ammonium salicylate + camphor + menthol + salicylic acid: clinical use

Prescribing considerations

• Consider cumulative salicylate exposure; avoid application to large areas or prolonged excessive use.
• Review warfarin therapy before use.
• Counsel on external use, ingestion risk and fabric flammability.

Contraindications and cautions

• Age under 12 years
• Pregnancy or breastfeeding
• Broken, abraded or irritated skin
• Hypersensitivity to ingredients
• Aspirin, salicylate or NSAID hypersensitivity, particularly with associated asthma

Monitoring

• Stop if irritation or hypersensitivity develops.
• Following extensive exposure, excessive use or ingestion, assess for salicylate, camphor and menthol toxicity.

Clinical pharmacology

Salicylate ions contribute local analgesia; salicylate esters, menthol and camphor produce counter-irritant, cooling and rubefacient effects. Topical salicylate absorption can be measurable.

Formulation and product differences

• Lotion may be smoothed or massaged into skin.
• Pump spray permits application without initial hand contact but requires avoidance of the face, inhalation and confined spaces.