No

Salicylate

Temporary relief of pain of rheumatoid arthritis, rheumatic fever, osteoarthritis, and other conditions for which oral salicylates are recommended; useful in patients in which there is difficulty in administering doses in a tablet or capsule dosage form, because of the liquid dosage form

C (D in 3rd trimester)

Hypersensitivity to salicylates or any component or other nonacetylated salicylates

Use with caution in patients with impaired renal function, dehydration, erosive gastritis, or peptic ulcer; avoid use in patients with suspected varicella or influenza (salicylates have been associated with Reye's syndrome in children <16 years of age when used to treat symptoms of chickenpox or the flu)

>10%: Gastrointestinal: Nausea, heartburn, stomach pains, dyspepsia, epigastric discomfort

1% to 10%:

Central nervous system: Fatigue

Dermatologic: Rash

Gastrointestinal: Gastrointestinal ulceration

Hematologic: Hemolytic anemia

Neuromuscular & skeletal: Weakness

Respiratory: Dyspnea

Miscellaneous: Anaphylactic shock

<1%: Insomnia, nervousness, jitters, occult bleeding, prolongation of bleeding time, leukopenia, thrombocytopenia, iron deficiency anemia, hepatotoxicity, impaired renal function, bronchospasm

Symptoms of overdose include tinnitus, vomiting, acute renal failure, hyperthermia, irritability, seizures, coma, metabolic acidosis

For acute ingestions, determine serum salicylate levels 6 hours after ingestion; the "Done" nomogram may be helpful for estimating the severity of aspirin poisoning and directing treatment using serum salicylate levels.

Treatment should also be based upon symptomatology. Toxic symptoms and corresponding treatments are as follows:

• Overdose: Induce emesis with ipecac, and/or lavage with saline, followed with activated charcoal
• Dehydration: I.V. fluids with KCl (no D₅W only)
• Metabolic acidosis (must be treated): Sodium bicarbonate
• Hyperthermia: Cooling blankets or sponge baths
• Coagulopathy/hemorrhage: Vitamin K I.V.
• Hypoglycemia (with coma, seizures, or change in mental status): Dextrose 25 g I.V.
• Seizures: Diazepam 5-10 mg I.V.

Decreased effect with antacids; ACE-inhibitor effects may be decreased by concurrent therapy with NSAIDS

Increased effect of warfarin

Inhibits prostaglandin synthesis; acts on the hypothalamus heat-regulating center to reduce fever; blocks the generation of pain impulses

Absorption: From the stomach and small intestine within ~2 hours

Distribution: Readily distributes into most body fluids and tissues; crosses the placenta; appears in breast milk

Protein binding: 75% to 90%

Metabolism: Hydrolyzed to salicylate in the liver

Half-life: Dose-dependent ranging from 2-3 hours at low doses to 30 hours at high doses

Time to peak serum concentration: 1-2 hours

Elimination: In urine

Children >12 years and Adults: Oral: 5 mL (870 mg) every 3-4 hours, if necessary, but not more than 6 doses in 24 hours

Rheumatoid arthritis: 870-1740 mg (5-10 mL) up to 4 times/day

Dosing adjustment/comments in renal impairment: Avoid use in severe renal impairment

May be administered with food

False-negative results for Clinistix® urine test; false-positive results with Clinitest®

No information available to require special precautions

NSAID formulations are known to reversibly decrease platelet aggregation via mechanisms different than observed with aspirin. The dentist should be aware of the potential of abnormal coagulation. Caution should also be exercised in the use of NSAIDs in patients already on anticoagulant therapy with drugs such as warfarin (Coumadin®).

Take with food; do not take with antacids; watch for bleeding gums or any signs of GI bleeding; take with food or milk to minimize GI distress, notify physician if ringing in ears or persistent GI pain occurs

Liquid may be mixed with fruit juice just before drinking; do not administer with antacids

Liquid (mint flavor): 870 mg/5 mL (240 mL, 480 mL)