magnesium salicylate

Absorption: Well absorbed after oral administration.

Distribution: Rapidly and widely distributed; crosses the placenta and enter breast milk.

Metabolism/Excretion: Extensively metabolized by the liver; inactive metabolites excreted by the kidneys. Amount excreted unchanged by the kidneys depends on urine pH; as pH increases, amount excreted unchanged increases from 2–3% up to 80%.

Half-Life: 2–3 hr for low doses; up to 15–30 hr with larger doses because of saturation of liver metabolism.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	5–30 min	1–3 hr	3–6 hr

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to aspirin or other salicylates;
Cross-sensitivity with other NSAIDs may exist (less with nonaspirin salicylates);
Children or adolescents with viral infections (may increase the risk of Reye’s syndrome).

Use Cautiously in:

History of GI bleeding or ulcer disease;
Chronic alcohol use/abuse;
Severe renal disease (magnesium toxicity may occur);
Severe hepatic disease;
Geriatric patients (↑ risk of adverse reactions especially GI bleeding; more sensitive to toxic levels);
OB: Salicylates may have adverse effects on fetus and mother and in general should be avoided during pregnancy, especially during the 3rd trimester;
Lactation: Safety not established.

Adv. Reactions/Side Effects ⬆ ⬇

EENT: tinnitus

GI: dyspepsia, epigastric distress, nausea, GI BLEEDING, abdominal pain, anorexia, hepatotoxicity, vomiting

Misc: ANAPHYLAXIS AND LARYNGEAL EDEMAALLERGIC REACTIONS INCLUDING

Interactions ⬆ ⬇

Drug-drug:

May ↑ activity of penicillins, phenytoin, methotrexate, valproic acid, oral hypoglycemic agents, and sulfonamides.
May ↓ beneficial effects of probenecid.
Urinary acidification↑ reabsorption and may ↑ serum salicylate levels.
Alkalinization of the urine or the ingestion of large amounts of antacids ↑excretion and ↓ serum salicylate levels.
May blunt the therapeutic response to diuretics or other antihypertensives.
↑risk of GI irritation with NSAIDs.

Drug-Food:

Foods capable of acidifying the urine (see Food Sources for Specific Nutrients) may ↑ serum salicylate levels.

Route/Dosage ⬆ ⬇

PO (Adults ): 304 mg q 4 hr or 467 mg q 6 hr.

Availability ⬆ ⬇

Tablets: 304 mg^OTC; 467 mg^OTC; 545 mg; 600 mg; 650 mg

Assessment ⬆ ⬇

Patients who have asthma, allergies, and nasal polyps or who are allergic to tartrazine are at an increased risk for developing hypersensitivity reactions.
Pain: Assess pain and limitation of movement; note type, location, and intensity before and at the peak (see Time/Action Profile) after administration.
Fever: Assess fever and note associated signs (diaphoresis, tachycardia, malaise, chills).

Lab Test Considerations:

Monitor hepatic function before antirheumatic therapy and if symptoms of hepatotoxicity occur; more likely in patients, especially children, with rheumatic fever, systemic lupus erythematosus, juvenile arthritis, or pre-existing hepatic disease. May cause ↑ serum AST, ALT, and alkaline phosphatase, especially when plasma concentrations exceed 25 mg/100 mL. May return to normal despite continued use or dose reduction. If severe abnormalities or active liver disease occurs, discontinue and use with caution in future.
- Monitor serum salicylate levels periodically with prolonged high-dose therapy to determine dose, safety, and efficacy, especially in children with Kawasaki disease.
- May alter results of serum uric acid, urine vanillylmandelic acid (VMA), protirelin-induced thyroid-stimulating hormone (TSH), urine hydroxyindoleacetic acid (5-HIAA) determinations, and radionuclide thyroid imaging.

Toxicity and Overdose:

Monitor patient for the onset of tinnitus, headache, hyperventilation, agitation, mental confusion, lethargy, diarrhea, and sweating. If these symptoms appear, withhold medication and notify physician or other health care professional immediately.

Implementation ⬆ ⬇

Use lowest effective dose for shortest period of time.
PO: Administer after meals or with food or an antacid to minimize gastric irritation. Food slows but does not alter the total amount absorbed.

Patient/Family Teaching ⬆ ⬇

Instruct patient to take salicylates with a full glass of water and to remain in an upright position for 15–30 min after administration.
- Advise patient to report tinnitus; unusual bleeding of gums; bruising; black, tarry stools; or fever lasting longer than 3 days.
- Caution patient to avoid concurrent use of alcohol with this medication to minimize possible gastric irritation; 3 or more glasses of alcohol per day may increase the risk of GI bleeding. Caution patient to avoid taking concurrently with acetaminophen or NSAIDs for more than a few days, unless directed by health care professional to prevent analgesic nephropathy.
- Teach patients on a sodium-restricted diet to avoid effervescent tablets or buffered-aspirin preparations.
- Tablets with an acetic (vinegar-like) odor should be discarded.
- Advise patients on long-term therapy to inform health care professional of medication regimen before surgery. Salicylates may need to be withheld for 1 wk before surgery.

Evaluation/Desired Outcomes ⬆ ⬇

Relief of mild to moderate discomfort.
Increased ease of joint movement. May take 2–3 wk for maximum effectiveness.
Reduction of fever.

US Brand Names ⬆ ⬇

Doan’s Regular Strength Tablets, Magan, Mobidin

Canadian Brand Names ⬆ ⬇

Doan’s Backache Pills

Code ⬆

NDC Code

15127- Land R Distributors, Inc.
- 15127-448- Backache Aid
  - 15127-448-24- 3 BLISTER PACK in 1 CARTON (15127-448-24) > 8 TABLET, FILM COATED in 1 BLISTER PACK

55741- Dr. Reddy's Laboratories Inc.
- 55741-224- Doans Extra Strength
  - 55741-224-24- 1 BOTTLE in 1 BOX (55741-224-24) > 24 TABLET in 1 BOTTLE

59779- CVS Pharmacy
- 59779-338- Backache Relief
  - 59779-338-08- 3 BLISTER PACK in 1 CARTON (59779-338-08) > 8 TABLET, FILM COATED in 1 BLISTER PACK

63029- Medtech Products Inc.
- 63029-051- Percogesic
  - 63029-051-48- 1 BOTTLE in 1 CARTON (63029-051-48) > 48 TABLET, COATED in 1 BOTTLE

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇