MOA Menthol dilates the blood vessels causing a sensation of coldness, followed by an analgesic effect. Menthol also acts as a penetration enhancer, increasing the penetration of drugs when applied on the skin, to give a faster onset of action [L2814].; ; Methyl salicylate is a salicylic acid derivative, and when combined with menthol, produces menthyl salicylate [L2814].; ; Salicylates inhibit cyclooxygenase, thereby reducing the formation of prostaglandins, and cause platelet dysfunction; Methyl salicylate is used topically as a counter-irritant. Upon application, it is absorbed through the skin and is applied for the relief of pain in rheumatic conditions and painful muscle or joints [L2814].; ; The menthol dilates blood vessels, why the salicylate portion provides a topical anesthetic and analgesic action on the affected area. The cooling and warning action may interfere with the transmission of pain signals through nerves [L2814].

INDICATION ; For the temporary relief of pain associated with rheumatism, arthritis, neuralgia, sprains and strains of joints and muscles, lumbago and fibrositis [F91].

TOXICITY Salicylate intoxication may occur after ingestion or topical application of menthyl salicylate.; Mild chronic salicylate intoxication, also known as _salicylism_, normally occurs only after repeated use of large doses. ; ; Salicylism can also occur following the excessive topical application of salicylates. Symptoms of toxicity include dizziness, tinnitus, deafness, sweating, nausea and vomiting, headache, and confusion, and may be controlled by reducing the dosage [F91].; ; Symptoms of more severe intoxication or of acute poisoning following overdose include hyperventilation, fever, restlessness, ketosis, and respiratory alkalosis and metabolic acidosis. Depression of the CNS may lead to coma, cardiovascular collapse and respiratory failure may also result [F91].