Pharmacy Author: Annette Gbemudu-Ogbru, PharmD, MBA
Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: choline magnesium salicylate

BRAND NAME: Trilisate (Please Note: This brand name drug is no longer available in the US)

DRUG CLASS AND MECHANISM: Choline magnesium salicylate is a type of nonsteroidal antiinflammatory drug (NSAID), referred to as a salicylate, which is effective in treating fever, pain, and inflammation in the body. Other drugs within the same class are aspirin, diflunisal (Dolobid) and salsalate (Disalcid). They work by reducing the levels of prostaglandins, chemicals that are responsible for pain, fever, and inflammation. The salicylates block the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 500, 750, and 1000 mg. Liquid: 500 mg/5ml.

STORAGE: Choline magnesium salicylate should be stored at controlled room temperature 59 to 86 F ( 15 to 30 C) in a sealed container protected from light and moisture.

PRESCRIBED FOR: Choline magnesium salicylate is used for the rapid relief of mild to moderate pain and fever. Choline magnesium salicylate also is used for the treatment of inflammation and pain due to soft tissue injuries, tendinitis, bursitis, rheumatoid arthritis, osteoarthritis, juvenile arthritis, and other related arthritis conditions.

DOSING: For rheumatoid arthritis, osteoarthritis, other severe arthritis, and acute painful joints, the recommended starting dosage is 1500 mg given twice a day. For mild to moderate pain or fever, the usual dosage is 2000 mg to 3000 mg daily. It should be taken with food to prevent an upset stomach.

DRUG INTERACTIONS: Choline magnesium salicylate, as other salicylates, should not be given within six weeks of influenza virus vaccine as this can increase risk of Reye's syndrome (a serious, often fatal disease that causes numerous detrimental effects to many organs, especially the brain and liver) due to unknown mechanisms.

When choline magnesium salicylate is used in combination with methotrexate (Rheumatrex, Trexall) an antimetabolite, the blood levels of methotrexate may increase, presumably because the elimination of methotrexate from the body is reduced. This may lead to more methotrexate-related side effects.

Concurrent use of choline magnesium salicylate and warfarin (Coumadin), a blood thinner, may cause excessive bleeding as choline magnesium salicylate enhances the effect of warfarin. It is therefore important to reduce the dosage of warfarin.

PREGNANCY: There are no adequate studies in pregnant women. Choline magnesium salicylate should only be given if the potential benefits outweigh the potential risks to the fetus.

NURSING MOTHERS: Choline magnesium salicylate is excreted in breast milk; therefore, caution should be exercised when administering it to nursing women.

SIDE EFFECTS: Common side effects of choline magnesium salicylate are heartburn, stomach ulcers, nausea, or vomiting. Patients should tell their doctor immediately if any of these unusual but potentially serious side effects occur: severe abdominal pain, easy bruising or bleeding, fast heartbeat, persistent nausea or vomiting, unusual tiredness, change in the amount or color of urine, yellowing of the eyes or skin, unusual bleeding and hearing loss.

Reference: FDA Prescribing Information