Salsalate Side Effects: What You Need to Know
Most people tolerate salsalate reasonably well, but like all NSAIDs it carries risks. Here's what's common, what's serious, and when to get help.
📅 Last reviewed: July 27, 2026 · Cross-checked against FDA labeling and Cleveland Clinic patient materials.
Common Side Effects
These reactions are relatively frequent and often mild. They don't always require you to stop the medication, but you should mention them to your doctor or pharmacist, especially if they persist or bother you:
- Tinnitus (ringing or buzzing in the ears) — often an early sign that your salicylate level is rising and worth reporting promptly
- Headache
- Nausea or upset stomach
- Loss of appetite
- Diarrhea
- Dizziness
If any of these symptoms are severe, don't improve, or interfere with daily activities, call your prescriber rather than simply pushing through them — a dose adjustment often resolves mild side effects.
Serious Side Effects — Call Your Doctor Immediately
The reactions below are less common but can be dangerous. Contact your doctor right away, or go to the emergency room, if you notice any of the following.
Gastrointestinal Bleeding or Ulcers
NSAIDs, including salsalate, can irritate the stomach and intestinal lining and, in some cases, cause ulcers or internal bleeding — sometimes without any warning symptoms beforehand. Warning signs include stomach pain, heartburn that won't go away, black or tarry-looking stools, and vomit that resembles coffee grounds. Any of these findings warrants prompt medical attention.
Cardiovascular Warning Signs
Chest pain, shortness of breath, sudden weakness on one side of the body, and slurred speech can indicate a heart attack or stroke. NSAIDs as a class — including salsalate — carry an FDA-mandated warning about increased cardiovascular risk (see the box below). Treat any of these symptoms as a medical emergency.
Allergic Reactions
Signs of an allergic reaction include rash, hives, itching, and swelling of the face, lips, tongue, or throat. Swelling of the throat or difficulty breathing is a medical emergency requiring immediate care, as it can progress to a life-threatening reaction.
Liver Problems
Watch for yellowing of the skin or eyes (jaundice), unusually dark urine, pain in the upper right side of the abdomen, or extreme, unexplained fatigue. These can point to liver stress or injury and should be evaluated promptly, particularly if you also drink alcohol regularly or take other medications processed by the liver.
Kidney Problems
Decreased urination, or swelling in the ankles, feet, or hands, can be signs that the kidneys are not filtering fluid properly. NSAIDs can affect kidney function, especially with long-term use, in older adults, or in people who are dehydrated.
Severe Skin Reactions
Rarely, NSAIDs can trigger severe skin reactions — a spreading red rash, blistering, or peeling skin. These reactions can develop anywhere from a few weeks to several months after starting the medication, so don't assume a new rash is unrelated just because you've been taking salsalate safely for a while. Seek medical care promptly for any unexplained blistering or skin peeling.
Reye's Syndrome Warning
Salsalate should not be given to children or teenagers who have or are recovering from chicken pox, influenza, or flu-like symptoms. Salicylates have been linked to Reye's syndrome in this situation — a rare but serious condition involving dangerous fatty buildup in the brain, liver, and other organs. See Precautions & Contraindications for more.
FDA Cardiovascular Warning
NSAIDs, including salsalate, can increase the risk of heart attack or stroke, even in people without existing heart disease. This risk appears to increase the longer the medication is used, and is higher in people who already have heart disease or risk factors for it. Do not take more than your prescribed dose, and tell your doctor about any history of heart problems before starting treatment.
FDA Gastrointestinal Warning
NSAIDs can cause ulcers, bleeding, or perforation of the stomach or intestines at any point during treatment, often without warning symptoms. The risk is higher with long-term use, in older adults, and in people who smoke, drink alcohol, or have a history of ulcers.
Reporting Side Effects to the FDA
If you experience a serious side effect from salsalate, you can report it to the FDA's MedWatch program, which tracks adverse drug reactions nationally. You can report online at www.fda.gov/medwatch or by calling 1-800-FDA-1088. Reporting doesn't replace calling your doctor for treatment, but it helps regulators track patterns in drug safety over time.