choline magnesium trisalicylate (Rx)

Brand and Other Names:Trilisate ASA combination

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

liquid

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

tablet

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

Osteoarthritis

1000-3000 mg PO q8-12hr

Rheumatoid Arthritis

1000-3000 mg PO q8-12hr

Fever

1000-1500 mg PO q12hr

Renal Impairment

Avoid use in severe renal impairment

Other Indications & Uses

Shoulder pain

Dosage Forms & Strengths

liquid

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

tablet

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

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

Next:

Interactions

Interaction Checker

and choline magnesium trisalicylate

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            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.

            Previous
            Next:

            Adverse Effects

            Frequency Not Defined

            GI pain/ulceration/bleeding

            Tinnitus, hearing loss

            Hepatotoxicity

            Renal damage

            Premature hemolysis

            CNS alteration

            Pulmonary edema (salicylate-induced/noncardiogenic)

            Dermatologic problems, urticaria

            Angioedema

            Bronchospasm

            Previous
            Next:

            Warnings

            Contraindications

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

            Relative: Erosive gastritis, GI ulcer, NOS

            Cautions

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

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

            Previous
            Next:

            Pregnancy & Lactation

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

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

            Pregnancy Categories

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

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

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

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

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

            NA: Information not available.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

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

            Pharmacokinetics

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

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

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

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

            Vd: 0.15-0.2 L/kg

            Metabolism: Liver, microsomal enzyme system

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

            Clearance: 24-72 hr

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

            Dialyzable: Yes

            Enzymes inhibited: Prostaglandin synthesis (insignificant)

            Concentration

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

            Protein Bound

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

            Images

            No images available for this drug.
            Previous
            Next:

            Patient Handout

            A Patient Handout is not currently available for this monograph.
            Previous
            Next:

            Formulary

            FormularyPatient Discounts

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

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

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

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

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

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.