Also indexed as: Amigesic, Disalcid, Marthritic, Mono Gesic,
Salflex, Salicylic Acid, Salsitab
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 May Be Beneficial: Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them. |
Folic acid*
Potassium*
Vitamin C*
|
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results. |
Lithium*
White willow*
|
| Side effect reduction/prevention |
None known
|
| Supportive interaction |
None known
|
| Reduced drug
absorption/bioavailability |
None known
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
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.
Interactions with Foods and Other Compounds
Food
Taking salsalate with food can slow the speed of absorption but not the overall amount of drug
absorbed;6 therefore, it can be taken with a meal, if needed, to avoid stomach
upset.
References: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.