White willow bark extract is 150 mg of the two-capsule serving, fifth by weight on the panel.
Memorial Sloan Kettering states the connection plainly: “Aspirin is derived from salicin, an active compound in willow bark”, and notes that “aspirin-like side effects may occur with willow bark”.
Blood thinners. “Do not take if you are taking warfarin or other blood thinners: Willow bark may increase the risk of bleeding.” The same page notes that salicin “may affect blood clotting”, and that the clinical significance in patients with impaired platelet functioning is yet to be determined.
NSAIDs. Avoid combining willow bark with NSAIDs because of the increased risk of stomach damage. Anyone already taking ibuprofen or naproxen for a joint problem is exactly the person most likely to reach for this product.
Aspirin sensitivity, asthma, ulcers. The same source lists aspirin sensitivity, asthma, breathing problems, stomach issues and ulcers among the reasons to avoid it.
Children. “Children should not be given willow bark because of the potential for developing Reye syndrome, a serious condition associated with the use of aspirin.”
On effectiveness, the same source is measured: clinical trials suggest willow bark extract is effective for back pain, while results are mixed for osteoarthritis.
And the specification gap: the label prints 150 mg of extract and no salicin percentage. Every caution above is dose-related in principle, and the dose of the relevant compound cannot be established from the label.