Choline-magnesium salicylate

A method of preparation is to react an acid salt of choline (such as choline chloride or choline bromide) with an alkaline salt of salicylic acid (such as sodium salicylate, potassium salicylate, or magnesium salicylate) in an alcoholic media. 

Aspirin, sodium salicylate, choline magnesium trisalicylate, salsalate, diflunisal, salicylsalicylic acid, sulfasalazine, olsalazine... 

In medical practice, other salicylic acid derivatives are used in the form of salts. Magnesium salicylate and sodium salicylate are less effective than respective doses of aspirin however, they are easier on patients that are sensitive to aspirin. Choline magnesium trisalicylate represents a mixture of choline salicylate and magnesium salicylate, which has the same effect as aspirin however, it is easier on patients in which gastrointestinal effects are observed upon taking aspirin. 

Tablets 500 mg salicylate (as 293 mg choline salicylate and 362 mg Mg salicylate), 750 mg salicylate (as 440 mg choline salicylate and 544 mg Mg salicylate), 1,000 mg salicylate (as 587 mg choline salicylate, 725 mg Mg salicylate) (Rx) Choline Magnesium Trisalicylate (Sidmak), Tricosal (Invamed)...

Aspirin Diflunisal Choline salicylate Choline-magnesium trisalicylate Sodium salicylate Salsalate... 

Aspirin is available as capsules, tablets, enteric-coated tablets (Ecotrin), timed-release tablets (ZORprin), buffered tablets Ascriptin, Bufferin), and as rectal suppositories. Sodium salicylate is available genericaUy. Other salicylates include choline salicylate (Arthropan), choline magnesium trisalicylate (Trilisate), and magnesium salicylate Momentum). 

Aspirin is often given in a buffered form. The addition of small amounts of antacids decreases GI irritation and increases the dissolution and absorption rate of the aspirin. Nonacetylated salicylates, including salsalate, sodium salicylate, choline salicylate, magnesium salicylate, and various salicylate combinations, are usually more expensive but can be effective. Although these aspirin substitutes provide less anti-inflammatory effects than aspirin, they exhibit minimal antiplatelet properties and have fewer GI side effects.They can therefore be useful for patients who cannot tolerate aspirin or other NSAIDs. 

Choline Salicylate. Choline. salicylate (Arihropan) is extremely soluble in water and is available as a flavored liquid. It is claimed to be absorbed more rapidly than a.spirin. giving faster peak blotx) levels. It is used when salicylates arc indicated in a recommended dose of 870 mg to 1.74 g 4 times daily. It is also available in combination with magnesium. salicylate (Trilisute. Tricosal). 

The adult standard dosage form for acetylsalicylic acid, sodium and magnesium salicylate will be 325 mg, and 435 mg for choline salicylate. The children s stcin-dard dosage form will be 80 mg and 110 mg respectively. 

If the label indicates it is not the standard adult dosage form, the amount of drug in a tablet or capsule may be increased to 500 mg in the case of acetylsedi-cylic acid and sodium or magnesium salicylates or 670 mg in the Ccise of choline salicylate. 

Synonyms Aspirin Acetylsalicylic acid Ace-taminosalol Aluminum aspirin Bismuth subsalicylate Choline salicylate Magnesium salicylate Methyl salicylate Phenyl salicylate Potassium salicylate Salsate Salicylsalicylic acid Sodium salicylate Sodium thiosalicylate Triethanolamine salicylate Willow extract... 

Other salicylates available for systemic use include salsalate (salicylsalicylic acid disalcid, others), which is hydrolyzed to salicylic acid during and after absorption, sodium thiosalicylate (injection REXOLATe), choline salicylate (oral liquid arthropan), and magnesium salicylate (tablets magan, momemtum, others). A combination of choline and magnesium salicylates (choline magnesium, trisahcylate, triusate, others) also is available. 

Several salts of salicylic acid, sodium salicylate USP, choline salicylate USP, and magnesium salicylate USP, and... 

Give tetracycline 1-3 hours before or after giving the patient antacids, calcium supplements, choline and magnesium salicylates, iron supplements, magnesium salicylate, or magnesium laxatives, foods containing milk and milk products. These lower the absorption of tetracycline. 

Aspirin and oral salicylates Aloxiprin, Aspirin, Benorilate, Choline salicylate, Diflunisal, Etheniamide, Lysine aspirin. Magnesium salicylate, Salsalate, Sodium salicylate... 

Aspirin 1.3 to 3.6 g daily more than halved the serum levels of ibuprofen 800 mg to 2.4 g daily, without affecting salicylate levels. There was little additional clinical benefit from the combination. Similarly, aspirin reduced the AUC of flurbiprofen by about two-thirds, but without any clear changes in clinical effectiveness. The pharmacokinetics of the aspirin were unchanged by flurbiprofen. Aspirin 3.9 g daily also virtually halved the AUC of fenoprofen 2.4 g daily,and reduced the AUC of ke-toprofen 200 mg daily by about one-third. The AUC of naproxen was only minimally reduced (by 10 to 15%). Choline magnesium trisalicylate increased the clearance of naproxen by 56% and decreased its serum levels by 26% in one study. ... 

A study in 4 patients found that the renal clearance of methotrexate was reduced by 35% by an infusion of sodium salicylate (2 g initially, then 33 mg/minute). A further study found that choline magnesium trisali-cylate reduced methotrexate clearance by 24 to 41%, and increased the unbound fraction by 28%, when compared with paracetamol (acetaminophen). ... 

About 10% of asthmatics are hypersensitive to aspirin, and in some individuals life-threatening bronchoconstriction can occur. This is not a drug-drug interaction but an adverse response of asthmatic patients to aspirin, whether taking an anti-asthmatic drug or not. The reasons are not fully understood. Those known to be sensitive to aspirin may also possibly react to other NSAIDs, in particular the acetylated salicylates, the indole and indene acetic acids, and the propionic acid derivatives (see Table 6.1 , (p.l34)). The fenamates, oxicams, pyrazolones and pyrazolidinediones are better tolerated. The nonacetylated salicylates (sodium salicylate, salicylamide, choline magnesium trisalicylate) are normally well tolerated. Aspirin-sensitive individuals are also less likely to react to nimesulide. ... 

Salicylic acid derivatives Acetylsalicylic acid Sodium salicylate Choline salicylate Choline magnesium trisalicylate... 

These drugs include magnesium choline salicylate, sodium salicylate, and salicyl salicylate. All nonacetylated salicylates are effective antiinflammatory drugs, although they may be less effective analgesics than aspirin. Because they are much less effective than aspirin as COX inhibitors and they do not inhibit platelet aggregation, they may be preferable when COX inhibition is undesirable such as in patients with asthma, those with bleeding tendencies, and even (under close supervision) those with renal dysfunction. 

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