Salsalate

Salsalate
Clinical data
Trade names	Disalcid, Salflex
AHFS/Drugs.com	Monograph
MedlinePlus	a682880
ATC code	N02BA06 (WHO) ;
Legal status
Legal status	US: WARNINGRx-only;
Identifiers
	IUPAC name 2-(2-Hydroxybenzoyl)oxybenzoic acid;
CAS Number	552-94-3 ;
PubChem CID	5161;
DrugBank	DB01399 ;
ChemSpider	4977 ;
UNII	V9MO595C9I;
KEGG	D00428 ;
ChEBI	CHEBI:9014 ;
CompTox Dashboard (EPA)	DTXSID1023572 ;
ECHA InfoCard	100.008.208
Chemical and physical data
Formula	C14H10O5
Molar mass	258.229 g·mol−1
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Salsalate is a medication that belongs to the salicylate and nonsteroidal anti-inflammatory drug (NSAID) classes.

Salsalate is the generic name of a prescription drug marketed under the brandnames Mono-Gesic, Salflex, Disalcid, and Salsitab. Other generic and brand name formulations may be available.^[2]

Mechanism of action

Relative to other NSAIDs, salsalate has a weak inhibitory effect on the cyclooxygenase enzyme and decreases the production of several proinflammatory chemical signals such as interleukin-6, TNF-alpha, and C-reactive protein.^[3]

The mechanism through which salsalate is thought to reduce the production of these inflammatory chemical signals is through the inhibition of IκB kinase resulting in decreased action of NF-κB genes.^[3]^[4]^[5] This mechanism is thought to be responsible for salsalate's insulin-sensitizing and blood sugar lowering properties.^[4]

Medical uses

Salsalate may be used for inflammatory disorders such as rheumatoid arthritis or noninflammatory disorders such as osteoarthritis.^[3]^[6]

Safety

The risk of bleeding is a common concern with use of the NSAID class of medications. However, the bleeding risk associated with salsalate is lower than that associated with aspirin use.^[4]

Research

Salsalate has been proposed for the prevention and treatment of type 2 diabetes mellitus due to its ability to lower insulin resistance associated with inflammation and may be useful in prediabetes.^[3] However, the use of salsalate to prevent the progression from prediabetes to type 2 diabetes mellitus has received limited study.^[3]

History

Salsalate had been suggested as possible treatment for diabetes as early as 1876.^[3]^[7]^[8]

Synthesis

References

^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 Oct 2023.
^ "Salsalate". drugs.com.
^ ^a ^b ^c ^d ^e ^f Anderson K, Wherle L, Park M, Nelson K, Nguyen L (June 2014). "Salsalate, an old, inexpensive drug with potential new indications: a review of the evidence from 3 recent studies". American Health & Drug Benefits. 7 (4): 231–5. PMC 4105730. PMID 25126374.
^ ^a ^b ^c Esser N, Paquot N, Scheen AJ (March 2015). "Anti-inflammatory agents to treat or prevent type 2 diabetes, metabolic syndrome and cardiovascular disease". Expert Opinion on Investigational Drugs (Review). 24 (3): 283–307. doi:10.1517/13543784.2015.974804. PMID 25345753. S2CID 23674166.
^ Ridker PM, Lüscher TF (July 2014). "Anti-inflammatory therapies for cardiovascular disease". European Heart Journal. 35 (27): 1782–91. doi:10.1093/eurheartj/ehu203. PMC 4155455. PMID 24864079.
^ Hardie DG (July 2013). "AMPK: a target for drugs and natural products with effects on both diabetes and cancer". Diabetes. 62 (7): 2164–72. doi:10.2337/db13-0368. PMC 3712072. PMID 23801715.
^ Powell K (May 2007). "Obesity: the two faces of fat". Nature. 447 (7144): 525–7. Bibcode:2007Natur.447..525P. doi:10.1038/447525a. PMID 17538594. S2CID 28974642.
^ Ebstein W (1876). "Zur therapie des diabetes mellitus, insbesondere uber die anwendung des salicylsauren natron bei demselben". Berliner Klinische Wochenschrift. 13: 337–340.
^ Cavallito CJ, Buck JS (1943). "Synthesis of Phenolic Acid Esters. I. Depsides1". Journal of the American Chemical Society. 65 (11): 2140–2142. doi:10.1021/ja01251a034.
^ Baker W, Ollis WD, Zealley TS (1951). "42. Eight- and higher-membered ring compounds. Part II. Di-, tri-, tetra-, and hexa-salicylides". Journal of the Chemical Society (Resumed): 201. doi:10.1039/JR9510000201.
^ DE 211403, "Verfarhen zur Darstellung einer kristallisierten Salicylosalicylsäure aus Salicylsäure oder ihrne Salzen [Process for preparing a crystallized salicylosalicylic acid from salicylic acid or its salts]", published 1909-06-25, assigned to C.F. Boehringer & Söhne
^ DE 214044, "Verfarhen zur Darstellung einer kristallisierten Salicylosalicylsäure [Process for preparing a crystallized salicylosalicylic acid]", published 1909-09-20, assigned to C.F. Boehringer & Söhne

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[FDA-AllBoxedWarnings-1] "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 Oct 2023.

[2] "Salsalate". drugs.com.

[Anderson2014-3] ^ ^a ^b ^c ^d ^e ^f Anderson K, Wherle L, Park M, Nelson K, Nguyen L (June 2014). "Salsalate, an old, inexpensive drug with potential new indications: a review of the evidence from 3 recent studies". American Health & Drug Benefits. 7 (4): 231–5. PMC 4105730. PMID 25126374.

[Esser2015-4] Esser N, Paquot N, Scheen AJ (March 2015). "Anti-inflammatory agents to treat or prevent type 2 diabetes, metabolic syndrome and cardiovascular disease". Expert Opinion on Investigational Drugs (Review). 24 (3): 283–307. doi:10.1517/13543784.2015.974804. PMID 25345753. S2CID 23674166.

[Ridker2014-5] Ridker PM, Lüscher TF (July 2014). "Anti-inflammatory therapies for cardiovascular disease". European Heart Journal. 35 (27): 1782–91. doi:10.1093/eurheartj/ehu203. PMC 4155455. PMID 24864079.

[Hardie2013-6] Hardie DG (July 2013). "AMPK: a target for drugs and natural products with effects on both diabetes and cancer". Diabetes. 62 (7): 2164–72. doi:10.2337/db13-0368. PMC 3712072. PMID 23801715.

[nature2007-7] Powell K (May 2007). "Obesity: the two faces of fat". Nature. 447 (7144): 525–7. Bibcode:2007Natur.447..525P. doi:10.1038/447525a. PMID 17538594. S2CID 28974642.

[8] Ebstein W (1876). "Zur therapie des diabetes mellitus, insbesondere uber die anwendung des salicylsauren natron bei demselben". Berliner Klinische Wochenschrift. 13: 337–340.

[9] Cavallito CJ, Buck JS (1943). "Synthesis of Phenolic Acid Esters. I. Depsides1". Journal of the American Chemical Society. 65 (11): 2140–2142. doi:10.1021/ja01251a034.

[10] Baker W, Ollis WD, Zealley TS (1951). "42. Eight- and higher-membered ring compounds. Part II. Di-, tri-, tetra-, and hexa-salicylides". Journal of the Chemical Society (Resumed): 201. doi:10.1039/JR9510000201.

[11] DE 211403, "Verfarhen zur Darstellung einer kristallisierten Salicylosalicylsäure aus Salicylsäure oder ihrne Salzen [Process for preparing a crystallized salicylosalicylic acid from salicylic acid or its salts]", published 1909-06-25, assigned to C.F. Boehringer & Söhne

[12] DE 214044, "Verfarhen zur Darstellung einer kristallisierten Salicylosalicylsäure [Process for preparing a crystallized salicylosalicylic acid]", published 1909-09-20, assigned to C.F. Boehringer & Söhne

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v t e Non-steroidal anti-inflammatory drugs (NSAIDs) (primarily M01A and M02A, also N02BA)
pyrazolones / pyrazolidines	Aminophenazone Ampyrone Azapropazone Clofezone Difenamizole Famprofazone Feprazone Kebuzone Metamizole Mofebutazone Morazone Nifenazone Oxyphenbutazone Phenazone Phenylbutazone Propyphenazone Sulfinpyrazone Suxibuzone^‡
salicylates	Aspirin (acetylsalicylic acid)^# Aloxiprin Benorylate Carbasalate calcium Diflunisal Dipyrocetyl Ethenzamide Guacetisal Magnesium salicylate Methyl salicylate Salsalate Salicin Salicylamide Salicylic acid (salicylate) Sodium salicylate
acetic acid derivatives and related substances	Aceclofenac Acemetacin Alclofenac Amfenac Bendazac Bromfenac Bufexamac Bumadizone Diclofenac Difenpiramide Etodolac Felbinac Fenclozic acid Fentiazac Indometacin Indometacin farnesil Isoxepac Ketorolac Lonazolac Mofezolac Oxametacin Prodolic acid Proglumetacin Sulindac Tiopinac Tolmetin Zomepirac^†
oxicams	Ampiroxicam Droxicam Isoxicam Lornoxicam Meloxicam Piroxicam Pivoxicam Tenoxicam
propionic acid derivatives (profens)	Alminoprofen Benoxaprofen^† Carprofen^‡ Dexibuprofen Dexketoprofen Fenbufen Fenoprofen Flunoxaprofen Flurbiprofen Ibuprofen^# Ibuproxam Indoprofen^† Ketoprofen Loxoprofen Miroprofen Naproxen Oxaprozin Pelubiprofen Piketoprofen Pirprofen Suprofen Tarenflurbil Tepoxalin^‡ Tiaprofenic acid Vedaprofen^‡ Zaltoprofen COX-inhibiting nitric oxide donator: Naproxcinod
n-arylanthranilic acids (fenamates)	Azapropazone Clonixin Etofenamate Floctafenine Flufenamic acid Flunixin Flutiazin Glafenine^† Meclofenamic acid Mefenamic acid Morniflumate Niflumic acid Tolfenamic acid
COX-2 inhibitors (coxibs)	Apricoxib Celecoxib (+tramadol) Cimicoxib^‡ Deracoxib^‡ Etoricoxib Firocoxib^‡ Lumiracoxib^† Mavacoxib^‡ Parecoxib Robenacoxib^‡ Rofecoxib^† Valdecoxib^†
other	Aminopropionitrile Benzydamine Chondroitin sulfate Diacerein Fluproquazone Glucosamine Glycosaminoglycan Hyperforin Nabumetone Nimesulide Oxaceprol Proquazone Superoxide dismutase / orgotein Tenidap
NSAID combinations	Ibuprofen/famotidine Ibuprofen/hydrocodone Ibuprofen/oxycodone Ibuprofen/paracetamol Meloxicam/bupivacaine Naproxen/diphenhydramine Naproxen/esomeprazole
Key: underline indicates initially developed first-in-class compound of specific group; ^#WHO-Essential Medicines; ^†withdrawn drugs; ^‡veterinary use.
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