Salsalate Warnings: Who Should Not Take Salsalate
Salsalate isn't appropriate for everyone. Here's who should avoid it, and what your doctor needs to know before you start.
📅 Last reviewed: July 27, 2026
Do Not Take Salsalate If You:
- Are allergic to salsalate, aspirin, or any other NSAID (such as ibuprofen or naproxen)
- Have a history of asthma, hives, or an allergic-type reaction after taking aspirin or another NSAID
- Are about to undergo, or have recently had, coronary artery bypass graft (CABG) surgery
- Are a child or teenager with chicken pox, influenza, or flu-like symptoms (risk of Reye's syndrome)
Why These Contraindications Matter
People with a known aspirin or NSAID allergy can experience serious, sometimes life-threatening reactions to salsalate because it belongs to the same broader drug family. Similarly, some people with asthma have a specific sensitivity to aspirin and related salicylates that can trigger severe bronchospasm (asthma attacks), so a past reaction is an important red flag your doctor needs to know about.
The CABG surgery restriction exists because NSAIDs taken shortly before or after this specific type of heart surgery have been associated with an increased risk of heart attack and stroke in that setting. Always tell your surgical team about every medication you take, including over-the-counter NSAIDs, well before any planned procedure.
Tell Your Doctor Before Taking Salsalate If You Have:
- Heart disease, heart failure, high blood pressure, or high cholesterol
- A history of heart attack or stroke
- Stomach ulcers, gastrointestinal bleeding, or a bleeding disorder
- Kidney disease or liver disease
- Asthma, especially with nasal polyps
- Diabetes
- A pattern of smoking or heavy alcohol use
None of these conditions automatically rule out salsalate, but each one changes the risk-benefit calculation your doctor makes. For example, someone with kidney disease may need more frequent monitoring or a lower dose, since the kidneys play a role in clearing salicylates from the body. Full disclosure lets your prescriber weigh the benefits of treating your joint pain against your personal risk factors.
Pregnancy
Pregnancy Warning
NSAIDs, including salsalate, should generally be avoided starting at 20 weeks of pregnancy because of a potential risk to fetal kidney development, and should not be used after 30 weeks of pregnancy due to the risk of premature closure of a fetal blood vessel (the ductus arteriosus) and other complications. If you are pregnant, think you might be pregnant, or are planning a pregnancy, tell your doctor before starting or continuing salsalate so they can weigh alternative options.
Breastfeeding
Salicylates can pass into breast milk. If you are breastfeeding, talk with your doctor before taking salsalate so they can weigh the benefits for you against any potential exposure for your baby, and discuss monitoring or alternative options if needed.
Fertility
NSAIDs, including salsalate, have been associated with temporary, reversible effects on fertility in some patients, generally resolving after the medication is stopped. If you are trying to conceive and have concerns, raise them with your doctor — they can discuss whether this is relevant to your situation and whether an alternative treatment makes sense while you are trying to become pregnant.
Older Adults (65 and Older)
Older adults are generally more sensitive to the side effects of NSAIDs, including gastrointestinal bleeding, kidney effects, and cardiovascular risks. Doctors often start older patients on a lower dose of salsalate and monitor more closely. If you're caring for an older family member taking salsalate, watch for the warning signs described on the Side Effects page and keep regular follow-up appointments.
Before Surgery or Dental Procedures
Tell your surgeon, anesthesiologist, or dentist that you take salsalate before any procedure, including routine dental work. Depending on the type of procedure, your doctor may advise pausing salsalate for a period beforehand to reduce bleeding risk. Never stop or resume salsalate around a procedure without your prescriber's guidance.