choline magnesium trisalicylate (Rx)

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

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

Contraindicated (1)

• dichlorphenamide

  dichlorphenamide increases levels of choline magnesium trisalicylate by unknown mechanism. Contraindicated. Coadministration of dichlorphenamide with high-dose aspirin may increase salicylate levels. Anorexia, tachypnea, lethargy, and coma reported.

Serious - Use Alternative (16)

• benazepril

  choline magnesium trisalicylate, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• captopril

  choline magnesium trisalicylate, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• enalapril

  choline magnesium trisalicylate, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• fosinopril

  choline magnesium trisalicylate, fosinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• ketorolac

  choline magnesium trisalicylate, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.

• lisinopril

  choline magnesium trisalicylate, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• measles, mumps, rubella and varicella vaccine, live

  choline magnesium trisalicylate, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.

• methotrexate

  choline magnesium trisalicylate increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. The relative risk of interaction of different NSAIDs w/methotrexate is not established. Selective COX 2 inhibitors are believed to have minimal interaction. Greater risk in pts. with renal impairment. Greater toxicity with high dose methotrexate (e.g., anti neoplastic regimen).

• moexipril

  choline magnesium trisalicylate, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• pemetrexed

  choline magnesium trisalicylate increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Especially in pts. w/mild moderate renal insufficiency. D/C NSAIDs 2 5 d before and 2 d after pemetrexed administration.

• perindopril

  choline magnesium trisalicylate, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• quinapril

  choline magnesium trisalicylate, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• ramipril

  choline magnesium trisalicylate, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• trandolapril

  choline magnesium trisalicylate, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• varicella virus vaccine live

  choline magnesium trisalicylate, varicella virus vaccine live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.

• warfarin

  choline magnesium trisalicylate increases effects of warfarin by anticoagulation. Avoid or Use Alternate Drug.

Monitor Closely (220)

• acebutolol

  acebutolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• aceclofenac

  aceclofenac and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  aceclofenac and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• acemetacin

  acemetacin and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  acemetacin and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• acetazolamide

  acetazolamide, choline magnesium trisalicylate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.
  
  acetazolamide, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• agrimony

  choline magnesium trisalicylate and agrimony both increase anticoagulation. Use Caution/Monitor.

• albuterol

  choline magnesium trisalicylate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• alfalfa

  choline magnesium trisalicylate and alfalfa both increase anticoagulation. Use Caution/Monitor.

• alfuzosin

  choline magnesium trisalicylate decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• aliskiren

  choline magnesium trisalicylate will decrease the level or effect of aliskiren by Other (see comment). Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.

• alteplase

  choline magnesium trisalicylate and alteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

• American ginseng

  choline magnesium trisalicylate and American ginseng both increase anticoagulation. Use Caution/Monitor.

• amiloride

  amiloride and choline magnesium trisalicylate both increase serum potassium. Modify Therapy/Monitor Closely.

• amoxicillin

  amoxicillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  amoxicillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• ampicillin

  ampicillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  ampicillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• antithrombin alfa

  antithrombin alfa and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• antithrombin III

  antithrombin III and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• arformoterol

  choline magnesium trisalicylate increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• argatroban

  argatroban and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• asenapine

  choline magnesium trisalicylate decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• aspirin

  aspirin and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  aspirin and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• aspirin/citric acid/sodium bicarbonate

  aspirin/citric acid/sodium bicarbonate and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  aspirin/citric acid/sodium bicarbonate and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• atenolol

  atenolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• azilsartan

  choline magnesium trisalicylate, azilsartan. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

• bemiparin

  bemiparin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• benazepril

  benazepril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• bendroflumethiazide

  choline magnesium trisalicylate increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• betaxolol

  betaxolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• betrixaban

  choline magnesium trisalicylate, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.

• bimatoprost

  bimatoprost, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• bisoprolol

  bisoprolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• bivalirudin

  bivalirudin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• brinzolamide

  brinzolamide, choline magnesium trisalicylate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

• budesonide

  choline magnesium trisalicylate, budesonide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• bumetanide

  choline magnesium trisalicylate increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
  
  choline magnesium trisalicylate decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• candesartan

  candesartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  candesartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• captopril

  captopril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• carbenoxolone

  choline magnesium trisalicylate increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• carvedilol

  carvedilol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• celecoxib

  celecoxib and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  celecoxib and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• celiprolol

  celiprolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• chlorothiazide

  choline magnesium trisalicylate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• chlorpropamide

  choline magnesium trisalicylate increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

• chlorthalidone

  choline magnesium trisalicylate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• cinnamon

  choline magnesium trisalicylate and cinnamon both increase anticoagulation. Use Caution/Monitor.

• citalopram

  citalopram, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of GI adverse effects may be increased. If possible, avoid concurrent use.

• clomipramine

  clomipramine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.

• clopidogrel

  clopidogrel, choline magnesium trisalicylate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Clopidogrel and NSAIDs both inhibit platelet aggregation.

• cordyceps

  choline magnesium trisalicylate and cordyceps both increase anticoagulation. Use Caution/Monitor.

• cortisone

  choline magnesium trisalicylate, cortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• cyclopenthiazide

  choline magnesium trisalicylate increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• dabigatran

  dabigatran and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.

• dalteparin

  dalteparin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• deferiprone

  choline magnesium trisalicylate decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.

• defibrotide

  defibrotide increases effects of choline magnesium trisalicylate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.

• deflazacort

  choline magnesium trisalicylate, deflazacort. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• dexamethasone

  choline magnesium trisalicylate, dexamethasone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• diclofenac

  diclofenac and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  diclofenac and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• dicloxacillin

  dicloxacillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  dicloxacillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• diflunisal

  diflunisal and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  diflunisal and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• digoxin

  choline magnesium trisalicylate and digoxin both increase serum potassium. Use Caution/Monitor.

• dobutamine

  choline magnesium trisalicylate increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• dong quai

  choline magnesium trisalicylate and dong quai both increase anticoagulation. Use Caution/Monitor.

• dopexamine

  choline magnesium trisalicylate increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• doxazosin

  choline magnesium trisalicylate decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• drospirenone

  drospirenone and choline magnesium trisalicylate both increase serum potassium. Modify Therapy/Monitor Closely.

• duloxetine

  duloxetine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• edoxaban

  edoxaban, choline magnesium trisalicylate. Either increases toxicity of the other by anticoagulation. Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.

• eltrombopag

  eltrombopag increases levels of choline magnesium trisalicylate by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  elvitegravir/cobicistat/emtricitabine/tenofovir DF, choline magnesium trisalicylate. Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

• enalapril

  enalapril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• enoxaparin

  enoxaparin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• ephedrine

  choline magnesium trisalicylate increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• epinephrine

  choline magnesium trisalicylate increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• epinephrine racemic

  choline magnesium trisalicylate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• epoprostenol

  choline magnesium trisalicylate and epoprostenol both increase anticoagulation. Use Caution/Monitor.

• eprosartan

  eprosartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  eprosartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• escitalopram

  escitalopram, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• esmolol

  esmolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• ethacrynic acid

  choline magnesium trisalicylate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• etodolac

  etodolac and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  etodolac and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• fennel

  choline magnesium trisalicylate and fennel both increase anticoagulation. Use Caution/Monitor.

• fenoprofen

  fenoprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  fenoprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• feverfew

  choline magnesium trisalicylate and feverfew both increase anticoagulation. Use Caution/Monitor.

• fludrocortisone

  choline magnesium trisalicylate, fludrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• fluoxetine

  fluoxetine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• flurbiprofen

  flurbiprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  flurbiprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• fluvoxamine

  fluvoxamine, choline magnesium trisalicylate. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• fondaparinux

  fondaparinux and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• formoterol

  choline magnesium trisalicylate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• forskolin

  choline magnesium trisalicylate and forskolin both increase anticoagulation. Use Caution/Monitor.

• fosinopril

  fosinopril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• furosemide

  choline magnesium trisalicylate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• garlic

  choline magnesium trisalicylate and garlic both increase anticoagulation. Use Caution/Monitor.

• gentamicin

  choline magnesium trisalicylate increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ginger

  choline magnesium trisalicylate and ginger both increase anticoagulation. Use Caution/Monitor.

• ginkgo biloba

  choline magnesium trisalicylate and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.

• glimepiride

  choline magnesium trisalicylate increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

• glipizide

  choline magnesium trisalicylate increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

• glyburide

  choline magnesium trisalicylate increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

• griseofulvin

  griseofulvin decreases levels of choline magnesium trisalicylate by unknown mechanism. Use Caution/Monitor.

• heparin

  heparin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• horse chestnut seed

  choline magnesium trisalicylate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

• hyaluronidase

  choline magnesium trisalicylate decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Salicylates, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect. .

• hydralazine

  choline magnesium trisalicylate decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• hydrocortisone

  choline magnesium trisalicylate, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• ibuprofen

  ibuprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  ibuprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• ibuprofen IV

  ibuprofen IV will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
  
  ibuprofen IV and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  ibuprofen IV and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• indapamide

  choline magnesium trisalicylate increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• indomethacin

  indomethacin and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  indomethacin and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• irbesartan

  irbesartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  irbesartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• isoproterenol

  choline magnesium trisalicylate increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ketoprofen

  ketoprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  ketoprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• ketorolac

  ketorolac and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  ketorolac and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• labetalol

  labetalol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• latanoprost

  latanoprost, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• latanoprostene bunod ophthalmic

  latanoprostene bunod ophthalmic, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• levalbuterol

  choline magnesium trisalicylate increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• levomilnacipran

  levomilnacipran, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.

• lisinopril

  lisinopril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• lithium

  choline magnesium trisalicylate increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.

• lornoxicam

  lornoxicam and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  lornoxicam and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• losartan

  losartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  losartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• meclofenamate

  meclofenamate and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  meclofenamate and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• mefenamic acid

  mefenamic acid and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  mefenamic acid and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• meloxicam

  meloxicam and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  meloxicam and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• mesalamine

  mesalamine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.

• metaproterenol

  choline magnesium trisalicylate increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• methazolamide

  methazolamide, choline magnesium trisalicylate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

• methotrexate

  choline magnesium trisalicylate will increase the level or effect of methotrexate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

• methylprednisolone

  choline magnesium trisalicylate, methylprednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• metolazone

  choline magnesium trisalicylate increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• metoprolol

  metoprolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• milnacipran

  milnacipran, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• mistletoe

  choline magnesium trisalicylate increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• moexipril

  moexipril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• mycophenolate

  choline magnesium trisalicylate will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

• nabumetone

  nabumetone and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  nabumetone and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• nadolol

  nadolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• nafcillin

  nafcillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  nafcillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• naproxen

  naproxen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  naproxen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• nebivolol

  nebivolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• nefazodone

  nefazodone, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• nettle

  choline magnesium trisalicylate increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• norepinephrine

  choline magnesium trisalicylate increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• olmesartan

  olmesartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  olmesartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• oxacillin

  oxacillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  oxacillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• oxaprozin

  oxaprozin and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  oxaprozin and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• parecoxib

  parecoxib and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  parecoxib and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• paroxetine

  paroxetine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• pau d'arco

  choline magnesium trisalicylate and pau d'arco both increase anticoagulation. Use Caution/Monitor.

• penbutolol

  penbutolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• penicillin G aqueous

  penicillin G aqueous, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  penicillin G aqueous, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• penicillin VK

  penicillin VK, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• perindopril

  perindopril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• phenindione

  phenindione and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• phenoxybenzamine

  choline magnesium trisalicylate decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• phentolamine

  choline magnesium trisalicylate decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• phytoestrogens

  choline magnesium trisalicylate and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

• pindolol

  pindolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• pirbuterol

  choline magnesium trisalicylate increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• piroxicam

  piroxicam and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  piroxicam and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• pivmecillinam

  pivmecillinam, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  pivmecillinam, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• potassium acid phosphate

  choline magnesium trisalicylate and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.

• potassium chloride

  choline magnesium trisalicylate and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.

• potassium citrate

  choline magnesium trisalicylate and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.

• potassium iodide

  potassium iodide and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• pralatrexate

  choline magnesium trisalicylate increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor.

• prasugrel

  choline magnesium trisalicylate, prasugrel. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.

• prazosin

  choline magnesium trisalicylate decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• prednisolone

  choline magnesium trisalicylate, prednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• prednisone

  choline magnesium trisalicylate, prednisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.

• probenecid

  choline magnesium trisalicylate will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of probenecid by unknown mechanism. Use Caution/Monitor.

• propranolol

  propranolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• protamine

  protamine and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• quinapril

  quinapril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• ramipril

  ramipril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• reishi

  choline magnesium trisalicylate and reishi both increase anticoagulation. Use Caution/Monitor.

• reteplase

  choline magnesium trisalicylate and reteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

• sacubitril/valsartan

  sacubitril/valsartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  sacubitril/valsartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

• salmeterol

  choline magnesium trisalicylate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• salsalate

  choline magnesium trisalicylate and salsalate both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and salsalate both increase serum potassium. Use Caution/Monitor.

• sertraline

  sertraline, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• Siberian ginseng

  choline magnesium trisalicylate and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.

• silodosin

  choline magnesium trisalicylate decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• sodium picosulfate/magnesium oxide/anhydrous citric acid

  choline magnesium trisalicylate, sodium picosulfate/magnesium oxide/anhydrous citric acid. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May be associated with fluid and electrolyte imbalances.

• sodium sulfate/?magnesium sulfate/potassium chloride

  sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of choline magnesium trisalicylate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

• sodium sulfate/potassium sulfate/magnesium sulfate

  sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of choline magnesium trisalicylate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

• sotalol

  sotalol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• sparsentan

  choline magnesium trisalicylate and sparsentan both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Coadministration of NSAIDS, including selective COX-2 inhibitors, may result in deterioration of kidney function (eg, possible kidney failure). Monitor for signs of worsening renal function with concomitant use with NSAIDs.

• spironolactone

  spironolactone and choline magnesium trisalicylate both increase serum potassium. Modify Therapy/Monitor Closely.

• succinylcholine

  choline magnesium trisalicylate and succinylcholine both increase serum potassium. Use Caution/Monitor.

• sulfasalazine

  choline magnesium trisalicylate and sulfasalazine both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and sulfasalazine both increase serum potassium. Use Caution/Monitor.

• sulindac

  choline magnesium trisalicylate and sulindac both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and sulindac both increase serum potassium. Use Caution/Monitor.

• tafluprost

  tafluprost, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• telmisartan

  telmisartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  telmisartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• temocillin

  temocillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  temocillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• tenecteplase

  choline magnesium trisalicylate and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

• terazosin

  choline magnesium trisalicylate decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• terbutaline

  choline magnesium trisalicylate increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ticarcillin

  ticarcillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  ticarcillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• timolol

  timolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

• tobramycin inhaled

  tobramycin inhaled and choline magnesium trisalicylate both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

• tolazamide

  choline magnesium trisalicylate increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

• tolbutamide

  choline magnesium trisalicylate increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

• tolfenamic acid

  choline magnesium trisalicylate and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and tolfenamic acid both increase serum potassium. Use Caution/Monitor.

• tolmetin

  choline magnesium trisalicylate and tolmetin both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and tolmetin both increase serum potassium. Use Caution/Monitor.

• tolvaptan

  choline magnesium trisalicylate and tolvaptan both increase serum potassium. Use Caution/Monitor.

• torsemide

  choline magnesium trisalicylate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• travoprost ophthalmic

  travoprost ophthalmic, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• trazodone

  trazodone, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• triamcinolone acetonide injectable suspension

  choline magnesium trisalicylate, triamcinolone acetonide injectable suspension. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .

• triamterene

  triamterene and choline magnesium trisalicylate both increase serum potassium. Modify Therapy/Monitor Closely.

• valsartan

  valsartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  valsartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• venlafaxine

  venlafaxine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• vitamin K1 (phytonadione)

  choline magnesium trisalicylate increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• voclosporin

  voclosporin, choline magnesium trisalicylate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

• vorapaxar

  choline magnesium trisalicylate, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur.

• vortioxetine

  choline magnesium trisalicylate, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.

• zanubrutinib

  choline magnesium trisalicylate, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

• zotepine

  choline magnesium trisalicylate decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

Minor (120)

• aceclofenac

  aceclofenac will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• acemetacin

  acemetacin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• acyclovir

  choline magnesium trisalicylate will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• alendronate

  choline magnesium trisalicylate, alendronate. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.

• aluminum hydroxide

  aluminum hydroxide, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• amikacin

  choline magnesium trisalicylate increases levels of amikacin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• aminohippurate sodium

  choline magnesium trisalicylate will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• anamu

  choline magnesium trisalicylate and anamu both increase anticoagulation. Minor/Significance Unknown.

• ascorbic acid

  ascorbic acid will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
  
  ascorbic acid increases levels of choline magnesium trisalicylate by decreasing renal clearance. Minor/Significance Unknown.
  
  choline magnesium trisalicylate decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown.

• aspirin

  aspirin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• aspirin/citric acid/sodium bicarbonate

  aspirin/citric acid/sodium bicarbonate will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• balsalazide

  choline magnesium trisalicylate will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• bendroflumethiazide

  bendroflumethiazide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• budesonide

  budesonide decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• bumetanide

  choline magnesium trisalicylate, bumetanide. Other (see comment). Minor/Significance Unknown. Comment: Salicylates are less likely than other NSAIDs to interact w/bumetanide.

• calcium carbonate

  calcium carbonate, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• cefaclor

  cefaclor will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefadroxil

  cefadroxil will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefamandole

  cefamandole will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefdinir

  cefdinir will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefditoren

  cefditoren will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefepime

  cefepime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefixime

  cefixime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefotaxime

  cefotaxime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefotetan

  cefotetan will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefoxitin

  cefoxitin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefpirome

  cefpirome will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefpodoxime

  cefpodoxime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefprozil

  cefprozil will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ceftazidime

  ceftazidime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ceftibuten

  ceftibuten will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ceftriaxone

  ceftriaxone will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefuroxime

  cefuroxime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• celecoxib

  celecoxib will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cephalexin

  cephalexin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• chlorothiazide

  chlorothiazide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• chlorpropamide

  choline magnesium trisalicylate will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
  
  choline magnesium trisalicylate increases effects of chlorpropamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• chlorthalidone

  chlorthalidone will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cortisone

  cortisone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• creatine

  creatine, choline magnesium trisalicylate. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.

• cyanocobalamin

  choline magnesium trisalicylate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

• cyclopenthiazide

  cyclopenthiazide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• danshen

  choline magnesium trisalicylate and danshen both increase anticoagulation. Minor/Significance Unknown.

• deflazacort

  deflazacort decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• devil's claw

  choline magnesium trisalicylate and devil's claw both increase anticoagulation. Minor/Significance Unknown.

• dexamethasone

  dexamethasone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• dexrazoxane

  choline magnesium trisalicylate increases levels of dexrazoxane by unspecified interaction mechanism. Minor/Significance Unknown.

• diclofenac

  diclofenac will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• diclofenac topical

  diclofenac topical, choline magnesium trisalicylate. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.

• diflunisal

  diflunisal will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• diltiazem

  diltiazem increases effects of choline magnesium trisalicylate by unknown mechanism. Minor/Significance Unknown. Enhanced antiplatelet activity.

• eplerenone

  choline magnesium trisalicylate decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

• ethanol

  ethanol increases toxicity of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

• etodolac

  etodolac will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• fenoprofen

  fenoprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• feverfew

  choline magnesium trisalicylate decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.

• fludrocortisone

  fludrocortisone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• flurbiprofen

  flurbiprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• folic acid

  choline magnesium trisalicylate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

• furosemide

  choline magnesium trisalicylate decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

• ganciclovir

  choline magnesium trisalicylate will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• gentamicin

  choline magnesium trisalicylate increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• glimepiride

  choline magnesium trisalicylate increases effects of glimepiride by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• glipizide

  choline magnesium trisalicylate increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• glyburide

  choline magnesium trisalicylate increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• hydrocortisone

  hydrocortisone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• ibuprofen

  ibuprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• imidapril

  choline magnesium trisalicylate decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

• indapamide

  indapamide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• indomethacin

  indomethacin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• insulin aspart

  choline magnesium trisalicylate increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

• insulin lispro

  choline magnesium trisalicylate increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

• insulin regular human

  choline magnesium trisalicylate increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

• ketoprofen

  ketoprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ketorolac

  ketorolac will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• L-methylfolate

  choline magnesium trisalicylate decreases levels of L-methylfolate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

• levofloxacin

  levofloxacin, choline magnesium trisalicylate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

• lornoxicam

  lornoxicam will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• meclofenamate

  meclofenamate will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• mefenamic acid

  mefenamic acid will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• meloxicam

  meloxicam will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• mesalamine

  choline magnesium trisalicylate will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• methylprednisolone

  methylprednisolone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• metolazone

  metolazone will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• nabumetone

  nabumetone will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• naproxen

  naproxen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• neomycin PO

  choline magnesium trisalicylate increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• noni juice

  choline magnesium trisalicylate and noni juice both increase serum potassium. Minor/Significance Unknown.

• ofloxacin

  ofloxacin, choline magnesium trisalicylate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

• oxaprozin

  oxaprozin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• parecoxib

  parecoxib will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• paromomycin

  choline magnesium trisalicylate increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• pegaspargase

  pegaspargase increases effects of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of bleeding events.

• piperacillin

  piperacillin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown. Salicylate saltscould be displaced from binding sites or could displace other highly protein-bound drugs such as penicillins

• piroxicam

  piroxicam will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• prednisolone

  prednisolone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• prednisone

  prednisone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• rivastigmine

  rivastigmine increases toxicity of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Increased GI symptoms.

• rose hips

  choline magnesium trisalicylate decreases levels of rose hips by increasing renal clearance. Minor/Significance Unknown.
  
  rose hips will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
  
  rose hips increases levels of choline magnesium trisalicylate by decreasing renal clearance. Minor/Significance Unknown.

• salsalate

  choline magnesium trisalicylate will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• sodium bicarbonate

  sodium bicarbonate, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• sodium citrate/citric acid

  sodium citrate/citric acid, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• streptomycin

  choline magnesium trisalicylate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• sulfadiazine

  choline magnesium trisalicylate increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.

• sulfamethoxazole

  choline magnesium trisalicylate increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

• sulfasalazine

  choline magnesium trisalicylate will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• sulfisoxazole

  choline magnesium trisalicylate increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

• sulindac

  choline magnesium trisalicylate will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• teniposide

  choline magnesium trisalicylate increases levels of teniposide by unspecified interaction mechanism. Minor/Significance Unknown.

• tobramycin

  choline magnesium trisalicylate increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• tolazamide

  choline magnesium trisalicylate increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• tolbutamide

  choline magnesium trisalicylate increases effects of tolbutamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• tolfenamic acid

  choline magnesium trisalicylate will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• tolmetin

  choline magnesium trisalicylate will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• triamcinolone acetonide injectable suspension

  triamcinolone acetonide injectable suspension decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• triamterene

  triamterene, choline magnesium trisalicylate. Other (see comment). Minor/Significance Unknown. Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.
  
  choline magnesium trisalicylate increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.

• valganciclovir

  choline magnesium trisalicylate will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• vancomycin

  choline magnesium trisalicylate increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.

• verapamil

  verapamil increases effects of choline magnesium trisalicylate by unknown mechanism. Minor/Significance Unknown. Enhanced antiplatelet activity.

• willow bark

  choline magnesium trisalicylate will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
  
  willow bark increases effects of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Willow bark contains salicylic acid, which may have additive effects/toxicity with salicylate drugs.

• acebutolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  acebutolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• aceclofenac

  Monitor Closely (2)aceclofenac and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  aceclofenac and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)aceclofenac will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• acemetacin

  Monitor Closely (2)acemetacin and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  acemetacin and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)acemetacin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• acetazolamide

  Monitor Closely (2)acetazolamide, choline magnesium trisalicylate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.
  
  acetazolamide, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Salicylate levels increased at moderate doses; risk of CNS toxicity. Salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• acyclovir

  Minor (1)choline magnesium trisalicylate will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• agrimony

  Monitor Closely (1)choline magnesium trisalicylate and agrimony both increase anticoagulation. Use Caution/Monitor.

• albuterol

  Monitor Closely (1)choline magnesium trisalicylate increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• alendronate

  Minor (1)choline magnesium trisalicylate, alendronate. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.

• alfalfa

  Monitor Closely (1)choline magnesium trisalicylate and alfalfa both increase anticoagulation. Use Caution/Monitor.

• alfuzosin

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• aliskiren

  Monitor Closely (1)choline magnesium trisalicylate will decrease the level or effect of aliskiren by Other (see comment). Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.

• alteplase

  Monitor Closely (1)choline magnesium trisalicylate and alteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

• aluminum hydroxide

  Minor (1)aluminum hydroxide, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• American ginseng

  Monitor Closely (1)choline magnesium trisalicylate and American ginseng both increase anticoagulation. Use Caution/Monitor.

• amikacin

  Minor (1)choline magnesium trisalicylate increases levels of amikacin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• amiloride

  Monitor Closely (1)amiloride and choline magnesium trisalicylate both increase serum potassium. Modify Therapy/Monitor Closely.

• aminohippurate sodium

  Minor (1)choline magnesium trisalicylate will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• amoxicillin

  Monitor Closely (2)amoxicillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  amoxicillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• ampicillin

  Monitor Closely (2)ampicillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  ampicillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• anamu

  Minor (1)choline magnesium trisalicylate and anamu both increase anticoagulation. Minor/Significance Unknown.

• antithrombin alfa

  Monitor Closely (1)antithrombin alfa and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• antithrombin III

  Monitor Closely (1)antithrombin III and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• arformoterol

  Monitor Closely (1)choline magnesium trisalicylate increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• argatroban

  Monitor Closely (1)argatroban and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• ascorbic acid

  Minor (3)ascorbic acid will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
  
  ascorbic acid increases levels of choline magnesium trisalicylate by decreasing renal clearance. Minor/Significance Unknown.
  
  choline magnesium trisalicylate decreases levels of ascorbic acid by increasing renal clearance. Minor/Significance Unknown.

• asenapine

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• aspirin

  Monitor Closely (2)aspirin and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  aspirin and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)aspirin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• aspirin/citric acid/sodium bicarbonate

  Monitor Closely (2)aspirin/citric acid/sodium bicarbonate and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  aspirin/citric acid/sodium bicarbonate and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)aspirin/citric acid/sodium bicarbonate will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• atenolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  atenolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• azilsartan

  Monitor Closely (2)choline magnesium trisalicylate, azilsartan. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.

• balsalazide

  Minor (1)choline magnesium trisalicylate will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• bemiparin

  Monitor Closely (1)bemiparin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• benazepril

  Monitor Closely (1)benazepril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• bendroflumethiazide

  Monitor Closely (1)choline magnesium trisalicylate increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)bendroflumethiazide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• betaxolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  betaxolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• betrixaban

  Monitor Closely (1)choline magnesium trisalicylate, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.

• bimatoprost

  Monitor Closely (1)bimatoprost, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• bisoprolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  bisoprolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• bivalirudin

  Monitor Closely (1)bivalirudin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• brinzolamide

  Monitor Closely (1)brinzolamide, choline magnesium trisalicylate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

• budesonide

  Monitor Closely (1)choline magnesium trisalicylate, budesonide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)budesonide decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• bumetanide

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
  
  choline magnesium trisalicylate increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)choline magnesium trisalicylate, bumetanide. Other (see comment). Minor/Significance Unknown. Comment: Salicylates are less likely than other NSAIDs to interact w/bumetanide.

• calcium carbonate

  Minor (1)calcium carbonate, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• candesartan

  Monitor Closely (3)candesartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  candesartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• captopril

  Monitor Closely (1)captopril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• carbenoxolone

  Monitor Closely (1)choline magnesium trisalicylate increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• carvedilol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  carvedilol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• cefaclor

  Minor (1)cefaclor will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefadroxil

  Minor (1)cefadroxil will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefamandole

  Minor (1)cefamandole will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefdinir

  Minor (1)cefdinir will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefditoren

  Minor (1)cefditoren will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefepime

  Minor (1)cefepime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefixime

  Minor (1)cefixime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefotaxime

  Minor (1)cefotaxime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefotetan

  Minor (1)cefotetan will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefoxitin

  Minor (1)cefoxitin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefpirome

  Minor (1)cefpirome will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefpodoxime

  Minor (1)cefpodoxime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefprozil

  Minor (1)cefprozil will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ceftazidime

  Minor (1)ceftazidime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ceftibuten

  Minor (1)ceftibuten will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ceftriaxone

  Minor (1)ceftriaxone will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cefuroxime

  Minor (1)cefuroxime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• celecoxib

  Monitor Closely (2)celecoxib and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  celecoxib and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)celecoxib will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• celiprolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  celiprolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• cephalexin

  Minor (1)cephalexin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• chlorothiazide

  Monitor Closely (1)choline magnesium trisalicylate increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)chlorothiazide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• chlorpropamide

  Monitor Closely (1)choline magnesium trisalicylate increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (2)choline magnesium trisalicylate will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
  
  choline magnesium trisalicylate increases effects of chlorpropamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• chlorthalidone

  Monitor Closely (1)choline magnesium trisalicylate increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)chlorthalidone will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• cinnamon

  Monitor Closely (1)choline magnesium trisalicylate and cinnamon both increase anticoagulation. Use Caution/Monitor.

• citalopram

  Monitor Closely (1)citalopram, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of GI adverse effects may be increased. If possible, avoid concurrent use.

• clomipramine

  Monitor Closely (1)clomipramine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.

• clopidogrel

  Monitor Closely (1)clopidogrel, choline magnesium trisalicylate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Clopidogrel and NSAIDs both inhibit platelet aggregation.

• cordyceps

  Monitor Closely (1)choline magnesium trisalicylate and cordyceps both increase anticoagulation. Use Caution/Monitor.

• cortisone

  Monitor Closely (1)choline magnesium trisalicylate, cortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)cortisone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• creatine

  Minor (1)creatine, choline magnesium trisalicylate. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.

• cyanocobalamin

  Minor (1)choline magnesium trisalicylate decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

• cyclopenthiazide

  Monitor Closely (1)choline magnesium trisalicylate increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)cyclopenthiazide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• dabigatran

  Monitor Closely (1)dabigatran and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.

• dalteparin

  Monitor Closely (1)dalteparin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• danshen

  Minor (1)choline magnesium trisalicylate and danshen both increase anticoagulation. Minor/Significance Unknown.

• deferiprone

  Monitor Closely (1)choline magnesium trisalicylate decreases levels of deferiprone by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Deferiprone may bind polyvalent cations (eg, iron, aluminum, and zinc), separate administration by at least 4 hr between deferiprone and other medications (eg, antacids), or supplements containing these polyvalent cations.

• defibrotide

  Monitor Closely (1)defibrotide increases effects of choline magnesium trisalicylate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.

• deflazacort

  Monitor Closely (1)choline magnesium trisalicylate, deflazacort. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)deflazacort decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• devil's claw

  Minor (1)choline magnesium trisalicylate and devil's claw both increase anticoagulation. Minor/Significance Unknown.

• dexamethasone

  Monitor Closely (1)choline magnesium trisalicylate, dexamethasone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)dexamethasone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• dexrazoxane

  Minor (1)choline magnesium trisalicylate increases levels of dexrazoxane by unspecified interaction mechanism. Minor/Significance Unknown.

• dichlorphenamide

  Contraindicated (1)dichlorphenamide increases levels of choline magnesium trisalicylate by unknown mechanism. Contraindicated. Coadministration of dichlorphenamide with high-dose aspirin may increase salicylate levels. Anorexia, tachypnea, lethargy, and coma reported.

• diclofenac

  Monitor Closely (2)diclofenac and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  diclofenac and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)diclofenac will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• diclofenac topical

  Minor (1)diclofenac topical, choline magnesium trisalicylate. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.

• dicloxacillin

  Monitor Closely (2)dicloxacillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  dicloxacillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• diflunisal

  Monitor Closely (2)diflunisal and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  diflunisal and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)diflunisal will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• digoxin

  Monitor Closely (1)choline magnesium trisalicylate and digoxin both increase serum potassium. Use Caution/Monitor.

• diltiazem

  Minor (1)diltiazem increases effects of choline magnesium trisalicylate by unknown mechanism. Minor/Significance Unknown. Enhanced antiplatelet activity.

• dobutamine

  Monitor Closely (1)choline magnesium trisalicylate increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• dong quai

  Monitor Closely (1)choline magnesium trisalicylate and dong quai both increase anticoagulation. Use Caution/Monitor.

• dopexamine

  Monitor Closely (1)choline magnesium trisalicylate increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• doxazosin

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• drospirenone

  Monitor Closely (1)drospirenone and choline magnesium trisalicylate both increase serum potassium. Modify Therapy/Monitor Closely.

• duloxetine

  Monitor Closely (1)duloxetine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• edoxaban

  Monitor Closely (1)edoxaban, choline magnesium trisalicylate. Either increases toxicity of the other by anticoagulation. Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.

• eltrombopag

  Monitor Closely (1)eltrombopag increases levels of choline magnesium trisalicylate by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF, choline magnesium trisalicylate. Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.

• enalapril

  Monitor Closely (1)enalapril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• enoxaparin

  Monitor Closely (1)enoxaparin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• ephedrine

  Monitor Closely (1)choline magnesium trisalicylate increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• epinephrine

  Monitor Closely (1)choline magnesium trisalicylate increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• epinephrine racemic

  Monitor Closely (1)choline magnesium trisalicylate increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• eplerenone

  Minor (1)choline magnesium trisalicylate decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

• epoprostenol

  Monitor Closely (1)choline magnesium trisalicylate and epoprostenol both increase anticoagulation. Use Caution/Monitor.

• eprosartan

  Monitor Closely (3)choline magnesium trisalicylate decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  eprosartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
  
  eprosartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.

• escitalopram

  Monitor Closely (1)escitalopram, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• esmolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  esmolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• ethacrynic acid

  Monitor Closely (1)choline magnesium trisalicylate increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ethanol

  Minor (1)ethanol increases toxicity of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI bleeding.

• etodolac

  Monitor Closely (2)etodolac and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  etodolac and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)etodolac will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• fennel

  Monitor Closely (1)choline magnesium trisalicylate and fennel both increase anticoagulation. Use Caution/Monitor.

• fenoprofen

  Monitor Closely (2)fenoprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  fenoprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)fenoprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• feverfew

  Monitor Closely (1)choline magnesium trisalicylate and feverfew both increase anticoagulation. Use Caution/Monitor.Minor (1)choline magnesium trisalicylate decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.

• fludrocortisone

  Monitor Closely (1)choline magnesium trisalicylate, fludrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)fludrocortisone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• fluoxetine

  Monitor Closely (1)fluoxetine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• flurbiprofen

  Monitor Closely (2)flurbiprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  flurbiprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)flurbiprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• fluvoxamine

  Monitor Closely (1)fluvoxamine, choline magnesium trisalicylate. Either decreases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding SSRIs inhib. serotonin uptake by platelets.

• folic acid

  Minor (1)choline magnesium trisalicylate decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

• fondaparinux

  Monitor Closely (1)fondaparinux and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• formoterol

  Monitor Closely (1)choline magnesium trisalicylate increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• forskolin

  Monitor Closely (1)choline magnesium trisalicylate and forskolin both increase anticoagulation. Use Caution/Monitor.

• fosinopril

  Monitor Closely (1)fosinopril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, fosinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• furosemide

  Monitor Closely (1)choline magnesium trisalicylate increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)choline magnesium trisalicylate decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

• ganciclovir

  Minor (1)choline magnesium trisalicylate will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• garlic

  Monitor Closely (1)choline magnesium trisalicylate and garlic both increase anticoagulation. Use Caution/Monitor.

• gentamicin

  Monitor Closely (1)choline magnesium trisalicylate increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)choline magnesium trisalicylate increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• ginger

  Monitor Closely (1)choline magnesium trisalicylate and ginger both increase anticoagulation. Use Caution/Monitor.

• ginkgo biloba

  Monitor Closely (1)choline magnesium trisalicylate and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.

• glimepiride

  Monitor Closely (1)choline magnesium trisalicylate increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)choline magnesium trisalicylate increases effects of glimepiride by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• glipizide

  Monitor Closely (1)choline magnesium trisalicylate increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)choline magnesium trisalicylate increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• glyburide

  Monitor Closely (1)choline magnesium trisalicylate increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)choline magnesium trisalicylate increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• griseofulvin

  Monitor Closely (1)griseofulvin decreases levels of choline magnesium trisalicylate by unknown mechanism. Use Caution/Monitor.

• heparin

  Monitor Closely (1)heparin and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• horse chestnut seed

  Monitor Closely (1)choline magnesium trisalicylate and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.

• hyaluronidase

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Salicylates, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect. .

• hydralazine

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• hydrocortisone

  Monitor Closely (1)choline magnesium trisalicylate, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)hydrocortisone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• ibuprofen

  Monitor Closely (2)ibuprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  ibuprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ibuprofen IV

  Monitor Closely (3)ibuprofen IV will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
  
  ibuprofen IV and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  ibuprofen IV and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• imidapril

  Minor (1)choline magnesium trisalicylate decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.

• indapamide

  Monitor Closely (1)choline magnesium trisalicylate increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)indapamide will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• indomethacin

  Monitor Closely (2)indomethacin and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  indomethacin and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)indomethacin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• insulin aspart

  Minor (1)choline magnesium trisalicylate increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

• insulin lispro

  Minor (1)choline magnesium trisalicylate increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

• insulin regular human

  Minor (1)choline magnesium trisalicylate increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

• irbesartan

  Monitor Closely (3)irbesartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  irbesartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• isoproterenol

  Monitor Closely (1)choline magnesium trisalicylate increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ketoprofen

  Monitor Closely (2)ketoprofen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  ketoprofen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)ketoprofen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• ketorolac

  Monitor Closely (2)ketorolac and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  ketorolac and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Serious - Use Alternative (1)choline magnesium trisalicylate, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ketorolac will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• L-methylfolate

  Minor (1)choline magnesium trisalicylate decreases levels of L-methylfolate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

• labetalol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  labetalol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• latanoprost

  Monitor Closely (1)latanoprost, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• latanoprostene bunod ophthalmic

  Monitor Closely (1)latanoprostene bunod ophthalmic, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• levalbuterol

  Monitor Closely (1)choline magnesium trisalicylate increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• levofloxacin

  Minor (1)levofloxacin, choline magnesium trisalicylate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

• levomilnacipran

  Monitor Closely (1)levomilnacipran, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.

• lisinopril

  Monitor Closely (1)lisinopril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• lithium

  Monitor Closely (1)choline magnesium trisalicylate increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.

• lornoxicam

  Monitor Closely (2)lornoxicam and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  lornoxicam and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)lornoxicam will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• losartan

  Monitor Closely (3)losartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  losartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• measles, mumps, rubella and varicella vaccine, live

  Serious - Use Alternative (1)choline magnesium trisalicylate, measles, mumps, rubella and varicella vaccine, live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.

• meclofenamate

  Monitor Closely (2)meclofenamate and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  meclofenamate and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)meclofenamate will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• mefenamic acid

  Monitor Closely (2)mefenamic acid and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  mefenamic acid and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)mefenamic acid will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• meloxicam

  Monitor Closely (2)meloxicam and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  meloxicam and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• mesalamine

  Monitor Closely (1)mesalamine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.Minor (1)choline magnesium trisalicylate will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• metaproterenol

  Monitor Closely (1)choline magnesium trisalicylate increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• methazolamide

  Monitor Closely (1)methazolamide, choline magnesium trisalicylate. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Carbonic anhydrase inhibitors (CAIs) and salicylates inhibit each other's renal tubular secretion, resulting in increased plasma levels. CAIs also shift salicylates from plasma to the CNS, leading to potential neurotoxicity.

• methotrexate

  Monitor Closely (1)choline magnesium trisalicylate will increase the level or effect of methotrexate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.Serious - Use Alternative (1)choline magnesium trisalicylate increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. The relative risk of interaction of different NSAIDs w/methotrexate is not established. Selective COX 2 inhibitors are believed to have minimal interaction. Greater risk in pts. with renal impairment. Greater toxicity with high dose methotrexate (e.g., anti neoplastic regimen).

• methylprednisolone

  Monitor Closely (1)choline magnesium trisalicylate, methylprednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)methylprednisolone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• metolazone

  Monitor Closely (1)choline magnesium trisalicylate increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)metolazone will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• metoprolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  metoprolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• milnacipran

  Monitor Closely (1)milnacipran, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• mistletoe

  Monitor Closely (1)choline magnesium trisalicylate increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• moexipril

  Monitor Closely (1)moexipril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• mycophenolate

  Monitor Closely (1)choline magnesium trisalicylate will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.

• nabumetone

  Monitor Closely (2)nabumetone and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  nabumetone and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)nabumetone will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• nadolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  nadolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• nafcillin

  Monitor Closely (2)nafcillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  nafcillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• naproxen

  Monitor Closely (2)naproxen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  naproxen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)naproxen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• nebivolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  nebivolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• nefazodone

  Monitor Closely (1)nefazodone, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• neomycin PO

  Minor (1)choline magnesium trisalicylate increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• nettle

  Monitor Closely (1)choline magnesium trisalicylate increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• noni juice

  Minor (1)choline magnesium trisalicylate and noni juice both increase serum potassium. Minor/Significance Unknown.

• norepinephrine

  Monitor Closely (1)choline magnesium trisalicylate increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ofloxacin

  Minor (1)ofloxacin, choline magnesium trisalicylate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

• olmesartan

  Monitor Closely (3)olmesartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  olmesartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• oxacillin

  Monitor Closely (2)oxacillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  oxacillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• oxaprozin

  Monitor Closely (2)oxaprozin and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  oxaprozin and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)oxaprozin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• parecoxib

  Monitor Closely (2)parecoxib and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  parecoxib and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)parecoxib will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• paromomycin

  Minor (1)choline magnesium trisalicylate increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• paroxetine

  Monitor Closely (1)paroxetine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• pau d'arco

  Monitor Closely (1)choline magnesium trisalicylate and pau d'arco both increase anticoagulation. Use Caution/Monitor.

• pegaspargase

  Minor (1)pegaspargase increases effects of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of bleeding events.

• pemetrexed

  Serious - Use Alternative (1)choline magnesium trisalicylate increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Especially in pts. w/mild moderate renal insufficiency. D/C NSAIDs 2 5 d before and 2 d after pemetrexed administration.

• penbutolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  penbutolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• penicillin G aqueous

  Monitor Closely (2)penicillin G aqueous, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  penicillin G aqueous, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• penicillin VK

  Monitor Closely (1)penicillin VK, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• perindopril

  Monitor Closely (1)perindopril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• phenindione

  Monitor Closely (1)phenindione and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• phenoxybenzamine

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• phentolamine

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• phytoestrogens

  Monitor Closely (1)choline magnesium trisalicylate and phytoestrogens both increase anticoagulation. Use Caution/Monitor.

• pindolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  pindolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• piperacillin

  Minor (1)piperacillin will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown. Salicylate saltscould be displaced from binding sites or could displace other highly protein-bound drugs such as penicillins

• pirbuterol

  Monitor Closely (1)choline magnesium trisalicylate increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• piroxicam

  Monitor Closely (2)piroxicam and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
  
  piroxicam and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)piroxicam will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• pivmecillinam

  Monitor Closely (2)pivmecillinam, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  pivmecillinam, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• potassium acid phosphate

  Monitor Closely (1)choline magnesium trisalicylate and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.

• potassium chloride

  Monitor Closely (1)choline magnesium trisalicylate and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.

• potassium citrate

  Monitor Closely (1)choline magnesium trisalicylate and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.

• potassium iodide

  Monitor Closely (1)potassium iodide and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• pralatrexate

  Monitor Closely (1)choline magnesium trisalicylate increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor.

• prasugrel

  Monitor Closely (1)choline magnesium trisalicylate, prasugrel. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.

• prazosin

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• prednisolone

  Monitor Closely (1)choline magnesium trisalicylate, prednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)prednisolone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• prednisone

  Monitor Closely (1)choline magnesium trisalicylate, prednisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.Minor (1)prednisone decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• probenecid

  Monitor Closely (2)choline magnesium trisalicylate will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
  
  choline magnesium trisalicylate decreases effects of probenecid by unknown mechanism. Use Caution/Monitor.

• propranolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  propranolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• protamine

  Monitor Closely (1)protamine and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.

• quinapril

  Monitor Closely (1)quinapril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• ramipril

  Monitor Closely (1)ramipril, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)choline magnesium trisalicylate, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• reishi

  Monitor Closely (1)choline magnesium trisalicylate and reishi both increase anticoagulation. Use Caution/Monitor.

• reteplase

  Monitor Closely (1)choline magnesium trisalicylate and reteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

• rivastigmine

  Minor (1)rivastigmine increases toxicity of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Increased GI symptoms.

• rose hips

  Minor (3)choline magnesium trisalicylate decreases levels of rose hips by increasing renal clearance. Minor/Significance Unknown.
  
  rose hips will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
  
  rose hips increases levels of choline magnesium trisalicylate by decreasing renal clearance. Minor/Significance Unknown.

• sacubitril/valsartan

  Monitor Closely (3)sacubitril/valsartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  sacubitril/valsartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• salmeterol

  Monitor Closely (1)choline magnesium trisalicylate increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• salsalate

  Monitor Closely (2)choline magnesium trisalicylate and salsalate both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and salsalate both increase serum potassium. Use Caution/Monitor.Minor (1)choline magnesium trisalicylate will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• sertraline

  Monitor Closely (1)sertraline, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• Siberian ginseng

  Monitor Closely (1)choline magnesium trisalicylate and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.

• silodosin

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• sodium bicarbonate

  Minor (1)sodium bicarbonate, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• sodium citrate/citric acid

  Minor (1)sodium citrate/citric acid, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).

• sodium picosulfate/magnesium oxide/anhydrous citric acid

  Monitor Closely (1)choline magnesium trisalicylate, sodium picosulfate/magnesium oxide/anhydrous citric acid. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May be associated with fluid and electrolyte imbalances.

• sodium sulfate/?magnesium sulfate/potassium chloride

  Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of choline magnesium trisalicylate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

• sodium sulfate/potassium sulfate/magnesium sulfate

  Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of choline magnesium trisalicylate by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

• sotalol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  sotalol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• sparsentan

  Monitor Closely (1)choline magnesium trisalicylate and sparsentan both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Coadministration of NSAIDS, including selective COX-2 inhibitors, may result in deterioration of kidney function (eg, possible kidney failure). Monitor for signs of worsening renal function with concomitant use with NSAIDs.

• spironolactone

  Monitor Closely (1)spironolactone and choline magnesium trisalicylate both increase serum potassium. Modify Therapy/Monitor Closely.

• streptomycin

  Minor (1)choline magnesium trisalicylate increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• succinylcholine

  Monitor Closely (1)choline magnesium trisalicylate and succinylcholine both increase serum potassium. Use Caution/Monitor.

• sulfadiazine

  Minor (1)choline magnesium trisalicylate increases levels of sulfadiazine by unspecified interaction mechanism. Minor/Significance Unknown.

• sulfamethoxazole

  Minor (1)choline magnesium trisalicylate increases levels of sulfamethoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

• sulfasalazine

  Monitor Closely (2)choline magnesium trisalicylate and sulfasalazine both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)choline magnesium trisalicylate will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• sulfisoxazole

  Minor (1)choline magnesium trisalicylate increases levels of sulfisoxazole by unspecified interaction mechanism. Minor/Significance Unknown.

• sulindac

  Monitor Closely (2)choline magnesium trisalicylate and sulindac both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and sulindac both increase serum potassium. Use Caution/Monitor.Minor (1)choline magnesium trisalicylate will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• tafluprost

  Monitor Closely (1)tafluprost, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• telmisartan

  Monitor Closely (3)telmisartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  telmisartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• temocillin

  Monitor Closely (2)temocillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  temocillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• tenecteplase

  Monitor Closely (1)choline magnesium trisalicylate and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.

• teniposide

  Minor (1)choline magnesium trisalicylate increases levels of teniposide by unspecified interaction mechanism. Minor/Significance Unknown.

• terazosin

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.

• terbutaline

  Monitor Closely (1)choline magnesium trisalicylate increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• ticarcillin

  Monitor Closely (2)ticarcillin, choline magnesium trisalicylate. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
  
  ticarcillin, choline magnesium trisalicylate. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.

• timolol

  Monitor Closely (2)choline magnesium trisalicylate decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
  
  timolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• tobramycin

  Minor (1)choline magnesium trisalicylate increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.

• tobramycin inhaled

  Monitor Closely (1)tobramycin inhaled and choline magnesium trisalicylate both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity

• tolazamide

  Monitor Closely (1)choline magnesium trisalicylate increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)choline magnesium trisalicylate increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• tolbutamide

  Monitor Closely (1)choline magnesium trisalicylate increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)choline magnesium trisalicylate increases effects of tolbutamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

• tolfenamic acid

  Monitor Closely (2)choline magnesium trisalicylate and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and tolfenamic acid both increase serum potassium. Use Caution/Monitor.Minor (1)choline magnesium trisalicylate will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• tolmetin

  Monitor Closely (2)choline magnesium trisalicylate and tolmetin both increase anticoagulation. Use Caution/Monitor.
  
  choline magnesium trisalicylate and tolmetin both increase serum potassium. Use Caution/Monitor.Minor (1)choline magnesium trisalicylate will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• tolvaptan

  Monitor Closely (1)choline magnesium trisalicylate and tolvaptan both increase serum potassium. Use Caution/Monitor.

• torsemide

  Monitor Closely (1)choline magnesium trisalicylate increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• trandolapril

  Serious - Use Alternative (1)choline magnesium trisalicylate, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.

• travoprost ophthalmic

  Monitor Closely (1)travoprost ophthalmic, choline magnesium trisalicylate. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).

• trazodone

  Monitor Closely (1)trazodone, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• triamcinolone acetonide injectable suspension

  Monitor Closely (1)choline magnesium trisalicylate, triamcinolone acetonide injectable suspension. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .Minor (1)triamcinolone acetonide injectable suspension decreases levels of choline magnesium trisalicylate by increasing renal clearance. Minor/Significance Unknown.

• triamterene

  Monitor Closely (1)triamterene and choline magnesium trisalicylate both increase serum potassium. Modify Therapy/Monitor Closely.Minor (2)triamterene, choline magnesium trisalicylate. Other (see comment). Minor/Significance Unknown. Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.
  
  choline magnesium trisalicylate increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.

• valganciclovir

  Minor (1)choline magnesium trisalicylate will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.

• valsartan

  Monitor Closely (3)valsartan, choline magnesium trisalicylate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
  
  choline magnesium trisalicylate decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
  
  valsartan and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

• vancomycin

  Minor (1)choline magnesium trisalicylate increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.

• varicella virus vaccine live

  Serious - Use Alternative (1)choline magnesium trisalicylate, varicella virus vaccine live. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Risk of Reye's Syndrome with combination; avoid salicylate use for 6 wks after vaccination.

• venlafaxine

  Monitor Closely (1)venlafaxine, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• verapamil

  Minor (1)verapamil increases effects of choline magnesium trisalicylate by unknown mechanism. Minor/Significance Unknown. Enhanced antiplatelet activity.

• vitamin K1 (phytonadione)

  Monitor Closely (1)choline magnesium trisalicylate increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• voclosporin

  Monitor Closely (1)voclosporin, choline magnesium trisalicylate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

• vorapaxar

  Monitor Closely (1)choline magnesium trisalicylate, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur.

• vortioxetine

  Monitor Closely (1)choline magnesium trisalicylate, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.

• warfarin

  Serious - Use Alternative (1)choline magnesium trisalicylate increases effects of warfarin by anticoagulation. Avoid or Use Alternate Drug.

• willow bark

  Minor (2)choline magnesium trisalicylate will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
  
  willow bark increases effects of choline magnesium trisalicylate by pharmacodynamic synergism. Minor/Significance Unknown. Willow bark contains salicylic acid, which may have additive effects/toxicity with salicylate drugs.

• zanubrutinib

  Monitor Closely (1)choline magnesium trisalicylate, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

• zotepine

  Monitor Closely (1)choline magnesium trisalicylate decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.