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SALICYLATES (Systemic)

Some commonly used brand names are:

In the U.S.—

• Acuprin 81 ¹
• Amigesic ⁸
• Anacin Caplets ²
• Anacin Maximum Strength ²
• Anacin Tablets ²
• Anaflex 750 ⁸
• Arthritis Pain Ascriptin ³
• Arthritis Pain Formula ³
• Arthritis Strength Bufferin ³
• Arthropan ⁵
• Aspergum ¹
• Aspirin Regimen Bayer Adult Low Dose ¹
• Aspirin Regimen Bayer Regular Strength Caplets ¹
• Aspir-Low ¹
• Aspirtab ¹
• Aspirtab-Max ¹
• Backache Caplets ⁷
• Bayer Children"s Aspirin ¹
• Bayer Select Maximum Strength Backache Pain Relief Formula ⁷
• Bufferin Caplets ³
• Bufferin Tablets ³
• Buffex ³
• Buffinol ³
• Buffinol Extra ³
• Cama Arthritis Pain Reliever ³
• CMT ⁶
• Cope ⁴
• Disalcid ⁸
• Doan"s Regular Strength Tablets ⁷
• Easprin ¹
• Ecotrin Caplets ¹
• Ecotrin Tablets ¹
• Empirin ¹
• Extended-release Bayer 8-Hour ¹
• Extra Strength Bayer Arthritis Pain Formula Caplets ¹
• Extra Strength Bayer Aspirin Caplets ¹
• Extra Strength Bayer Aspirin Tablets ¹
• Extra Strength Bayer Plus Caplets ³
• Gensan ²
• Genuine Bayer Aspirin Caplets ¹
• Genuine Bayer Aspirin Tablets ¹
• Halfprin ¹
• Healthprin Adult Low Strength ¹
• Healthprin Full Strength ¹
• Healthprin Half-Dose ¹
• Magan ⁷
• Magnaprin ³
• Marthritic ⁸
• Maximum Strength Arthritis Foundation Safety Coated Aspirin ¹
• Maximum Strength Ascriptin ³
• Maximum Strength Doan"s Analgesic Caplets ⁷
• Mobidin ⁷
• Mono-Gesic ⁸
• Norwich Aspirin ¹
• P-A-C Revised Formula ²
• Regular Strength Ascriptin ³
• Salflex ⁸
• Salsitab ⁸
• Sloprin ¹
• St. Joseph Adult Chewable Aspirin ¹
• Tricosal ⁶
• Trilisate ⁶
• ZORprin ¹

In Canada—

• Anacin ²
• Anacin Extra Strength ²
• Antidol ²
• Apo-Asa ¹
• Apo-ASEN ¹
• Arco Pain Tablet ²
• Arthrisin ¹
• Artria S.R ¹
• Aspergum ¹
• Aspirin Caplets ¹
• Aspirin Children"s Tablets ¹
• Aspirin, Coated ¹
• Aspirin Plus Stomach Guard Extra Strength ³
• Aspirin Plus Stomach Guard Regular Strength ³
• Aspirin Tablets ¹
• Astone ²
• Astrin ¹
• Bufferin Caplets ³
• Bufferin Extra Strength Caplets ³
• Calmine ²
• C2 ²
• C2 Buffered ⁴
• Coryphen ¹
• Disalcid ⁸
• Doan"s Backache Pills ⁷
• Dodd"s Extra Strength ⁹
• Dodd"s Pills ⁹
• Dolomine ²
• Entrophen Caplets ¹
• Entrophen Extra Strength ¹
• Entrophen 15 Maximum Strength Tablets ¹
• Entrophen 10 Super Strength Caplets ¹
• Entrophen Tablets ¹
• Gin Pain Pills ⁹
• Headache Tablet ¹
• Herbopyrine ²
• Instantine ²
• Kalmex ²
• Nervine ²
• Novasen ¹
• Novasen Sp.C ¹
• Pain Aid ²
• PMS-ASA ¹
• Sero-Gesic ⁷
• 217 Strong ²
• 217 ²
• Tri-Buffered ASA ³
• Trilisate ⁶

Other commonly used names are:

• acetylsalicylic acid
• ASA #
• choline magnesium trisalicylate
• salicylsalicylic acid

# Aspirin is a brand name in Canada; acetylsalicylic acid is the generic name. ASA, a commonly used designation for aspirin (or acetylsalicylic acid) in both the U.S. and Canada, is the term used in Canadian product labeling.

** Some of the buffered aspirin products may be identified on the label as Aspirin (ASA), Alumina, and Magnesia or as Aspirin, Alumina, and Magnesium Oxide.

Category

• Analgesic—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered; Aspirin, Buffered; Choline and Magnesium Salicylates; Choline Salicylate; Magnesium Salicylate; Salsalate; Sodium Salicylate
• Anti-inflammatory, nonsteroidal—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered; Aspirin, Buffered; Choline and Magnesium Salicylates; Choline Salicylate; Magnesium Salicylate; Salsalate; Sodium Salicylate
• Antipyretic—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered; Aspirin, Buffered; Choline and Magnesium Salicylates; Choline Salicylate; Magnesium Salicylate; Salsalate; Sodium Salicylate
• Antirheumatic, nonsteroidal anti-inflammatory—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered; Aspirin, Buffered; Choline and Magnesium Salicylates; Choline Salicylate; Magnesium Salicylate; Salsalate; Sodium Salicylate
• Antithrombotic—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered; Aspirin, Buffered
• Myocardial infarction prophylactic—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered; Aspirin, Buffered
• Myocardial reinfarction prophylactic—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered; Aspirin, Buffered
• Platelet aggregation inhibitor—Aspirin; Aspirin and Caffeine; Aspirin and Caffeine, Buffered; Aspirin, Buffered

Description

Salicylates are used to relieve pain and reduce fever. Most salicylates are also used to relieve some symptoms caused by arthritis (rheumatism), such as swelling, stiffness, and joint pain. However, they do not cure arthritis and will help you only as long as you continue to take them.

Aspirin may also be used to lessen the chance of heart attack, stroke, or other problems that may occur when a blood vessel is blocked by blood clots. Aspirin helps prevent dangerous blood clots from forming. However, this effect of aspirin may increase the chance of serious bleeding in some people. Therefore, aspirin should be used for this purpose only when your doctor decides, after studying your medical condition and history, that the danger of blood clots is greater than the risk of bleeding. Do not take aspirin to prevent blood clots or a heart attack unless it has been ordered by your doctor .

Salicylates may also be used for other conditions as determined by your doctor.

The caffeine present in some of these products may provide additional relief of headache pain or faster pain relief.

Some salicylates are available only with your medical doctor"s or dentist"s prescription. Others are available without a prescription; however, your medical doctor or dentist may have special instructions on the proper dose of these medicines for your medical condition.

These medicines are available in the following dosage forms:

• Oral
• Aspirin
  • Tablets (U.S. and Canada)
  • Chewable tablets (U.S. and Canada)
  • Chewing gum tablets (U.S. and Canada)
  • Delayed-release (enteric-coated) tablets (U.S. and Canada)
  • Extended-release tablets (U.S. and Canada)
• Aspirin and Caffeine
  • Capsules (Canada)
  • Tablets (U.S. and Canada)
• Buffered Aspirin
  • Tablets (U.S. and Canada)
• Buffered Aspirin and Caffeine
  • Tablets (U.S. and Canada)
• Choline Salicylate
  • Oral solution (U.S.)
• Choline and Magnesium Salicylates
  • Oral solution (U.S.)
  • Tablets (U.S. and Canada)
• Magnesium Salicylate
  • Tablets (U.S. and Canada)
• Salsalate
  • Capsules (U.S.)
  • Tablets (U.S. and Canada)
• Sodium Salicylate
  • Tablets (Canada)
  • Delayed-release (enteric-coated) tablets (U.S.)

• Rectal
• Aspirin
  • Suppositories (U.S. and Canada)

Before Using This Medicine

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For salicylates, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to aspirin or other salicylates, including methyl salicylate (oil of wintergreen), or to any of the following medicines:

• Diclofenac (e.g., Voltaren)
• Diflunisal (e.g., Dolobid)
• Etodolac (e.g., Lodine)
• Fenoprofen (e.g., Nalfon)
• Floctafenine (e.g., Idarac)
• Flurbiprofen, oral (e.g., Ansaid)
• Ibuprofen (e.g., Motrin)
• Indomethacin (e.g., Indocin)
• Ketoprofen (e.g., Orudis)
• Ketorolac (e.g., Toradol)
• Meclofenamate (e.g., Meclomen)
• Mefenamic acid (e.g., Ponstel)
• Nabumetone (e.g., Relafen)
• Naproxen (e.g., Naprosyn)
• Oxaprozin (e.g., Daypro)
• Oxyphenbutazone (e.g., Tandearil)
• Phenylbutazone (e.g., Butazolidin)
• Piroxicam (e.g., Feldene)
• Sulindac (e.g., Clinoril)
• Suprofen (e.g., Suprol)
• Tenoxicam (e.g., Mobiflex)
• Tiaprofenic acid (e.g., Surgam)
• Tolmetin (e.g., Tolectin)
• Zomepirac (e.g., Zomax)

Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet—Make certain your health care professional knows if you are on a low-sodium diet. Regular use of large amounts of sodium salicylate (as for arthritis) can add a large amount of sodium to your diet. Sodium salicylate contains 46 mg of sodium in each 325-mg tablet and 92 mg of sodium in each 650-mg tablet.

Pregnancy—Salicylates have not been shown to cause birth defects in humans. Studies on birth defects in humans have been done with aspirin but not with other salicylates. However, salicylates caused birth defects in animal studies.

Some reports have suggested that too much use of aspirin late in pregnancy may cause a decrease in the newborn"s weight and possible death of the fetus or newborn infant. However, the mothers in these reports had been taking much larger amounts of aspirin than are usually recommended. Studies of mothers taking aspirin in the doses that are usually recommended did not show these unwanted effects. However, there is a chance that regular use of salicylates late in pregnancy may cause unwanted effects on the heart or blood flow in the fetus or in the newborn infant.

Use of salicylates, especially aspirin, during the last 2 weeks of pregnancy may cause bleeding problems in the fetus before or during delivery or in the newborn infant. Also, too much use of salicylates during the last 3 months of pregnancy may increase the length of pregnancy, prolong labor, cause other problems during delivery, or cause severe bleeding in the mother before, during, or after delivery. Do not take aspirin during the last 3 months of pregnancy unless it has been ordered by your doctor .

Studies in humans have not shown that caffeine (present in some aspirin products) causes birth defects. However, studies in animals have shown that caffeine causes birth defects when given in very large doses (amounts equal to those present in 12 to 24 cups of coffee a day).

Breast-feeding—Salicylates pass into the breast milk. Although salicylates have not been reported to cause problems in nursing babies, it is possible that problems may occur if large amounts are taken regularly, as for arthritis (rheumatism).

Caffeine passes into the breast milk in small amounts.

Children—Do not give aspirin or other salicylates to a child or a teenager with a fever or other symptoms of a virus infection, especially flu or chickenpox, without first discussing its use with your child"s doctor . This is very important because salicylates may cause a serious illness called Reye"s syndrome in children and teenagers with fever caused by a virus infection, especially flu or chickenpox.

Some children may need to take aspirin or another salicylate regularly (as for arthritis). However, your child"s doctor may want to stop the medicine for a while if a fever or other symptoms of a virus infection occur. Discuss this with your child"s doctor, so that you will know ahead of time what to do if your child gets sick.

Children who do not have a virus infection may also be more sensitive to the effects of salicylates, especially if they have a fever or have lost large amounts of body fluid because of vomiting, diarrhea, or sweating. This may increase the chance of side effects during treatment.

Older adults—Elderly people are especially sensitive to the effects of salicylates. This may increase the chance of side effects during treatment.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a salicylate, it is especially important that your health care professional know if you are taking any of the following:

• Anticoagulants (blood thinners) or
• Carbenicillin by injection (e.g., Geopen) or
• Cefamandole (e.g., Mandol) or
• Cefoperazone (e.g., Cefobid) or
• Cefotetan (e.g., Cefotan) or
• Dipyridamole (e.g., Persantine) or
• Divalproex (e.g., Depakote) or
• Heparin or
• Inflammation or pain medicine, except narcotics, or
• Pentoxifylline (e.g., Trental) or
• Plicamycin (e.g., Mithracin) or
• Ticarcillin (e.g., Ticar) or
• Valproic acid (e.g., Depakene)—Taking these medicines together with a salicylate, especially aspirin, may increase the chance of bleeding

• Antidiabetics, oral (diabetes medicine you take by mouth)—Salicylates may increase the effects of the antidiabetic medicine; a change in dose may be needed if a salicylate is taken regularly

• Ciprofloxacin (e.g., Cipro) or
• Enoxacin (e.g., Penetrex) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) or
• Lomefloxacin (e.g., Maxaquin) or
• Norfloxacin (e.g., Noroxin) or
• Ofloxacin (e.g., Floxin) or
• Tetracyclines (medicine for infection), taken by mouth—Buffered aspirin, choline and magnesium salicylates, and magnesium salicylate may keep these medicines from working properly if taken too close to them

• Methotrexate (e.g., Mexate) or
• Vancomycin (e.g., Vancocin)—The chance of serious side effects may be increased

• Probenecid (e.g., Benemid)—Salicylates can keep probenecid from working properly for treating gout

• Sulfinpyrazone (e.g., Anturane)—Salicylates can keep sulfinpyrazone from working properly for treating gout; also, taking a salicylate, especially aspirin, with sulfinpyrazone may increase the chance of bleeding

• Urinary alkalizers (medicine that makes the urine less acid, such as acetazolamide [e.g., Diamox], calcium- and/or magnesium-containing antacids, dichlorphenamide [e.g., Daranide], methazolamide [e.g., Neptazane], potassium or sodium citrate and/or citric acid, sodium bicarbonate [baking soda])—These medicines may make the salicylate less effective by causing it to be removed from the body more quickly

Other medical problems—The presence of other medical problems may affect the use of salicylates. Make sure you tell your doctor if you have any other medical problems, especially:

• Anemia or
• Overactive thyroid or
• Stomach ulcer or other stomach problems—Salicylates may make your condition worse

• Asthma, allergies, and nasal polyps (history of) or
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency or
• High blood pressure (hypertension) or
• Kidney disease or
• Liver disease—The chance of side effects may be increased.

• Gout—Salicylates can make this condition worse and can also lessen the effects of some medicines used to treat gout

• Heart disease—The chance of some side effects may be increased. Also, the caffeine present in some aspirin products can make some kinds of heart disease worse

• Hemophilia or other bleeding problems—The chance of bleeding may be increased, especially with aspirin

Proper Use of This Medicine

Take this medicine after meals or with food (except for enteric-coated capsules or tablets and aspirin suppositories) to lessen stomach irritation.

Take tablet or capsule forms of this medicine with a full glass (8 ounces) of water . Also, do not lie down for about 15 to 30 minutes after swallowing the medicine. This helps to prevent irritation that may lead to trouble in swallowing.

For patients taking aspirin (including buffered aspirin and/or products containing caffeine) :

• Do not use any product that contains aspirin if it has a strong, vinegar-like odor . This odor means the medicine is breaking down. If you have any questions about this, check with your health care professional.
• If you are to take any medicine that contains aspirin within 7 days after having your tonsils removed, a tooth pulled, or other dental or mouth surgery, be sure to swallow the aspirin whole. Do not chew aspirin during this time.
• Do not place any medicine that contains aspirin directly on a tooth or gum surface. This may cause a burn.
• There are several different forms of aspirin or buffered aspirin tablets. If you are using:
  • chewable aspirin tablets , they may be chewed, dissolved in liquid, crushed, or swallowed whole.
  • delayed-release (enteric-coated) aspirin tablets , they must be swallowed whole. Do not crush them or break them up before taking.
  • extended-release (long-acting) aspirin tablets , check with your pharmacist as to how they should be taken. Some may be broken up (but must not be crushed) before swallowing if you cannot swallow them whole. Others should not be broken up and must be swallowed whole.

To use aspirin suppositories :

• If the suppository is too soft to insert, chill it in the refrigerator for 30 minutes or run cold water over it before removing the foil wrapper.
• To insert the suppository: First remove the foil wrapper and moisten the suppository with cold water. Lie down on your side and use your finger to push the suppository well up into the rectum.

To take choline and magnesium salicylates (e.g., Trilisate) oral solution :

• The liquid may be mixed with fruit juice just before taking.
• Drink a full glass (8 ounces) of water after taking the medicine.

To take enteric-coated sodium salicylate tablets :

• The tablets must be swallowed whole. Do not crush them or break them up before taking.

Unless otherwise directed by your medical doctor or dentist:

• Do not take more of this medicine than recommended on the label, to lessen the chance of side effects.
• Children up to 12 years of age should not take this medicine more than 5 times a day.

When used for arthritis (rheumatism), this medicine must be taken regularly as ordered by your doctor in order for it to help you . Up to 2 to 3 weeks or longer may pass before you feel the full effects of this medicine.

Dosing—The dose of these medicines will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets or teaspoonfuls of solution that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on whether you are taking a long-acting or a short-acting form of the medicine and the medical problem for which you are taking the salicylate .

• For aspirin
• For short-acting tablet, chewable tablet, and delayed-release (enteric-coated) tablet oral dosage forms:
  • For pain or fever:
    • Adults and teenagers—325 to 500 milligrams (mg) every three or four hours, 650 mg every four to six hours, or 1000 mg every six hours as needed.
    • Children up to 2 years of age—Dose must be determined by your doctor.
    • Children 2 to 4 years of age—160 mg every four hours as needed.
    • Children 4 to 6 years of age—240 mg every four hours as needed.
    • Children 6 to 9 years of age—320 to 325 mg every four hours as needed.
    • Children 9 to 11 years of age—320 to 400 mg every four hours as needed.
    • Children 11 to 12 years of age—320 to 480 mg every four hours as needed.
  • For arthritis:
    • Adults and teenagers—A total of 3600 to 5400 mg a day, divided into several smaller doses.
    • Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound) of body weight a day, divided into several smaller doses.
  • For preventing a heart attack, stroke, or other problems caused by blood clots:
    • Adults—Most people will take 81, 162.5, or 325 mg a day or 325 mg every other day. Some people taking aspirin to prevent a stroke may need as much as 1000 mg a day.
    • Children—Use and dose must be determined by your doctor.
• For chewing gum tablet dosage form:
  • For pain:
    • Adults and teenagers—2 tablets every four hours as needed.
    • Children up to 3 years of age—Dose must be determined by your doctor.
    • Children 3 to 6 years of age—1 tablet (227 mg) up to three times a day.
    • Children 6 to 12 years of age—1 or 2 tablets (227 mg each) up to four times a day.
• For long-acting oral dosage forms (extended-release tablets):
  • For pain:
    • Adults and teenagers—1 or 2 tablets twice a day.
    • Children—The long-acting aspirin tablets are too strong for use in children.
  • For arthritis:
    • Adults and teenagers—1 or 2 tablets twice a day, at first. Your doctor will then adjust your dose as needed.
    • Children—The long-acting aspirin tablets are too strong for use in children.
• For rectal dosage form (suppositories):
  • For pain or fever:
    • Adults and teenagers—325 to 650 mg every four hours as needed.
    • Children up to 2 years of age—Dose must be determined by your doctor.
    • Children 2 to 4 years of age—160 mg every four hours as needed.
    • Children 4 to 6 years of age—240 mg every four hours as needed.
    • Children 6 to 9 years of age—325 mg every four hours as needed.
    • Children 9 to 11 years of age—325 to 400 mg every four hours as needed.
    • Children 11 to 12 years of age—325 to 480 mg every four hours as needed.
  • For arthritis:
    • Adults and teenagers—A total of 3600 to 5400 mg a day, divided into several smaller doses.
    • Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound) of body weight a day, divided into several smaller doses.

• For aspirin and caffeine
• For oral capsule dosage form:
  • For pain or fever:
    • Adults and teenagers—325 to 500 milligrams (mg) of aspirin every three or four hours, 650 mg of aspirin every four to six hours, or 1000 mg of aspirin every six hours as needed.
    • Children up to 6 years of age—Aspirin and caffeine capsules are too strong for use in children up to 6 years of age.
    • Children 6 to 9 years of age—325 mg every four hours as needed.
    • Children 9 to 12 years of age—325 to 400 mg every four hours as needed.
  • For arthritis:
    • Adults and teenagers—A total of 3600 to 5400 mg of aspirin a day, divided into several smaller doses.
    • Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound) of body weight a day, divided into several smaller doses.
  • For preventing a heart attack, stroke, or other problems caused by blood clots:
    • Adults—325 mg a day or every other day. People who take smaller doses of aspirin will have to use a different product. Some people taking aspirin to prevent a stroke may need as much as 1000 mg a day.
    • Children—Use and dose must be determined by your doctor.
• For oral tablet dosage form:
  • For pain or fever:
    • Adults and teenagers—325 to 500 mg of aspirin every three or four hours, 650 mg of aspirin every four to six hours, or 1000 mg of aspirin every six hours as needed.
    • Children up to 9 years of age—Aspirin and caffeine tablets are too strong for use in children up to 9 years of age.
    • Children 9 to 12 years of age—325 to 400 mg every four hours as needed.
  • For arthritis:
    • Adults and teenagers—A total of 3600 to 5400 mg of aspirin a day, divided into several smaller doses.
    • Children—A total of 80 to 100 mg per kg (32 to 40 mg per pound) of body weight a day, divided into several smaller doses.
  • For preventing a heart attack, stroke, or other problems caused by blood clots:
    • Adults—325 mg a day or every other day. People who take smaller doses of aspirin will have to use a different product. Some people taking aspirin to prevent a stroke may need as much as 1000 mg a day.
    • Children—Use and dose must be determined by your doctor.

• For buffered aspirin
• For oral dosage form (tablets):
  • For pain or fever:
    • Adults and teenagers—325 to 500 milligrams (mg) of aspirin every three or four hours, 650 mg of aspirin every four to six hours, or 1000 mg of aspirin every six hours as needed.
    • Children up to 2 years of age—Dose must be determined by your doctor.
    • Children 2 to 4 years of age—One-half of a 325-mg tablet every four hours as needed.
    • Children 4 to 6 years of age—Three-fourths of a 325-mg tablet every four hours as needed.
    • Children 6 to 9 years of age—One 325-mg tablet every four hours as needed.
    • Children 9 to 11 years of age—One or one and one-fourth 325-mg tablets every four hours as needed.
    • Children 11 to 12 years of age—One or one and one-half 325-mg tablets every four hours as needed.
  • For arthritis:
    • Adults and teenagers—A total of 3600 to 5400 mg of aspirin a day, divided into several smaller doses.
    • Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound) of body weight a day, divided into several smaller doses.
  • For preventing a heart attack, stroke, or other problems caused by blood clots:
    • Adults—325 mg a day or every other day. People who take smaller doses of aspirin will have to use a different product. Some people taking aspirin to prevent a stroke may need as much as 1000 mg a day.
    • Children—Use and dose must be determined by your doctor.

• For buffered aspirin and caffeine
• For oral dosage form (tablets):
  • For pain or fever:
    • Adults and teenagers—325 or 421 milligrams (mg) of aspirin every three or four hours, 650 mg of aspirin every four to six hours, or 842 mg of aspirin every six hours as needed.
    • Children up to 2 years of age—Dose must be determined by your doctor.
    • Children 2 to 4 years of age—One-half of a 325-mg tablet every four hours as needed.
    • Children 4 to 6 years of age—Three-fourths of a 325-mg tablet every four hours as needed.
    • Children 6 to 9 years of age—One 325-mg or 421-mg tablet every four hours as needed.
    • Children 9 to 11 years of age—One or one and one-fourth 325-mg tablets every four hours as needed.
    • Children 11 to 12 years of age—One or one and one-half 325-mg tablets, or one 421-mg tablet, every four hours as needed.
  • For arthritis:
    • Adults and teenagers—A total of 3600 to 5400 mg of aspirin a day, divided into several smaller doses.
    • Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound) of body weight a day, divided into several smaller doses.
  • For preventing a heart attack, stroke, or other problems caused by blood clots:
    • Adults—162.5 or 325 mg (one-half or one 325-mg tablet) a day or 325 mg every other day. People who need smaller doses of aspirin will have to use a different product. Some people taking aspirin to prevent a stroke may need as much as 1000 mg a day.
    • Children—Use and dose must be determined by your doctor.

• For choline salicylate
• For oral dosage form (oral solution):
  • For pain or fever:
    • Adults and teenagers—One-half or three-fourths of a teaspoonful every three hours, one-half or one teaspoonful every four hours, or one or one and one-half teaspoonfuls every six hours as needed.
    • Children up to 2 years of age—Dose must be determined by your doctor.
    • Children 2 to 4 years of age—1.25 milliliters (mL) (one-fourth of a teaspoonful) every four hours as needed. This amount should be measured by a special dropper or measuring spoon.
    • Children 4 to 6 years of age—1.66 mL every four hours as needed. This amount should be measured by a special dropper or measuring spoon.
    • Children 6 to 11 years of age—2.5 mL (one-half of a teaspoonful) every four hours as needed. This amount should be measured by a special measuring spoon.
    • Children 11 to 12 years of age—2.5 to 3.75 mL (one-half to three-fourths of a teaspoonful) every four hours as needed. This amount should be measured by a special measuring spoon.
  • For arthritis:
    • Adults—A total of five and one-half to eight teaspoonfuls a day, divided into several smaller doses.
    • Children—A total of 0.6 to 0.7 mL per kilogram (kg) (0.25 to 0.28 mL per pound) of body weight a day, divided into several smaller doses.

• For choline and magnesium salicylates
• For oral dosage forms (oral solution or tablets):
  • For pain or fever:
    • Adults and teenagers—A total of 2000 to 3000 milligrams (mg) a day, divided into two or three doses.
    • Children weighing up to 37 kilograms (kg) (about 89 pounds)—A total of 50 mg per kg (20 mg per pound) of body weight a day, divided into two doses.
    • Children weighing more than 37 kg (90 pounds or more)—2200 mg a day, divided into two doses.
  • For inflammation or arthritis:
    • Adults and teenagers—A total of 3000 mg a day, divided into two or three doses, to start. Your doctor will then adjust your dose as needed.
    • Children weighing up to 37 kg (about 89 pounds)—A total of 50 mg per kg (20 mg per pound) of body weight a day, divided into two doses.
    • Children weighing more than 37 kg (90 pounds or more)—2200 mg a day, divided into two doses.

• For magnesium salicylate
• For oral dosage form (tablets):
  • For pain:
    • Adults and teenagers—2 regular-strength tablets every four hours, up to a maximum of 12 tablets a day, or 2 extra-strength tablets every eight hours, up to a maximum of 8 tablets a day.
    • Children—Dose must be determined by your doctor.

• For salsalate
• For oral dosage forms (capsules or tablets):
  • For arthritis:
    • Adults and teenagers—500 to 1000 milligrams (mg) two or three times a day, to start. Your doctor will then adjust your dose as needed.
    • Children—Dose must be determined by your doctor.

• For sodium salicylate
• For oral dosage forms (tablets or delayed-release [enteric-coated] tablets):
  • For pain or fever:
    • Adults and teenagers—325 or 650 milligrams (mg) every four hours as needed.
    • Children up to 6 years of age—This medicine is too strong for use in children younger than 6 years of age.
    • Children 6 years of age and older—325 mg every four hours as needed.
  • For arthritis:
    • Adults and teenagers—A total of 3600 to 5400 mg a day, divided into several smaller doses.
    • Children—A total of 80 to 100 mg per kilogram (kg) (32 to 40 mg per pound) of body weight a day, divided into several smaller doses.

Missed dose—If your medical doctor or dentist has ordered you to take this medicine according to a regular schedule and you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children. Overdose is very dangerous in young children.
• Store away from heat and direct light.
• Do not store tablets or capsules in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep liquid forms of this medicine from freezing.
• Store aspirin suppositories in a cool place. It is usually best to keep them in the refrigerator, but keep them from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Check the labels of all nonprescription (over-the-counter [OTC]) and prescription medicines you now take. If any contain aspirin or other salicylates (including bismuth subsalicylate [e.g., Pepto-Bismol] or any shampoo or skin medicine that contains salicylic acid or any other salicylate), check with your health care professional . Taking or using them together with this medicine may cause an overdose.

If you will be taking salicylates for a long time (more than 5 days in a row for children or 10 days in a row for adults) or in large amounts, your doctor should check your progress at regular visits .

Serious side effects can occur during treatment with this medicine. Sometimes serious side effects can occur without any warning. However, possible warning signs often occur, including swelling of the face, fingers, feet, and/or lower legs; severe stomach pain, black, tarry stools, and/or vomiting of blood or material that looks like coffee grounds; unusual weight gain; and/or skin rash. Also, signs of serious heart problems could occur such as chest pain, tightness in chest, fast or irregular heartbeat, or unusual flushing or warmth of skin. Stop taking this medicine and check with your doctor immediately if you notice any of these warning signs.

Check with your medical doctor or dentist:

• If you are taking this medicine to relieve pain and the pain lasts for more than 10 days (5 days for children) or if the pain gets worse, if new symptoms occur, or if redness or swelling is present. These could be signs of a serious condition that needs medical or dental treatment.
• If you are taking this medicine to bring down a fever, and the fever lasts for more than 3 days or returns, if the fever gets worse, if new symptoms occur, or if redness or swelling is present. These could be signs of a serious condition that needs treatment.
• If you are taking this medicine for a sore throat, and the sore throat is very painful, lasts for more than 2 days, or occurs together with or is followed by fever, headache, skin rash, nausea, or vomiting.
• If you are taking this medicine regularly, as for arthritis (rheumatism), and you notice a ringing or buzzing in your ears or severe or continuing headaches. These are often the first signs that too much salicylate is being taken. Your doctor may want to change the amount of medicine you are taking every day.

For patients taking aspirin to lessen the chance of heart attack, stroke, or other problems caused by blood clots :

• Take only the amount of aspirin ordered by your doctor . If you need a medicine to relieve pain, a fever, or arthritis, your doctor may not want you to take extra aspirin. It is a good idea to discuss this with your doctor, so that you will know ahead of time what medicine to take.
• Do not stop taking this medicine for any reason without first checking with the doctor who directed you to take it .

Taking certain other medicines together with a salicylate may increase the chance of unwanted effects. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. If your doctor directs you to take these medicines together on a regular basis, follow his or her directions carefully. However, do not take any of the following medicines together with a salicylate for more than a few days, unless your doctor has directed you to do so and is following your progress :

• Acetaminophen (e.g., Tylenol)
• Diclofenac (e.g., Voltaren)
• Diflunisal (e.g., Dolobid)
• Etodolac (e.g., Lodine)
• Fenoprofen (e.g., Nalfon)
• Floctafenine (e.g., Idarac)
• Flurbiprofen, oral (e.g., Ansaid)
• Ibuprofen (e.g., Motrin)
• Indomethacin (e.g., Indocin)
• Ketoprofen (e.g., Orudis)
• Ketorolac (e.g., Toradol)
• Meclofenamate (e.g., Meclomen)
• Mefenamic acid (e.g., Ponstel)
• Nabumetone (e.g., Relafen)
• Naproxen (e.g., Naprosyn)
• Oxaprozin (e.g., Daypro)
• Phenylbutazone (e.g., Butazolidin)
• Piroxicam (e.g., Feldene)
• Sulindac (e.g., Clinoril)
• Tenoxicam (e.g., Mobiflex)
• Tiaprofenic acid (e.g., Surgam)
• Tolmetin (e.g., Tolectin)

For diabetic patients :

• False urine sugar test results may occur if you are regularly taking large amounts of salicylates, such as:
  • Aspirin : 8 or more 325-mg (5-grain), or 4 or more 500-mg or 650-mg (10-grain), or 3 or more 800-mg (or higher strength), doses a day.
  • Buffered aspirin or
  • Sodium salicylate : 8 or more 325-mg (5-grain), or 4 or more 500-mg or 650-mg (10-grain), doses a day.
  • Choline salicylate : 4 or more teaspoonfuls (each teaspoonful containing 870 mg) a day.
  • Choline and magnesium salicylates : 5 or more 500-mg tablets or teaspoonfuls, 4 or more 750-mg tablets, or 2 or more 1000-mg tablets, a day.
  • Magnesium salicylate : 7 or more regular-strength, or 4 or more extra-strength, tablets a day.
  • Salsalate : 4 or more 500-mg doses, or 3 or more 750-mg doses, a day.
• Smaller doses or occasional use of salicylates usually will not affect urine sugar tests. However, check with your health care professional (especially if your diabetes is not well-controlled) if:
  • you are not sure how much salicylate you are taking every day.
  • you notice any change in your urine sugar test results.
  • you have any other questions about this possible problem.

Do not take aspirin for 5 days before any surgery, including dental surgery, unless otherwise directed by your medical doctor or dentist. Taking aspirin during this time may cause bleeding problems.

For patients taking buffered aspirin, choline and magnesium salicylates (e.g., Trilisate), or magnesium salicylate (e.g., Doan"s) :

• Buffered aspirin, choline and magnesium salicylates, or magnesium salicylate can keep many other medicines, especially some medicines used to treat infections, from working properly. This problem can be prevented by not taking the 2 medicines too close together. Ask your health care professional how long you should wait between taking a medicine for infection and taking buffered aspirin, choline and magnesium salicylates, or magnesium salicylate.

If you are taking a laxative containing cellulose, take the salicylate at least 2 hours before or after you take the laxative. Taking these medicines too close together may lessen the effects of the salicylate.

For patients taking this medicine by mouth:

• Stomach problems may be more likely to occur if you drink alcoholic beverages while being treated with this medicine, especially if you are taking it in high doses or for a long time. Check with your doctor if you have any questions about this.

For patients using aspirin suppositories :

• Aspirin suppositories may cause irritation of the rectum. Check with your doctor if this occurs.

Salicylates may interfere with the results of some medical tests. Before you have any medical tests, tell the doctor in charge if you have taken any of these medicines within the past week. If possible, it is best to check with the doctor first, to find out whether the medicine may be taken during the week before the test.

For patients taking one of the products that contain caffeine :

• Caffeine may interfere with the result of a test that uses adenosine (e.g., Adenocard) or dipyridamole (e.g., Persantine) to help find out how well your blood is flowing through certain blood vessels. Therefore, you should not have any caffeine for at least 8 to 12 hours before the test.

If you think that you or anyone else may have taken an overdose, get emergency help at once . Taking an overdose of these medicines may cause unconsciousness or death. Signs of overdose include convulsions (seizures), hearing loss, confusion, ringing or buzzing in the ears, severe drowsiness or tiredness, severe excitement or nervousness, and fast or deep breathing.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. When this medicine is used for short periods of time at low doses, side effects usually are rare. Although not all of the following side effects may occur, if they do occur they may need medical attention.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your health care professional if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 08/04/2005

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