Triflusal

In vitro protein binding studies showed an increase in the free fraction of HTB (main active metabolite of triflusal) in the presence of NSAIDs. In addition, high HTB concentrations increase free fractions and may therefore increase the effect of NSAIDs, glisentide, and warfarin. Dose adjustment of these drugs may be required if they are administered concomitantly with triflusal.

Triflusal may potentiate the action of oral anti-diabetics. A dose adjustment of oral anti-diabetics may be required.

Safety of concomitant administration of triflusal with thrombolytic agents (rt-PA and streptokinase) was assessed in patients with acute myocardial infarction. Incidence of intracranial haemorrhage was lower than in patients treated with a combination of ASA and thrombolytic agents (0.1% vs. 1.1%, p=0.04).

If elective surgery is planned in a patient, bleeding risk should be assessed and, if considered necessary, triflusal should be discontinued 7 days before surgery.

While triflusal has caused a low incidence of bleeding complications in clinical studies, it should be used with caution in patients at risk of bleeding due to trauma or other pathological conditions.

For triflusal, no clinical data on exposed pregnancies are available. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonic/foetal development, parturition or postnatal development. The benefit/risk should therefore be assessed when it is administered to pregnant women.

It is not known whether triflusal is excreted in human milk. The benefit/risk should therefore be assessed when it is administered during the lactation period.

Triflusal has no influence on the ability to drive and use machines.