation — can occur without warning; elderly at greater risk
- Anaphylactoid reactions; caution in pre-existing asthma
Adverse reactions
- Tinnitus
- Nausea
- Hearing impairment
- Rash
- Vertigo
Pregnancy Undefined
Lactation Undefined
⚠ BOXED WARNINGS
- Cardiovascular thrombotic events
- Gastrointestinal bleeding, ulceration and perforation
Cost, est. cash$10–$300/month
Generic entryBy 2023
Classes and tags
Clinical profile
Legacy pregnancy categoryMultiple / indication-, trimester- or formulation-dependent
Defining liabilityGI bleeding, kidney injury, hypertension and fluid retention; many agents increase lithium concentrations.
Mechanism of action: Salsalate ballicule
Open Salsalate in the interactive console ↗
Memory aids: mascots and interaction avatars
“The N said... NSAID”
