shipping [2:<18 years of age should be under the direction of a clinician. 109 Salicylates should not be used in children and adolescents with varicella infection or influenza because of an increased risk of developing Reye s syndrome. 117 Hepatic Impairment Prolonged and repeated topical use over large areas in patients with substantial hepatic impairment may cause salicylate toxicity. 117 Limit treatment area and monitor for possible signs of salicylate toxicity in patients with hepatic impairment. 117 (See Salicylate Toxicity under Cautions.) Renal Impairment Prolonged and repeated topical use over large areas in patients with substantial renal impairment may cause salicylate toxicity. 117 Limit treatment area and monitor for possible signs of salicylate toxicity in patients with renal impairment. 117 (See Salicylate Toxicity under Cautions.) Common Adverse Effects Skin irritation and dryness. 100 Interactions for Salicylic Acid Because salicylic acid is rapidly and efficiently absorbed percutaneously following topical application to the skin, drug interactions as a result of systemic exposure to the drug are possible. 118 Topical Acne Preparations Cumulative irritant or drying effect. 100 If irritation occurs, use only one topical acne medication at a time. 100 Protein-bound Drugs Potential for salicylate to displace or to be displaced by other protein-bound drugs. 117 Specific Drugs Drug Interaction Comments Acidifying agents Potential increased plasma salicylate concentrations 117 Alkalinizing agents Potential decreased plasma salicylate concentrations 117 Anticoagulants (warfarin, heparin) Increased risk of bleeding 117 118 Salicylates decrease platelet adhesiveness and may potentially interfere with the effects of heparin 117 Antidiabetic agents (sulfonylureas) Potential for increased hypoglycemic effect because of displacement of sulfonylureas from protein binding sites 117 Aspirin or other salicylate-containing drugs Increased risk of salicylate toxicity 117 Caution advised; if possible, use alternative NSAIA that is not salicylate-based 117 Corticosteroids Potential decreased plasma salicylate concentrations 117 Potential increased plasma salicylate concentrations and salicylate toxicity when corticosteroids are discontinued 117 Diuretics Possible increased plasma salicylate concentrations due to contracted extracellular space 117 Methotrexate Possible increased methotrexate toxicity because of displacement from protein binding sites 117 Pyrazinamide Possible prevention or reduction of hyperuricemic effects 117 Uricosuric agents (e.g., probenecid, sulfinpyrazone) Reduced uricosuric effect 117 Salicylic Acid Pharmacokinetics Absorption Bioavailability Rapidly and well absorbed percutaneously following topical application. 117 118 Bioavailability of topical salicylic acid varies according to duration of contact and vehicle. 118 120 Absorption has ranged from 9 to> 60%. 117 118 Following topical application of salicylic acid 6% gel with occlusion, >60% absorbed, with peak plasma concentrations usually attained within 5 hours. 117 Plasma Concentrations Following topical application of salicylic acid 6% gel, peak serum salicylate concentrations were <50 mcg/mL; concentrations> 300 mcg/mL generally associated with salicylate toxicity. 117 Distribution Extent Distributed into extracellular space. 117 Plasma Protein Binding 50 80%. 117 Special Populations Patients with a contracted extracellular space secondary to dehydration or diuretics may have increased plasma salicylate levels. 117 Elimination Elimination Route Excreted principally in urine as salicyluric acid (52%), salicylate glucuronides (42%), and free salicylic acid (6%). 117 Stability Storage Topical Tightly closed containers at room temperature. 106 116 117 Do not freeze. 117 Preparations in flexible collodion are flammable; keep away from heat and open flame. 101 102 107 110 111 Actions Topical keratolytic agent that produces desquamation of the horny layer (stratum corneum) of skin by dissolving the intercellular cement that holds epithelial cells together. 117 118 120 Exact mechanism(s) of action in the treatment of warts not elucidated; keratolytic activity may result in mechanical removal of epidermal cells infected with wart viruses. 106 116 In low concentrations, has keratoplastic activity (correction of abnormal keratinization); at concentrations 1%, has keratolytic activity (causes peeling of skin); and at concentrations 20%, has a caustic effect. a Has weak antifungal and antibacterial activity. a Advice to Patients Importance of keeping salicylic acid preparations out of reach of children. 104 105 107 Importance of avoiding heat or flames during use of certain salicylic acid collodion formulations. 107 For external use only. 101 102 103 Importance of avoiding contact with eyes. 101 102 103 Advise patients that salicylic acid topical preparations used concurrently with other topical acne medications may increase skin dryness or irritation. 100 When used for self-medication of dandruff, seborrheic dermatitis, or psoriasis, importance of consulting a clinician if the condition worsens or does not improve after regular use. 103 109 Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. 117 Importance of patients informing clinician of existing or contemplated concomitant therapy, including prescription and OTC drugs. 117 Importance of informing patients of other important precautionary information. 117 (See Cautions.) Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. * available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name Salicylic Acid Routes Dosage Forms Strengths Brand Names Manufacturer Bulk Powder* Topical Cake 1% Proactiv Cleansing Bar Rodan and Fields Cleansing Cream 0.5% Ambi Even & Clear Exfoliating Wash Valeant 1% ClarityMD Deep Pore Cleanser Envy Medical 2% Aveeno Clear Complexion Cream Cleanser Johnson and Johnson Clearasil Daily Clear Oil-free Daily Face Wash Reckitt Benckiser Clearasil Ultra Rapid Action Daily Face Wash Reckitt Benckiser Cleansing Gel 2% Clearasil Ultra Rapid Action Daily Gel Wash Reckitt Benckiser Cleansing Pledgets (saturated with solution) 0.5% AcneFree 2-in-1 Acne Wipes Valeant Aveeno Clear Complexion Daily Cleansing Pads Johnson and Johnson Stridex Sensitive Pads Blistex 1% Stridex Essential Pads Blistex 2% ClarityMD Acne Treatment Pads Envy Medical Clearasil Daily Clear Daily Pore Cleansing Pads Reckitt Benckiser Clearasil Ultra On-The-Go Rapid Action Wipes Reckitt Benckiser Clearasil Ultra Rapid Action Pads Reckitt Benckiser Neutrogena Rapid Clear Treatment Pads Neutrogena Noxzema Ultimate Clear Anti-Blemish Pads Unilever Oxy Rapid Treatment 3-in-1 Pads Mentholatum Oxy Skin Clearing Cleansing Pads Mentholatum Stridex Maximum Pads Blistex Cleansing Solution 2% Neutrogena Oil-Free Acne Wash Neutrogena Oxy Skin Clearing Cleanser Mentholatum Proactiv Deep Cleansing Wash Rodan and Fields Cleansing Suspension 0.5% Clean and Clear Blackhead Erasing Cleanser Mask Johnson and Johnson Neutrogena Blackhead Eliminating Cleanser Mask Neutrogena 1% Noxzema Ultimate Clear Anti-Blemish Daily Scrub Unilever 2% Clearasil Daily Clear Daily Facial Scrub Reckitt Benckiser Clearasil Ultra Rapid Action Face Scrub Reckitt Benckiser Neutrogena Blackhead Eliminating Daily Scrub Neutrogena Neutrogena Oil-Free Acne Wash Daily Scrub Neutrogena Oxy Blackhead Removing Scrub Mentholatum Cream 3% MG217 Medicated Salicylic Cream Lake Consumer Products 6%* Salex Coria Salicylic Acid Cream Gel 2% Clearasil Ultra Rapid Action Treatment Gel Reckitt Benckiser Neutrogena Rapid Clear Acne Eliminating Spot Gel Neutrogena 3% Dermarest Psoriasis Medicated Treatment Gel Prestige Keralyt Gel Summers 5% Keralyt 5 Gel Summers 6%* Keralyt Gel Summers Salicylic Acid Gel 17% Compound W Gel Prestige Hydrisalic Pedinol Pharmacal Sal-Plant Gel Pedinol Pharmacal Lotion 0.5% Aveeno Clear Complexion Daily Moisturizer Johnson and Johnson Clean and Clear Acne Control Moisturizer Johnson and Johnson Proactiv Advanced Daily Oil Control Rodan and Fields 1% AcneFree Drying Lotion Valeant ClarityMD Clarifying Serum Envy Medical 2% Clearasil Ultra Rapid Action Treatment Lotion Reckitt Benckiser Dermarest Psoriasis Medicated Moisturizer Prestige Sebasorb Summers 6%* Salex Coria Salicylic Acid Cream Plaster 40%* Compound W One Step Invisible Strips Prestige Compound W One Step Plantar Foot Pads Prestige Compound W One Step Pads Prestige Curad Mediplast Medline Dr. Scholl s Clear Away One-Step Clear Strips Bayer Dr. Scholl s Clear Away Plantar Wart Remover Bayer Dr. Scholl s Clear Away Wart Remover Ultra-thin Discs Bayer Dr. Scholl s One-Step Corn Remover Bayer Paraid One Step Wart Removal Strips Mcure Health Solutions Salicylic Acid Plaster Shampoo 3% Denorex Extra Strength Dandruff Shampoo and Conditioner Ultimark Products Dermarest Psoriasis Medicated Shampoo Plus Conditioner Prestige DHS Sal Shampoo Person & Covey Neutrogena T/Sal Therapeutic Shampoo Neutrogena Psoriasin Therapeutic Shampoo & Body Wash Alva-Amco Pharmacal 5% Keralyt 5 Shampoo Summers 6% Salex Coria Solution 16.7% Gordofilm Wart Remover Gordon 17% Compound W Liquid Prestige Dr. Scholl s Clear Away Fast Acting Liquid Bayer Dr. Scholl s Liquid Corn/Callus Remover Bayer DuoFilm Wart Remover MSD Consumer Care Salactic Film Pedinol Pharmacal 27.5%* Salicylic Acid 27.5% Wart Remover Virasal Elorac Solution, extended-release 28.5% UltraSal -ER Elorac Salicylic Acid Combinations Routes Dosage Forms Strengths Brand Names Manufacturer Topical Ointment 5% with Urea 10% Kerasal Foot Ointment Moberg Pharma AHFS DI Essentials. Copyright 2017, Selected Revisions February 29, 2016. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. References 100. Department of Health and Human Services, Food and Drug Administration. Part 333---Topical antimicrobial drug products for over-the-counter human use. Subpart D---Topical acne drug products. (21 CFR Ch. 1 (Current as of 10-30-15.)) 2015. From Electronic Code of Federal Regulations website. 101. Department of Health and Human Services, Food and Drug Administration. Part 358---Miscellaneous external drug products for over-the-counter human use. Subpart B---Wart remover drug products. (21 CFR Ch. 1 (Current as of 10-30-15.)) 2015. From Electronic Code of Federal Regulations website. 102. Department of Health and Human Services, Food and Drug Administration. Part 358---Miscellaneous external drug products for over-the-counter human use. Subpart F---Corn and callus remover drug products. (21 CFR Ch. 1 Current as of 10-30-15.)) 2015. 103. Department of Health and Human Services, Food and Drug Administration. Part 358---Miscellaneous external drug products for over-the-counter human use. Subpart H---Drug products for the control of dandruff, seborrheic dermatitis, and psoriasis. (21 CFR Ch. 1 (Current as of 10-30-15.)) 2015. 104. Unilever. Noxzema Ultimate Clear Anti-Blemish Daily Scrub (salicylic acid 1%) product information. Trumbull, CT. 2012 Oct. 105. Rodan and Fields. Proactiv cleaning bar (salicylic acid 1%) product information. San Francisco, CA. 2010 Sep. 106. Elorac. UltraSal-ER (28.5% Salicylic Acid Extended Release) antiviral film-forming solution) prescribing information. Vernon Hills, IL; 2014 Jan. 107. Prestige. Compound W Fast Acting Wart Removal Gel (salicylic acid 17%) product information. Tarrytown, NY. Undated. 108. Moberg Pharma. Kerasal Exfoliating Moisturizer Foot Therapy (salicylic acid 5% and urea 10%) product information. Undated. 109. Alva-Amco Pharmacal. Psoriasin Therapeutic Shampoo and Body Wash (salicylic acid 3%) product information. Niles, IL. 2010 May. 110. Pedinol Pharmacal. Hydrisalic gel (salicylic acid 17%) product information. Farmingdale, NY; 2014 Nov. 111. Prestige. Compound W Fast Acting Liquid (salicylic acid 17%) product information. Tarrytown, NY. Undated. 112. Medline Industries. Mediplast Corn, Callus, and Wart Remover (salicylic acid 40% ) plaster product information. Mundelein, IL. 2012 Nov. 113. Blistex. Stridex Essential (salicylic acid 1%) pads product information. Oak Brook, IL. 2013 Dec. 114. Neutrogena Coporation. Neutrogena Rapid Clear Acne Eliminating Spot Gel (salicylic acid 2%) product information. Los Angeles, CA. 2015 May. 115. Rodan and Fields. Proactiv Advanced Daily Oil Control (salicylic acid 0.5%) product information. San Francisco, CA. 2012 Aug. 116. Elorac. Virasal (salicylic acid 27.5%) antiviral film-forming vehicle product information. Vernon Hills, IL. 2011 Jan. 117. Coria Laboratories. Salex (salicylic acid 6%) cream and lotion prescribing information. Fort Worth, TX; 2013 July. 118. Akhavan A, Bershad S. Topical acne drugs: review of clinical properties, systemic exposure, and safety. Am J Clin Dermatol . 2003; 4:473-92. [PubMed 12814337] 119. Eichenfield LF, Krakowski AC, Piggott C et al. Evidence-based recommendations for the diagnosis and treatment of pediatric acne. Pediatrics . 2013; 131 Suppl 3:S163-86. [PubMed 23637225] 120. Madan RK, Levitt J. A review of toxicity from topical salicylic acid preparations. J Am Acad Dermatol . 2014; 70:788-92. [PubMed 24472429] 121. Mason AR, Mason J, Cork M et al. Topical treatments for chronic plaque psoriasis. Cochrane Database Syst Rev . 2013; 3:CD005028. 122. Kwok CS, Gibbs S, Bennett C et al. Topical treatments for cutaneous warts. Cochrane Database Syst Rev . 2012; 9:CD001781. 123. Dall'oglio F, D'Amico V, Nasca MR et al. Treatment of cutaneous warts: an evidence-based review. Am J Clin Dermatol . 2012; 13:73-96. [PubMed 22292461] 124. US Food and Drug Administration. FDA Drug Safety Communication: FDA warns of rare but serious hypersensitivity reactions with certain over-the-counter topical acne products. Rockville, MD; 2014 Jun 25. From FDA website. Accessed 2015 Jul 30. 125. Titus S, Hodge J. Diagnosis and treatment of acne. Am Fam Physician . 2012; 86:734-40. [PubMed 23062156] 126. Shalita AR. Comparison of a salicylic acid cleanser and a benzoyl peroxide wash in the treatment of acne vulgaris. Clin Ther . 1989 Mar-Apr; 11:264-7. 127. Menter A, Korman NJ, Elmets CA et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol . 2009; 60:643-59. [PubMed 19217694] a. AHFS Drug Information 2016. McEvoy GK, ed. Salicylic Acid. Bethesda, MD: American Society of Health-System Pharmacists; 2016:3545-6. Next Interactions Print this page Add to My Med List More about salicylic acid topical Side Effects Dosage Information Drug Interactions Compare Alternatives Support Group Pricing & Coupons En Español 7 Reviews Add your own review/rating Drug class: topical acne agents Consumer resources Salicylic acid topical ... +12 more Professional resources Salicylic Acid (FDA) Salicylic Acid Foam (FDA) Salicylic Acid Gel (FDA) Salicylic Acid Liquid (FDA) Salicylic Acid Lotion (FDA) ... +3 more Other brands: Salacyn , KeralytGel , Virasal , Keralyt Shampoo , ... +11 more Related treatment guides Dermatological Disorders Warts Acne Dandruff ]} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx OTC Availability Rx and/or OTC C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Manufacturers Perrigo Company Acella Pharmaceuticals, LLC Drug Class Topical acne agents Topical keratolytics Related Drugs Warts Compound W , Duofilm , silver nitrate topical , Wart Remover , Virasal , More... Dermatological Disorders triamcinolone , clobetasol topical , betamethasone , Temovate , Diprolene , More... Acne doxycycline , clindamycin topical , erythromycin topical , minocycline , tretinoin topical , tetracycline topical , More... Dandruff ketoconazole topical , Nizoral Topical , Selsun Blue , selenium sulfide topical , Xolegel , More... Salicylic acid topical Rating 7 User Reviews 8.3 /10 7 User Reviews 8.3 Rate it!} } really unique
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