Trittico
Trittico: 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: Trittico
ATX code: N06AX05
Active ingredient: trazodone (trazodone)
Producer: Aziende Chimiche Riunite Angelini Francesco ACRAF, SpA (Italy)
Description and photo updated: 2018-26-11
Prices in pharmacies: from 749 rubles.
Buy
Trittico is an antidepressant.
Release form and composition
Dosage form Trittico - tablets of prolonged action (controlled release tablets): white with a yellow tinge or white, biconvex, oval, a dividing line is applied on both sides (in blisters: 150 mg - 10 pcs., In a cardboard box 2 or 6 blisters; 20 pcs., In a cardboard box 1 or 3 blisters; 75 mg each - 15 pcs., In a cardboard box 2 blisters; 30 pcs., In a cardboard box 1 blister).
1 tablet contains:
- active substance: trazodone hydrochloride - 75 mg or 150 mg;
- auxiliary components: sucrose, povidone (polyvinylpyrrolidone), carnauba wax, magnesium stearate.
Pharmacological properties
Pharmacodynamics
Trittico is a drug with an antidepressant effect and a slight anxiolytic and sedative effect. Its active ingredient, trazodone, is a triazolopyridine derivative. Unlike MAO (monoamine oxidase) inhibitors and tricyclic antidepressants, it has no effect on MAO.
The mechanism of action of the drug is due to the specific ability of trazodone to cause inhibition of serotonin reuptake and its high affinity for some subtypes of serotonin receptors. Depending on their subtype, the interaction of trazodone is antagonistic or agonistic.
Trittico has a rapid effect on the somatic and mental symptoms of anxiety. Somatic symptoms of anxiety include sweating, hyperventilation, headache, muscle aches, palpitations, and frequent urination. Mental symptoms - fear, affective tension, insomnia, irritability.
In patients with depression, the drug is effective for sleep disorders, increases the duration and depth of sleep, and helps to restore its quality.
Trittico's action stabilizes the patient's emotional state, improves mood. In patients suffering from chronic alcoholism, during the period of alcohol withdrawal syndrome and remission, it causes a decrease in the pathological craving for alcohol. In case of withdrawal symptoms after the withdrawal of benzodiazepine derivatives, the use of trazodone is effective for the treatment of sleep disorders and anxiety-depressive conditions. During the period of remission, benzodiazepines can be completely replaced with Trittico.
Trittico has little effect on the neutral uptake of dopamine and norepinephrine, is not addictive and does not affect body weight.
Trazodone helps restore potency and libido, including in patients with depression.
Pharmacokinetics
After taking Trittico inside, trazodone is well absorbed from the gastrointestinal tract (GIT). The time to reach the maximum plasma concentration (TC max) of trazodone is 1.5–2 hours. Simultaneous food intake decreases the rate of absorption and increases TC max.
Trazodone is absorbed into tissues and fluids, including breast milk, bile, and saliva.
Plasma proteins bind 89–95% of the dose taken.
It is metabolized in the liver with the formation of an active metabolite - 1-m-chlorophenylpiperazine. According to research results, it is believed that metabolism mainly occurs with the participation of the isoenzyme of cytochrome P 450 (isoenzyme CYP3A4).
The half-life is 3-6 hours, in the second phase - 5-9 hours.
It is excreted to a greater extent in the form of metabolites, through the kidneys - about 75%, with bile - about 20%. Completely excreted 98 hours after ingestion.
Indications for use
- depressive conditions due to prolonged pain syndrome;
- psychogenic depression, including reactive and neurotic;
- involutional depression and other anxiety-depressive states of endogenous etiology;
- alcoholic depression;
- anxiety and depressions arising from organic disorders of the central nervous system (CNS) - cerebral atherosclerosis, dementia, Alzheimer's disease;
- benzodiazepine dependence;
- disorder of libido or potency, including against the background of depressive conditions.
Contraindications
- isomaltase (sucrase) deficiency, glucose-galactose malabsorption syndrome, fructose intolerance;
- intoxication due to alcoholism and hypnotics;
- period of pregnancy;
- breast-feeding;
- age up to 6 years;
- hypersensitivity to the components of the drug.
According to the instructions, Trittico should be prescribed with caution for arterial hypertension, atrioventricular block (AV block), ventricular arrhythmia, myocardial infarction (early recovery period), hepatic and / or renal failure, history of priapism, under the age of 18 years.
Instructions for use of Trittico: method and dosage
Trittico tablets are taken orally, swallowed whole, washed down with a sufficient amount of water, 0.5 hours before or 2-4 hours after a meal.
Recommended dosage of Trittico:
- depression with and without anxiety: the initial dose is 100 mg once at bedtime. After three days of therapy, the dose can be increased to 150 mg. Further, until the optimal clinical effect is achieved, the dose should be increased by 50 mg every 3-4 days. If the daily dose exceeds 150 mg, then it should be divided into 2 doses: after lunch, a smaller dose is taken, before bedtime, the main dose. Maximum daily dose: for outpatients - 450 mg, for inpatients - 600 mg;
- impotence treatment: monotherapy - more than 200 mg per day, in combination therapy - 50 mg per day;
- treatment of libido disorders: 50 mg per day;
- benzodiazepine dependence: according to the scheme, which provides for a simultaneous decrease in the dose of benzodiazepine by 1/4 or 1/2 tablet and an increase in the dose of trazodone by 50 mg, it is taken within 21 days. Then continue to gradually reduce the dose of benzodiazepines, each time increasing the dose of trazodone. After the complete abolition of benzodiazepine, they begin to reduce the daily dose of trazodone by 50 mg with an interval of 21 days.
The initial dose of Trittico for debilitated and elderly patients should not exceed 100 mg per day. It is selected individually and prescribed once before bedtime or divided into two doses. Dose increases should be carried out under medical supervision, taking into account the effectiveness and tolerability of the drug. For this category of patients, it is not recommended to exceed the maximum daily dose of 300 mg.
For children aged 6 to 18 years, the dose is determined taking into account the weight of the child at the rate of 1.5–2 mg per 1 kg of body weight per day and divided into several doses. To achieve the desired therapeutic effect, the initial dose of Trittico can be gradually increased, observing an interval of 3-4 days. The maximum daily dose for children should not exceed 6 mg per 1 kg of body weight.
Side effects
- mental disorders: emotional instability, mania, confusion, hallucinations, phobias, delirium, suicidal thoughts, suicidal behavior;
- from the blood and lymphatic system: anemia, agranulocytosis, leukopenia, thrombocytopenia, eosinophilia;
- from the nervous system: impaired taste, insomnia or drowsiness, headache, dizziness, epileptic seizures, amnesia, tremors, paresthesia, convulsions;
- from the endocrine system: SNS ADH (syndrome of inadequate secretion of antidiuretic hormone);
- from the cardiovascular system: lowering blood pressure (BP), increased blood pressure, palpitations, tachycardia, ventricular extrasystoles, bradycardia, prolongation of the QT interval, ventricular paroxysmal tachycardia, loss of consciousness;
- from the immune system: allergic reactions;
- from the gastrointestinal tract: dry mouth, nausea, vomiting, diarrhea, increased salivation, abdominal pain, dyspepsia, paralytic intestinal obstruction;
- from the reproductive system: priapism;
- from the musculoskeletal and connective tissue: arthralgia, myalgia;
- from the urinary system: violation of urination;
- dermatological reactions: sweating, itching, erythematous rash;
- others: fever, weakness, flu-like syndrome, fatigue.
Overdose
Symptoms: nausea, vomiting, drowsiness, dizziness, respiratory failure, cardiovascular function (including prolongation of the QT interval, bradycardia, tachycardia), hypotension, convulsions, hyponatremia, coma. Symptoms may appear within 24 hours or more after an overdose.
Treatment: there is no specific antidote. Immediately (preferably within the first hour) after taking an ultra-high dose of Trittico, it is necessary to wash the stomach and take activated charcoal. Further, symptomatic and supportive therapy is prescribed.
special instructions
During depression, the risk of suicidal thoughts or behavior increases, including while taking antidepressants, especially before the age of 24. Therefore, before the onset of pronounced remission, patients need careful monitoring. If unusual changes in behavior appear, you should immediately seek the advice of your doctor.
When prescribing Trittico to patients with impaired cardiac conduction, AV blockade or after a recent myocardial infarction, the adrenolytic activity of trazodone and the risk of developing bradycardia and lowering blood pressure should be taken into account.
During the period of treatment, it is recommended to periodically conduct a peripheral blood test, including when sore throat appears when swallowing or fever. This will make it possible to diagnose agranulocytosis in a timely manner and establish cases of severe leukopenia.
The absence of anticholinergic action in Trittico allows its appointment in case of prostatic hypertrophy, angle-closure glaucoma, impaired cognitive functions, and elderly patients.
If, while taking the pills, the patient develops a prolonged and inadequate erection, it is necessary to consult a doctor.
Drinking alcohol is contraindicated while taking Trittico.
Influence on the ability to drive vehicles and complex mechanisms
Trittico has a weak sedative effect, which can negatively affect the patient's ability to concentrate and reduce the speed of his psychomotor reactions. In this regard, during the period of treatment, it is necessary to abandon the performance of potentially hazardous activities, including the management of vehicles and complex mechanisms.
Application during pregnancy and lactation
The use of Trittico is contraindicated during gestation and lactation.
Pediatric use
The use of Trittico is contraindicated for the treatment of children under 6 years of age.
Special care should be taken when prescribing Trittico to patients under the age of 18.
At the age of 6 to 18 years, the dose is prescribed, taking into account the patient's weight, at the rate of 1.5-2 mg per 1 kg of body weight per day and divided into several doses. If necessary, the initial dose can be gradually increased, observing an interval of 3-4 days. The maximum daily dose should not exceed 6 mg per 1 kg of body weight.
With impaired renal function
Trazodone should be used with caution in renal failure.
For violations of liver function
Trazodone should be used with caution in liver failure.
Use in the elderly
For elderly patients, the initial daily dose of Trittico is selected individually, it should not exceed 100 mg. It is taken once before bedtime or divided into two doses. Dose escalation should be carried out under medical supervision, taking into account the effectiveness and tolerability of trazodone. It is not recommended to exceed the maximum daily dose of 300 mg.
Drug interactions
With the simultaneous use of Trittico:
- carbamazepine: may cause a decrease in the concentration of trazodone in the blood plasma;
- ketoconazole, ritonavir, fluoxetine, indinavir (inhibitors of cytochrome P450 CYP3A4): can cause a significant increase in the content of trazodone in the blood plasma, increasing the risk of adverse events. Consideration should be given to dose reduction of trazodone when combined with potent CYP3A4 inhibitors;
- antihypertensive drugs: can increase their effect, therefore, consideration should be given to lowering their dose;
- clonidine, methyldopa and other drugs that depress the central nervous system: may increase their effect;
- antihistamines and anticholinergic drugs: cause an increase in the anticholinergic effect of trazodone;
- tricyclic antidepressants, loxapine, maprotiline, haloperidol, phenothiazine, thioxanthene, pimozide: there is an increase and prolongation of the period of their sedative and anticholinergic effects;
- MAO inhibitors: increase the risk of developing unwanted effects of trazodone;
- digoxin, phenytoin: the level of their concentration in blood plasma increases.
Analogs
Trittico analogs are: Amitriptyline, Velaksin, Venlaxor, Mirtastadin, Melitor, Mirzaten, Prefaxin.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Trittico
Reviews about Trittico are controversial. Some patients indicate the effectiveness of the drug, normalization of sleep and good tolerance.
There are many negative reviews of patients in whom the use of Trittico caused the development of severe side effects.
Doctors report that they often face complaints from patients about a decrease in libido, an increase in blood pressure, and an increase in body weight.
The price of Trittico in pharmacies
The price of Trittico for a package containing 20 tablets in a dose of 150 mg can range from 648 to 815 rubles.
Trittico: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Trittico 150 mg controlled release tablets 20 pcs. 749 RUB 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!
