12 August 2013

Salsalate Warning and Cautions

Part 1 of 3 parts

This is in three parts because there are many good points and some information that is not being given out in the hype for potential use for treatment of diabetes. This will be necessary for your doctor to determine before you could be given salsalate; if the FDA approves it for diabetes, (This is at least more than two years or more from now). We are fortunate that this has been around for centuries and in wide use in the last century, because we are aware of the side effects. It is currently being used (FDA approved) to treat cancer, osteoarthritis and rheumatoid arthritis which gives us a plethora of information.

This source covers the side effects and what to be alert for with salsalate. These are important enough to quote:
Before taking this medicine
Tell your doctor…
  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as asthma, nasal polyps, allergies, high blood pressure, kidney disease, liver disease (including hepatitis), stroke, high cholesterol, diabetes, or heart disease. These conditions increase the risk of side effects from or reactions to salsalate.
  • If you have ulcers or other stomach problem. Salsalate can worsen these conditions.
  • If you drink more than 3 alcoholic drinks per day. This can increase your risk of side effects while taking salsalate.
  • If you have gout. Salsalate may worsen it and also decrease the effects of some medicines used to treat gout.
  • If you have congestive heart failure or fluid retention (swelling, usually of the legs and feet). Salsalate may worsen this problem.
If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. There may be an increased risk of harm to the fetus if a woman takes this drug during pregnancy, especially during the last few months.
  • If you are breast-feeding. Salsalate passes into breast milk and can affect the baby.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.”

Interactions with other drugs – “this is serious:
#1. Taking salsalate while using "blood thinners" (such as warfarin and heparin) can increase your risk of serious bleeding.
#2. If you take salsalate while taking lithium, your lithium level may go up. This can increase your risk of toxic effects from lithium. You may need more frequent checking of lithium levels while on salsalate.
#3. Taking salsalate along with other non-steroidal anti-inflammatory drugs that are used for pain, inflammation, or fever, such as ibuprofen, naproxen, diclofenac, fenoprofen, indomethacin, and ketaprofen, can increase your risk of bleeding or other side effects.
#4. Taking salsalate along with other salicylates (or medicines containing salicylates) such as aspirin, trisalicylate, bismuth subsalicylate, etc., can result in a dangerous overdose of salicylates. See "Precautions" section for more details.
#5. Medicines for gout may not work properly while taking salsalate.
#6. Alcohol may increase your risk of stomach irritation or bleeding while taking salsalate. Steroids such as prednisone may also increase this risk.
#7. Pills that are used for diabetes (oral hypoglycemic drugs) may have more effect if taken with salsalate. This can increase your risk for low blood sugar.
#8. If you are taking medicine to make your urine less acid, salsalate may not work as well because it will be removed from the body more quickly.
#9. If salsalate is taken with antacids or drugs that block stomach acid, it may absorb too quickly and cause stomach irritation.”

Please check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine. Presently there are no known serious interactions with food. It is advised to always tell all doctors, dentists, nurses, and pharmacists that you are taking this drug.

Salsalate is a tablet or capsule, which is normally taken by mouth with food or a full glass (8 ounce) of water or milk. It is not to be taken with antacids. The dose will depend on why you are taking and how many times per day you are taking it (2 or 3 times). This is an often heard direction, but I will emphasize this in bold because it is so important for this medication. Take this drug exactly as directed by your doctor. Keep salsalate in a tightly closed container, away from heat, moisture, and out of the reach of children and pets.

Yes – first approved before 1984 (FDA cannot verify dates of drugs approved before 1984.)

This is a disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.

I urge you to read the source as I only covered part of it. Other warnings and cautions should be read here and here. There are other good sources, which you may wish to read about salsalate by typing it into your search engine and reading those of interest.

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