A fixed-dose combination topical analgesic and anti-inflammatory agent. Choline Salicylate is a non-steroidal anti-inflammatory drug (NSAID) derivative of salicylic acid, providing anti-inflammatory and analgesic effects. Lidocaine is a local anesthetic (amide type) that provides rapid pain relief by blocking sodium channels in nerve fibers. The combination offers a synergistic effect for topical pain management, with the anti-inflammatory action of choline salicylate complementing the anesthetic action of lidocaine.
Adult: Apply a thin layer to the affected area 3 to 4 times daily. Do not exceed 4 applications per day. The amount should be sufficient to cover the area without excessive rubbing.
Note: Apply to clean, dry, intact skin. Gently rub in until absorbed. Wash hands immediately after application unless treating hands. Do not apply with occlusive dressings unless advised by a doctor. Do not use with heating pads. Avoid contact with eyes and mucous membranes.
The combination works via two distinct mechanisms. Lidocaine blocks voltage-gated sodium channels on neuronal membranes, inhibiting the initiation and conduction of nerve impulses, leading to reversible local anesthesia. Choline Salicylate, after conversion to salicylic acid, inhibits the cyclooxygenase (COX) enzymes, particularly COX-1 and COX-2, thereby reducing the synthesis of prostaglandins, which are mediators of pain, inflammation, and fever at the site of application.
Pregnancy: Category C (US FDA). Avoid, especially in third trimester, due to risk of premature closure of ductus arteriosus from salicylate, potential lidocaine toxicity, and increased maternal bleeding risk. Use only if potential benefit justifies risk, under strict supervision.
Driving: Unlikely to affect driving ability when used topically as directed. Systemic absorption causing dizziness or tinnitus may impair ability.
| Anticoagulants (Warfarin, Acenocoumarol) | Increased risk of bleeding due to antiplatelet effect of salicylate | Major |
| Other NSAIDs (Oral: Ibuprofen, Diclofenac) | Increased risk of GI toxicity and reduced anti-inflammatory effect | Moderate |
| Methotrexate | Salicylates can decrease renal clearance of methotrexate, increasing toxicity risk | Major |
| Sulfonylureas (Glibenclamide, Glimepiride) | Salicylates may potentiate hypoglycemic effect | Moderate |
| ACE Inhibitors (Enalapril, Ramipril) | Salicylates may reduce antihypertensive efficacy | Moderate |
| Antiarrhythmics (Mexiletine) | Additive cardiac effects with lidocaine; increased toxicity risk | Major |
| Beta-blockers (Propranolol) | May increase lidocaine levels by reducing hepatic blood flow | Moderate |
Same composition (Choline Salicylate (NA) + Lidocaine (NA)), different brands: