Topical salicylates trolamine salicylate

Topical rubefacients containing methyl salicylate, trolamine salicylate,... 

Topical mbefacients containing methyl salicylate, trolamine salicylate, and other salicylates may have modest, short-term efficacy for treating acute pain associated with OA. 

Topical analgesics sometimes are used for mild pain or as an adjunct to systemic therapy. There are limited data to support the use of salicylate-containing rubefacients (e.g., methyl salicylate and trolamine salicylate) or other counterirritants (e.g., menthol, camphor, and methyl nicotinate) in OA.32 See Chap. 57 for more information on these products when used for musculoskeletal disorders. 

Methyl salicylate, in the form of gels, oil, or ointment applied to the skin, has been found to increase the effects of warfarin. Bleeding and bruising and/or raised INRs have been seen with both high " and low doses of methyl salicylate. One report described the possible additive effects of methyl salicylate oil (Kwan Loong Medicated Oil) and a decoction of Danshen (the root of Salvia miltiorrhiza) on the response to warfarin (see also Coumarins and related drugs + Herbal medicines Danshen (Salvia miltiorrhizay, p.415). A raised prothrombin time has also been reported with topical trolamine salicylate. ... 

Although the evidence is limited, it appears that topical methyl salicylate and trolamine salicylate can increase the effect of warfarin. 

Salicylate can be applied to the skin as un-ionized salicylic acid (normally for its keratolytic activity), as a salicylate salt (most commonly trolamine salicylate), as esters such as methyl salicylate and, rarely, as aspirin. In the form most often used in topical products, salicylates work primarily as rubefacients. Rubefacients are compoimds that work by counter-irritation. 

Trolamine (triethanolamine salicylate, TEAS) is a salicylate derivative, which is also known as topical aspirin . It is an amino alcohol that is used for its topical analgesic and antiinflammatory properties. Like the better-known salicylate derivative, methyl salicylate - which has a rubefacient action used to good effect in sports injuries and rheumatism - TEAS is rapidly absorbed through normal skin after topical application. It is used widely for treating sunburn. 

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