SALONPAS

Clinical safety rating: caution

Comprehensive clinical and safety monograph for SALONPAS (SALONPAS).

How it works

Salicylate topical analgesic; inhibits cyclooxygenase (COX) and prostaglandin synthesis, providing local anti-inflammatory and analgesic effects.

What the body does with it

Metabolism	Primarily metabolized by hepatic conjugation; salicylate undergoes glucuronidation and glycine conjugation; also excreted renally.
Excretion	Primarily renal excretion of glucuronide conjugates and unchanged drug; approximately 50-60% excreted in urine as glucuronide conjugates, 10-20% as unchanged salicylate, and <5% as salicyluric acid. Biliary excretion is minimal, with less than 5% eliminated in feces.
Half-life	Approximately 2-3 hours for salicylate at therapeutic concentrations; increases dose-dependently (e.g., >20 hours at anti-inflammatory doses) due to saturation of hepatic metabolism. Clinical context: extended half-life at high doses requires monitoring for accumulation.
Protein binding	Salicylate is 75-90% bound to albumin, binding is saturable; at toxic concentrations, free fraction increases significantly.
Volume of Distribution	0.15-0.2 L/kg; low Vd indicates distribution primarily in extracellular fluid. At toxic doses, Vd may increase due to tissue accumulation.
Bioavailability	Topical: Systemic absorption is low (approximately 5-15% of applied dose). Oral: Not applicable for SALONPAS; intended for topical use only.
Onset of Action	Topical: Analgesic effect begins 30-60 minutes after application, with peak effect at 2-4 hours.
Duration of Action	Topical: Analgesic effect lasts 4-6 hours. Note: Systemic absorption is minimal; effects are primarily local.

Classification & Brands

Dosing & administration

Apply one 10 cm x 14 cm patch topically to affected area every 12 hours; maximum 2 patches daily.

Dosage form	PATCH
Renal impairment	No dosage adjustment required for methyl salicylate due to negligible systemic absorption following topical application. However, caution advised in severe renal impairment (GFR <30 mL/min) due to potential accumulation of salicylate metabolites.
Liver impairment	No dosage adjustment needed for topical use. In Child-Pugh Class C, consider increased risk of systemic toxicity from salicylate; use with caution.
Pediatric use	Not recommended for children under 12 years of age. For adolescents 12+ years, apply 1 patch every 12 hours as needed; maximum 1 patch daily.
Geriatric use	Use with caution in elderly patients due to thinner skin and potential for increased percutaneous absorption. Apply 1 patch every 12 hours; monitor for local irritation or systemic effects. Maximum 1 patch daily.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for SALONPAS (SALONPAS).

Breastfeeding	Methyl salicylate and menthol are minimally absorbed via topical route. Excretion into breast milk is negligible; M/P ratio not established. Use with caution on small areas, avoiding application to breast or nipple area to limit infant exposure.
Teratogenic Risk	Salonpas contains methyl salicylate and menthol as active ingredients. Topical salicylate absorption is minimal, but high doses could theoretically cause premature closure of the ductus arteriosus in the third trimester. Use is generally avoided in the third trimester due to risk of premature ductal closure. No teratogenic effects reported from topical use.

Warnings & precautions

■ FDA Black Box Warning

None.

Side Effect Profile

Serious Effects

Absolute Contraindications

Hypersensitivity to salicylates or NSAIDs; avoid use in children and teenagers with or recovering from chickenpox or flu-like symptoms due to risk of Reye's syndrome.

Clinical Precautions

Precautions

Do not use on wounds, damaged skin, or with other topical products; avoid contact with eyes and mucous membranes; discontinue if rash or irritation occurs; limit use to 7 days unless directed by a physician; avoid concurrent use with oral anticoagulants due to potential for enhanced bleeding.

Clinical Tips & Counseling

Drug interactions

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SALONPAS

Clinical safety rating: caution

Comprehensive clinical and safety monograph for SALONPAS (SALONPAS).

How it works

Salicylate topical analgesic; inhibits cyclooxygenase (COX) and prostaglandin synthesis, providing local anti-inflammatory and analgesic effects.

What the body does with it

Metabolism	Primarily metabolized by hepatic conjugation; salicylate undergoes glucuronidation and glycine conjugation; also excreted renally.
Excretion	Primarily renal excretion of glucuronide conjugates and unchanged drug; approximately 50-60% excreted in urine as glucuronide conjugates, 10-20% as unchanged salicylate, and <5% as salicyluric acid. Biliary excretion is minimal, with less than 5% eliminated in feces.
Half-life	Approximately 2-3 hours for salicylate at therapeutic concentrations; increases dose-dependently (e.g., >20 hours at anti-inflammatory doses) due to saturation of hepatic metabolism. Clinical context: extended half-life at high doses requires monitoring for accumulation.
Protein binding	Salicylate is 75-90% bound to albumin, binding is saturable; at toxic concentrations, free fraction increases significantly.
Volume of Distribution	0.15-0.2 L/kg; low Vd indicates distribution primarily in extracellular fluid. At toxic doses, Vd may increase due to tissue accumulation.
Bioavailability	Topical: Systemic absorption is low (approximately 5-15% of applied dose). Oral: Not applicable for SALONPAS; intended for topical use only.
Onset of Action	Topical: Analgesic effect begins 30-60 minutes after application, with peak effect at 2-4 hours.
Duration of Action	Topical: Analgesic effect lasts 4-6 hours. Note: Systemic absorption is minimal; effects are primarily local.

Classification & Brands

Dosing & administration

Apply one 10 cm x 14 cm patch topically to affected area every 12 hours; maximum 2 patches daily.

Dosage form	PATCH
Renal impairment	No dosage adjustment required for methyl salicylate due to negligible systemic absorption following topical application. However, caution advised in severe renal impairment (GFR <30 mL/min) due to potential accumulation of salicylate metabolites.
Liver impairment	No dosage adjustment needed for topical use. In Child-Pugh Class C, consider increased risk of systemic toxicity from salicylate; use with caution.
Pediatric use	Not recommended for children under 12 years of age. For adolescents 12+ years, apply 1 patch every 12 hours as needed; maximum 1 patch daily.
Geriatric use	Use with caution in elderly patients due to thinner skin and potential for increased percutaneous absorption. Apply 1 patch every 12 hours; monitor for local irritation or systemic effects. Maximum 1 patch daily.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for SALONPAS (SALONPAS).

Breastfeeding	Methyl salicylate and menthol are minimally absorbed via topical route. Excretion into breast milk is negligible; M/P ratio not established. Use with caution on small areas, avoiding application to breast or nipple area to limit infant exposure.
Teratogenic Risk	Salonpas contains methyl salicylate and menthol as active ingredients. Topical salicylate absorption is minimal, but high doses could theoretically cause premature closure of the ductus arteriosus in the third trimester. Use is generally avoided in the third trimester due to risk of premature ductal closure. No teratogenic effects reported from topical use.

Warnings & precautions

■ FDA Black Box Warning

None.

Side Effect Profile

Serious Effects

Absolute Contraindications

Hypersensitivity to salicylates or NSAIDs; avoid use in children and teenagers with or recovering from chickenpox or flu-like symptoms due to risk of Reye's syndrome.