Please check your internet connection and try again.
## Overview
Mylotat is the brand name for triflusal. Triflusal is an antiplatelet agent belonging to the salicylate class. It is a prodrug that is rapidly converted to its active metabolite, 2-hydroxy-4-trifluoromethylbenzoic acid (HTFMBA), which irreversibly inhibits cyclooxygenase (COX) and thus platelet aggregation.
## Primary Indications
* Prevention of thromboembolic events in patients with a history of transient ischemic attack (TIA) or ischemic stroke.
* Adjunctive therapy in patients with unstable angina or following myocardial infarction.
## Adult Dosing
* **Prevention of thromboembolic events:** 300 mg orally once daily.
* **Unstable angina/post-myocardial infarction:** 300 mg orally once daily.
## Pediatric Dosing
There is limited data on the use of triflusal in pediatric populations. Dosing in children is not established.
## Dose Adjustments
* **Renal Impairment:** Use with caution in patients with severe renal impairment. No specific dose adjustment is recommended, but close monitoring is advised.
* **Hepatic Impairment:** Use with caution in patients with hepatic impairment. No specific dose adjustment is recommended, but close monitoring is advised.
## Contraindications
* Hypersensitivity to triflusal, other salicylates, or any component of the formulation.
* Active bleeding (e.g., peptic ulcer, intracranial hemorrhage).
* Severe hepatic insufficiency.
* Severe renal insufficiency (creatinine clearance < 30 mL/min).
## Adverse Effects
Common adverse effects include gastrointestinal disturbances (nausea, vomiting, diarrhea, abdominal pain), dyspepsia, bleeding (including epistaxis, gingival bleeding, hematuria), headache, and dizziness. Serious adverse effects include severe gastrointestinal bleeding, hemorrhagic stroke, and hypersensitivity reactions.
## Key Drug Interactions
* **Anticoagulants (e.g., warfarin, heparin, direct oral anticoagulants):** Increased risk of bleeding.
* **Other Antiplatelet Agents (e.g., clopidogrel, prasugrel, ticagrelor):** Increased risk of bleeding.
* **Nonsteroidal Anti-inflammatory Drugs (NSAIDs):** Increased risk of gastrointestinal bleeding and potentially reduced antihypertensive effects of some agents.
* **Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs):** May increase the risk of bleeding.
* **Uricosuric agents (e.g., probenecid):** Triflusal may decrease the efficacy of uricosuric agents.
## Monitoring
* Monitor for signs and symptoms of bleeding (e.g., bruising, melena, hematuria, epistaxis).
* Monitor for signs of gastrointestinal distress.
* In patients with impaired renal or hepatic function, monitor relevant laboratory parameters as clinically indicated.
## Clinical Pearls
* Triflusal is administered once daily, which may improve adherence compared to some other antiplatelet agents.
* It is a prodrug and its onset of action is dependent on conversion to its active metabolite.
* Caution is advised when discontinuing triflusal, especially in patients with acute coronary syndromes or following stent placement, due to the risk of thrombotic events. Discontinuation should be based on individual patient risk assessment.
***
*Disclaimer: This information is intended for educational purposes and should not be considered a substitute for professional medical advice. Always consult with a qualified healthcare provider and refer to the most current prescribing information for complete details and contraindications.*
