Version July 2025
Back pain: Oral: Magnesium salicylate 580 mg: 2 tablets every 6 hours (maximum: 8 tablets per 24 hours).
There are no dosage adjustments provided in the manufacturer's labeling. Also refer to the Aspirin monograph.
There are no dosage adjustments provided in the manufacturer's labeling. Also refer to the Aspirin monograph.
Use with caution; increased risk of GI bleeding.
Relief of mild to moderate pain: Children ≥12 years: Refer to adult dosing.
Refer to Aspirin monograph.
OTC labeling: When used for self-medication, do not use if you are allergic to salicylates (including aspirin), any other pain reliever/fever reducer, or any component of the formulation.
Concerns related to adverse effects:
• GI bleeding: May cause severe stomach bleeding; risk factors include patients ≥60 years of age; history of stomach ulcers or bleeding problems; coadministration with anticoagulants or steroids; coadministration with other nonsteroidal anti-inflammatory drugs (NSAIDs); ≥3 alcoholic drinks every day during therapy; and prolonged use or administration of more than the recommended dose.
• Hypersensitivity: Severe allergic reactions (eg, asthma, facial swelling, hives, shock, wheezing) have occurred. If an allergic reaction occurs, discontinue use immediately.
• Salicylate sensitivity: Patients with sensitivity to tartrazine dyes, nasal polyps, and asthma may have an increased risk of salicylate sensitivity.
Disease-related concerns:
• Ethanol use: Heavy ethanol use (>3 drinks/day) can increase bleeding risks and may enhance gastric mucosal damage.
Special populations:
• Pediatric: Children and teenagers who have or are recovering from chickenpox or flu-like symptoms should not use this product. Changes in behavior (along with nausea and vomiting) may be an early sign of Reye syndrome; patients should be instructed to contact their health care provider if these occur.
• Surgical patients: Use with caution prior to surgery; surgical patients should avoid salicylates, if possible, for 1 to 2 weeks prior to surgery to reduce the risk of excessive bleeding.
Other warnings/precautions:
• Self-medication (OTC use): When used for self-medication, do not exceed recommended dose. Contact a health care provider before use if you have a history of GI problems (including ulcers) or stomach problems (eg, heartburn); coadministration with a diuretic or a prescription medication for diabetes, gout, or arthritis, or if you have asthma, hypertension, cardiac disease, hepatic cirrhosis, or renal disease. Discontinue use if any of the following occur: feeling faint, vomiting blood, bloody or black stools, stomach pain that does not get better, pain gets worse or lasts >10 days, fever gets worse or lasts >3 days, ringing in the ears or loss of hearing, redness or swelling in the painful area, or any new symptoms appear.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, Oral:
Doans Pills: 325 mg
Tablet, Oral, as tetrahydrate:
Doans Extra Strength: 580 mg
Doans Extra Strength: 580 mg [contains methylparaben]
No
Tablets (Doans Extra Strength Oral)
580 mg (per each): $0.23
Tablets (Doans Pills Oral)
325 mg (per each): $0.18
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Administer with a full glass of water.
Oral: Administer with a full glass of water.
Back pain: Temporary relief of minor backache pain.
KIDs List: Salicylates, when used in pediatric patients <18 years of age with suspicion of viral illness (influenza, chickenpox), are identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be used with caution due to risk of Reye syndrome (weak recommendation; very low quality of evidence) (PPA [Meyers 2020]).
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Agents with Blood Glucose Lowering Effects: Salicylates may increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Risk C: Monitor
Ajmaline: Salicylates may increase adverse/toxic effects of Ajmaline. Specifically, the risk for cholestasis may be increased. Risk C: Monitor
Alfacalcidol: May increase serum concentration of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving alfacalcidol. If magnesium-containing products must be used with alfacalcidol, serum magnesium concentrations should be monitored closely. Risk D: Consider Therapy Modification
Alpha-Lipoic Acid: Magnesium Salts may decrease absorption of Alpha-Lipoic Acid. Alpha-Lipoic Acid may decrease absorption of Magnesium Salts. Management: Separate administration of alpha-lipoic acid from that of any magnesium-containing compounds by several hours. If alpha-lipoic acid is given 30 minutes before breakfast, then administer oral magnesium-containing products at lunch or dinner. Risk D: Consider Therapy Modification
Ammonium Chloride: May increase serum concentration of Salicylates. Risk C: Monitor
Angiotensin-Converting Enzyme Inhibitors: Salicylates may decrease therapeutic effects of Angiotensin-Converting Enzyme Inhibitors. Salicylates may increase nephrotoxic effects of Angiotensin-Converting Enzyme Inhibitors. Risk C: Monitor
Anticoagulants: Salicylates may increase anticoagulant effects of Anticoagulants. Risk C: Monitor
Baloxavir Marboxil: Polyvalent Cation Containing Products may decrease serum concentration of Baloxavir Marboxil. Risk X: Avoid
Benzbromarone: Salicylates may decrease therapeutic effects of Benzbromarone. Risk C: Monitor
Bictegravir: Polyvalent Cation Containing Products may decrease serum concentration of Bictegravir. Management: Administer bictegravir at least 2 hours before or 6 hours after polyvalent cation containing products. Coadministration of bictegravir with or 2 hours after most polyvalent cation products is not recommended. Risk D: Consider Therapy Modification
Bisphosphonate Derivatives: Polyvalent Cation Containing Products may decrease serum concentration of Bisphosphonate Derivatives. Management: Avoid administration of oral medications containing polyvalent cations within: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Risk D: Consider Therapy Modification
Cabotegravir: Polyvalent Cation Containing Products may decrease serum concentration of Cabotegravir. Management: Administer polyvalent cation containing products at least 2 hours before or 4 hours after oral cabotegravir. Risk D: Consider Therapy Modification
Calcitriol (Systemic): May increase serum concentration of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving calcitriol. If magnesium-containing products must be used with calcitriol, serum magnesium concentrations should be monitored closely. Risk D: Consider Therapy Modification
Carbonic Anhydrase Inhibitors: Salicylates may increase adverse/toxic effects of Carbonic Anhydrase Inhibitors. Salicylate toxicity might be enhanced by this same combination. Management: Avoid these combinations when possible.Dichlorphenamide use with high-dose aspirin as contraindicated. If another combination is used, monitor patients closely for adverse effects. Tachypnea, anorexia, lethargy, and coma have been reported. Risk D: Consider Therapy Modification
Corticosteroids (Systemic): Salicylates may increase adverse/toxic effects of Corticosteroids (Systemic). These specifically include gastrointestinal ulceration and bleeding. Corticosteroids (Systemic) may decrease serum concentration of Salicylates. Withdrawal of corticosteroids may result in salicylate toxicity. Risk C: Monitor
Deferiprone: Polyvalent Cation Containing Products may decrease serum concentration of Deferiprone. Management: Separate administration of deferiprone and oral medications or supplements that contain polyvalent cations by at least 4 hours. Risk D: Consider Therapy Modification
Dexketoprofen: Salicylates may increase adverse/toxic effects of Dexketoprofen. Dexketoprofen may decrease therapeutic effects of Salicylates. Salicylates may decrease serum concentration of Dexketoprofen. Management: The use of high-dose salicylates (3 g/day or more in adults) together with dexketoprofen is inadvisable. Consider administering dexketoprofen 30-120 min after or at least 8 hrs before cardioprotective doses of aspirin to minimize any possible interaction. Risk X: Avoid
Dolutegravir: Magnesium Salts may decrease serum concentration of Dolutegravir. Management: Administer dolutegravir at least 2 hours before or 6 hours after oral magnesium salts. Administer the dolutegravir/rilpivirine combination product at least 4 hours before or 6 hours after oral magnesium salts. Risk D: Consider Therapy Modification
Doxercalciferol: May increase hypermagnesemic effects of Magnesium Salts. Management: Consider using a non-magnesium-containing antacid or phosphate-binding product in patients also receiving doxercalciferol. If magnesium-containing products must be used with doxercalciferol, serum magnesium concentrations should be monitored closely. Risk D: Consider Therapy Modification
Eltrombopag: Polyvalent Cation Containing Products may decrease serum concentration of Eltrombopag. Management: Administer eltrombopag at least 2 hours before or 4 hours after oral administration of any polyvalent cation containing product. Risk D: Consider Therapy Modification
Elvitegravir: Polyvalent Cation Containing Products may decrease serum concentration of Elvitegravir. Management: Administer elvitegravir-containing products 2 hours before, or 2 to 6 hours after, the administration of polyvalent cation containing products. Risk D: Consider Therapy Modification
Gabapentin: Magnesium Salts may increase CNS depressant effects of Gabapentin. Specifically, high dose intravenous/epidural magnesium sulfate may enhance the CNS depressant effects of gabapentin. Magnesium Salts may decrease serum concentration of Gabapentin. Management: Administer gabapentin at least 2 hours after use of a magnesium-containing antacid. Monitor patients closely for evidence of reduced response to gabapentin therapy. Monitor for CNS depression if high dose IV/epidural magnesium sulfate is used. Risk D: Consider Therapy Modification
Ginkgo Biloba: May increase anticoagulant effects of Salicylates. Management: Consider alternatives to this combination of agents. Monitor for signs and symptoms of bleeding (especially intracranial bleeding) if salicylates are used in combination with ginkgo biloba. Risk D: Consider Therapy Modification
Hyaluronidase: Salicylates may decrease therapeutic effects of Hyaluronidase. Risk C: Monitor
Influenza Virus Vaccine (Live/Attenuated): May increase adverse/toxic effects of Salicylates. Specifically, Reye's syndrome may develop. Risk X: Avoid
Levonadifloxacin: Magnesium Salts may decrease serum concentration of Levonadifloxacin. Risk X: Avoid
Levothyroxine: Magnesium Salts may decrease serum concentration of Levothyroxine. Management: Separate administration of oral levothyroxine and oral magnesium salts by at least 4 hours. Risk D: Consider Therapy Modification
Loop Diuretics: Salicylates may decrease therapeutic effects of Loop Diuretics. Loop Diuretics may increase serum concentration of Salicylates. Risk C: Monitor
Methotrexate: Salicylates may increase serum concentration of Methotrexate. Salicylate doses used for prophylaxis of cardiovascular events are not likely to be of concern. Management: Consider avoiding coadministration of methotrexate and salicylates. If coadministration cannot be avoided, monitor for increased toxic effects of methotrexate. Salicylate doses used for prophylaxis of cardiovascular events are not likely to be of concern. Risk D: Consider Therapy Modification
Multivitamins/Fluoride (with ADE): Magnesium Salts may decrease serum concentration of Multivitamins/Fluoride (with ADE). Specifically, magnesium salts may decrease fluoride absorption. Management: To avoid this potential interaction separate the administration of magnesium salts from administration of a fluoride-containing product by at least 1 hour. Risk D: Consider Therapy Modification
Neuromuscular-Blocking Agents: Magnesium Salts may increase neuromuscular-blocking effects of Neuromuscular-Blocking Agents. Risk C: Monitor
Nonsteroidal Anti-Inflammatory Agents (Nonselective): May increase adverse/toxic effects of Salicylates. An increased risk of bleeding may be associated with use of this combination. Risk X: Avoid
Nonsteroidal Anti-Inflammatory Agents (Topical): May increase adverse/toxic effects of Salicylates. Specifically, the risk of gastrointestinal (GI) toxicity is increased. Management: Coadministration of salicylates and topical NSAIDs is not recommended. If salicylates and topical NSAIDs are coadministered, ensure the benefits outweigh the risks and monitor for increased NSAID toxicities. Risk D: Consider Therapy Modification
PenicillAMINE: Polyvalent Cation Containing Products may decrease serum concentration of PenicillAMINE. Management: Separate the administration of penicillamine and oral polyvalent cation containing products by at least 1 hour. Risk D: Consider Therapy Modification
Phosphate Supplements: Magnesium Salts may decrease serum concentration of Phosphate Supplements. Management: Administer oral phosphate supplements as far apart from the administration of an oral magnesium salt as possible to minimize the significance of this interaction. Risk D: Consider Therapy Modification
PRALAtrexate: Salicylates may increase serum concentration of PRALAtrexate. Salicylate doses used for prophylaxis of cardiovascular events are unlikely to be of concern. Management: Consider avoiding concomitant use of salicylates and pralatrexate. If coadministered, monitor for increased pralatrexate adverse effects. Salicylate doses used for prophylaxis of cardiovascular events are not likely to be of concern. Risk D: Consider Therapy Modification
Probenecid: Salicylates may decrease therapeutic effects of Probenecid. Salicylates may increase serum concentration of Probenecid. Probenecid may increase serum concentration of Salicylates. Risk X: Avoid
Quinolones: Magnesium Salts may decrease serum concentration of Quinolones. Management: Administer oral quinolones several hours before (4 h for moxi/pe/spar/enox-, 2 h for others) or after (8 h for moxi-, 6 h for cipro/dela-, 4 h for lome/pe/enox-, 3 h for gemi-, and 2 h for levo-, nor-, or ofloxacin or nalidixic acid) oral magnesium salts. Risk D: Consider Therapy Modification
Raltegravir: Magnesium Salts may decrease serum concentration of Raltegravir. Management: Avoid the use of oral / enteral magnesium salts with raltegravir. No dose separation schedule has been established that adequately reduces the magnitude of interaction. Risk X: Avoid
Roxadustat: Polyvalent Cation Containing Products may decrease serum concentration of Roxadustat. Management: Administer roxadustat at least 1 hour after the administration of oral polyvalent cation containing products. Risk D: Consider Therapy Modification
Salicylates: May increase anticoagulant effects of Salicylates. Risk C: Monitor
Sulfinpyrazone: Salicylates may decrease serum concentration of Sulfinpyrazone. Risk X: Avoid
Tetracyclines: Magnesium Salts may decrease absorption of Tetracyclines. Only applicable to oral preparations of each agent. Management: Avoid coadministration of oral magnesium salts and oral tetracyclines. If coadministration cannot be avoided, administer oral magnesium at least 2 hours before, or 4 hours after, oral tetracyclines. Monitor for decreased tetracycline therapeutic effects. Risk D: Consider Therapy Modification
Trientine: Polyvalent Cation Containing Products may decrease serum concentration of Trientine. Management: Avoid concomitant use of trientine and polyvalent cations. If oral iron supplements are required, separate the administration by 2 hours. For other oral polyvalent cations, give trientine 1 hour before, or 1 to 2 hours after the polyvalent cation. Risk D: Consider Therapy Modification
Unithiol: May decrease therapeutic effects of Polyvalent Cation Containing Products. Risk X: Avoid
Valproic Acid and Derivatives: Salicylates may increase serum concentration of Valproic Acid and Derivatives. Risk C: Monitor
Varicella Virus-Containing Vaccines: Salicylates may increase adverse/toxic effects of Varicella Virus-Containing Vaccines. Specifically, the risk for Reye's syndrome may increase. Risk X: Avoid
Refer to Aspirin monograph for additional information.
Salicylates are excreted into human milk. Refer to Aspirin monograph for additional information.
Absorption: Rapid from stomach and upper intestine.
Bioavailability: 86% to 100% (Ranade 2001).
Distribution: Readily into most body fluids and tissues.
Protein binding: Concentration dependent; as salicylate concentration increases, protein binding decreases; primarily albumin.
Metabolism: Released into plasma as salicylic acid, which is predominantly converted to salicyluric acid.
Half-life elimination: Magnesium: 8 hours (Ranade 2001); Salicylate: ~2 hours at lower doses; may increase with repeated dosing (Mason 1980).
Time to peak: 1 hour (Ranade 2001).
Excretion: Urine (~70% as salicyluric acid) (Mason 1980).
