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Drugs in this class include aspirin (Anacin, Ascriptin, Bayer Aspirin, Ecotrin) and salsalate (Mono-Gesic, Salgesic).

How salicylates work: These drugs decrease the production of prostaglandins. Prostaglandins are substances found in many tissues. They cause pain and inflammation. The use of salicylates for rheumatoid arthritis has been largely replaced by nonsteroidal anti-inflammatory drugs.

Who should not use these medications: Children younger than 16 years who have viral infections should not take salicylates because of the risk of Reye syndrome; additionally, people with the following conditions should not take these medications:

• Allergy to salicylates
• Liver impairment
• Vitamin K deficiency
• Bleeding disorders
• Severe anemia
• Peptic ulcer disease
• Gout

Use: Salicylates are given as oral tablets or capsules in various dosage regimens. Take them with food to decrease stomach irritation.

Drug or food interactions: Individuals taking anticoagulants, such as warfarin (Coumadin), should not take certain salicylates (aspirin). The large doses used for RA may increase effects of oral diabetic drugs, thereby lowering blood sugar levels. Use with corticosteroids, such as prednisone (Deltasone, Orasone) or nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of developing gastric ulcers or gastrointestinal bleeding. Additional interactions are possible, which makes it essential to consult with a doctor or pharmacist before taking prescription or over-the-counter drugs.

Side effects: Salicylates may decrease kidney function and further impair existing kidney disease, and they must be used with caution in individuals with a history of peptic ulcer disease. Do not use these drugs during the last 3 months of pregnancy. Individuals with asthma are more likely to be allergic to salicylates. Call a doctor if any of the following occur:

• Severe stomach pain
• Vomiting with blood
• Bloody or black, tarry stools
• Bloody or cloudy urine
• Unexplained bruising or bleeding
• Wheezing or breathing troubles
• Swelling in the face or around the eyes
• Severe rash or red, itchy skin

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