Salsalate is used to treat rheumatoid arthritis and osteoarthritis and is in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).
Safetychecker Summary
for Salsalate
(for details about the summarized interactions, read the full article)
|
Folic acid* Potassium* Vitamin C* |
|
|
Lithium* White willow* |
|
| Side effect reduction/prevention |
None known |
| Supportive interaction |
None known |
| Reduced drug absorption/bioavailability |
None known |
Interactions with Dietary Supplements
Folic
acid
Salsalate and aspirin produce
anti-inflammatory effects after they are converted in the body to salicylic acid. Studies have
shown that aspirin can reduce the amount of folic acid in the blood,1 though it is
not known whether this change is significant. Controlled studies are needed to determine
whether people taking salsalate are at risk for folic acid deficiency.
Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts
to treat mood disorders such as manic-depression (bipolar disorder). Most NSAIDs inhibit the excretion
of lithium from the body, resulting in higher blood levels of the mineral, though sulindac may have an opposite effect.2
Since major changes in lithium blood levels can produce unwanted side effects or interfere
with its efficacy, NSAIDs should be used with caution, and only under medical supervision, in
people taking lithium supplements.
Potassium
Salsalate and aspirin are rapidly converted in
the body to salicylic acid. Taking large amounts of aspirin can result in lower than normal
blood levels of potassium,3 though it is not known whether this change is
significant. Controlled studies are needed to determine whether people taking salsalate are at
risk for potassium deficiency.
Vitamin
C
Salsalate and aspirin are rapidly converted in
the body to salicylic acid. Controlled studies show that taking aspirin increases the
elimination of vitamin C from the body and lowers blood levels.4 Further controlled
research is needed to determine whether salsalate specifically reduces vitamin C levels and
whether people taking the drug are at risk for vitamin C deficiency.
Interactions with Herbs
Willow
(Salix alba)
Willow bark contains salicin, which is related to
aspirin. Salsalate, salicin, and aspirin produce anti-inflammatory effects after they have
been converted to salicylic acid in the body. Taking aspirin at the same time as other
salicylate drugs can result in adverse effects, such as ringing in the ears, dizziness, headache, confusion,
and diarrhea.5 Though there are no
studies specifically investigating an interaction between willow bark and salsalate, people
taking salsalate should probably avoid using the herb until more information is available.
1. Alter HJ, Zvaifler NJ, Rath CE. Interrelationship of rheumatoid arthritis, folic acid and aspirin. Blood 1971;38:405–16.
2. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
3. Smith MJH, Smith PK, eds. The Salicylates: A Critical Bibliographic Review. New York: Interscience, 1966.
4. Loh HS, Watters K, Wilson CWM. The effects of aspirin on the metabolic availability of ascorbic acid in human beings. J Clin Pharmacol 1974;13:480.
5. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1661–2.
6. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1661–2.
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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2003.