Magnesium Salicylate is used for the treatment of patients with mild to moderate pain, fever, and inflammation as in patients with rheumatoid arthritis and osteoarthritis.
Magnesium salicylate Uses:
- It is used in the treatment of mild-to-moderate pain, fever, and other inflammatory conditions.
- It may be used for the relief of pain and inflammation in patients with rheumatoid arthritis and osteoarthritis.
Magnesium Dose in Adults:
Magnesium Dose in the treatment of Relief of mild-to-moderate pain:
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Doan's® Extra Strength, Momentum®:
- Two caplets every 6 hours as required.
- The maximum dose is 8 caplets/24 hours.
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Keygesic:
- One tablet every 4 hours as required.
- The maximum dose is 4 tablets per day.
Magnesium Dose in Childrens:
Magnesium salicylate dose in the treatment of Relief of mild-to-moderate pain:
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Children ≥12 years:
- Refer to adult dosing.
Pregnancy Category: C (D in the third trimester)
- Refer to Aspirin monograph for additional information.
Use during breastfeeding:
- Salicylates are excreted in human breastmilk.
- Refer to the Aspirin monograph for additional information.
Dose in Kidney disease:
- Use with caution in patients with mild to moderate kidney disease.
- Avoid in severe and advanced renal impairment.
Dose in Liver disease:
- Avoid in patients with advanced liver disease.
- Use with caution in patients with mild to moderate hepatic dysfunction.
Side effects of Magnesium Salicylate:
Refer to Aspirin monograph.
Contraindications to Magnesium salicylate:
- Hypersensitivity to magnesium salicylate, salticylates, and other NSAIDs or any component of formulation
- Advanced chronic renal disease;
- Concomitant use of uricosuric drugs
- Patients 65 years old and older should consult:
- Patients with chronic salicylate use history, chronic liver disease and carditis are also advised not to take it.
Warnings and precautions
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Sensitivity to salicylates:
- Tartrazine dyes, nasal polyps and asthma patients should be cautious when using the drug.
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Tinnitus
- Patients with tinnitus and impaired hearing should stop using the treatment.
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Bleeding disorders:
- It can cause platelet dysfunction, so patients with bleeding disorders should be cautious.
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Dehydration
- Patients suffering from dehydration should be cautious.
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Use of ethanol:
- Patients who consume more than 3 ethanol drinks per day should not use it. These patients are at high risk for bleeding.
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Gastrointestinal Disease:
- Patients with erosive gastritis and peptic ulcer disease should not use it.
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Hepatic impairment
- Patients with severe liver disease should use caution.
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Hypoprothrombinemia, vitamin K deficiency
- Patients with hypoprothrombinemia or vitamin k deficiency should not use it.
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Renal impairment
- Patients with severe kidney impairment should avoid it.
Magnesium salicylate: Drug Interaction
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Agents with Antiplatelet Properties (e.g., P2Y12 inhibitors, NSAIDs, SSRIs, etc.) |
May enhance the adverse/toxic effect of Salicylates. Increased risk of bleeding may result. |
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Ajmaline |
Salicylates may enhance the adverse/toxic effect of Ajmaline. Specifically, the risk for cholestasis may be increased. |
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Ammonium Chloride |
May increase the serum concentration of Salicylates. |
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Angiotensin-Converting Enzyme Inhibitors |
Salicylates may enhance the nephrotoxic effect of Angiotensin-Converting Enzyme Inhibitors. Salicylates may diminish the therapeutic effect of Angiotensin-Converting Enzyme Inhibitors. |
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Anticoagulants |
Salicylates may enhance the anticoagulant effect of Anticoagulants. |
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Benzbromarone |
Salicylates may diminish the therapeutic effect of Benzbromarone. |
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Blood Glucose Lowering Agents |
Salicylates may enhance the hypoglycemic effect of Blood Glucose Lowering Agents. |
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Calcium Channel Blockers |
May enhance the adverse/toxic effect of Magnesium Salts. Magnesium Salts may enhance the hypotensive effect of Calcium Channel Blockers. |
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Corticosteroids (Systemic) |
Salicylates may enhance the adverse/toxic effect of Corticosteroids (Systemic). These specifically include gastrointestinal ulceration and bleeding. Corticosteroids (Systemic) may decrease the serum concentration of Salicylates. Withdrawal of corticosteroids may result in salicylate toxicity. |
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Loop Diuretics |
Salicylates may diminish the diuretic effect of Loop Diuretics. Loop Diuretics may increase the serum concentration of Salicylates. |
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Neuromuscular-Blocking Agents |
Magnesium Salts may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. |
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Probenecid |
Salicylates may diminish the therapeutic effect of Probenecid. |
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Salicylates |
May enhance the anticoagulant effect of other Salicylates. |
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Thrombolytic Agents |
Salicylates may enhance the adverse/toxic effect of Thrombolytic Agents. An increased risk of bleeding may occur. |
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Valproate Products |
Salicylates may increase the serum concentration of Valproate Products. |
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Risk Factor D (Consider therapy modification) |
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Alfacalcidol |
May increase the serum concentration of Magnesium Salts. |
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Alpha-Lipoic Acid |
Magnesium Salts may decrease the absorption of Alpha-Lipoic Acid. AlphaLipoic Acid may decrease the absorption of Magnesium Salts. |
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Bictegravir |
|
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Bisphosphonate Derivatives |
Polyvalent Cation Containing Products may decrease the serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Exceptions: Pamidronate; Zoledronic Acid. |
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Calcitriol (Systemic) |
May increase the serum concentration of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving calcitriol. If magnesium-containing products must be used with calcitriol, serum magnesium concentrations should be monitored closely. |
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Carbonic Anhydrase Inhibitors |
Salicylates may enhance the adverse/toxic effect of Carbonic Anhydrase Inhibitors. Salicylate toxicity might be enhanced by this same combination. Management: Avoid these combinations when possible.Dichlorphenamide use with high-dose aspirin as contraindicated. If another combination is used, monitor patients closely for adverse effects. Tachypnea, anorexia, lethargy, and coma have been reported. Exceptions: Brinzolamide; Dorzolamide. |
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Deferiprone |
Polyvalent Cation Containing Products may decrease the serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. |
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Dolutegravir |
Magnesium Salts may decrease the serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral magnesium salts. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral magnesium salts. |
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Doxercalciferol |
May enhance the hypermagnesemic effect of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving doxercalciferol. If magnesium-containing products must be used with doxercalciferol, serum magnesium concentrations should be monitored closely. |
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Eltrombopag |
Polyvalent Cation Containing Products may decrease the serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. |
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Gabapentin |
Magnesium Salts may enhance the CNS depressant effect of Gabapentin. Specifically, high dose intravenous/epidural magnesium sulfate may enhance the CNS depressant effects of gabapentin. Magnesium Salts may decrease the serum concentration of Gabapentin. Management: Administer gabapentin at least 2 hours after use of a magnesiumcontaining antacid. Monitor patients closely for evidence of reduced response to gabapentin therapy. Monitor for CNS depression if high dose IV/epidural magnesium sulfate is used. |
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Ginkgo Biloba |
May enhance the anticoagulant effect of Salicylates. Management: Consider alternatives to this combination of agents. Monitor for signs and symptoms of bleeding (especially intracranial bleeding) if salicylates are used in combination with ginkgo biloba. |
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Herbs (Anticoagulant/Antiplatelet Properties) (eg, Alfalfa, Anise, Bilberry) |
May enhance the adverse/toxic effect of Salicylates. Bleeding may occur. |
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Hyaluronidase |
Salicylates may diminish the therapeutic effect of Hyaluronidase. Management: Patients receiving salicylates (particularly at larger doses) may not experience the desired clinical response to standard doses of hyaluronidase. Larger doses of hyaluronidase may be required. |
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Levothyroxine |
Magnesium Salts may decrease the serum concentration of Levothyroxine. Management: Separate administration of oral levothyroxine and oral magnesium salts by at least 4 hours. |
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Methotrexate |
Salicylates may increase the serum concentration of Methotrexate. Salicylate doses used for prophylaxis of cardiovascular events are not likely to be of concern. |
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Multivitamins/Fluoride (with ADE) |
Magnesium Salts may decrease the serum concentration of Multivitamins/Fluoride (with ADE). Specifically, magnesium salts may decrease fluoride absorption. Management: To avoid this potential interaction separate the administration of magnesium salts from administration of a fluoride-containing product by at least 1 hour. |
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Mycophenolate |
Magnesium Salts may decrease the serum concentration of Mycophenolate. Management: Separate doses of mycophenolate and oral magnesium salts. Monitor for reduced effects of mycophenolate if taken concomitant with oral magnesium salts. |
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Nonsteroidal Anti-Inflammatory Agents (Nonselective) |
May enhance the adverse/toxic effect of Salicylates. An increased risk of bleeding may be associated with use of this combination. Nonsteroidal Anti-Inflammatory Agents (Nonselective) may diminish the cardioprotective effect of Salicylates. Salicylates may decrease the serum concentration of Nonsteroidal Anti-Inflammatory Agents (Nonselective). |
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PenicillAMINE |
Polyvalent Cation Containing Products may decrease the serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. |
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Phosphate Supplements |
Magnesium Salts may decrease the serum concentration of Phosphate Supplements. Management: Administer oral phosphate supplements as far apart from the administration of an oral magnesium salt as possible to minimize the significance of this interaction. Exceptions: Sodium Glycerophosphate Pentahydrate. |
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PRALAtrexate |
Salicylates may increase the serum concentration of PRALAtrexate. Salicylate doses used for prophylaxis of cardiovascular events are unlikely to be of concern. |
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Quinolones |
Magnesium Salts may decrease the serum concentration of Quinolones. Management: Administer oral quinolones several hours before (4 h for moxi/pe/spar-, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome/pe-, 3 h for gemi-, and 2 h for levo-, nor-, or ofloxacin or nalidixic acid) oral magnesium salts. Exceptions: LevoFLOXacin (Oral Inhalation). |
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Tetracyclines |
Magnesium Salts may decrease the absorption of Tetracyclines. Only applicable to oral preparations of each agent. Exceptions: Eravacycline. |
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Trientine |
Polyvalent Cation Containing Products may decrease the serum concentration of Trientine. Management: Avoid concomitant administration of trientine and oral products that contain polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. If other oral polyvalent cations are needed, separate administration by 1 hour. |
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Vitamin K Antagonists (eg, warfarin) |
Salicylates may enhance the anticoagulant effect of Vitamin K Antagonists. |
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Risk Factor X (Avoid combination) |
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Baloxavir Marboxil |
Polyvalent Cation Containing Products may decrease the serum concentration of Baloxavir Marboxil. |
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Dexketoprofen |
Salicylates may enhance the adverse/toxic effect of Dexketoprofen. Dexketoprofen may diminish the therapeutic effect of Salicylates. Salicylates may decrease the serum concentration of Dexketoprofen. Management: The use of high-dose salicylates (3 g/day or more in adults) together with dexketoprofen is inadvisable. Consider administering dexketoprofen 30-120 min after or at least 8 hrs before cardioprotective doses of aspirin to minimize any possible interaction. |
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Influenza Virus Vaccine (Live/Attenuated) |
May enhance the adverse/toxic effect of Salicylates. Specifically, Reye's syndrome may develop. |
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Raltegravir |
Magnesium Salts may decrease the serum concentration of Raltegravir. Management: Avoid the use of oral / enteral magnesium salts with raltegravir. No dose separation schedule has been established that adequately reduces the magnitude of interaction. |
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Sulfinpyrazone |
Salicylates may decrease the serum concentration of Sulfinpyrazone. |
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Varicella Virus-Containing Vaccines |
Salicylates may enhance the adverse/toxic effect of Varicella Virus-Containing Vaccines. Specifically, the risk for Reye's syndrome may increase. |
Monitoring Parameters:
Monitor Renal functions in patients on long-term therapy and those with pre-existing renal impairment.
How to administer Magnesium salicylate?
Administer after meals with a full glass of water.
Mechanism of action of Magnesium salicylate:
- It decreases inflammation, pain, fever, and by irreversibly inhibiting cyclooxygenase-1 (COX-1) enzymes via acetylation.
- This results in decreased production of prostaglandin A precursors and thromboxane B precursors.
Absorption:
- It is rapidly absorbed from the stomach and upper intestine.
Distribution:
- It is distributed readily into tissues and most body fluids.
Protein binding:
- 50% to 90% of the drug is bound to plasma proteins, primarily to albumin.
Metabolism:
- It is released into the plasma as salicylic acid that is enzymatically converted to salicyluric acid and salicylphenolic glucuronide
Half-life elimination:
- About 2 hours;
- The half-life is increased with repeated dosing
Time to peak effect:
- 1.5 hours
Excretion:
- Urine
International Brand Names of Magnesium salicylate:
- Doans Extra Strength
- Doans Pills
- Bexidermil
- Dencorub
- Geniol Flex
- Metsal AR
- Salimag
- Topicrem
Magnesium salicylate Brand Names in Pakistan:
Magnesium Salicylate Tablets 250 mg in Pakistan |
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| Femistar Max | Drug Pharm (Pvt) Ltd. |
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