Salsalate Drug Interactions: What Should Not Be Taken with Salsalate
Salsalate can interact with a range of common medications and supplements. Always give your doctor and pharmacist a complete list of everything you take.
📅 Last reviewed: July 27, 2026
Do Not Combine with Salsalate
- Aspirin and other salicylates — combining raises the risk of salicylate toxicity
- Other NSAIDs — ibuprofen (Advil, Motrin), naproxen (Aleve), ketorolac, and similar drugs increase GI bleeding and kidney risk without added benefit
- Cidofovir — an antiviral medication with a specific, serious interaction
- Probenecid — salsalate can reduce this gout medication's effectiveness by interfering with its excretion pathway
Many over-the-counter cold, flu, and pain-relief products contain hidden aspirin or NSAIDs. Always read OTC labels carefully before combining them with salsalate — a "sinus and pain" combination product, for instance, may contain ibuprofen even though it isn't marketed as a pain reliever front-and-center.
Use with Caution — Monitor Closely
The medications below aren't necessarily forbidden, but they require your doctor's oversight, and sometimes closer lab monitoring, when combined with salsalate:
| Medication / Class | Why It Matters |
|---|---|
| Blood thinners (warfarin, heparin, apixaban, rivaroxaban) | Increased bleeding risk |
| Antiplatelet drugs (clopidogrel / Plavix) | Increased bleeding risk |
| Oral steroids (prednisone, dexamethasone, methylprednisolone) | Higher risk of GI ulcers and bleeding |
| Methotrexate | Salsalate may raise methotrexate levels, increasing toxicity risk |
| Lithium | Salsalate can raise lithium blood levels |
| Digoxin | Levels may be affected; monitoring recommended |
| Cyclosporine, tacrolimus | Potential added strain on kidney function |
| Diuretics ("water pills") | NSAIDs can reduce diuretic effectiveness and affect kidney function |
| Blood pressure medications (ACE inhibitors, ARBs) | NSAIDs can blunt blood-pressure-lowering effects and stress the kidneys |
| SSRIs (antidepressants) | Combined with an NSAID, bleeding risk increases |
Alcohol
Drinking alcohol while taking salsalate increases the risk of stomach irritation and gastrointestinal bleeding. If you drink, talk with your doctor about how much may be reasonable, if any, while you're on this medication — and never combine heavy drinking with an NSAID.
Supplements That May Interact
Some herbal and dietary supplements can add to salsalate's bleeding risk or interact in other ways. These include garlic, ginger, ginkgo biloba, and MSM (methylsulfonylmethane). "Natural" doesn't mean risk-free — tell your doctor about every supplement you take, not just prescription drugs.
The Simplest Safety Step
Keep an up-to-date list of every medication, supplement, and herbal product you take, and share it with any doctor, pharmacist, or dentist involved in your care. Many interactions are easy to avoid once your care team has the full picture.