Triampur compositum tabs #50

Instruction for Triampur compositum

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Composition

One tablet of the preparation contains 25 mg of triamterene, 12.5 mg of hydrochlorothiazide + additional ingredients (potato starch, silicon dioxide, magnesium stearate, lactose monohydrate, povidone, sodium carboxymethyl starch).

Form of issue

The medicine is released in the form of round tablets of yellow color, with a risk and bevelled edge. In bottles of 50 pieces, one bottle in a cardboard pack.

pharmachologic effect

Diuretic, antihypertensive.

Pharmacodynamics and pharmacokinetics

The two main active components of the drug are triamterene and hydrochlorothiazide - moderately strong diuretics. Their pharmacodynamic and clinical features are very well studied. The substances mutually reinforce each other's effects on the body, especially on the water and electrolyte balance in the body.
Triamteren enhances the process of removing sodium ions from the body, reduces the loss of potassium and hydrogen ions, and belongs to the group of potassium-saving saluretics. The substance inhibits the sodium exchange process for potassium and hydrogen, which usually occurs in the terminal parts of the distal tubules. However, an insignificant amount of sodium is produced, and the drug has no effect on the urea excretion process.
Hydrochlorothiazide reduces the intensity of a similar process in the initial part of the distal tubules. The excretion of potassium, chlorine, water and sodium ions is enhanced. Also, the drug has the ability to inhibit carbonic anhydrase, which can lead to excessive excretion of bicarbonate. The primary effect of the drug is associated with increased excretion of electrolytes, and secondary - with the stimulation of urea excretion.
In the preparation, a combination of active components in a ratio of one to two (hydrochlorothiazide and triamterene) occurs, which greatly enhances the efficacy of the agent. Their opposite effect on potash leads to the desired effect of neutralizing the balance of potassium and its compensation.
With oral administration of the drug, the active components in the gastrointestinal tract are absorbed (80%). The biological availability of thiazide is approximately 70%, triamterene is 50%. 2/3 hydrochlorothiazide binds to plasma proteins, and 60% triamterene. After 1 hour, the diuretic effect begins to manifest, a maximum of 4 hours is reached its maximum and lasts up to 12 hours, depending on the dose taken. The hypotensive effect is more stable and may last another day. The half-life is approximately 7 hours for hydrochlorothiazide and 4 to 7 for triamterene.
Thiazide is not metabolized, excreted by the kidneys almost unchanged. Triamterene, on the other hand, undergoes metabolic reactions in the liver. Its main metabolite - 4-hydroxytriamterene - is also pharmacologically active, excreted from the blood after 3 hours with bile or through the kidneys.

Indications for use Triampur Compositum

What is the prescription for? This tool uses:
    for depression of pressure in arterial hypertension;
    with edema caused by heart, kidney or liver diseases, in cases where it is necessary to avoid loss of potassium from the body.
Heart failure is also an indication for the use of the drug. The medicine is prescribed as part of a complex therapy with cardiac glycosides to avoid loss of potassium and stimulate the excretion of excess fluid from the body.

Contraindications

The medicine is contraindicated:
    with increased individual sensitivity to the components of the agent or a group of sulfonamides;
    with severe violations in the work of the kidneys and liver;
    with anuria, acute glomerulonephritis, violations in the water-electrolyte balance;
    with intolerance to lactose;
    for newborns and children under the age of 14;
    with chronic alcoholism;
    with kidney stones;
    with diabetes and gout;
    pregnant and lactating women;
    with a deficiency of folic acid.

Side effects

The drug is well researched. In the process of clinical trials and judging by the opinions of patients, the following reactions are possible:
    hemolytic anemia, thrombocytopenia, agranulocytosis, aplastic anemia, leukopenia, neutropenia, megablastic anemia;
    lethargy, dry mucous membranes, headache, drowsiness, convulsions, collapse, depression, paresthesia, disorientation, mood change;
    ataxia, increased heart rate, arrhythmia, changes in the electrocardiogram, lowering blood pressure;
    loss of consciousness, pre-stupor;
    violations of orthostatic regulation;
    dry eyes, violations in the perception of flowers; myopia;
    pulmonary edema, pneumonia and respiratory distress syndrome;
    pancreatitis, increased levels of hepatic enzymes, cholecystitis, jaundice;
    rashes on the skin, hives, vasculitis, itching and allergic reactions to light;
    nausea, epigastric pain, constipation, vomiting, intestinal obstruction (symptoms do not appear if taking the pill after meals);
    increased renal activity;
    muscle cramps, muscle strain, skeletal muscle hypotension;
    shock, vasculitis, anaphylactic and anaphylactoid reactions, exacerbation of lupus;
    increased fatigue, weakness, impotence, decreased libido and sexual function, general weakness;
    development of the syndrome of Stephen-Johnson, hepatic coma, latent diabetes;
    possibly deterioration of the pre-diabetic and diabetic state, hyperkalemia, hyperglycemia, metabolic acidosis, hyponatremia, increased blood cholesterol and creatinine.

Triampur, instructions for use (Method and dosage)

The dosage and duration of the medication should be determined individually by the attending physician.
If the course of treatment with the drug is prolonged, then you should not stop taking pills abruptly. The dose should be reduced gradually.
The tablets are drunk after eating, without separating or chewing.

Instructions for use Triampur compositum for adults

For the treatment of hypertension, the initial dosage is 4 tablets per day, divided into 2 doses. Then, after a certain time, the dosage is reduced to 2 tablets per day (for one or two doses). If the patient additionally takes other means that reduce the pressure, then the daily dosage is 2 pieces per day.
For the treatment of edema, in the beginning they drink 4-8 ​​tablets a day, for 2 doses. The maintenance dosage is 1 tablet a day, or 2 a day, or 4 tablets per day.
As a complex therapy for the treatment of heart failure, patients are prescribed 2 tablets per day (up to 4 depending on the results of the tests).
In case of kidney disease, a dose adjustment should be performed. If the serum creatinine concentration is 1.5-1.8 mg per 100 ml or the clearance is 50-30 ml per minute, then the daily dosage should not exceed one tablet.

Overdose

In acute overdose, there is a strong decrease in blood pressure, up to an osteopathic collapse.
With prolonged intake of high doses of the drug, dehydration, electrolyte imbalance, nausea, weakness, vomiting are observed.
At the first symptoms of an overdose (weakness, confusion, heart rhythm disturbance, nausea), stop taking the medication immediately. In especially severe cases, alkalosis, acidosis, adynamia, spasms and overexcitation were observed.
Specific antidote has no means. In this connection, gastric lavage, reception of enterosorbents, symptomatic therapy is carried out.
It is necessary to closely monitor the patient's condition and adjust the electrolyte and water balance in the body, blood sugar level, blood pH.
If there is hypovolemia, a profuse drink is shown, in order to avoid the crystallization of the drug in the kidneys. It is recommended to administer isotonic sodium bicarbonate solution, with hyperkalemia - glucose and insulin.
In patients with kidney failure, there is a need for hemodialysis. If there is a bradycardia that does not respond to treatment, the pacemaker should be installed.
If the blood pressure reaches a critical minimum, a shock occurs, it is recommended to administer potassium, sodium and magnesium in the form of a solution of electrolytes.

Interaction

When combined with diuretics, phenothiazines, vasodilators, antihypertensive drugs, ethanol and barbiturates, the hypotensive effect is enhanced.
Simultaneous reception with methyldopa increases the likelihood of hemolysis.
The risk of kidney disease increases if you combine the drug Triampur Compositum with indomethacin.
The diuretic effect and the effect of lowering the pressure is enhanced if the drug is taken with non-steroidal anti-inflammatory drugs. Salicylates increase the burden on the central nervous system.
Caution should be combined with lithium drugs and medication, as the load on the heart increases; both agents differ in cardiotoxicity.
The effect of curare-like muscle relaxants is enhanced when combined in a preparation.
ACE inhibitors when combined with the drug contribute to a sharp decrease in pressure, especially in the early days of therapy.
Absorption capacity of the drug is reduced if it is used together with colestipol or colestrial amine.
Potassium salts, potassium-sparing diuretics and ACE inhibitors when combined with the drug contribute to the development of hyperkalemia, and glucocorticosteroids, chlorpropamide and laxatives - hypokalemia.
The drug weakens the effect of drugs from gout, hypoglycemic drugs, norepinephrine and epinephrine.
Triampur Compositum and beta-adrenergic blockers increase the risk of impotence.
With the combination of Triampur and quinidine, excretion from the body of the latter slows down, the effect of cytostatics on the bone marrow is enhanced.

Terms of sale

To buy Triampur Compositum, you don't need a prescription.

Storage conditions

Store at a temperature not exceeding 30 degrees Celsius.
Shelf life - 5 years.

special instructions

The medicine should be taken with care and strictly under the supervision of a doctor:
    patients with calculi in the kidney;
    patients with diabetes mellitus;
    with a deficiency or suspicion of a deficiency of folic acid in the body;
    with violations of the liver and kidneys.
3 days before the test for diabetes mellitus or the study of kidney or thyroid function, the medicine should be canceled.
If one of the regular methods of the drug was missed, you can not use a double dose.
During therapy, drink a sufficient amount of liquid.
If you wear contact lenses, chances are that the mucous eye will need additional moisturizing.
In order to prescribe a remedy for children, not enough research has been done. In connection with this, the drug is not used in pediatrics.
During the administration of the drug should be constantly monitor the content of potassium, sodium, uric acid, chlorine, creatinine and glucose.
Care should be taken when controlling machinery and transport due to a decrease in reaction speed. The effect is especially pronounced when taking alcohol, increasing the dose, starting treatment, replacing the medicine with analogs.

In pregnancy and lactation

The medicine is not prescribed during pregnancy and during lactation.

Reviews of Triampur Compositum

The drug quickly and effectively relieves swelling and high blood pressure. However, he, like other diuretics, washes potassium and magnesium out of the body, so the drug should be taken at the same time. Some are unhappy with the fact that if you drink a medicine before going to bed, you have to run to the toilet all night.
There are on the Internet and reviews about Triampur for weight loss, usually good. It is even prescribed by doctors to treat obesity.