Salicylate

Drug Name
Salicylate

Brand Name(s)
Rub A535®, Aspercreme®, BenGay®, Flexall®, Myoflex®, etc.

Drug Class
Non-prescription medication

Salicylate topical preparations are an alternative for osteoarthritis (OA) pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications.

  • What types of arthritis are salicylates used for?

    Salicylate topical preparations are an alternative for osteoarthritis (OA) pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications. Topical salicylate may work by decreasing pain and inflammation; however, there is limited evidence to support the use of topical salicylate as an effective treatment for OA pain.

    Topical salicylates may be used in addition to DMARDs or biologics to treat the pain of inflammatory arthritis; however, these products are not routinely used in the treatment of inflammatory arthritis.

  • How are salicylates administered?

    Salicylate is available in topical preparations that may be applied directly to the skin over a joint to help lessen the pain of OA.

  • What is the typical dose and when do I take it?

    Apply sparingly three or four times daily and massage into the affected area. 

  • How long will it take to work?

    Salicylates do not provide immediate relief to pain; pain relief may take several weeks with daily administration.

  • When should I not use salicylates and call my doctor?

    Do not use topical salicylate preparations if you are allergic to salicylates (acetylsalicylic acid-based medications, such as Aspirin®), or if you are taking anticoagulant medications (e.g., warfarin). When administered with anticoagulant medications, a possible additive effect on blood thinning may occur and may increase the risk of bleeding.

    For people taking oral non-steroidal anti-inflammatory drugs (NSAIDs) regularly, please speak with your health-care provider before using topical salicylates.

    Salicylate products are for external use only. If rash or irritation occurs, discontinue use. If condition worsens or symptoms persist discontinue use and contact your health-care provider. 

    Avoid contact with eyes. After application, wash hands thoroughly to prevent spreading the product to eyes and mouth. Flush with water if contact does occur. 

    Don’t bandage the areas where salicylate has been applied and avoid other sources of heat such as heating pads.

    Never apply to wounds or damaged skin.

  • What are the side effects of salicylates?

    Skin irritation, local burning, stinging and/or redness are common.

    Overuse of salicylate creams can lead to increased absorption into the bloodstream. This can increase the risk of adverse effects, such as bleeding from salicylate toxicity.

  • What helps to reduce side effects?

    Apply topical salicylate products as recommended and contact your health-care provider if you have any concerns while using the medication. 

  • Do I need any monitoring while using salicylates?

    On occasion, you may need blood work while using topical salicylates. Your health-care provider may meet with you regularly to ensure that your pain is adequately controlled.


This information was last updated November 2017, with expert advice from:

Jason Kielly, B.Sc. (pharm.), Pharm.D.
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health

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