choline magnesium trisalicylate (Rx)

Brand and Other Names:Trilisate ASA combination
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

liquid

  • 500mg/5mL (294 mg choline salicylate, 362 mg magnesium salicylate)

tablet

  • 500mg (294 mg choline salicylate, 362 mg magnesium salicylate)
  • 750mg (440 mg choline salicylate, 544 mg magnesium salicylate)
  • 1000mg (587 mg choline salicylate, 725 mg magnesium salicylate)
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Osteoarthritis

1000-3000 mg PO q8-12hr

Rheumatoid Arthritis

1000-3000 mg PO q8-12hr

Fever

1000-1500 mg PO q12hr

Renal Impairment

Avoid use in severe renal impairment

Other Indications & Uses

Shoulder pain

Dosage Forms & Strengths

liquid

  • 500mg/5mL salicylate (294 mg choline salicylate, 362 mg magnesium salicylate)

tablet

  • 500mg salicylate (294 mg choline salicylate, 362 mg magnesium salicylate)
  • 750mg salicylate (440 mg choline salicylate, 544 mg magnesium salicylate)
  • 1000mg salicylate (587 mg choline salicylate, 725 mg magnesium salicylate)
more...

Mild to Moderate Pain

<37 kg: 50 mg/kg PO divided q12hr

>37 kg: 2250 mg PO divided q12hr

Fever

<37 kg: 50 mg/kg PO divided q12hr

>37 kg: 2250 mg PO divided q12hr

Osteoarthritis

750 mg PO q8hr

Rheumatoid arthritis

500-1500 mg PO q8-12hr

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Interactions

Interaction Checker

and choline magnesium trisalicylate

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            GI pain/ulceration/bleeding

            Tinnitus, hearing loss

            Hepatotoxicity

            Renal damage

            Premature hemolysis

            CNS alteration

            Pulmonary edema (salicylate-induced/noncardiogenic)

            Dermatologic problems, urticaria

            Angioedema

            Bronchospasm

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            Warnings

            Contraindications

            Absolute: bleeding disorders, chronic advanced renal insufficiency, GI hemorrhage, hemorrhagic diathesis, salicylate allergy

            Relative: Erosive gastritis, GI ulcer, NOS

            Cautions

            Anemia, gout, hepatic function impairment, hypertension, hypoprothrombinemia, nasal polyps, renal function impairment, thyrotoxicosis, vitamin K deficiency

            Use of salicylates in pediatric pts with varicella or influenza-like illness is associated with incr incidence of Reye's Syndrome

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            Pregnancy & Lactation

            Pregnancy Category: C; D if used for prolonged periods or near term

            Lactation: excreted in human breast milk; adverse effect on the nursing infant

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Inhibits cyclooxygenase; [at least 2 isoenzymes, cyclooxygenase-1 (COX-1) and -2 (COX-2)], thereby inhibiting prostaglandin synthesis

            Pharmacokinetics

            Half-Life: 2-3 hr (low-dose); 15-30 hr (high dose)

            Duration: 3-6 hr (PO); >7 hr (PR)

            Onset: 5-30 min (PO); 1-2 hr (PR)

            Peak Plasma: 2 hr (PO); 4-5 hr (PR)

            Vd: 0.15-0.2 L/kg

            Metabolism: Liver, microsomal enzyme system

            Metabolites: Salicylurate, salicyl phenolic glucuronide, salicyl acyl glucuronide, 2,5-dihydroxybenzoic acid (gentisic acid), 2,3-dihydroxybenzoic acid, 2,3,5-trihydroxybenzoic acid, gentisuric acid (active)

            Clearance: 24-72 hr

            Excretion: Principally in urine (80-100%), sweat, saliva, feces

            Dialyzable: Yes

            Enzymes inhibited: Prostaglandin synthesis (insignificant)

            Concentration

            • Analgesia and antipyresis 30-100 mcg/mL
            • Anti-inflammatory effect 150-300 mcg/mL
            • Rheumatic fever 250-350 mcg/mL

            Protein Bound

            • 90-95% with concentrations up to 100 mcg/mL
            • 70-85% with concentrations up to 100-400 mcg/mL
            • 25-60% with higher concentrations
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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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