Trigan-D
Trigan-D: 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. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Trigan-D
ATX code: N02BE51
Active ingredient: Dicycloverin + Paracetamol (Dicycloverine + Paracetamol)
Manufacturer: CADILA PHARMACEUTICALS, Ltd. (India)
Description and photo update: 2018-27-07
Prices in pharmacies: from 40 rubles.
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Trigan-D is an analgesic drug (antispasmodic drug + non-narcotic analgesic agent).
Release form and composition
The drug is available in the form of tablets: flat, round, smooth, white, beveled at the edges, with a risk on only one side (10 tablets in PVC / aluminum blister or aluminum strip, 1, 2 blisters or 10 strips in a cardboard box).
Composition of 1 tablet:
- active substances: paracetamol - 500 mg, dicycloverine hydrochloride - 20 mg;
- excipients: sodium starch glycolate, maize starch, microcrystalline cellulose, aerosil (colloidal silicon dioxide), povidone, magnesium stearate.
Pharmacological properties
Pharmacodynamics
Paracetamol, which is part of the drug, has antipyretic, analgesic and insignificant anti-inflammatory properties. The mechanism of action is associated with moderate inhibition of cyclooxygenase-1, as well as cyclooxygenase-2 (to a lesser extent) in peripheral tissues and the central nervous system, which results in inhibition of the biosynthesis of prostaglandins - modulators of pain sensitivity, thermoregulation and inflammation.
Dicycloverine hydrochloride is a tertiary amine that has a relatively weak indiscriminate m-anticholinergic and direct myotropic antispasmodic effect on the smooth muscles of internal organs. In therapeutic doses, it causes an effective relaxation of smooth muscles, which is not accompanied by the side reactions characteristic of atropine.
Trigan-D, due to the combined action of the two components, relaxes spasmodic smooth muscles of internal organs and reduces pain.
Pharmacokinetics
Absorption from the gastrointestinal tract is rapid. The maximum concentration in blood plasma is reached after 1–1.5 hours. The volume of distribution is 3.65 l / kg. Paracetamol is metabolized in the liver with the formation of a few metabolites, one of which is N-acetyl-benzoquinone imine - under certain conditions (lack of glutathione in the liver, drug overdose) can have a damaging effect on the kidneys and liver. Approximately 80% of the drug is excreted in the urine, a small amount in the feces.
Indications for use
Indications for Trigan-D are:
- infectious and inflammatory diseases accompanied by fever;
- spasm of smooth muscles of internal organs (renal, hepatic and intestinal colic, algomenorrhea);
- toothache, headache, migraine pain, neuralgia, myalgia.
Contraindications
- hypersensitivity to drug components;
- obstructive bowel disease, urinary and biliary tract;
- peptic ulcer of the duodenum and stomach (stage of exacerbation);
- reflux esophagitis;
- hypovolemic shock;
- myasthenia gravis;
- pregnancy and the period of breastfeeding;
- age up to 15 years.
Diseases / conditions for which caution should be exercised:
- severe renal or liver dysfunction;
- lack of glucose-6-phosphate dehydrogenase (at the genetic level);
- blood disease;
- glaucoma;
- benign hyperbilirubinemia (including Gilbert's syndrome);
- viral hepatitis;
- alcoholism, alcoholic liver damage;
- elderly age.
Instructions for use of Trigan-D: method and dosage
For adults and children over 15 years old, Trigan-D is prescribed 2-3 times a day, 1 pc. The maximum single dose is 2 pcs., The daily dose is 4 pcs. When prescribed as an anesthetic drug, the duration of the course without consulting a doctor should not exceed 5 days, and as an antipyretic agent - 3 days.
With prolonged use of the drug, it is necessary to monitor the functional state of the liver and the picture of peripheral blood.
An increase in the dose or course of treatment is possible only under the supervision of a physician.
Side effects
- gastrointestinal tract: loss of taste, dry mouth, decreased appetite, constipation, epigastric pain, increased activity of liver enzymes (usually without the development of jaundice), hepatonecrosis (dose-dependent result);
- organs of vision: blurred vision, mydriasis, increased intraocular pressure, accommodation paralysis;
- central nervous system (most often develops when taking high doses): dizziness, drowsiness, psychomotor agitation and disorientation;
- endocrine system: hypoglycemia (hypoglycemic coma is possible);
- hematopoietic organs: anemia, methemoglobinemia (shortness of breath, cyanosis, heart pain), hemolytic anemia (especially for patients with glucose-6-phosphate dehydrogenase deficiency);
- genitourinary system: urinary retention, pyuria, papillary necrosis, interstitial nephritis;
- reproductive system: decreased potency.
In addition, allergic reactions may occur: urticaria, pruritus, skin rash, Quincke's edema, exudative erythema multiforme, including Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome).
Overdose
In case of an overdose of the drug, the following adverse reactions are possible: tachypnea, tachycardia, agitation, fever, convulsions, decreased appetite, epigastric pain, anemia, hemolytic anemia, thrombocytopenia, aplastic anemia, pancytopenia, methemoglobinemia, papillary necrosis (nephrotoxicity).
With the manifestation of the above reactions, Trigan-D must be canceled, gastric lavage should be performed, adsorbents should be taken, agents that enhance conjugation reactions (methionine inside) and increase the formation of glutathione (intravenous acetylcysteine) should be introduced.
special instructions
Patients with impaired renal or liver function should take Trigan-D at the same time with other analgesic and anti-inflammatory drugs, as well as with anticoagulants and medications that affect the central nervous system, with extreme caution and under close medical supervision. When taking domperidone, metoclopramide or cholestyramine, you also need to consult a specialist.
Paracetamol distorts laboratory tests in the quantitative determination of plasma uric acid and glucose.
It is not recommended to combine paracetamol with alcoholic beverages, as well as to take it to patients prone to chronic alcohol consumption, in order to avoid toxic liver damage. Individuals with alcoholic hepatosis have an increased risk of developing liver damage.
During the period of prolonged therapy, regular monitoring of the peripheral blood picture and the functional state of the liver should be carried out.
Influence on the ability to drive vehicles and complex mechanisms
During the period of drug therapy, it is recommended to refrain from theoretically dangerous activities that require increased attention and speed of psychomotor reactions.
Application during pregnancy and lactation
The drug is contraindicated in pregnant and lactating women.
Pediatric use
According to the instructions, Trigan-D is contraindicated in patients under 15 years of age.
With impaired renal function
In patients with severe renal impairment, the drug should be taken with extreme caution.
For violations of liver function
The drug should be used with caution in patients with severe liver dysfunction.
Use in the elderly
Elderly patients should take Trigan-D with caution when indicated.
Drug interactions
The effect of the drug on other medicinal products:
- class 1 antiarrhythmic drugs, amantadine, antipsychotic drugs, indirect anticoagulants, benzodiazepines, narcotic analgesics, MAO inhibitors, nitrites and nitrates, sympathomimetic drugs, tricyclic antidepressants: Trigan-D enhances their effect;
- digoxin: increases its concentration in the blood (as a result of slowing gastric emptying);
- uricosuric drugs: reduces their effectiveness.
The effect of drugs on Trigan-D:
- adrenostimulants and other drugs with anticholinergic action: increase the risk of adverse reactions;
- stimulants of microsomal oxidation in the liver (ethanol, phenytoin, rifampicin, barbiturates, tricyclic antidepressants, phenylbutazone): increase the production of hydroxylated active metabolites, which causes the possibility of severe intoxication with small paracetamol overdoses;
- inhibitors of microsomal oxidation (cimetidine): reduce the risk of hepatotoxic effects.
Analogs
An analogue of Trigan-D is Dolospa tabs.
Terms and conditions of storage
Store in a dry place, protected from light and out of reach of children, at a temperature not exceeding 25 ° C.
Shelf life is 3 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about Trigan-D
According to available reviews, Trigan-D is an effective and inexpensive drug.
Price for Trigan-D in pharmacies
The price of Trigan-D (10 tablets per pack) is approximately 81 rubles.
Trigan-D: prices in online pharmacies
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Drug name Price Pharmacy |
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Trigan-D tablets 10 pcs. RUB 40 Buy |
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Trigan-D tablets 20 pcs. RUB 76 Buy |
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Trigan-D tablets 500mg 20 pcs. 108 RUB Buy |
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Trigan-D tablets 100 pcs. RUB 185 Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
