Trinalgin
Trinalgin: 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: Trianalgin
ATX code: N02BB52
Active ingredient: metamizole sodium (metamizole sodium) + pitofenone (pitofenone) + fenpiverinium bromide (fenpiverinium bromide)
Manufacturer: Biosynthesis (Russia)
Description and photo updated: 22.11.2018
Prices in pharmacies: from 92 rubles.
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Trinalgin is a combined preparation with analgesic, antipyretic and anti-inflammatory action, used for spasms of smooth muscles of internal organs.
Release form and composition
Dosage form Trinalgin - solution for intravenous and intramuscular administration: colorless or slightly colored, transparent (in a cardboard box 10 ampoules of 2 ml each or 1-2 blisters of 5 ampoules of 2 or 5 ml).
The composition of 1 ml of solution contains:
- active substances: analgin (metamizole sodium monohydrate) - 500 mg; pitofenone hydrochloride - 2 mg; fenpiverinium bromide - 0.02 mg;
- auxiliary components: sodium disulfite - 1 mg; 2M sodium hydroxide solution - in an amount sufficient to bring the pH to 6–7.5; water for injection - up to 1 ml.
Pharmacological properties
Pharmacodynamics
Trinalgin is one of the combined drugs, the action of which is determined by the properties of the active ingredients:
- metamizole sodium: non-narcotic analgesic; has an analgesic, antipyretic and weak anti-inflammatory effect;
- pitofenone: myotropic antispasmodic agent; like papaverine, it has a direct myotropic effect on the smooth muscles of the internal organs, which leads to its relaxation;
- fenpiverinium bromide: m-anticholinergic agent; due to the m-anticholinergic effect, it has an additional antispasmodic effect on smooth muscles.
The active substances of Trinalgin are characterized by synergism of action - mutual enhancement of pharmacological effectiveness.
Pharmacokinetics
Metamizole sodium: fast absorption; absorbed to a large extent from the injection site after intramuscular administration, systemic bioavailability up to 85%. The connection with blood plasma proteins varies from 50 to 60%. It is excreted in breast milk when used in therapeutic doses. It is intensively biotransformed in the liver. After intravenous administration in plasma, the unchanged substance is found only in negligible concentrations. Major metabolites: 4-acetylaminoantipyrine, 4-methylaminoantipyrine, 4-amino-antipyrine and 4-formylaminoantipyrine. Found in cerebrospinal fluid. Approximately 20 additional metabolites have been identified, including derivatives of glucuronic acid. It is excreted mainly by the kidneys in the form of metabolites, unchanged ~ 3%. Half-life (T 1/2) ~ 10 hours.
Fenpiverinium bromide and pitofenone: they are characterized by incomplete resorption, while the substances are completely ionized. They have poor liposolubility. They do not penetrate the blood-brain barrier. In the liver, they are metabolized by oxidative reactions. Excretion of pitofenone occurs by the kidneys. The maximum plasma concentration is reached within 30-60 minutes. The half-life is 1.8 hours. Excretion of fenpiverinium bromide: by the kidneys - 32.4-40.4% unchanged, with bile - 2.5-5.3%.
Indications for use
- mild or moderate pain syndrome with spasms of smooth muscles of internal organs, including diseases of the pelvic organs, spasm of the bladder / ureter, renal, biliary and intestinal colic, biliary dyskinesia, chronic colitis, postcholecystectomy syndrome, algomenorrhea;
- sciatica, arthralgia, neuralgia, myalgia (for short-term use);
- pain syndrome after diagnostic procedures and surgical interventions (as an additional tool).
Contraindications
Absolute:
- severe angina;
- collapse;
- angle-closure glaucoma;
- acute intermittent porphyria;
- intestinal obstruction;
- hyperplasia of the prostate;
- granulocytopenia;
- oppression of bone marrow hematopoiesis;
- decompensated chronic heart failure;
- severe liver or kidney dysfunction;
- tachyarrhythmia;
- megacolon;
- deficiency of glucose-6-phosphate dehydrogenase;
- pregnancy and lactation;
- age up to 1 year or weight up to 9 kg / age up to 3 months or weight up to 5 kg (intravenous / intramuscular administration);
- individual intolerance to the components of the drug, as well as pyrazolone derivatives, non-steroidal anti-inflammatory drugs or non-narcotic analgesics.
Relative (Trinalgin is prescribed under medical supervision):
- bronchial asthma;
- tendency to arterial hypotension;
- polyps of the nose;
- impaired renal / hepatic function;
- intolerance to acetylsalicylic acid.
Instructions for the use of Trinalgin: method and dosage
Trinalgin solution is intended for intravenous or intramuscular administration. The ampoule should be warmed in hand before injection.
The solution should not be mixed with other drugs in the same syringe.
The recommended regimen of Trinalgin for adults and children over 15 years old:
- intravenously slowly: in acute severe colic - 2 ml (1 ml for 1 minute); if necessary, re-introduction is possible in 6-8 hours. Trinalgin in a dose of more than 1000 mg should be administered intravenously in the conditions of the possibility of carrying out anti-shock therapy;
- intramuscularly: 2 times a day, 2 ml.
The daily dose is not more than 4 ml. The duration of the course is up to 5 days.
The recommended regimen of Trinalgin for children from 3 months to 15 years old (intravenous / intramuscular):
- 3-11 months (5-8 kg): 0 / 0.1-0.2 ml;
- 1-2 years (9-15 kg): 0.1-0.2 / 0.2-0.3 ml;
- 3-4 years (16-23 kg): 0.2-0.3 / 0.3-0.4 ml;
- 5-7 years (24-30 kg): 0.3-0.4 / 0.4-0.5 ml;
- 8-12 years (31-45 kg): 0.5-0.6 / 0.6-0.7 ml;
- 12-15 years: 0.8-1 / 0.8-1 ml.
If necessary, Trinalgin can be re-prescribed in the same doses.
Side effects
- cardiovascular system: lowering blood pressure;
- urinary system: interstitial nephritis, anuria, oliguria, proteinuria, impaired renal function, urine staining red;
- anticholinergic effects: paresis of accommodation, difficulty urinating, tachycardia, xerostomia, decreased sweating;
- hematopoietic organs: leukopenia, thrombocytopenia, agranulocytosis (may manifest as an unmotivated rise in temperature, chills, sore throat, difficulty swallowing, stomatitis, as well as the occurrence of proctitis or vaginitis);
- local reactions (with intramuscular injection): infiltrates at the injection site;
- allergic reactions: angioedema, urticaria (including localized on the mucous membranes of the nasopharynx and conjunctiva); in rare cases - anaphylactic shock, bronchospastic syndrome, malignant exudative erythema, toxic epidermal necrolysis.
Overdose
The main symptoms are: nausea, convulsions, epigastric pain, drowsiness, vomiting, decreased blood pressure, confusion, impaired renal / hepatic function.
Recommended gastric lavage, activated charcoal intake, symptomatic treatment.
special instructions
Trinalgin should be used only in cases where oral administration is not possible, or absorption from the gastrointestinal tract is impaired.
Due to the likelihood of a sharp drop in blood pressure, special care must be taken when injecting more than 2 ml of solution.
Intravenous Trinalgin should be administered slowly, in the supine position, monitoring blood pressure, heart rate and respiratory rate.
The use of metamizole sodium in children under 5 years of age and patients who receive cytostatic drugs should be carried out only under medical supervision.
For intramuscular administration of Trinalgin, a long needle must be used.
It is not recommended to take ethanol during therapy.
With thrombocytopenia or suspicion of agranulocytosis, Trinalgin is canceled.
It is unacceptable to use the drug to relieve acute abdominal pain until their causes are clarified.
Intolerance to Trinalgin is extremely rare, however, after intravenous administration of the drug, the threat of anaphylactic shock is relatively higher than after oral administration.
Patients with pollinosis and atopic bronchial asthma have an increased likelihood of allergic reactions.
Influence on the ability to drive vehicles and complex mechanisms
Patients during the period of Trinalgin therapy are advised to refrain from driving.
Application during pregnancy and lactation
According to the instructions, Trinalgin is not prescribed during pregnancy / lactation.
Pediatric use
Contraindications:
- intravenous administration: age up to 1 year or weight up to 9 kg;
- intramuscular injection: age up to 3 months or weight up to 5 kg.
With impaired renal function
- severe renal dysfunction: therapy is contraindicated;
- renal dysfunction: Trinalgin should be used under medical supervision.
For violations of liver function
- severe liver dysfunction: therapy is contraindicated;
- liver dysfunction: Trinalgin should be used under medical supervision.
Drug interactions
Possible interactions with metamizole sodium:
- cyclosporine: its concentration in the blood decreases;
- indirect anticoagulants, oral hypoglycemic drugs, indomethacin and glucocorticosteroids: the severity of their action increases, which is associated with the displacement of sodium metamizole from the bonds with the protein;
- cytostatics, thiamazole: the risk of developing leukopenia increases;
- codeine, propranolol, blockers of H 2 -histamine receptors: the effect of Trinalgin is enhanced, which is associated with a slowdown in the inactivation of sodium metamizole.
Data on drug interactions between fenpiverinium bromide and pitofenone are not presented.
Analogs
Trinalgin's counterparts are: Spazgan, Geomag, Bral, Spazmalgon, Maksigan, Baralgetas, Revalgin, Spazmoblok, Plenalgin, Spazmaton, Bralangin, Renalgan.
Terms and conditions of storage
Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Trinalgin
Reviews about Trinalgin are few. It is noted that the drug is effective for pain syndrome with spasms of smooth muscles of internal organs, including the prenatal period. It is indicated that side effects are rare, so Trinalgin can be prescribed for children over three months old.
Price for Trinalgin in pharmacies
The price of Trinalgin is unknown because the drug is not available in pharmacies.
Approximate price for analogs: Revalgin, solution for injection (5 ampoules of 5 ml each) - 116-137 rubles; Spazgan, solution for intravenous and intramuscular injection (5 ampoules, 5 ml each) - 110 rubles; Spazmalin, tablets (20 pcs.) - 92–110 rubles. The use of analogs should be agreed with the attending physician.
Trinalgin: prices in online pharmacies
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Drug name Price Pharmacy |
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Trinalgin solution for intravenous and intramuscular injection. amp. 5ml 5 pcs 92 RUB Buy |
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Trinalgin solution for intravenous and intramuscular administration 5 ml 5 pcs. 92 RUB Buy |
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Trinalgin solution for intravenous and intramuscular administration 5 ml 10 pcs. 156 r Buy |
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Trinalgin solution for intravenous and intramuscular injection. amp. 5ml 10 pcs 157 r Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, 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!
