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Salsalate is a
nonsteroidal anti-inflammatory drug (NSAID).
Salsalate is a nonsteroidal anti-inflammatory drug (NSAID).
It is mainly used for treating pain and inflammation caused due to arthritis
and rheumatoid arthritis. It works by blocking several different chemical
processes within the body that cause pain and inflammation.
Pharmacological
class: NSAID
Salsalate is believed to act primarily through the
inhibition of prostaglandin synthesis. This prostaglandin synthesis inhibition
is done through the inactivation of cyclooxygenase-1 (COX-1) and COX-2, which
are responsible for catalyzing the formation of prostaglandins in the
arachidonic acid pathway. Although salicylic acid (the primary metabolite of
salsalate) is a weak inhibitor of prostaglandin synthesis in vitro, salsalate appears to selectively inhibit prostaglandin
synthesis in vivo, providing
anti-inflammatory activity equivalent to aspirin and indomethacin. Unlike
aspirin, salsalate does not inhibit platelet aggregation.
Osteoarthritis: 3000
mg orally, daily in divided doses
Rheumatoid Arthritis:
3000 mg orally, daily in divided doses
Salsalate is insoluble in acid gastric fluids, but readily
soluble in the small intestine where it is partially hydrolyzed to two
molecules of salicylic acid. A significant portion of the parent compound is
absorbed unchanged. Food slows the absorption of all salicylates including
salsalate. Salsalate is readily soluble in the small intestine where it is
partially hydrolyzed to two molecules of salicylic acid. A significant portion
of the parent compound is absorbed unchanged and undergoes rapid esterase
hydrolysis in the body. The parent compound has an elimination half-life of
about 1 hour.
Common (affecting between 1
in 10 to 1 in 100):
Uncommon (affecting 1 in 100 to 1 in 1000):
Very rare (affecting less than 1 in 10,000):
Total 301 patients meeting
the ACR criteria for RA were drawn from 16 centers. After withdrawal of NSAIDs
and subsequent flare, patients were randomized to receive either salsalate or
diclofenac for 8 weeks, according to a double blind, double dummy protocol.
Initial doses of salsalate 3.0 g/day and diclofenac 75 mg/day were titrated for
the first 5 weeks. The primary outcome measure was a multivariate analysis at 8
weeks of tender joint count, pain, visual analog scale score, and physician's
global assessment. A 190 patients completed the study. All outcomes showed a
tendency for more improvement with salsalate. Salsalate is as efficacious as
diclofenac. It may be considered an alternative to other NSAID as the first
line treatment of patients with RA.1
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