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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
Salicylic acid is a keratolytic, a medicine that loosens and sheds thickened outer skin, commonly compounded in topical creams, ointments, gels and solutions.
Salicylic acid is a keratolytic agent. It dissolves the intercellular cement that holds the cells of the outermost skin layer together, so the thick, scaly surface sheds while the living skin underneath is left intact, and it slows the overgrowth of keratin-producing cells. Many over-the-counter salicylic acid products are sold for acne, dandruff, corns, calluses and warts. Prescription salicylic acid 6% gels, shampoos and lotions are marketed as unapproved drugs; their labels state they are a topical aid in the removal of excessive keratin in hyperkeratotic skin disorders, including verrucae, the ichthyoses and psoriasis.
A prescriber may order salicylic acid compounded when a patient needs a strength or vehicle that is not manufactured, a preparation free of a specific allergen, or a combination with another active ingredient. Compounded salicylic acid preparations are not FDA-approved and require a prescription.
Salicylic acid labels carry no boxed warning, but they warn that prolonged use over large areas, especially in children or people with kidney or liver impairment, can cause salicylate poisoning (salicylism). Warning signs include nausea, vomiting, dizziness, ringing in the ears, hearing loss, tiredness, rapid breathing, diarrhea and confusion; stop use and talk to your prescriber or pharmacist right away if these occur. Do not cover treated skin with bandages, plastic or petrolatum unless directed, because occlusion increases absorption, and do not apply to broken, inflamed or infected skin, the eyes, lips or mucous membranes. Do not use salicylic acid if you are sensitive to salicylates, and it is not for children under 2 years. Children and teenagers with chickenpox or flu should not use salicylate products because of the risk of Reye's syndrome. Tell your prescriber or pharmacist if you take aspirin or other salicylates, blood thinners, methotrexate or sulfonylurea diabetes medicines. The label advises use in pregnancy only if the potential benefit justifies the risk, and not on the chest while nursing; LactMed notes it is unlikely to be appreciably absorbed into breast milk.
Salicylic acid is a beta-hydroxy acid keratolytic. It produces desquamation of the stratum corneum by dissolving intercellular cement, reduces keratinocyte proliferation and inhibits cholesterol sulfotransferase, without altering the viable epidermis. Percutaneous absorption is substantial: in a psoriasis study, more than 60 percent of an applied 6% dose was absorbed, although peak serum salicylate never exceeded 5 mg/100 mL; toxicity is usually associated with 30 to 40 mg/100 mL. Absorbed salicylate is 50 to 80 percent albumin bound, and almost 95 percent of a single dose is excreted within 24 hours of entering the extracellular space. Absorption rises sharply with a breached stratum corneum, occlusion, higher concentrations and lipophilic vehicles, and salicylate accumulates with repeated application. A 2014 review identified 25 cases of toxicity and 4 deaths from topical salicylic acid, all involving large body surface areas, most in psoriasis or ichthyosis, and neonatal toxicity at concentrations as low as 1 to 2 percent.
Labeled indications (salicylic acid 6% Rx products, unapproved marketed drugs): topical aid in removal of excessive keratin in hyperkeratotic disorders including verrucae, ichthyoses, keratosis pilaris and psoriasis. Prescribers have ordered compounded salicylic acid at higher concentrations for warts and localized hyperkeratosis, and in combination with other actives for hyperkeratotic dermatoses. Madan and Levitt (J Am Acad Dermatol 2014) note that higher concentrations are used for warts and localized hyperkeratosis and lower concentrations for plaque psoriasis. Concentration, vehicle, surface area and duration are per prescriber. Monitor for salicylism with large-area or prolonged use, in children and in renal or hepatic impairment; counsel against concurrent oral salicylates. Interactions reported with sulfonylureas, methotrexate and anticoagulants. Salicylic acid is not a controlled substance.
Wash your hands. Apply the amount on your label to clean, dry skin using the applicator provided or a cotton swab. Let it dry before covering. Use an accurate measuring device if your label gives a volume. Keep it away from the eyes and avoid open flame if the solution contains alcohol. Wash your hands afterward.
Topical solutions are aqueous or alcohol based. Under USP <795>, a preserved aqueous solution usually carries a beyond-use date of up to 35 days; an unpreserved one 14 days refrigerated; a nonaqueous solution may carry up to 180 days. Keep the bottle tightly closed at room temperature, away from heat and flame, out of reach of children, and discard after the beyond-use date on your label.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
