magnesium salicylate (Doan's Extra Strength, Percogesic Maximum Strength Backache Relief)
Classes: Salicylates
Dosing and uses of Doan's Extra Strength, Percogesic Maximum Strength Backache Relief (magnesium salicylate)
Adult dosage forms and strengths
tablet
- 325 mg
- 580 mg as tetrahydrate (equal to 467.2 mg anhydrous magnesium salicylate)
- 600 mg
Mild-to-Moderate Pain
2 tabs PO q6hr PRN; not to exceed 8 tabs/24 hr
Pediatric dosage forms and strengths
tablet
- 325 mg
- 580 mg as tetrahydrate (equal to 467.2 mg anhydrous magnesium salicylate)
- 600 mg
Mild-to-Moderate Pain
<12 years: Safety and efficacy not established
>12 years: 2 tabs PO q6hr PRN; not to exceed 8 tabs/24 hr
Warnings
Contraindications
Hypersensitivity
Advanced chronic renal impairment
Coadministration with uricosuric agents
Elderly patients (65 years or older) with carditis, hepatic impairment
Children and adolescents with viral illness (eg, varicella, influenza); increased risk for Reye’s syndrome
Cautions
Chronic ingestion of salicylates in patients older than 65 years may cause noncardiogenic pulmonary edema
May cause GI ulceration or bleeding
Consuming 3 or more alcoholic drinks daily may increase risk for GI bleeding
Caution in patients with asthma; may have increased risk for hypersensitivity or exacerbation of asthma
Do not take if on other chronic NSAIDs
Caution if coadministered with anticoagulant drugs
May cause tinnitus
Use caution in patients with dehydration, erosive gastritis or peptic ulcer
Heart Failure (HF) risk
- NSAIDS have the potential to trigger HF by prostaglandin inhibition that leads to sodium and water retention, increased systemic vascular resistance, and blunted response to diuretics
- High dose salicylates should be avoided or withdrawn whenever possible
- AHA/ACC Heart Failure Guidelines; Circulation. 2016; 134
Pregnancy and lactation
Pregnancy category: C
Lactation: Salicylates are excreted in breast milk; caution advised
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Doan's Extra Strength, Percogesic Maximum Strength Backache Relief (magnesium salicylate)
Mechanism of action
NSAID with antipyretic and analgesic properties via central and peripheral effects
Absorption
Absorbed rapidly
Peak Plasma Time: 1.5 hr (salicylic acid metabolite)
Peak Plasma Concentration: 3.6 mg/dL (salicylic acid metabolite)
Distribution
Protein Bound: 50-90%
Metabolism
Released in plasma as salicylic acid, which is then enzymatically metabolized to salicyluric acid and salicylphenolic glucuronide
Elimination
Half-life: 2 hr (salicylic acid metabolite); half-life prolonged with repeated dosing
Excretion: Urine
