Triampur Compositum

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Triampur compositum: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Drug interactions
14. Analogs
15. Terms and conditions of storage
16. Terms of dispensing from pharmacies
17. Reviews
18. Price in pharmacies

Latin name: Triampur compositum

ATX code: C03EA01

Active ingredient: Hydrochlorothiazide + Triamterene (Hydrochlorothiazide + Triamterene)

Producer: GmbH Menarini-von Heiden (Germany)

Description and photo update: 2018-18-05

Prices in pharmacies: from 300 rubles.

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Triampur compositum is a combined preparation with diuretic action.

Release form and composition

Dosage form Triampura compositum - tablets: round, with beveled edges, yellow, with a line on one side (50 pcs. In colorless glass bottles, 1 bottle in a cardboard box).

Active ingredients in 1 tablet:

triamterene - 25 mg;
hydrochlorothiazide - 12.5 mg.

Additional components: sodium carboxymethyl starch, povidone K25, potato starch, lactose monohydrate, highly dispersed silicon dioxide, magnesium stearate.

Pharmacological properties

Pharmacodynamics

Triampur compositum is a combination drug that has a diuretic and hypotensive effect. It contains 2 substances as active ingredients:

triamterene is a potassium-sparing diuretic that reduces the permeability of the cell membranes of the distal tubules for sodium ions, enhances their excretion in the urine and reduces their secretion, without increasing the release of potassium ions. The diuretic effect after taking the drug develops in 15–20 minutes, reaches a maximum in 2–3 hours and lasts for 12 hours;
hydrochlorothiazide is a thiazide diuretic, the mechanism of action of which is due to the ability to disrupt the reabsorption of sodium, magnesium and chlorine ions, as well as water in the distal nephron. In this case, the substance delays the excretion of uric acid and calcium ions. Due to the expansion of arterioles, it also has an antihypertensive effect, with virtually no effect on normal blood pressure. The diuretic effect after taking the drug develops in 1-2 hours, reaches a maximum in 4 hours and lasts up to 10-12 hours, depending on the dose taken. The antihypertensive effect of the drug is longer - up to 24 hours.

Triamterene in combination with hydrochlorothiazide reduces hypokalemia caused by it and enhances its diuretic effect.

Pharmacokinetics

Triamterene is rapidly absorbed from the gastrointestinal tract (about 80% of the dose taken). The maximum concentration reaches within 2-4 hours. Approximately 60% binds to blood plasma proteins. It is metabolized in the liver with the formation of active metabolites, the main of which is 4-hydroxytriamterene. The half-life (T _1/2) of triamterene is 4–7 hours, 4-hydroxytriamterene is 2–3 hours (in patients with liver cirrhosis, the elimination time can be increased by 4 times). It is excreted unchanged in small amounts with bile and urine. 4-hydroxytriamterene is excreted mainly by the kidneys, in small quantities - with bile.

Hydrochlorothiazide is rapidly absorbed from the gastrointestinal tract (about 80% of the dose taken). The maximum concentration, which is 142 ng / ml, after taking a dose of 25 mg reaches in 2-5 hours. Bioavailability is about 70%. Communication with blood plasma proteins - 60-80%. In the range of therapeutic doses, the average area under the AUC curve increases in direct proportion to the dose increase. When taking the drug once a day, the accumulation of hydrochlorothiazide is insignificant. The substance crosses the placental barrier and is excreted in breast milk. Period T _1/2- 6-8 hours. Hydrochlorothiazide is not metabolized, excreted by the kidneys (95% - unchanged, about 4% - in the form of hydrolyzate-2-amino-4-chloro-m-benzenedisulfonamide) by glomerular filtration and active tubular secretion in the proximal nephron.

Indications for use

edematous syndrome of various origins (with nephrotic syndrome, liver cirrhosis, chronic heart failure);
arterial hypertension.

Contraindications

Absolute:

acute glomerulonephritis;
anuria;
hypovolemia;
severe liver dysfunction (precoma and hepatic coma);
chronic renal failure (creatinine clearance <30 ml / min, serum creatinine more than 1.8 mg / dl);
electrolyte metabolism disorders that cannot be corrected (hypercalcemia, hyperkalemia, hypokalemia, hyponatremia);
period of pregnancy and lactation;
age up to 18 years (safety and efficacy have not been established);
hypersensitivity to the components of the drug, as well as to sulfonamides (due to the danger of cross-allergic reactions).

Relative (conditions / diseases in which Triampur compositum should be used with caution and only under medical supervision):

impaired renal and / or liver function;
gout;
urolithiasis disease;
diabetes;
suspicion of a deficiency of folic acid in the body (for example, with cirrhosis of the liver caused by chronic alcohol abuse);
conditions accompanied by the risk of developing acidosis.

Instructions for the use of Triampur compositum: method and dosage

Triampur compositum should be taken orally: swallow the tablets whole and drink plenty of liquid.

The initial dose for edematous syndrome is 1 or 2 tablets 2 times a day, morning and afternoon. With long-term treatment, the dose may vary depending on the dynamics of the patient's condition and the severity of the diuretic effect. For maintenance therapy, usually 1 tablet is prescribed once a day (in the morning) or 2 tablets every other day (1 pc. In the morning and in the afternoon). In some cases, the daily dose is increased to 4 tablets (2 pcs. In the morning and afternoon).

The initial dose for hypertension is 2 tablets 2 times a day (morning and afternoon). In cases of long-term treatment and the simultaneous appointment of other antihypertensive drugs, Triampur compositum is prescribed 1 tablet 2 times a day (morning and afternoon).

In heart failure Triampur compositum is used in combination with cardiac glycosides. The dose is selected individually depending on the patient's condition. Usually, 1 tablet is prescribed 2 times a day (morning and afternoon), if necessary, the daily dose is increased, but not more than up to 4 tablets (2 pcs. In the morning and afternoon).

For patients with reduced renal function (creatinine clearance 30-50 ml / minute), the recommended daily dose is 1 tablet.

Side effects

from the side of metabolism: decreased glucose tolerance, hypercalcemia, a temporary increase in the blood concentration of nitrogen-containing substances excreted in the urine (urea, creatinine) (more often at the beginning of treatment), accumulation of non-volatile acids in the blood (metabolic acidosis), development of a latent form or aggravation already existing diabetes mellitus, an increase in blood lipids in predisposed patients (depending on the total dose of the drug taken); with long-term continuous therapy - violations of the water-electrolyte balance (more often hypo- or hyperkalemia, a decrease in the content of chlorides, magnesium and sodium in the blood); an increase in the content of uric acid in the blood is possible, due to which predisposed patients have a risk of developing an attack of gout, the formation of urinary stones;
on the part of the musculoskeletal system: muscle weakness, muscle tension, cramps of the calf muscles;
from the digestive system: pain and discomfort in the epigastric region, thirst, dry mouth, constipation, nausea, vomiting, colicky abdominal pain; sometimes when taking the drug before meals - diarrhea; in some cases - hemorrhagic pancreatitis; in patients with gallstone disease - acute cholecystitis;
from the hematopoietic system: thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia; with a previous deficiency of folic acid in the body - megaloblastic anemia; with the simultaneous use of methyldopa - hemolysis due to the appearance in the blood of autoantibodies to hydrochlorothiazide;
from the central nervous system: feeling tired, drowsiness, headache, uncoordinated movements, nervousness;
on the part of the cardiovascular system: lowering blood pressure, heart rhythm disturbances, palpitations, disturbances in the regulation of blood circulation with stunned consciousness, dizziness or a tendency to faint; against the background of taking the drug in high doses and abundant excretion of urine - thromboembolism; in rare cases - confusion, convulsions, acute renal failure, vascular collapse;
on the part of the organ of vision: a decrease in the production of lacrimal fluid, worsening of the existing myopia, visual impairment;
allergic reactions: fever, photoallergic exanthema, pruritus, urticaria, skin redness, anaphylactoid reactions, systemic lupus erythematosus, severe inflammation of blood vessels, non-bacterial inflammation of kidney tissue (aseptic interstitial nephritis); in isolated cases - suddenly developing pulmonary edema (probably due to an allergic reaction to hydrochlorothiazide);
others: icteric coloration of the mucous membranes, sclera and skin.

Overdose

Symptoms: fatigue, weakness, confusion, frequent urge to urinate, heart rhythm disturbances, a marked decrease in blood pressure, paresthesia, convulsions.

In case of overdose, gastric lavage should be performed. Treatment of the developed disorders is symptomatic.

special instructions

Treatment should be carried out under the constant supervision of a physician. It is necessary to control the blood levels of glucose, creatinine, urea, uric acid, sodium, potassium and chlorine. If a folic acid deficiency is suspected, the peripheral blood picture should be monitored, especially in the case of the simultaneous use of laxatives, cardiac glycosides or glucocorticosteroids.

During the period of therapy, you need to take a sufficient amount of liquid. If you miss taking the drug, you cannot take two doses at the same time.

Patients who wear contact lenses should remember that Triampur compositum can reduce the production of tear fluid.

The drug can distort the results of studies of the function of the parathyroid glands and tests with a sugar load, therefore, 3 days before they are carried out, treatment should be interrupted.

Influence on the ability to drive vehicles and complex mechanisms

It is recommended to refrain from performing potentially dangerous activities that require speed of reactions and increased attention during drug therapy, especially at the beginning of treatment, when increasing the dose, replacing one drug with another, as well as when drinking alcohol.

Application during pregnancy and lactation

During pregnancy, Triampur Compositum is contraindicated.

If treatment is necessary during lactation, stopping breastfeeding should be considered.

Pediatric use

Clinical experience of using Triampur Compositum in pediatrics is insufficient, therefore, the drug is not used to treat patients under the age of 18.

With impaired renal function

According to the instructions, Triampur Compositum is contraindicated in chronic renal failure (creatinine clearance <30 ml / minute).

Patients with reduced renal function (creatinine clearance 30-50 ml / minute) can take no more than 1 tablet per day.

For violations of liver function

Triampur Compositum is contraindicated in severe liver dysfunction (hepatic precoma and coma).

Drug interactions

The antihypertensive effect of Triampur Compositum is enhanced with the simultaneous use of other antihypertensive, as well as diuretics and vasodilators, ethanol-containing drugs, tricyclic antidepressants, barbiturates, phenothiazines.

The diuretic and antihypertensive effect of Triampur Compositum can be reduced while taking non-steroidal anti-inflammatory drugs (for example, salicylates, indomethacin).

Effect of Triampur Compositum on the action of other drugs:

slows down the excretion of quinidine;
enhances the neurotoxic and cardiotoxic effects of lithium;
enhances the effect of cytostatics on the bone marrow;
weakens the action of epinephrine (adrenaline), norepinephrine (norepinephrine), anti-gout and hypoglycemic agents;
enhances the effect of curariform muscle relaxants;
enhances the effects, including side effects, of cardiac glycosides in patients with potassium and / or magnesium deficiency in the body.

Other possible interaction reactions when Triampura Compositum is combined with certain drugs:

ACE inhibitors: there is a sharp decrease in blood pressure at the beginning of treatment;
indomethacin: the risk of developing renal failure increases;
salicylates: the likelihood of toxic manifestations from the central nervous system increases;
colestipol or cholestyramine: absorption of hydrochlorothiazide from the gastrointestinal tract decreases;
methyldopa: hemolysis may develop;
glucocorticoids, laxatives: hypokalemia may develop;
potassium-sparing diuretics, ACE inhibitors, potassium salts: hyperkalemia may develop;
beta-blockers: the risk of decreased potency increases;
chlorpropamide: development of severe hypokalemia is possible.

Analogs

Analogs of Triampur Compositum are: Triamtel, Apo-Triazid, Diuretidine, Triam-Co, Vero-Triamtezid, Diazid.

Terms and conditions of storage

Store no more than 3 years at temperatures up to 30 ° C.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Triampura Compositum

According to reviews, Triampur Compositum is an effective drug that quickly relieves edema and lowers high blood pressure. However, like other diuretics, it flushes magnesium and potassium from the body, so during treatment it is recommended to take magnesium and potassium preparations at the same time.

Price for Triampur Compositum in pharmacies

The approximate price for Triampur Compositum is 285–340 rubles. per pack of 50 tablets.