Trittyko: instructions for use, analogues and reviews, prices in pharmacies of Russia. Analogs of antidepressant Trittyko: review of similar effects Analog Trittico is cheaper
Composition and form of release
in a PVC blister / aluminum foil 10 pcs.; In a pack of cardboard 2 or 6 blisters.
Description of the dosage form
Two-screwed white or white tablets with a yellowish color shade, oval shape with two parallel risks on both sides.
pharmachologic effect
pharmachologic effect - Antidepressive.Pharmacodynamics
Trazodon, being derived triazolopyridine, has a predominantly antidepressant effect, with some sedative and anxiolytic effect. Trazodon does not affect Mao, which distinguishes it from mao inhibitors, tricyclic antidepressants.
Quickly affects mental (affective tension, irritability, fear, insomnia) and somatic symptoms of anxiety (heartbeat, headache, muscle pain, stripped urination, sweating, hyperventilation).
Trazodon is effective in sleep disorders in patients with depression, increases the depth and duration of sleep, restores its physiological structure and quality.
Trazodon stabilizes the emotional state, improves the mood, reduces the pathological attraction to alcohol in patients suffering from chronic alcoholism during the period of alcohol abstinence syndrome, also in remission. With an abstinence syndrome in patients suffering from dependence on benzodiazepine derivatives, trazodon is effective in the treatment of anxious-depressive states and sleep disorders. During the remission, benzodiazepines can be completely replaced by trazodone.
The drug is not addictive.
He contributes to the restoration of libido and potency, both in patients with depression and people who do not suffer from depression.
The mechanism of the actions of the trazodone is associated with high affinity of the drug to some subtypes of serotonin receptors, with which the trazodon enters into antagonistic or agonistic interaction depending on the subtype, as well as with a specific ability to cause inhibiting serotonin injecting.
On the neutral capture of norepinephrine and dopamine affects little.
The drug does not affect body weight.
Pharmacokinetics
Absorption of the drug from the gastrointestinal tract after taking inside is high. Tourzodone receiving during or immediately after eating slows the absorption speed, reduces C Max drug in blood plasma and increases T MAX. T MAX drug is achieved in 1/2 and 2-2 hours after intake.
The drug penetrates through histohematic barriers, as well as in tissue and liquid (bile, saliva, breast milk).
Binding with plasma proteins - 89-95%.
Trazodon is metabolized in the liver, active metabolite - 1-M-chlorofenylpiperazine. T 1/2 in the first phase is 3-6 hours, in the second phase - 5-9 hours. The excavation of most of the metabolized drug is carried out through the kidneys, with urine (about 75%) and completely ends 98 hours after taking the drug, with biliary About 20% are displayed.
Research in vitro. On human microsomes showed that the trazodon is mainly metabolized by cytochrome P450 CYP3A4.
Indications of the drug Tittiko
anxious and depressive states of endogenous nature (including involutional depression);
psychogenic depression (including reactive and neurotic depressed);
alarming-depressive states against the background of organic diseases of the central nervous system (Dementia, Alzheimer's disease, atherosclerosis of the brain vessels);
depressive conditions with prolonged pain syndrome;
alcoholic depressed;
benzodiazepic dependence;
libido disorders and potency (including erectile dysfunction with depressive states).
Contraindications
increased sensitivity to the drug;
pregnancy period;
lactation period;
children's age up to 6 years.
Carefully The drug should be prescribed to patients with AV blockade, myocardial infarction (early recovery period), arterial hypertension (the correction of the doses of hypotensive drugs), ventricular arrhythmia, priapism in history, renal and / or liver failure may be required. Patients under the age of 18, due to the possibility of developing the risk of suicidal behavior (suicidal plans, aggressiveness, a tendency to contradiction, anger).
Application in pregnancy and breastfeeding
Side effects
From the CNS: Increased fatigue, drowsiness, excitement, headache, dizziness, weakness, Malgy, Discordination, paresthesia, disorientation, tremor.
From the side of the SCC and the hematopoietic system: reduction of blood pressure, orthostatic hypotension due to adrenolytic action (especially in persons with vasomotor lability), arrhythmia, conduction disorder, bradycardia; leukopenia and neutropenia (usually minor) ..
From the gearbox: Dry and bitterness in the mouth, nausea, vomiting, diarrhea, decreased appetite.
Others: Allergic reactions, eye irritation, priapism (should immediately stop taking the drug and consult a doctor).
Interaction
Trazodon can enhance the effect of some hypotensive drugs and usually requires a decrease in their doses.
Simultaneous appointment with drugs depressing the CNS (including clonidine, methyldop), enhances the effect of the latter.
Antihistamines and drugs with cholinolitic activity increase the anticholinergic effect of trazodone.
Trazodon enhances and lengthens the sedative and antiholinergic effects of tricyclic antidepressants, haloperidol, locked, maprotylin, phenothiazine, pimosydan and thioxanthine.
With the simultaneous purpose of the tricyclic antidepressant and trazodon, the capacular side effects may occur.
Mao inhibitors increase the risk of developing side effects.
With co-use, the concentration of digoxin and phenyotine in the blood plasma increases.
In vitro. The studies of the metabolism of the drug indicate the possibility of the pharmacological interaction of trazodone with P450 CYP3A4 cytochrome inhibitors, such as ketoconazole, ritonavir, indinavir and fluoxetine. CYP3A4 inhibitors can lead to a significant increase in plasma trazodone concentration, thereby increasing the likelihood of unwanted phenomena. Therefore, in the case of admission, in combination with potent inhibitors of CYP3A4, the dose of trazodone should be reduced.
When taking a trazodone in combination with carbamazepine, the plasma trazodone is reduced. Therefore, patients parallel to trazodone and carbamazepine must be under thorough observation.
Method of application and dose
Inside, 30 minutes before or 2-4 hours after meals. Tablets should be taken entirely, not chewing and drinking enough water.
The initial dose is 50-100 mg, once before bedtime. On the 4th day it is possible to increase the dose to 150 mg. Further increase in dosage should be made by 50 mg / day every 3-4 days, until the optimal dose is achieved. The daily dose of more than 150 mg must be divided into 2 receptions, and the smaller dose is taken after lunch, and the main one is before bedtime.
Maximum daily dose for outpatient patients - 450 mg, for stationary patients - 600 mg.
Children are 6-18 years old: the initial daily dose of 1.5-2 mg / kg / day, divided into several techniques. If necessary, the dose gradually (with an interval of 3-4 days) increases to 6 mg / kg / day.
Elderly and weakened patients: the initial dose of up to 100 mg / day in several techniques or once before bedtime. If necessary, an increase in dose (usually no more than 300 mg / day) is possible.
Treatment of erectile dysfunction: monotherapy - the recommended daily dose - 150-200 mg, combined therapy - 50 mg.
Treatment of benzodiazepine dependence: The recommended treatment diagram is based on the gradual, sometimes for several months, the dose reduction of benzodiazepine. Each time, reducing the benzodiazepine dose by 1/4 or 1/2 tab., At the same time, 50 mg of trazodone is added. This ratio is left unchanged for 3 weeks, then proceed to a further gradual decrease in the dose of benzodiazepines up to their complete cancellation. After that, reduce the daily dose of trazodone by 50 mg every 3 weeks.
Overdose
Symptoms: Nausea, drowsiness, arterial hypotension, freight and weighting of side effects.
Treatment: Conducting symptomatic therapy (stomach washing, forced diuresis). Specific antidote is absent.
special instructions
Since the drug has some adrenolytic activity, bradycardia is possible and reduced blood pressure. Therefore, caution should be taken when prescribing the drug patients with heart conduction disorders, AV blockade of varying degrees of severity, recently suffered myocardial infarction. With the use of trazodon, a certain decrease in leukocytes is possible, which does not require specific treatment, except in cases of pronounced leukopenia. Therefore, it is recommended to conduct studies of peripheral blood, especially if there is pain in the throat when swallowing and the appearance of fever.
The drug does not have an anticholinergic effect, therefore, it can be assigned to the elderly patients suffering from prostate hypertrophy, closed-curved glaucoma, violations of cognitive functions.
With the appearance of long and inadequate erections, you should consult a doctor.
The relevant research on the effectiveness of the use of the drug in pediatrics was not carried out, so the drug should be applied with caution in persons younger than 18 years old. Doses for children under 6 years old are not installed.
During treatment, it should be refrained from alcohol intake.
Impact on the ability to control vehicles, mechanisms. Since the drug has anxiolytic and sedative activity, it is possible to reduce attention and the reaction rate. During treatment, it is necessary to refrain from classes of potentially hazardous activities that require the concentration of attention and rapid psychomotor reactions.
Conditions of vacation from pharmacies
On prescription.
Conditions for the storage of the drug Tritico
At a temperature not higher than 25 ° C.Keep out of the reach of children.
The shelf life of Tritico
3 years. List B.Do not apply after the expiration date indicated on the package.
Synonyms of nosological groups
| Rubric ICB-10 | Synonyms for diseases of the ICD-10 |
|---|---|
| F32 depressive episode | Adamynic subdepression |
| ASTENA-ADINAMIC subdepressive states | |
| Astena-Depressive Disorder | |
| Astheno-depressive condition | |
| Astandepressive disorder | |
| Astandepressive state | |
| Big depressive disorder | |
| Validoapathic depression with intensity | |
| Double depression | |
| Depressive pseudo-degeneration | |
| Depressive disease | |
| Depressive mood violation | |
| Depressive disorder | |
| Depressive mood disorder | |
| Depressive condition | |
| Depressive disorders | |
| Depressive syndrome | |
| Depressive syndrome Larvocy | |
| Depressive syndrome in psychosis | |
| Depressed masked | |
| Depression | |
| Depression of depletion | |
| Depression with phenomena of inhibition in cyclotimia | |
| Depressed smiling | |
| Involutional depression | |
| Involutionary melancholy | |
| Involutionary depression | |
| Manico-depressive disorder | |
| Masked depressed | |
| Melancholic attack | |
| Neurotic depression | |
| Neurotic depression | |
| Shallow depression | |
| Organic Depression | |
| Organic depressive syndrome | |
| Simple depression | |
| Simple melancholic syndrome | |
| Psychogenic depression | |
| Reactive depression | |
| Reactive depression with moderately pronounced psychopathological symptoms | |
| Reactive depressive states | |
| Jet depressed | |
| Recurrent depression | |
| Seasonal depressive syndrome | |
| Senestopathic depression | |
| Seenyl depression | |
| Single depression | |
| Symptomatic depression | |
| Somatogenic depression | |
| Cylotimic depression | |
| Exogenous depression | |
| Endogenous depression | |
| Endogenous depressive states | |
| Endogenous depressed | |
| Endogenous depressive syndrome | |
| F52 Sexy dysfunction, not caused by organic disorders or diseases | Maintaining the sexual activity of men and women |
| Field weakness | |
| Sexual weakness in older men | |
| Libido disorders | |
| Potency disorders | |
| Sexual violations in men | |
| Reduced sexual attraction | |
| Functional disorders of the sexual sphere in men | |
| R52.2 Other Permanent Pain | Pain of irremium origin |
| Pain syndrome at vertebrogenic lesions | |
| Painful syndrome with neuralgia | |
| Painful syndrome with burns | |
| Painful syndrome weak or moderate | |
| Neuropathic pain | |
| Neuropathic pain | |
| Perioperative pain | |
| Moderate and pronounced pain | |
| Moderately or weakly expressed pain syndrome | |
| Moderate and strong pain syndrome | |
| Own pain | |
| Y47.1 Adverse reactions with therapeutic use of benzodiazepines | |
| Dependence on anxiolytic and sleeping pills | |
| Dependence on benzodiazepines | |
| Z50.2 Rehabilitation with alcoholism | Alcoholism during remission |
| Z50.3 Rehabilitation during drug addiction | Benzodiazepic addiction |
Trazodon inhibits the reverse neural seizure of serotonin, is an antagonist of serotonin 5-NT 2A / 2C -receptors and a block of α 1 -adrenoreceptors and has an antidepressive effect.
Pharmacokinetics
Suction
Trazodone absorption from the gastrointestinal tract after taking inside is high. Tourzodon receiving during or immediately after meals slows the absorption rate, reduces C Max drug in blood plasma and increases the maximum concentration time (TC MAX). C Max in the blood plasma is reached after 0.5-2 hours after taking inside.
Distribution
Trazodon penetrates through histohematic barriers in fabrics and liquids (bile, saliva, breast milk).
Binding with plasma proteins - 89-95%.
Metabolism
Trazodon is metabolized in the liver, active metabolite - 1-M-chlorofenylpiperazine.
In vitro studies on human microsomes have shown that the trazodon is mainly metabolized by the Cytochrome R450 (CYP3A4) isoenzymer.
Election
T 1/2 is 3-6 hours, in the second phase - 5-9 hours. The elimination of most of the metabolites of trazodone is carried out by the kidneys with urine - about 75%, and completely completes 98 hours after taking; With bile output about 20%.
Form release
Tablets of the prolonged effect of white or white with a yellowish color shade, oval, double-screwed, with two parallel risks on both sides.
Auxiliary substances: sucrose - 84 mg, Karnubskiy wax - 24 mg, povidone - 24 mg, magnesium stearate - 6 mg.
10 pieces. - Blisters (2) - packs cardboard.
10 pieces. - Blister (6) - Cardboard packs.
Dosage
Tablets should be taken inside 30 minutes before meals or 2-4 hours after meals. Tablets should be taken entirely, not chewing and drinking enough water.
The initial dose of the drug: 100 mg, is accepted once before bedtime after meals. On the 4th day, you can increase the dose to 150 mg. Further increase in the dose to achieve an optimal therapeutic effect should be made by 50 mg / day every 3-4 days until the optimal dose is achieved.
The daily dose of more than 150 mg must be divided into 2 receptions, and a smaller dose is taken after lunch, and the main one is before bedtime.
Maximum daily dose for outpatient patients - 450 mg.
Maximum daily dose for stationary patients - 600 mg.
For older and weakened patients, the initial dose of up to 100 mg / day in fractional doses or once before bedtime. The dose can be increased under the supervision of the doctor, depending on the efficiency and tolerance of the drug. Usually no dose is required exceeding 300 mg / day.
Overdose
Symptoms: drowsiness, dizziness, nausea, vomiting. In more severe cases - coma, tachycardia, arterial hypotension, hyponatremia, convulsions, respiratory disruption, violation of the function of the cardiovascular system (the elongation of the Qt interval, bradycardia). After overdose, the symptoms may appear within 24 hours or more.
Treatment: there is no specific antidote of trazodone. In cases of overdose, it is necessary to wash the stomach and assign activated carbon for 1 h after taking the drug. Conduct symptomatic and supporting treatment.
Interaction
Trazodon can enhance the effect of some hypotensive drugs, which may require reduction of their doses.
Simultaneous use with drugs depressing the CNS (including clonidine, methyldop), enhances the effect of the latter.
Blockers of histamine H 1 -receptors and drugs with cholinolitic activity increase the anticholinergic effect of trazodon.
Trazodon enhances and lengthens the sedative and anticholinergic effects of tricyclic antidepressants, haloperidol, locked, maprotylin, phenothiazine, pymoside and thiocantne.
With the simultaneous use of tricyclic antidepressants and trazodon, the occurrence of cardiovascular side effects.
Mao inhibitors increase the risk of developing side effects of trazodone.
With co-use, the concentration of digoxin and phenyotine in the blood plasma increases.
In Vitro studies of the drug, the drug metabolism indicate the possibility of pharmacological interaction of trazodone with inhibitors of CYP3A4 isoenzyme, such as ketoconazole, rhythonavir, indinavir, fluoxetine. The use of CYP3A4 inhibitors can lead to a significant increase in plasma trazodone concentration, thereby increasing the likelihood of unwanted phenomena. Therefore, in the case of simultaneous use with potent inhibitors of CYP3A4, the dose of trazodon should be reduced.
After taking a trazodon in combination with carbamazepine, the plasma trazodone concentration is reduced. Therefore, patients taking traxadon and carbamazepine simultaneously must be under careful observation.
Side effects
Trittyko can cause side effects, although they do not arise from all patients.
From the hematopolosis system: agranulocytosis, thrombocytopenia, eosinophilia, leukopenia, anemia.
From the immune system: allergic reactions.
From the endocrine system: syndrome inadequate secretion ADG.
Violations of psyche: suicidal thoughts or suicidal behavior, confusion, mania, phobia, emotional instability, delirium, hallucinations.
From the nervous system: epileptic seizures, dizziness, headache, insomnia or drowsiness, amnesia, tremor, convulsions, paresthesia, violation of taste sensations.
From the side of the cardiovascular system: a feeling of heartbeat, tachycardia, bradycardia, ventricular extrasystoles, ventricular paroxysmal tachycardia, the elongation of the Qt interval, an increase in blood pressure, lowering hell, fainting.
From the digestive system: dry mouth, nausea, vomiting, dyspepsia, abdominal pain, increased salivation, paralytic intestinal obstruction.
From the side of the skin and subcutaneous fabrics: itching, erythematous rash, sweating.
On the part of the musculoskeletal system: Malgy, Arthralgia.
From the urinary system: impairment of urination.
On the part of the genital organs and breasts: Priapism (patients who have given a side effect, should immediately stop taking the drug and consult a doctor).
Others: Increased fatigue, weakness, body temperature, influencing syndrome.
Indications
- depression with anxiety or without it.
Contraindications
- alcoholic intoxication and intoxication with sleeping preparations;
- pregnancy;
- lactation period;
- children's and adolescent age up to 18 years old (the safety of trazodone for children is not installed);
- sakaraz / isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption syndrome (because the drug contains sucrose);
- increased sensitivity to the components of the drug.
Caution should be prescribed to patients with AV blockade, myocardial infarction (early recovery period), arterial hypertension (the correction of the doses of hypotensive drugs), ventricular arrhythmia, priapism in history, renal and / or hepatic failure may be corrected.
Features of application
Application in pregnancy and breastfeeding
The drug is contraindicated to use during pregnancy and during lactation (breastfeeding).
Application with violations of liver function
With caution should be prescribed to patients with hepatic insufficiency.Application with violations of the kidney function
Caution should be prescribed to patients with renal failure.Application in children
The use of the drug in children's and adolescent age up to 18 years has contraindicated (the safety of trazodone for children is not installed).
Application in elderly patients
For older and weakened patients, the initial dose is up to 100 mg / day in fractional doses or 1 time / day before bedtime. The dose can be increased under the supervision of the doctor, depending on the efficiency and tolerance of the drug. Usually no dose is required exceeding 300 mg / day.special instructions
With depressive states, the risk of manifestations of suicidal thoughts, making harm or suicide is increased. The risk can last before the emergence of pronounced remission. Since the improvement may not come during the first few weeks of treatment or more, patients must be under strict control before such an improvement. According to the general clinical experience, the risk of suicide can rise in the early stages of recovery. It is known that patients with suicidal events in history, or patients who exhibit a significant degree of suicidal thinking before treatment, have a higher risk of suicidal thoughts or suicide attempts, and should be under thorough observation during treatment. The results of the meta-analysis of placebo-controlled clinical studies of antidepressants, which are used in adults with mental disorders, showed an increased risk of suicidal behavior in patients under the age of 24 against the background of receiving antidepressants in comparison with placebo. Careful observation of patients, especially having a high risk, must accompany the medicinal therapy, especially in its early stages and after changing the dose. It is necessary to prevent patients (and caring for them) about the need to track any clinical deterioration of the state, suicidal behavior or suicidal thoughts, unusual behavior changes, and immediately apply for consultation to a specialist when such symptoms appear.
Since the drug has some adrenoblocking activity, bradycardia is possible and reduced blood pressure. Therefore, care should be taken when prescribing the drug to patients with a tendency to lengthen the Qt interval, AV blockade of varying degrees of severity, patients with recent myocardial infarction.
In the treatment of trazodone in patients with bipolar disorder, depressive attacks can vary from manico-depressive to manic psychosis. In these cases it is necessary to interrupt treatment.
In epilepsy, trazodon should be taken with caution, in particular avoiding sharp increases or dose reductions.
With the simultaneous use of trazodon with preparations with serotonergic activity (tricyclic, selection of serotonin reverse seizure inhibitors, inhibitors of norepinephrine and serotonin and Mao inhibitors), and neuroleptics, the occurrence of serotonin syndrome is possible.
With the simultaneous use of trazodone with preparations containing John's jungle, side effects may be more frequent.
With the use of trazodone, agranulocytosis is possible, therefore it is recommended to conduct studies of peripheral blood, especially if there are pain in the throat when swallowing and the appearance of fever.
Trazodon is effective in sleep disorders in patients with depression, increases the depth and duration of sleep, restores its physiological structure and quality.
The use of the drug does not affect body weight.
The drug is not addictive.
Impact on the ability to driving vehicles and control mechanisms
During the use of the drug, care must be taken when operating by vehicles and classes by other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.
Trittyko is an antidepressant from a group of triazolopyridine, used to treat various depressive disorders. Active substance - Trazodone (Trazodone).
The mechanism of exposure to trazodone is due to the high affinity of the drug to separate subspecies of serotonin receptors. It is with these subspecies of serotonin receptors that trazodon enters into agonistic or antagonistic interaction.
The drug has anxiolytic activity, has a sedative effect. Trazodon eliminates the pathogenetic cause of depression - the lack of serotonin, due to this, it has an antidepressive effect, eliminates affective tensions, removes the feeling of fear, speeds up.
Trittyko effectively removes tachycardia, headache, Malgia and other somatic symptoms of increased anxiety, restores sleep. During therapy, there is a stabilization of an emotional state, a decrease in attachment to alcohol with an abstineent syndrome, facilitating the refusal of benzodiazepines during the remission.
C care is used by the preparation for diseases of the heart, arterial hypotension, arterial hypertension, renal and / or liver failure. During treatment, it should be refrained from alcohol intake.
Indications for use
Why do you need Trittyko? According to the instructions, the drug is prescribed in the following cases:
- anxious and depressive states of endogenous nature (including involutional depression);
- psychogenic depression (including reactive and neurotic depressed);
- alarming-depressive states against the background of organic diseases of the central nervous system (Dementia, Alzheimer's disease, atherosclerosis of the brain vessels);
- depressive conditions with prolonged pain syndrome;
- alcoholic depressed;
- benzodiazepic dependence;
- libido disorders and potency (including erectile dysfunction with depressive states).
Trittico, dosage instructions
Tablets are advisable to take a few hours after meals. The usual time of reception is before bedtime.
The initial daily dosage is 1-2 Tattico Tablets 50 mg, which is accepted in one admission before bedtime. The dose can then be increased to 150-200 mg, which must be divided into 3 receptions.
With light shapes of depression, the average supporting dose is 1 TITICO Tablet 150 mg \\ 1 times a day. With moderate and severe forms - 300 mg / day.
If necessary, the dose can be increased to 600 mg per day. At the same time, the main part is recommended to take before bedtime.
For the treatment of libido - 50 mg per day, and to improve the erectile function - 150-200 mg per day.
- Maximum daily dose for outpatient patients - 450 mg.
- Maximum daily dose for stationary patients - 600 mg.
The therapy of the drugs on the drugs of benzodiazepine row is to slowly increase the doses of trazodone in parallel with the reduction of the doses of benzodiazepines in the following ratio: for each addition of daily dosage of the drug by 50 mg, a decrease in the dose of benzodiazepine to a quarter of a tablet.
Such recalculation of dosages spend every three weeks. After the moment when the dosage of benzodiazepine is zero, treatment is continued with reduction of doses of trazodone. The decrease in daily doses of Trittyko is carried out every three weeks by 50 mg.
Side effects
The instruction warns the possibility of the development of the following side effects when appointing Triothico:
- from the side of the nervous system - fatigue, dizziness, excitement, headache, Malgy, weakness, paresthesia, tremor;
- from the side of blood circulation and blood formation systems - orthostatic hypotension, bradycardia, decrease in pressure, conduction disorder, arrhythmia; neutropenia and leukopenia;
- from the digestion system - nausea, dry mouth, diarrhea;
- other - eye irritation, allergic reactions.
Contraindications
Contraindicated to assign Tritico in the following cases:
- chronic alcoholism;
- alcohol poisoning or sleeping preparations;
- pregnancy and breastfeeding period;
- age up to 18 years;
- individual intolerance to the drug.
Prescribed with caution in such states:
- atrioventricular blockade;
- recently suffered myocardial infarction (less than 3 months ago);
- heart arrhythmia in ventricular type;
- renal or liver failure;
- arterial hypertension.
Overdose
Signs of overdose are clinically expressed by the strengthening of side effects, arterial hypotension, a comatose state, a violation by the heart and blood vessels, severe bradycardia.
When symptoms of overdose, the reception of the medication should stop and consult a doctor. Treatment of overdose is to wash the stomach, appointing enterosorbents and conducting symptomatic therapy.
Tritico analogues, price in pharmacies
If necessary, it is possible to replace Trittico on analogue on therapeutic action - these are drugs:
- Glyciside;
- Pantogam.
By the ATX code:
- Azona.
Choosing analogues It is important to understand that the instructions for the use of Tritico, the price and reviews for drugs of similar action do not apply. It is important to obtain a doctor's advice and not to produce an independent replacement of the drug.
Price in the pharmacies of Russia: Tyttyko tablets 150 mg 20 pcs. - from 625 to 670 rubles.
Store in a dark place at a temperature not higher than 25 ° C. Shelf life - 3 years. In pharmacies, sales of a doctor's prescription.
Trittyko: instructions for use and reviews
Trittyko - antidepressant.
Release form and composition
Drug form Triothico - Tablets of prolonged action (controlled release tablets): White with a yellow tinge or white color, double-screwed, oval, on both sides are dividing risk (in blisters: 150 mg - 10 pcs, in a cardboard pack 2 or 6 blisters; 20 pcs, in a cardboard pack 1 or 3 blisters; 75 mg - 15 pcs., In a cardboard pack 2 blister; 30 pcs, in a cardboard pack 1 blister).
In 1 tablet contains:
- active substance: trazodone hydrochloride - 75 mg or 150 mg;
- auxiliary components: Sakhares, Plumon (Polyvinylpyrrolidone), Karnubsky wax, magnesium stearate.
Pharmacological properties
Pharmacodynamics
Tritico - a drug with antidepressant action and a minor anxiolytic and sedative effect. Its active substance is trazodon, is a derivative of triazolopyridine. Unlike Mao inhibitors (monoaminoxidase) and tricyclic antidepressants, it does not affect MAO.
The mechanism of action of the drug is due to the specific ability of the trazodone to cause inhibiting serotonin injecting and its high affinity to some subtypes of serotonin receptors. Depending on their subtype, the interaction of trazodon is antagonistic or agonistic.
Trittyko has a rapid effect on somatic and mental symptoms of anxiety. The somatic symptoms of anxiety include increased sweating, hyperventilation, headache, muscle pain, heartbeat, frequent urination. To mental symptoms - fear, affective tension, insomnia, irritability.
In patients with depression, the drug is effective in sleep disorders, increases the duration and depth of sleep, contributes to the restoration of its quality.
The effect of Trittico stabilizes the emotional state of the patient, improves the mood. In patients suffering from chronic alcoholism, during the alcohol abstinence syndrome and remission causes a decrease in pathological thrust to alcohol. With an abstineent syndrome, which occurred after the abolition of benzodiazepine derivatives, the use of trazodon is effectively for the treatment of sleep disturbance and anxious-depressive states. During the remission, the reception of benzodiazepines can be completely replaced by Trittico.
Trittico has a weak effect on the neutral capture of dopamine and norepinephrine, does not cause addiction and does not affect the weight of the body.
Trazodon contributes to the restoration of potency and libido, including patients with depression.
Pharmacokinetics
After receiving Trittico inside, the trazodon is well absorbed from the gastrointestinal tract (gastrointestinal tract). The time of achieving the maximum concentration (TC MAX) of trazodone in the blood plasma is 1.5-2 hours. Simultaneous meal reduces the absorption speed and increases TC MAX.
Trazodon penetrates tissue and liquid, including breast milk, bile, saliva.
Plasma proteins are associated with 89-95% of the adopted dose.
Metabolized in the liver with the formation of an active metabolite - 1-M-chlorofenylpiperazine. According to research results, it is believed that metabolism mainly occurs with the participation of the cytochrome of the p 450 (CYP3A4 isoenzyme).
The half-life is 3-6 hours, in the second phase - 5-9 hours.
It is derived to a greater extent in the form of metabolites, through the kidneys - about 75%, with bile - approximately 20%. Fully output 98 hours after taking.
Indications for use
- depressive states due to long pain syndrome;
- psychogenic depression, including jet and neurotic;
- involutionary depression and other anxious-depressive states of endogenous etiology;
- alcoholic depressed;
- anxious-depressive states arising from organic disorders of the central nervous system (CNS) - atherosclerosis of brain vessels, dementia, Alzheimer's disease;
- benzodiazepic dependence;
- libido disorder or potency, including on the background of depressive states.
Contraindications
- deficiency of isomaltase (sugar), glucose-galactose malabsorption syndrome, fructose intolerance;
- intoxication due to alcoholism and hypnotics;
- pregnancy period;
- breast-feeding;
- age up to 6 years;
- hypersensitivity to the components of the drug.
According to the instructions, it is necessary to prescribe with caution with arterial hypertension, an atrioventricular blockade (AV-block), ventricular arrhythmia, myocardial infarction (early recovery period), hepatic and / or renal failure, rechain a history of 18 years.
Trittico instructions: Method and dosage
Titchico tablets are taken inside, swallowing entirely, drinking enough water, 0.5 hours before or 2-4 hours after meals.
- depressed with anxiety and without it: the initial dose is 100 mg once before bedtime. After three days, the dose therapy can be increased to 150 mg. Further, until the optimal clinical effect is achieved, the increase in the dose should be made by 50 mg every 3-4 days. If the daily dose exceeds 150 mg, then it should be divided into 2 reception: after lunch, a smaller dose is taken, the main one is taken before bedtime. Maximum daily dose: for outpatient patients - 450 mg, for patients in the hospital - 600 mg;
- treatment of impotence: monotherapy - more than 200 mg per day, as part of combination therapy - 50 mg per day;
- treatment of libido disorders: 50 mg per day;
- benzodiazepic dependence: according to the scheme, which provides for a simultaneous decrease in the dose of benzodiazepine per 1/4 or 1/2 tablet and an increase in 50 mg of a tour of the trazodon, take within 21 days. Then continue to gradually reduce the dose of benzodiazepines, each time increasing the dose of trazodon. After complete cancellation of benzodiazepine, it is embarrassed to lower the daily dose of trazodone by 50 mg with an interval of 21 days.
The initial dose of Tittico for weakened and elderly patients should be no more than 100 mg per day. It is selected individually and prescribed once before bedtime or divide on two receptions. The increase in the dose should be carried out under the supervision of a doctor, 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 divide it into several techniques. To achieve the desired therapeutic effect, the initial dose of Trittico can gradually increase, observing the interval at 3-4 days. The maximum daily dose for children should not exceed 6 mg per 1 kg body weight.
Side effects
- psyche disorders: emotional instability, mania, state of confused, hallucinations, phobias, delirium, suicidal thoughts, suicidal behavior;
- from the side of the blood and lymphatic system: anemia, agranulocytosis, leukopenia, thrombocytopenia, eosinophilia;
- from the nervous system: violation of taste sensations, insomnia or drowsiness, headache, dizziness, epileptic seizures, amnesia, tremor, paresthesia, convulsions;
- from the endocrine system: ADG SNS (inadequate secretion syndrome of antidiuretic hormone);
- from the side of the cardiovascular system: decrease in blood pressure (AD), increased blood pressure, heartbeat, tachycardia, ventricular extrasystoles, bradycardia, elongation of the Qt interval, ventricular paroxysmal tachycardia, loss of consciousness;
- from the immune system: allergic reactions;
- from the head of the gastrointestinal tract: dry mouth, nausea, vomiting, diarrhea, increased salivation, abdominal pain, dyspepsia, paralytic intestinal obstruction;
- from the gender system: Priapism;
- from skeletal and muscular and connective tissue: arthralgia, Malgy;
- from the urinary system: impaired urination;
- dermatological reactions: sweating, itching, erythematous rash;
- others: Increased body temperature, weakness, influenza-like syndrome, increased fatigue.
Overdose
Symptoms: nausea, vomiting, drowsiness, dizziness, respiratory impairment, cardiovascular function (including the elongation of Qt interval, bradycardia, tachycardia), hypotension, convulsions, hyponatremia, coma. Symptoms can manifest themselves within 24 or more hours after overdose.
Treatment: Specific antidote is absent. Immediately (preferably during the first hour) after taking a ultra-high dose of Trittico, it is necessary to rinse the stomach, take activated coal. Next are prescribed symptomatic and supportive therapy.
special instructions
During the depression, the risk of manifestation of suicidal thoughts or behavior increases, including against the background of taking antidepressants, especially under the age of 24 years. Therefore, before the onset of pronounced remission, patients need careful observation. With the appearance of unusual changes in behavior, immediately apply for advice to the attending physician.
When appropriately patients with heart conduction disorders, AV blockade, or after a recently suffered myocardial infarction should take into account the adrenolytic activity of trazodon and the risk of developing bradycardia and decreased blood pressure.
During the treatment period, it is recommended to periodically analyze peripheral blood, including when pain in the throat when swallowing or fever. This will allow to diagnose agranulocytosis and establish cases of development of pronounced leukopenia.
The lack of anticholinergic anticholinergic effect allows its purpose with prostate hypertrophy, a closed-curved glaucoma, violation of cognitive functions, elderly patients.
If, on the background of receiving tablets, a continuous and inadequate erection appears in the patient, it is necessary to consult a doctor.
Alcohol use is contraindicated during the Trittico reception period.
Impact on the ability to control vehicles and complex mechanisms
Trittyko has a weak sedative effect, which can adversely affect the ability of patient to concentrate attention and reduce the speed of its psychomotor reactions. In this regard, during the treatment period, it is necessary to abandon the implementation of potentially hazardous activities, including management of vehicles and complex mechanisms.
Application during pregnancy and lactation
Contraindicated the use of Tritico during the period of beating and lactation.
Childcare
It is contraindicated to the use of Tritico for the treatment of children under the age of 6 years.
Special caution should be observed when appointing Triothico patients under the age of 18 years.
At the age of 6 to 18 years, the dose is prescribed, given the weight of the patient, at the rate of 1.5-2 mg per 1 kg of body weight per day and divide it into several techniques. If necessary, the initial dose can be gradually increased by observing the interval at 3-4 days. The maximum daily dose should not exceed 6 mg per 1 kg of body weight.
With violations of the kidney function
With caution, trazodon should be taken with renal failure.
When violations of the liver function
With caution, trazodon should be taken with liver failure.
Application in old age
For the elderly patients, the initial daose dose of the drug Tittyko is selected individually, it should not exceed 100 mg. It is taken once before bedtime or divided into two receptions. The increase in the dose should be carried out under the supervision of the doctor, taking into account the efficiency and tolerability of the trazodon. It is not recommended to exceed the maximum daily dose of 300 mg.
Medicinal interaction
With the simultaneous use of Trittyko:
- carbamazepine: can cause a decrease in the concentration of trazodone in blood plasma;
- ketoconazole, ritonavir, fluoxetine, indinavir (cytochrome inhibitors P450 CYP3A4): can cause a significant increase in blood plasma content, increasing the risk of developing undesirable phenomena. It should be considered a reduction in the dose of trazodone when combined with potent CYP3A4 inhibitors;
- hypotensive means: can enhance their action, so it should be considered to reduce their dose;
- klonidin, Methyldop and other drugs, depressing CNS: can enhance their action;
- antihistamines and anticholinergic drugs: cause an increase in the anticholinergic effect of trazodon;
- tricyclic antidepressants, locked, maprotilin, haloperidol, phenothiazine, thiochanten, pimozide: reinforcement and extension of the period of their sedative and anticholinergic effects;
- inhibitors of MAO: contribute to increasing the risk of developing the unwanted actions of trazodone;
- digoxin, phenytoin: The level of their concentration in the blood plasma increases.
Analogs
Analogues of Trittyko are: amitriptyline, Velaxin, Velanxor, Myrtastadin, Melitor, Mirzenten, Prefaxing.
Terms and conditions of storage
Take care of children.
Store at temperatures up to 25 ° C.
Shelf life - 3 years.
International Name
Trazodone (Trazodone)Group Affiliation
AntidepressantDosage form
Controlled Release Tabletspharmachologic effect
Antidepressive agent, tiazolopyridine derivative; It has a thymoleptic, anxiolytic, sedative and miorylaxing effect. Has a high affinity for some subtypes of serotonin receptors, suppresses the reverse seizure of serotonin; On the neuronal capture of norepinephrine and dopamine affects little. It does not have anticholinergic action, does not inhibit Mao, does not change body weight. Eliminates both mental (affective tension, irritability, fear, insomnia) and somatic manifestations of anxiety (heartbeat, headache, myalgia, stripped urination, enhanced sweating). Increases the depth and duration of sleep in patients in a state of depression, restores its physiological structure. Reduces pathological attraction to ethanol. Effective with an abstineent syndrome in patients with drug dependence on the anxiolytic drugs of a benzodiazepine structure, eliminates an alarming-depressive state and sleep disorder (during the remission of benzodiazepine can be completely replaced by trazodon). Does not find it. Promotes libido restoration and potency.
The therapeutic effect in 50% of patients is observed after 3-7 days, in 25% - after 2-4 weeks.
Indications
Various forms of depression (endogenous, psychotic, neurotic, somatogenic) incl. With pronounced anxiety, including at least 4 of the following signs: sleep disorders, appetite, psychomotor assessment or inhibition, a decline in interest in the surrounding, reduced sexual activity, a sense of guilt, increased fatigue, slowdown in thinking, reduce the ability to concentrate attention, suicidal attempts / thoughts ; Bulimia, kleptomania, anxiety, phobias.
Benzodiazepic drug addiction; Acute alcohol abstineent syndrome.
Reducing libido, impotence.
Prevention of migraine attacks.
Contraindications
Hypersensitivity, pregnancy, lactation period, ventricular arrhythmia, tachycardia, myocardial infarction (early recovery period), priapism in history. Caution. Heart diseases, arterial hypotension, arterial hypertension (correction of the dosing regime of hypotensive drugs due to possible hypotensive action), renal and / or liver failure, age up to 18 years.Side effects
Drowsiness, increased fatigue, dizziness, insomnia, headache, excitement, mealgia, discoordination, paresthesia, disorientation, darkening of consciousness, tremor; Arrhythmia, conduction disorder, bradycardia, ventricular fibrillation, decreased blood pressure, orthostatic hypotension, faint; Nausea, vomiting, diarrhea, dryness and bitterness in the mouth, violation of sight, eye irritation, nasal congestion, leukopenia, neutropenia (usually insignificant), priapism, followed by impotence, allergic reactions.Application and dosage
Inside. Initial dose for adults - 150 mg / day in 2 adhesives: 2/3 of the total daily dose are taken before bedtime (in order to avoid drowsiness, dizziness), and the remaining part - in the morning or during the day, in divided doses.
If necessary, the daily dose increases by 50 mg / day, at intervals of 3-4 days, until the optimal effect is achieved.
Maximum daily dose for outpatient patients - 450 mg, for stationary patients - 600 mg.
The initial daily dose for older and weakened patients is 75 mg, if necessary, it can be gradually increased with an interval of 3-4 days, but not more than 300 mg.
With light shapes of depression, the average supporting dose is 150 mg / day, with moderate and severe forms - 300 mg / day.
The initial dose for children is 6-18 years old - 1.5-2 mg / kg / day in divided doses, if necessary, the dose gradually increase to 6 mg / kg / day.
With a disturbance of the libido, a daily dose - 50 mg; In the treatment of impotence in the case of monotherapy - 200 mg / day, in the composition of complex therapy - 50 mg.
In the treatment of benzodiazepine drug addiction, the recommended scheme is based on a gradual decline in the dose of benzodiazepine. Each time, with a decrease in its dose on 1/4 or 1/2 tablets, 50 mg of trazodone is added at the same time. This ratio remains unchanged for 3 weeks, then continues to reduce the dose of benzodiazepine until its complete cancellation. After that, go to a decrease in the daily dose by 50 mg every 3 weeks.
Children 6-18 years old: Initial dose 1.5-2 mg / kg / day, divided into several techniques. If necessary (taking into account portability), the dose is gradually raised to 6 mg / kg / day with an interval of 3-4 days.
special instructions
When taking the drug, control of peripheral blood is necessary due to the possibility of reducing the number of leukocytes.
It does not have anticholinergic effects, it is possible to prescribe to patients suffering from prostate hypertrophy, glaucoma, violation of cognitive functions, as well as elderly patients.
Sedative and hypotensive effects are more often marked in elderly patients.
Male patients need to be prevented about the need to immediately appeal to the doctor (while canceling the drug) when prolonged and inadequate erections appear.
Before surgery using general anesthesia, it is necessary to cancel the drug in advance.
Related studies of the relationship of the effects of trazodone and age in pediatrics are not carried out, so the use of the drug in persons under the age of 18 must be carried out with caution. Doses for children under 6 years old are not installed.
Dry mouth can lead to the development of caries, periodontal diseases, candidiasis and the appearance of unpleasant sensations in the oral cavity. To facilitate the state, the chewing gum or lollipops do not contain sugars; If dry mouth persists more than 2 weeks, consultation of the therapist or dentist is necessary.
During the period of treatment, care must be taken when driving vehicles and the class of other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.
Interaction
Enhances the effect of hypotensive drugs, muscle relaxants, barbiturates, ethanol, etc. LS, depressing CNS.
The simultaneous purpose of the hypotensive drugs and drugs depressing the central nervous system (including with clonidine, guanabenz, methyloft, methodhosone, ravolphia alkaloids), together with trazodone, enhances (mutually) depression of the CNS.
Antihistamine drugs and others. Preparations with anticholinergic activity reinforce the anticholinergic effect of trazodone.
Antihistamines LS enhance the oppression of the CNS.
Reduces the effectiveness of norepinephrine, psychostimulants.
Enhances and lengthens (mutually) sedative and anticholinergic effects of tricyclic antidepressants, haloperidol, location, maprotylin, moldone, phenothiazine, pymosydan and thioxanthine.
Changes (enhances or reduces) Warfarin effect.
Increases the concentration of digoxin in plasma (increases toxicity).
Increases the concentration of phenytoin in the plasma (care must be taken and conduct thorough monitoring).
Mao inhibitors increase the risk of developing side effects.
Why you can not postpone the pregnancy
Effect from regular use of home recipes
Features of the structure of the neck