Type your tag names separated by a space and hit enter

Salicylate (Aspirin) Poisoning

Salicylate (Aspirin) Poisoning is a topic covered in the 5-Minute Pediatric Consult.

To view the entire topic, please or purchase a subscription.

Pediatrics Central™ is an all-in-one application that puts valuable medical information, via your mobile device or the web, in the hands of clinicians treating infants, children, and adolescents. Explore these free sample topics:

Pediatrics Central

-- The first section of this topic is shown below --



  • May occur with acute or chronic overdosage of the following:
    • Acetylsalicylic acid (aspirin)
    • Methyl salicylate (oil of wintergreen)
    • Bismuth subsalicylate (Pepto Bismol®)
    • Salicylic acid (a keratolytic)
    • Other salicylate-containing drugs
  • The potentially toxic acute oral dose of acetylsalicylic acid is >150 mg/kg.


  • Analgesics are the most common drugs implicated in human exposures reported to U.S. poison control centers.
  • Salicylate preparations constitute ~10% of all analgesic poisoning exposures reported to poison control centers.


  • Ingested drug is absorbed in stomach and proximal intestine.
  • With therapeutic aspirin dosing, serum levels peak in 1 to 2 hours (standard preparations) or 4 to 6 hours (enteric coated).
  • After oral overdose, absorption may be prolonged and erratic.
  • Acetylsalicylate ingestion may produce gastritis and may trigger centrally mediated vomiting.
  • After overdose, the elimination half-life of salicylate becomes prolonged.
  • As blood pH falls, the proportion of nonionized salicylate rises, and more salicylate shifts into tissues, including brain.
  • Toxic salicylate exposures uncouple mitochondrial oxidative phosphorylation and increase oxygen consumption.
  • Direct stimulation of the medullary respiratory center leads to hyperventilation and respiratory alkalosis.
  • Multiple metabolic derangements produce a wide anion gap metabolic acidosis.
  • Dehydration and electrolyte shifts are common.
  • Low cerebral glucose concentrations may exist despite normal serum glucose concentrations.
  • Pulmonary and/or cerebral edema may occur.

Commonly Associated Conditions

  • Aspirin is often marketed in combination with other pharmaceuticals, which may complicate drug overdose situations.
  • Adolescents frequently overdose on >1 drug preparation.
  • Therapeutic use of acetylsalicylic acid among children with influenza has been associated with the occurrence of Reye syndrome.

-- To view the remaining sections of this topic, please or purchase a subscription --


Cabana, Michael D., editor. "Salicylate (Aspirin) Poisoning." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617168/all/Salicylate__Aspirin__Poisoning.
Salicylate (Aspirin) Poisoning. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617168/all/Salicylate__Aspirin__Poisoning. Accessed April 19, 2019.
Salicylate (Aspirin) Poisoning. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617168/all/Salicylate__Aspirin__Poisoning
Salicylate (Aspirin) Poisoning [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 19]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617168/all/Salicylate__Aspirin__Poisoning.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Salicylate (Aspirin) Poisoning ID - 617168 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617168/all/Salicylate__Aspirin__Poisoning PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -