"The first US clinical practice guidelines for management of primary Sjögren's system were published online July 7 in Arthritis Care & Research and include a decision tree for the use of oral disease-modifying antirheumatic drugs (DMARD"...
(Generic versions may still be available.)
DISALCID (salsalate) is insoluble in acid gastric fluids (< 0.1 mg/ml at pH 1.0), but readily soluble in the small intestine where it is partially hydrolyzed to two molecules of salicylic acid. A significant portion of the parent compound is absorbed unchanged and undergoes rapid esterase hydrolysis in the body; its half-life is about one hour. About 13% is excreted through the kidneys as a glucuronide conjugate of the parent compound, the remainder as salicylic acid and its metabolites. Thus, the amount of salicylic acid available from DISALCID (salsalate) is about 15% less than from aspirin, when the two drugs are administered on a salicylic acid molar equivalent basis (3.6 g salsalate/5 g aspirin).
Salicylic acid biotransformation is saturated at anti-inflammatory doses of DISALCID (salsalate) . Such capacity limited biotransformation results in an increase in the half-life of salicylic acid from 3.5 to 16 or more hours. Thus, dosing with DISALCID (salsalate) twice a day will satisfactorily maintain blood levels within the desired therapeutic range (10 to 30 mg/100 ml) throughout the 12-hour intervals. Therapeutic blood levels continue for up to 16 hours after the last dose. The parent compound does not show capacity-limited biotransformation, nor does it accumulate in the plasma on multiple dosing. Food slows the absorption of all salicylates including DISALCID (salsalate) .
The mode of anti-inflammatory action of DISALCID (salsalate) and other nonsteroidal anti-inflammatory drugs is not fully defined. Although salicylic acid (the primary metabolite of DISALCID (salsalate) ) is a weak inhibitor of prostaglandin synthesis in vitro, DISALCID (salsalate) appears to selectively inhibit prostaglandin synthesis in vivo, providing anti-inflammatory activity equivalent to aspirin and indomethacin. Unlike aspirin, DISALCID (salsalate) does not inhibit platelet aggregation.
The usefulness of salicylic acid, the active in vivo product of DISALCID (salsalate) , in the treatment of arthritic disorders has been established. In contrast to aspirin, DISALCID (salsalate) causes no greater fecal gastrointestinal blood loss than placebo.
Last reviewed on RxList: 12/8/2004
This monograph has been modified to include the generic and brand name in many instances.
Additional Disalcid Information
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