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.
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.
Salicylate compounds block enzymes called cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). These enzymes are responsible for converting arachidonic acid into prostaglandin, which plays a role in inflammation. By blocking COX-1 and COX-2, topical salicylates reduce joint pain and inflammation where they are applied.
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 healthcare 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 healthcare 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.
Contributors
This information was last updated in June 2024 with expert review and advice by:
Alan Low, BSc(Pharm), PharmD, ACPR, FCSHP, CCD, RPh
Clinical Professor, Faculty of Pharmaceutical Sciences, University of British Columbia
Pharmacy Lead and Primary Care Pharmacist, BioPro Biologics Pharmacy
Care Director, MedInfuse Health
Garrett Tang, PharmD, RPh
Pharmacist Services Coordinator, MedInfuse Health
We also thank previous expert contributor:
Jason Kielly, BSc(Pharm), PharmD
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health
