magnesium salicylate (OTC)

Brand and Other Names:Doan's Extra Strength, Percogesic Maximum Strength Backache Relief
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 325 mg
  • 580 mg as tetrahydrate (equal to 467.2 mg anhydrous magnesium salicylate)
  • 600 mg

Mild-to-Moderate Pain

2 tabs PO q6hr PRN; not to exceed 8 tabs/24 hr

Dosage Forms & Strengths

tablet

  • 325 mg
  • 580 mg as tetrahydrate (equal to 467.2 mg anhydrous magnesium salicylate)
  • 600 mg

Mild-to-Moderate Pain

<12 years: Safety and efficacy not established

>12 years: 2 tabs PO q6hr PRN; not to exceed 8 tabs/24 hr

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Interactions

Interaction Checker

and magnesium salicylate

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (1)

            • dichlorphenamide

              dichlorphenamide increases levels of magnesium salicylate by unspecified interaction mechanism. Contraindicated. Coadministration of dichlorphenamide with high-dose aspirin may increase salicylate levels. Anorexia, tachypnea, lethargy, and coma reported.

            Serious - Use Alternative (1)

            • warfarin

              magnesium salicylate increases effects of warfarin by anticoagulation. Avoid or Use Alternate Drug.

            Monitor Closely (17)

            • benazepril

              benazepril, magnesium salicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly with high dose aspirin, elderly or volume depleted individuals.

            • captopril

              captopril, magnesium salicylate. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

            • deferiprone

              magnesium salicylate decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.

            • insulin aspart

              magnesium salicylate increases effects of insulin aspart by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin aspart protamine/insulin aspart

              magnesium salicylate increases effects of insulin aspart protamine/insulin aspart by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin degludec

              magnesium salicylate increases effects of insulin degludec by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin degludec/insulin aspart

              magnesium salicylate, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

            • insulin detemir

              magnesium salicylate increases effects of insulin detemir by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin glargine

              magnesium salicylate increases effects of insulin glargine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin glulisine

              magnesium salicylate increases effects of insulin glulisine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin inhaled

              magnesium salicylate increases effects of insulin inhaled by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin isophane human/insulin regular human

              magnesium salicylate increases effects of insulin isophane human/insulin regular human by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin lispro

              magnesium salicylate increases effects of insulin lispro by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin lispro protamine/insulin lispro

              magnesium salicylate increases effects of insulin lispro protamine/insulin lispro by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin NPH

              magnesium salicylate increases effects of insulin NPH by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • insulin regular human

              magnesium salicylate increases effects of insulin regular human by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

            • tobramycin inhaled

              tobramycin inhaled and magnesium salicylate both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

            Minor (0)

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              Warnings

              Contraindications

              Hypersensitivity

              Advanced chronic renal impairment

              Coadministration with uricosuric agents

              Elderly patients (65 years or older) with carditis, hepatic impairment

              Children and adolescents with viral illness (eg, varicella, influenza); increased risk for Reye’s syndrome

              Cautions

              Chronic ingestion of salicylates in patients older than 65 years may cause noncardiogenic pulmonary edema

              May cause GI ulceration or bleeding

              Consuming 3 or more alcoholic drinks daily may increase risk for GI bleeding

              Caution in patients with asthma; may have increased risk for hypersensitivity or exacerbation of asthma

              Do not take if on other chronic NSAIDs

              Caution if coadministered with anticoagulant drugs

              May cause tinnitus

              Use caution in patients with dehydration, erosive gastritis or peptic ulcer

              Heart Failure (HF) risk

              • NSAIDS have the potential to trigger HF by prostaglandin inhibition that leads to sodium and water retention, increased systemic vascular resistance, and blunted response to diuretics
              • High dose salicylates should be avoided or withdrawn whenever possible
              • AHA/ACC Heart Failure Guidelines; Circulation. 2016; 134
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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: Salicylates are excreted in breast milk; caution advised

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              NSAID with antipyretic and analgesic properties via central and peripheral effects

              Absorption

              Absorbed rapidly

              Peak Plasma Time: 1.5 hr (salicylic acid metabolite)

              Peak Plasma Concentration: 3.6 mg/dL (salicylic acid metabolite)

              Distribution

              Protein Bound: 50-90%

              Metabolism

              Released in plasma as salicylic acid, which is then enzymatically metabolized to salicyluric acid and salicylphenolic glucuronide

              Elimination

              Half-life: 2 hr (salicylic acid metabolite); half-life prolonged with repeated dosing

              Excretion: Urine

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Percogesic Backache Relief oral
              -
              580 (467) mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              magnesium salicylate oral

              MAGNESIUM SALICYLATE - ORAL

              (mag-NEE-zee-um sa-LIS-i-late)

              COMMON BRAND NAME(S): Doan's

              WARNING: Nonsteroidal anti-inflammatory drugs (including magnesium salicylate) may rarely increase the risk for a heart attack or stroke. This effect does not apply to low-dose aspirin. (See Drug Interactions section.) This effect can happen at any time while taking this drug but is more likely if you take it for a long time. The risk may be greater if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes). Do not take this drug right before or after heart bypass surgery (CABG). Also, this drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This bleeding can occur without warning symptoms at any time during treatment.Stop taking this medication and seek immediate medical attention if you notice any of the following rare but very serious side effects: stomach/abdominal pain that doesn't go away, chest pain, severe dizziness, weakness on one side of the body, sudden vision changes, trouble speaking, black stools, vomit that looks like coffee grounds. (See also Precautions section.)Talk with your doctor or pharmacist about the risks and benefits of treatment with this medication.

              USES: Magnesium salicylate is used to relieve pain from various conditions. It also reduces pain, swelling, and joint stiffness from arthritis. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID).

              HOW TO USE: If you are taking the over-the-counter product, read all directions on the product package before taking this medication. Take this medication by mouth, usually 3 to 4 times daily with a full glass of water (8 ounces or 240 milliliters) or as directed by your doctor. Do not lie down for at least 10 minutes after taking this drug. If stomach upset occurs while taking this medication, take it with food, milk, or an antacid.Dosage is based on your medical condition and response to therapy. To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose, take it more frequently, or take it for a longer time than prescribed. Do not take the over-the-counter product for more than 10 days unless otherwise directed. For ongoing conditions such as arthritis, continue taking this medication as directed by your doctor. Discuss the risks and benefits with your doctor or pharmacist.For certain conditions (such as arthritis), it may take up to 2 weeks of taking this drug regularly until you get the full benefit.If you are taking this drug "as needed" (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medicine may not work as well.If your condition lasts or gets worse, if you develop new symptoms, or if you think you may have a serious medical problem, seek immediate medical attention.

              SIDE EFFECTS: Upset stomach or nausea may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: heartburn, swelling of ankles/feet/hands, sudden/unexplained weight gain, hearing changes (such as ringing in the ears, decreased hearing), fast/pounding heartbeat, unusual/extreme tiredness, signs of kidney problems (such as change in the amount of urine), easy bruising/bleeding, signs of infection (such as sore throat that doesn't go away, fever).This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice any other side effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking magnesium salicylate, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, naproxen, salsalate); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: aspirin-sensitive asthma (a history of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDs), kidney disease, liver disease, poorly controlled diabetes, stomach/intestine/esophagus problems (such as bleeding, ulcers, recurring heartburn), heart disease (such as congestive heart failure, history of heart attack), high blood pressure, stroke, swelling of the ankles/feet/hands, dehydration, blood disorders (such as anemia), bleeding/clotting problems, asthma, growths in the nose (nasal polyps), certain genetic conditions (G-6-PD deficiency, pyruvate kinase deficiency).Before having surgery, tell your doctor or dentist that you are using this medication.This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.Older adults may be at greater risk for stomach bleeding and kidney effects.This medication is similar to aspirin. Children and teenagers younger than 18 years should not take this medication if they have chickenpox, flu, or any undiagnosed illness, or if they have just been given a live virus vaccine, without first consulting a doctor about Reye's syndrome, a rare but serious illness.Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using this medication. This medication may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication. Do not use this medication during the last 3 months of pregnancy because of possible harm to the unborn baby or problems during delivery.This drug may pass into breast milk and could have undesirable effects on a nursing infant. Breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: anabolic steroids (such as danazol, oxandrolone), carbonic anhydrase inhibitors (such as acetazolamide), certain drugs for seizures (phenytoin, phenobarbital, valproic acid), cidofovir, corticosteroids (such as prednisone), dichlorphenamide, drugs for gout (such as probenecid, sulfinpyrazone), gabapentin, lithium, magnesium-containing drugs (such as milk of magnesia), methotrexate, pemetrexed, tenofovir.This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, ketorolac, or naproxen) that are similar to this drug and, if taken together, may increase your risk for side effects. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.Some medications (such as ciprofloxacin, tetracycline) cannot be taken with magnesium. The magnesium in this product may bind with these medication, preventing their full absorption. Take these medications 2-3 hours before or after taking magnesium salicylate. Ask your pharmacist for more details.This medication may interfere with certain laboratory tests (including certain urine glucose tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: dizziness, ringing in the ears, weakness, nausea, vomiting, drowsiness, fast breathing, confusion, seizures.

              NOTES: If your doctor has prescribed this medication for you, do not share it with others.If your doctor has instructed you to take this medication regularly, laboratory and/or medical tests (such as blood pressure, complete blood count, liver and kidney function tests, magnesium levels) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.If you have arthritis, lifestyle changes (such as weight loss if needed, strengthening/conditioning exercises) may help improve your flexibility and joint function. Consult your doctor for specific instructions.

              MISSED DOSE: If you are taking this drug on a regular schedule (not "as needed") and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised February 2022. Copyright(c) 2022 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.