Trittico is an antidepressant that belongs to the triazolopridine group. The drug is available in the format of biconvex tablets of prolonged action, white, 75 mg, as well as 150 mg of the effective drug. How to take Trittico tablets, instructions. The drug contains trazodone hydrochloride and other substance impurities: wax, magnesium stearate, povidone, cane sugar.
Pharmacological functions of the drug trittiko
The functioning substance in the drug is trazodone, which has an antidepressant effect with sedative and anxiolytic properties.
The drug differs from other antidepressants in its tricyclic structure and the complete absence of monoamine oxidase. The active ingredient is trazodog, it can quickly remove somatic and mental symptoms; this drug is especially effective during prolonged insomnia.
Also, the product can qualitatively normalize a person’s excited, pathetic state, restores potency in men and has a positive effect on the general mood.
Trazodone bears certain similarities to certain types of serotonin receptors in the body. The medication can eliminate the pathogenetic cause of depression (low serotonin levels), resulting in an antidepressant effect on a person.
When the active component of the drug acts on the human body, the tension in the emotional background goes away, the feeling of panic is eliminated, and a quick process of falling asleep occurs. The drug is able to eliminate symptoms such as headache, myalgia, tachycardia and symptoms of aggravated levels of anxiety and anxiety.
Ultimately, the remedy creates a normalization of sleep patterns. When undergoing a special therapeutic procedure, you can see a stabilization of the emotional state and a decrease in the special attachment to alcohol with the development of withdrawal syndrome.
Addiction to this drug was not noticed by the treating specialists. The active components of the drug do not have anticholinergic activity, which is why it is not able to have any side effects on the functioning of the heart.
The scheme of functioning of the drug Trittico includes the ability to influence the serotonergic system. The active drug begins to actively block the recurrent rejection of serotonin in the body.
The drug provokes an adrenergic blocking effect and eliminates the special susceptibility of beta-adrenergic receptors. The active ingredients in the product affect the neural uptake of dopamine and norepinephrine. The drug has a greater effect during sleep disturbances in sick people who are in a state of apathy. The medicine can significantly increase the level of mood and emotional state, as well as the general pathetic state of the patient’s body.
Pharmacological action of the drug
The drug has a high degree of absorption from the gastrointestinal tract. At the same time, the drug in the blood plasma begins to actively influence the body within 1–2 hours after ingestion. The ability to switch proteins included in the plasma product is 90–95 percent. The active component of the product begins to penetrate granulocyte barriers in the body and is able to enter breast milk.
The action of metabolism actively occurs inside the liver, followed by the release of the active substance of the metabolite chlorophenylpiperazine. The half-life of the drug will be 3-6 hours. A large number of antrols begin to be actively excreted by the kidneys (in an amount of 75 percent). Complete release of substances occurs 98 hours after using the product. More than twenty percent of medicinal substances begin to be eliminated from the human body together with bile.
Pharmacodynamics
Trazodone, being a triazolopyridine derivative, has a predominantly antidepressant effect
Trazodone, being a triazolopyridine derivative, has a predominantly antidepressant effect, with some sedative and anxiolytic effects. Trazodone has no effect on MAO, which distinguishes it from MAO inhibitors and tricyclic antidepressants.
Quickly affects mental (affective tension, irritability, fear, insomnia) and somatic symptoms of anxiety (palpitations, headache, muscle pain, frequent urination, sweating, hyperventilation).
Trazodone is effective for sleep disorders in patients with depression, increases the depth and duration of sleep, and restores its physiological structure and quality.
Trazodone stabilizes the emotional state, improves mood, reduces pathological craving for alcohol in patients suffering from chronic alcoholism during the period of alcohol withdrawal syndrome, also in remission.
For withdrawal symptoms in patients suffering from dependence on benzodiazepine derivatives, trazodone is effective in the treatment of anxiety, depression and sleep disorders. During remission, benzodiazepines can be completely replaced by trazodone.
The drug is not addictive.
Helps restore libido and potency, both in patients with depression and in people who do not suffer from depression.
The mechanism of action of trazodone is associated with the high affinity of the drug for certain subtypes of serotonin receptors, with which trazodone enters into an antagonistic or agonistic interaction depending on the subtype, as well as with the specific ability to cause inhibition of serotonin reuptake.
The neutral uptake of norepinephrine and dopamine has little effect.
The drug does not affect body weight.
Indications for starting the drug
You should start taking Trittico for the following diseases:
- Presence of impotence.
- Apathy of hypogenic form.
- Development of involutional depressions.
- Cerebral atherosclerosis.
- Apathy during prolonged pain syndrome.
- Dementia due to old age.
- Alcohol disease.
- Certain phobias in the human body.
- Libido disturbance.
- For active prevention of migraine.
- Bulimia.
- A certain amount of anxiety in the body.
- Apathy due to developing Alzheimer's disease.
- Development of blues at the psychogenic level.
- Presence of anxiety syndromes.
- Patient's benzodiazepine addiction.
Special contraindications to the use of the medicine:
- The presence of hypersensitivity to any component in the drug.
- Development of tachycardia.
- Development of arterial hypertension.
- Pregnancy or breastfeeding.
- The child's age is up to six years.
- Liver or kidney failure.
- History of priapism.
- Development of symptoms of gastric extrasystole.
- The initial stage of recovery after a heart attack.
- Arterial type hypertension.
Instructions for using the medication
Trittico tablets should be used thirty minutes before eating orally, or four hours after eating.
The tablets should be used without chewing them, as the integrity of the film shell of the drug may be damaged. The course of drug therapy should begin with a dosage of 50–100 mg at a time. This dosage of the drug should be observed throughout all three days of treatment with the drug. Starting from the fourth day, the dosage of the drug should increase to 150 mg per day. Afterwards, the amount of the drug taken should be increased over time by 50 mg per day, until the required medical norm of the drug is established.
In general, the total daily amount of medication should not be more than 150 mg at a time. Schemes for using the drug are based on the age category of the patient.
- Age up to 18 years. The daily dose of the drug should be calculated at 1–2 mg per person’s body weight. The prescribed amount of the drug should be divided into several doses of the drug per day. If necessary, the daily dose of medication can be increased over time. Every three days it is worth increasing the drug by 6 mg per kilogram of the total dose of the drug.
- Elderly and exhausted patients. The course of treatment with the drug for this group of patients should begin with a dosage of 100 mg per day. Further, the amount of the drug should be increased over time to the overall optimal norm per day of 300 mg.
During the process of bearing fruit and while feeding the child with mother's milk, the product should not be used at all. Patients with impaired renal and liver function should prescribe the drug with even greater caution. Trittico should also not be used at too young an age (before six years). At the end of the course of treatment with the drug, drinking alcohol is strictly prohibited.
Side effects on the drug Trittico and special contraindications
During an overdose of Trittico, reactions from the human nervous system such as tremor, agitation, headaches and drowsiness begin to occur. You can also notice special disturbances in the human digestive system due to the development of nausea, bitterness and others.
Side effects include:
- Cardiovascular system - decreased blood pressure, neutropenia, bradycardia, leukopenia, conduction disturbances.
- Digestive system: loss of appetite, nausea, vomiting, and diarrhea.
The main and also peripheral nervous system of a person - an increased level of fatigue, trembling, dizziness, disturbance in human coordination, the process of numbness in the limbs and a high rate of weakness of the whole body.
In order to get rid of this symptomatology, it is worth conducting therapy to determine the disease in a person, as well as remove the remaining funds from the patient’s body using diuretic drugs.
Side effects of Trittico
During the course of treatment with Trittico, according to the instructions for use, side effects from the central nervous and cardiovascular systems are possible (dizziness and headaches, myalgia, impaired coordination of movements, drowsiness; changes in blood pressure, fainting). In some cases, negative consequences manifest themselves in the form of nausea, visual impairment, hematopoietic functions (formation of leukocytes) - leukopenia, neutropenia.
Overdose
The main evidence of a drug overdose, according to reviews, are nausea, a sharp drop in blood pressure, dizziness and fainting. If such reactions occur, you must stop taking the drug and undergo a course of rehabilitation therapy. According to the instructions for use, there is no specific antidote for trazodone, so treatment is carried out in accordance with the symptoms.
Drug interactions
The active component trazodone is able to influence antihypertensive drugs by enhancing their effect on the body. In this case, it is worth reducing the dosage of all medications.
During the combined use of medications that have anticholinergic properties, they provoke the development of an anticholinergic effect in trazadone. During parallel use of the drug with tricyclic simulants, an increase in the sedative and anticholinergic effect begins.
When used together with MAO blockers and carbamazepine, the possibility of developing unwanted symptoms and complications increases.
Use of the drug Trittico
The drug is completely contraindicated during pregnancy and breastfeeding.
Use by children.
The medicine is prohibited for use by children under 6 years of age. Adolescents under 18 years of age should use the product with extreme caution.
Use of the product by older people.
For elderly and severely weakened people, the initial dosage of the drug is up to 100 mg per day in fractional proportions or once a day before bedtime. The dosage of the drug can be increased on the advice of the attending physician, depending on the effectiveness and tolerability of this drug individually for each person. Most often, a dose not exceeding 300 mg is used per day.
Indications for use of Trittico
Since the treatment agent has a special adrenolytic activity, bradycardia or a decrease in blood pressure may develop. It is for this reason that it is worth prescribing the drug with extreme caution to patients who have certain disturbances in cardiac conduction, AV block of varying degrees of severity, and to patients with recent myocarditis.
While taking Trittico, a slight decrease in the number of leukocytes in the blood may occur, which does not require special treatment, except in cases of particularly severe leukopenia. That is why the time of treatment with the drug should be limited to the time of peripheral blood testing, especially if the throat hurts during swallowing or there is a constant fever.
The drug does not have an anticholinergic effect, so it can be used by patients who suffer from prostate hypertension, angle-closure glaucoma, as well as special deformation in cognitive functions.
The drug must be used according to a specific prescription from the treating specialist.
If prolonged and inadequate erections develop in the human body, the patient should immediately contact a treating specialist.
During the course of treatment, you must limit yourself in the use of alcoholic beverages.
Use in children
Use with caution in children and adolescents under 18 years of age.
Influence on driving vehicles and control of various types of mechanisms
Since the drug contains anxiolytic and sedative functions, it is possible to develop a decrease in the ability to concentrate attention, as well as the speed of psychomotor reactions within the patient’s body. During the course of treatment with the drug, the patient must protect himself from potential dangerous activities in everyday life, this also includes driving a car, as well as operating any equipment.
Use during pregnancy and lactation
The use of Trittiko is contraindicated during pregnancy and lactation.
Use in childhood
The use of Trittico is contraindicated for the treatment of children under 6 years of age.
Particular caution should be exercised when prescribing Trittico to patients under the age of 18 years.
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, maintaining an interval of 3-4 days. The maximum daily dose should not exceed 6 mg per 1 kg of body weight.
For impaired renal function
Trazodone should be used with caution if you have renal failure.
For liver dysfunction
Trazodone should be taken with caution in patients with liver failure.
Use in old age
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 increases should be carried out under the supervision of a physician, taking into account the effectiveness and tolerability of trazodone. It is not recommended to exceed the maximum daily dose of 300 mg.
Instructions for using the product
The drug should be taken orally half an hour before eating or 2–4 hours after eating. The dosage prescribed by a specialist should be used in full, without chewing or drinking too much water.
Adults are most often prescribed an initial dosage of 100 mg once a day after meals at bedtime. On the fourth day of the drug course, the dosage should be increased to 150 grams. In the future, in order to achieve the optimal level of therapeutic effect, the dose should be increased by 50 mg per day every 3-4 days until the desired level of drug use is achieved.
8 Features of application
The drug should not be prescribed to adolescents and children. Clinical trials of the effectiveness of Trittico in these categories showed the development of suicidal thinking and behavior, attempts and planning of suicide, aggression and protest behavior.
There are no data on the safety of the drug in children and adolescents, given its effect on puberty, cognitive and behavioral development.
The drug contains sucrose, therefore Trittico is contraindicated in patients with fructose intolerance, sucrose-isomaltose deficiency and glucose-galactose malabsorption.
8.1 Clinical deterioration, suicidal ideation
Depression is characterized by an increased risk of suicidal thoughts and desires to harm oneself. The risk remains until stable remission occurs. In the first weeks of treatment, a lack of therapeutic effect is allowed, but treatment should be continued for a month. Careful monitoring of patients is necessary until stable remission occurs.
Patients with manifestations of suicidal behavior or thinking before starting therapy require more careful monitoring and may therefore be placed in an inpatient unit. In patients under 25 years of age, the risk of suicide is significantly higher.
Observation is required not only at the initial stage of treatment, but also after changing the dosage. To reduce the risk of suicide attempts, limited dosages of trazodone are recommended.
8.2 Prescription with caution
Caution when prescribing trazodone should be observed in the following pathologies:
- epilepsy - a sharp increase or decrease in dosage is not recommended;
- severe disorders of the liver and kidneys;
- angina pectoris, cardiac conduction disorder, atrioventricular block, recent myocardial infarction;
- urinary disorders, prostate hypertrophy;
- hyperthyroidism;
- acute angle-closure glaucoma, increased intraocular pressure.
If jaundice occurs, you should immediately stop the course of treatment and conduct a liver examination using laboratory and instrumental diagnostic methods.
The use of Trittico in patients with schizophrenia may lead to increased symptoms. The depressive phase of manic-depressive psychosis can develop into a manic phase. In this case, treatment with Trittico should be discontinued.
8.3 Serotonin syndrome, agranulocytosis
Serotonin syndrome or neuroleptic malignant syndrome may develop during simultaneous therapy with Trittico with the following groups of drugs:
- tricyclic antidepressants;
- SSRIs;
- MAO inhibitors;
- norepinephrine and serotonin reuptake inhibitors;
- neuroleptics.
Neuroleptic malignant syndrome is a dangerous condition that threatens the patient’s life, therefore the simultaneous use of drugs from these groups with Trittico is strictly contraindicated.
Agranulocytosis is manifested by a symptomatic complex characteristic of influenza: sore throat, fever, chills, weakness. In this case, blood laboratory values should be checked.
8.4 Hypotension, ECG changes
Hypotension has been reported during treatment with trazodone. It may be necessary to reduce the dosage of the antihypertensive drug during concomitant treatment. Patients over 65 years of age are more susceptible to adverse effects from the heart and blood vessels.
During treatment with trazodone, ECG readings may deviate from the norm. Caution must be exercised with drugs that have similar activity. Monitoring is required for patients with cardiovascular diseases.
8.5 Withdrawal of the drug
There is no data on the development of addiction to the drug. There have been no reports of withdrawal symptoms following completion of treatment with Trittico. Despite this, cessation of treatment, especially after a long course, should be gradual.
8.6 Pregnancy and lactation
Clinical studies have not shown any undesirable effects on pregnancy or the condition of the fetus. Data from animal studies have not shown the detrimental effect of Trittiko on the development of the embryo, fetus, pregnancy and childbirth.
It is recommended to exercise caution and monitor the baby's condition after birth to ensure timely detection of possible withdrawal syndrome. Limited data indicate that trazodone passes into breast milk, therefore breastfeeding should be discontinued during treatment.
9 Analogues
An analogue of the active substance is the drug Azona. Known drugs with similar pharmacological activity:
- Miaser.
- Lerivon.
- Mianserin.
- Deprim Forte.
- Depresil.
- Gelarium Hypericum.
- Velaxin.
- Alventa.
Before using an analogue or similar medicinal product, a mandatory consultation with the attending physician is required, who will select an adequate regimen of use and take into account contraindications.
Conditions for dispensing from pharmacies
On prescription.
Storage conditions for the drug Trittico
At a temperature not exceeding 25 °C.
Keep out of the reach of children.
Shelf life of the drug Trittico
3 years. List B
Do not use after the expiration date stated on the package.
Trittico controlled-release tablets are usually white or white-yellow, oval-shaped, with two parallel stripes at both ends.
Release forms for tablets with a dosage of 75 mg:
- 15 tablets in a blister, 2 such blisters in paper packaging;
- 30 tablets in a blister, 1 such blister in a paper package.
Release forms for tablets with a dosage of 150 mg:
- 10 tablets in a blister, 2 or 6 such blisters in paper packaging;
- 20 tablets in a blister, 1 or 3 such blisters in paper packaging.
pharmachologic effect
The drug Trittico has antidepressant action.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Trazodone - derivative triazolopyridine , has antidepressant and weak sedative And anxiolytic effects. Has no effect on MAO , Unlike tricyclic antidepressants , inhibiting MAO inhibitors .
Quickly acts on mental (irritability, affective tension, fear) and somatic symptoms of anxiety (muscle pain, frequent urination, hyperventilation ).
The drug is also effective for sleep disorders in people with. Increases the duration of sleep, normalizes its physiological structure.
Trazodone has a stabilizing effect on the emotional state, reduces the craving for alcohol in people with chronic , improves mood. Not addictive. Helps strengthen libido And .
Trazodone has a high affinity to a number of serotonin receptor subtypes, with which it interacts agonistically or antagonistically, and is also capable of causing reuptake inhibition.
Pharmacokinetics
The degree of absorption of the drug from the intestine after administration is high. Taking during or after meals slows down the rate of absorption. The maximum concentration of the drug in the blood occurs 2 hours after consuming the drug.
Penetrates through histohematic
barriers, as well as into saliva, bile, and breast milk.
Interaction with plasma proteins - 90–95%. The drug is transformed in the liver. The half-life is 6–9 hours. Excretion is carried out through the kidneys (up to 75%) and with bile (up to 20%).
Indications for use
- Psychogenic (including neurotic And reactive depression ).
- Alcoholic depression.
- Anxiety and depression.
- Depressive states with severe pain syndrome.
- Anxiety and depression in combination with organic lesions of the nervous system ( , brain vessels ).
- Benzodiazepine addiction.
- Violations libido And potency .
Contraindications
- for Trittico tablets.
- Period.
- Age less than 6 years.
Prescribe with caution to persons with AV block, ventricular , , hepatic or renal failure , as well as persons under 18 years of age, due to the risk of developing suicidal behavior (aggression, suicidal plans, anger).
Side effects
The drug may cause the following side effects:
- from the nervous system – fatigue, agitation, headache, myalgia , weakness, , ;
- from the circulatory and hematopoietic systems – orthostatic hypotension, bradycardia, decreased pressure, conduction disturbances, ; neutropenia And leukopenia ;
- from the digestive system - nausea, dry mouth, ;
- others – eye irritation, reactions.
Instructions for Trittiko
Instructions for use Trittico prescribes taking the drug orally, half an hour before or 2 hours after a meal, without chewing and with water.
The starting dose of Trittico is 50–100 mg once daily at bedtime. After 3 days, you can increase the dose to 150 mg per day. A further increase of 50 mg per day can be done every 3 days until the desired effect occurs. A daily dose of over 150 mg is divided into 2 doses, a smaller dose is taken after lunch, and a larger dose before bed.
The maximum daily dose in inpatient settings is 600 mg, in outpatient settings - 450 mg.
For children at the age of 6-18 years: an initial dose of 1.5 mg per kilogram of body weight per day, divided into several doses. If necessary, the dose is increased to 6 mg per kilogram of body weight per day.
Elderly And weakened persons: initial dose up to 100 mg per day. If necessary, you can increase the dose to 300 mg per day.
Therapy of disorders libido : daily dose 50 mg.
Therapy erectile dysfunction : for monotherapy, the daily dose is up to 200 mg, for combination therapy - 50 mg.
Overdose
Symptoms: nausea, hypotension .
Treatment: symptomatic therapy. Specific antidote not known.
Interaction
Trazodone enhances the effect of the series hypotensive agents and requires a reduction in their doses.
Concomitant use with drugs that depress the nervous system (
, methylodopa
), activates the latter.
Antihistamines
drugs and anticholinergic
means enhance anticholinergic
action trazodone.
Trazodone enhances anticholinergic And sedative effects, tricyclic antidepressants, loxapine, phenothiazine,
Composition and release form
10 pcs in a PVC/aluminum foil blister; There are 2 or 6 blisters in a cardboard pack.
Description of the dosage form
Biconvex tablets, white or white with a yellowish tint, oval in shape with two parallel lines on both sides.
pharmachologic effect
pharmachologic effect- antidepressant.Pharmacodynamics
Trazodone, being a triazolopyridine derivative, has a predominantly antidepressant effect, with some sedative and anxiolytic effects. Trazodone has no effect on MAO, which distinguishes it from MAO inhibitors and tricyclic antidepressants.
Quickly affects mental (affective tension, irritability, fear, insomnia) and somatic symptoms of anxiety (palpitations, headache, muscle pain, frequent urination, sweating, hyperventilation).
Trazodone is effective for sleep disorders in patients with depression, increases the depth and duration of sleep, and restores its physiological structure and quality.
Trazodone stabilizes the emotional state, improves mood, reduces pathological craving for alcohol in patients suffering from chronic alcoholism during the period of alcohol withdrawal syndrome, also in remission. For withdrawal symptoms in patients suffering from dependence on benzodiazepine derivatives, trazodone is effective in the treatment of anxiety, depression and sleep disorders. During remission, benzodiazepines can be completely replaced by trazodone.
The drug is not addictive.
Helps restore libido and potency, both in patients with depression and in people who do not suffer from depression.
The mechanism of action of trazodone is associated with the high affinity of the drug for certain subtypes of serotonin receptors, with which trazodone enters into an antagonistic or agonistic interaction depending on the subtype, as well as with the specific ability to cause inhibition of serotonin reuptake.
The neutral uptake of norepinephrine and dopamine has little effect.
The drug does not affect body weight.
Pharmacokinetics
Absorption of the drug from the gastrointestinal tract after oral administration is high. Taking trazodone during or immediately after a meal slows down the rate of absorption, reduces Cmax of the drug in the blood plasma and increases Tmax. Tmax of the drug is achieved 1/2-2 hours after oral administration.
The drug penetrates histohematic barriers, as well as into tissues and fluids (bile, saliva, breast milk).
Plasma protein binding is 89-95%.
Trazodone is metabolized in the liver, the active metabolite is 1-m-chlorophenylpiperazine. T1/2 in the first phase is 3-6 hours, in the second phase - 5-9 hours. The majority of the metabolized drug is excreted through the kidneys, with urine (about 75%) and is completely completed 98 hours after taking the drug, with bile about 20% is excreted.
Research in vitro on human microsomes showed that trazodone is primarily metabolized by the cytochrome P450 CYP3A4.
Indications for the drug Trittico
anxiety-depressive states of endogenous nature (including involutional depression);
psychogenic depression (including reactive and neurotic depression);
anxiety-depressive states against the background of organic diseases of the central nervous system (dementia, Alzheimer's disease, cerebral atherosclerosis);
depressive states with prolonged pain syndrome;
alcoholic depression;
benzodiazepine dependence;
libido and potency disorders (including erectile dysfunction in depressive conditions).
Contraindications
hypersensitivity to the drug;
pregnancy period;
lactation period;
children under 6 years of age.
Carefully the drug should be prescribed to patients with AV block, myocardial infarction (early recovery period), arterial hypertension (dose adjustment of antihypertensive drugs may be required), ventricular arrhythmia, a history of priapism, renal and/or liver failure. Patients under the age of 18 years, due to the possibility of developing the risk of suicidal behavior (suicidal plans, aggressiveness, tendency to contradict, anger).
Use during pregnancy and breastfeeding
Side effects
From the central nervous system: increased fatigue, drowsiness, agitation, headache, dizziness, weakness, myalgia, incoordination, paresthesia, disorientation, tremor.
From the cardiovascular system and hematopoietic system: decreased blood pressure, orthostatic hypotension caused by adrenolytic action (especially in individuals with vasomotor lability), arrhythmia, conduction disturbances, bradycardia; leukopenia and neutropenia (usually minor)..
From the gastrointestinal tract: dry and bitter mouth, nausea, vomiting, diarrhea, loss of appetite.
Other: allergic reactions, eye irritation, priapism (you should immediately stop taking the drug and consult a doctor).
Interaction
Trazodone may enhance the effect of some antihypertensive drugs and usually requires a dose reduction.
Simultaneous administration with drugs that depress the central nervous system (including clonidine, methyldopa) enhances the effect of the latter.
Antihistamines and drugs with anticholinergic activity enhance the anticholinergic effect of trazodone.
Trazodone enhances and prolongs the sedative and anticholinergic effects of tricyclic antidepressants, haloperidol, loxapine, maprotiline, phenothiazine, pimozidane and thioxanthine.
When tricyclic antidepressants and trazodone are prescribed simultaneously, cardiovascular side effects may occur.
MAO inhibitors increase the risk of side effects.
When used together, it increases the concentration of digoxin and phenytoin in the blood plasma.
In vitro drug metabolism studies indicate the possibility of pharmacological interaction of trazodone with inhibitors of cytochrome P450 CYP3A4, such as ketoconazole, ritonavir, indinavir and fluoxetine. Inhibitors of CYP3A4 may lead to significant increases in plasma concentrations of trazodone, thereby increasing the likelihood of adverse events. Therefore, when used in combination with potent CYP3A4 inhibitors, the dose of trazodone should be reduced.
When trazodone is taken in combination with carbamazepine, the plasma concentration of trazodone is reduced. Therefore, patients taking trazodone and carbamazepine concomitantly should be closely monitored.
Directions for use and doses
Inside, 30 minutes before or 2-4 hours after meals. The tablets should be taken whole, without chewing and with plenty of 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 increases in dosage should be made by 50 mg/day every 3-4 days until the optimal dose is reached. A daily dose of more than 150 mg should be divided into 2 doses, with the smaller dose taken after lunch and the main dose before bed.
The maximum daily dose for outpatients is 450 mg, for inpatients - 600 mg.
Children 6-18 years old: initial daily dose of 1.5-2 mg/kg/day, divided into several doses. If necessary, the dose is gradually (with an interval of 3-4 days) increased to 6 mg/kg/day.
Elderly and debilitated patients: initial dose up to 100 mg/day in several doses or once before bedtime. If necessary, the dose can be increased (usually no more than 300 mg/day).
Treatment of erectile dysfunction: monotherapy - recommended daily dose - 150-200 mg, combination therapy - 50 mg.
Treatment of benzodiazepine dependence: The recommended treatment regimen is based on a gradual, sometimes over several months, reduction of the benzodiazepine dose. Each time, reducing the benzodiazepine dose by 1/4 or 1/2 tablet, 50 mg of trazodone is added at the same time. This ratio is left unchanged for 3 weeks, then a further gradual reduction in the dose of benzodiazepines is started until their complete abolition. After this, reduce the daily dose of trazodone by 50 mg every 3 weeks.
Overdose
Symptoms: nausea, drowsiness, arterial hypotension, increased frequency and severity of side effects.
Treatment: Conducting symptomatic therapy (gastric lavage, forced diuresis). There is no specific antidote.
special instructions
Since the drug has some adrenolytic activity, bradycardia and a decrease in blood pressure may develop. Therefore, caution should be exercised when prescribing the drug to patients with cardiac conduction disorders, AV block of varying severity, or recent myocardial infarction. When using trazodone, a slight decrease in the number of leukocytes is possible, which does not require specific treatment, except in cases of severe leukopenia. Therefore, it is recommended to conduct peripheral blood tests, especially if there is a sore throat when swallowing and fever.
The drug does not have an anticholinergic effect, so it can be prescribed to elderly patients suffering from prostatic hypertrophy, angle-closure glaucoma, and cognitive impairment.
If you experience prolonged and inadequate erections, you should consult a doctor.
There have been no relevant studies on the effectiveness of the drug in pediatrics, so the drug should be used with caution in persons under 18 years of age. Doses for children under 6 years of age have not been established.
During treatment you should refrain from drinking alcohol.
Influence on the ability to drive vehicles and machinery. Since the drug has anxiolytic and sedative activity, a decrease in attention and reaction speed is possible. During treatment, you should refrain from engaging in potentially hazardous activities that require concentration and rapid psychomotor reactions.
Conditions for dispensing from pharmacies
On prescription.
Storage conditions for the drug Trittico
At a temperature not exceeding 25 °C.Keep out of the reach of children.
Shelf life of the drug Trittico
3 years. List BDo not use after the expiration date stated on the package.
Synonyms of nosological groups
| ICD-10 rubric | Synonyms of diseases according to ICD-10 |
|---|---|
| F32 Depressive episode | Adynamic subdepression |
| Astheno-adynamic subdepressive states | |
| Astheno-depressive disorder | |
| Astheno-depressive state | |
| Asthenodepressive disorder | |
| Asthenodepressive state | |
| Major depressive disorder | |
| Sluggish depression with lethargy | |
| Double depression | |
| Depressive pseudodementia | |
| Depressive illness | |
| Depressive mood disorder | |
| Depressive disorder | |
| Depressive mood disorder | |
| Depressive state | |
| Depressive disorders | |
| Depressive syndrome | |
| Depressive syndrome larvated | |
| Depressive syndrome in psychosis | |
| Masked depressions | |
| Depression | |
| Depression of exhaustion | |
| Depression with symptoms of lethargy within the framework of cyclothymia | |
| Depression smiling | |
| Involutional depression | |
| Involutionary melancholy | |
| Involutional depressions | |
| Manic-depressive disorder | |
| Masked depression | |
| Melancholic attack | |
| Neurotic depression | |
| Neurotic depression | |
| Shallow depressions | |
| Organic depression | |
| Organic depressive syndrome | |
| Simple depression | |
| Simple melancholic syndrome | |
| Psychogenic depression | |
| Reactive depression | |
| Reactive depression with moderate psychopathological symptoms | |
| Reactive depressive states | |
| Reactive depression | |
| Recurrent depression | |
| Seasonal depressive syndrome | |
| Senestopathic depression | |
| Senile depression | |
| Senile depression | |
| Symptomatic depression | |
| Somatogenic depression | |
| Cyclothymic depression | |
| Exogenous depression | |
| Endogenous depression | |
| Endogenous depressive states | |
| Endogenous depression | |
| Endogenous depressive syndrome | |
| F52 Sexual dysfunction not due to organic disorders or diseases | Maintaining sexual activity in men and women |
| Sexual weakness | |
| Sexual weakness in older men | |
| Libido disorders | |
| Potency disorders | |
| Sexual disorders in men | |
| Decreased sex drive | |
| Functional disorders of the sexual sphere in men | |
| R52.2 Other persistent pain | Pain syndrome of non-rheumatic origin |
| Pain syndrome with vertebrogenic lesions | |
| Pain syndrome with neuralgia | |
| Pain syndrome from burns | |
| Pain syndrome is mild or moderate | |
| Neuropathic pain | |
| Neuropathic pain | |
| Perioperative pain | |
| Moderate to severe pain | |
| Moderate or mild pain syndrome | |
| Moderate to severe pain syndrome | |
| Ear pain due to otitis media | |
| Y47.1 Adverse reactions during therapeutic use of benzodiazepines | |
| Dependence on anxiolytics and sleeping pills | |
| Benzodiazepine addiction | |
| Z50.2 Rehabilitation for alcoholism | Alcoholism in remission |
| Z50.3 Drug rehabilitation | Benzodiazepine addiction |
Depression is a mental disorder in which a person loses a sense of reality. Manifests itself in the form of apathy, irritability, confusion, loss of mood, etc. In fact, depression is a fairly serious illness that you can hardly overcome on your own.
Trittico is an effective antidepressant that relieves symptoms of depression. We will describe the properties and indications of the medication in our article.
Another name for Trazadone. This substance is the active component of the drug. The tablets contain trazadone hydrochloride 150 mg. The tablet formula uses the following components:
- sucrose;
- carnauba wax;
- magnesium stearate;
- povidone.
Trittico 150 has antidepressant properties. This drug is considered a more gentle remedy, since there is no effect on MAO, which cannot be said about tricyclic antidepressants. When ingested, the drug almost immediately affects psychogenic and somatic signs of anxiety, which are expressed in:
- irritability;
- insomnia;
- fear, causeless tension;
- headache and muscle pain;
- frequent urge to go to the toilet, etc.
Trazodone reduces the desire for alcohol, improves mood, and also helps to increase erection and libido. The active ingredient of the drug causes suppression of the reuptake of serotonin (the hormone of joy).
Release form
Trittico is available in tablet form. The tablets are oval in shape, yellowish or white in color. Medicinal dosage:
- 75 mg of active ingredient. Packs of 15 or 30 tablets;
- 150 mg of active substance. 10 or 20 tablets in one package.
Experts' opinion
Trazodone should not be self-prescribed. Although the drug is well tolerated by the body, if the antidepressant medication is selected incorrectly, the symptoms of the disease may worsen. The active substance locally affects the psychosomatic functions of a person.
The drug Trittico helps with mild forms of depressive disorder. The medication is also prescribed for the treatment of erectile dysfunction in men. However, you should not take pills without a specialist’s testimony. The effectiveness of Trittico depends on the correctly prescribed dosage, which may differ from the instructions for use.
Instructions for use Trittico
The antidepressant has long been used in psychiatric practice. Prescribed for the treatment of depressive conditions, recurrent and initial, mental disorders, including anxiety, fear, confusion of thinking.
Indications for use
- Depression of various etiologies (mental, endogenous, neurotic), complicated by feelings of fear and anxiety;
- Dysfunction of the reproductive system in men (decreased potency, loss of libido at the psychogenic level);
- Alcohol depression.
List of contraindications
- hypersensitivity to the components of the product;
- chronic alcoholism;
- intoxication with alcohol or sleeping pills.
Main side effects
Trazadone has a wide range of side effects, but they mainly occur when the drug is taken incorrectly:
- dizziness, drowsiness, confusion;
- tachycardia, tremor, convulsions;
- from the gastrointestinal tract: dry mouth, stomach pain, frequent thirst, heaviness in the stomach, intestinal atony;
- hypotension.
Flu-like symptoms (fever, nasal congestion, fatigue) are rarely experienced.
Trittico: overdose
Do not exceed the dose indicated in the instructions. If you take more tablets, the patient will develop signs of overdose, which are expressed in increased side effects. Hallucination, apathy, aggressiveness, nausea and vomiting may also occur. If signs of overdose are detected, you should immediately stop taking the medication and consult a specialist.
Compatibility with other drugs
The active substance trazadone enhances the therapeutic effect of antihypertensive drugs, which results in an excessive decrease in blood pressure. This is fraught with the formation of vascular collapse. The intake of Trittico tablets and hypertensive drugs should be adjusted with the attending physician and the therapist should be notified in advance about taking an antidepressant to prescribe the optimal dose of the drug.
The drug does not combine well with tricyclic antidepressant medications. There is a high likelihood of side effects from the cardiovascular system. Moreover, Trittico cannot be combined with MAO inhibitors, as severe side effects occur, equating to a severe overdose.
Compatibility of alcoholic beverages is excluded. While taking the medication, alcohol is excluded even in minimal dosage.
special instructions
For the first couple of weeks, the patient should be under the supervision of the attending physician, since often when the drug is prescribed, the patient’s signs of a depressive state worsen. The same applies to patients who have been identified as suicidal.
Patients suffering from epilepsy should not reduce or exceed the prescribed dose without notifying the treating doctor. In some cases, it is better to stop driving a car and not use equipment that requires increased concentration.
Antidepressant.
Drug: TRITTICO
Active substance of the drug:
trazodone
ATX encoding: N06AX05
KFG: Antidepressant
Reg. number: P No. 015703/01
Registration date: 05/31/04
Owner reg. cert.: Aziende Chimiche Riunite ANGELINI FRANCESCO A.C.R.A.F. S.p.A. (Italy)
Trittico release form, drug packaging and composition.
1 tab.
trazodone hydrochloride
75 mg
15 pcs. - blisters (2) - cardboard packs.
30 pcs. - blisters (1) - cardboard packs.
Controlled-release tablets are white or off-white, oval, with two parallel lines on both sides.
1 tab.
trazodone hydrochloride
150 mg
Excipients: sucrose, carnauba wax, povidone (polyvinylpyrrolidone), magnesium stearate.
10 pieces. - blisters (2) - cardboard packs.
10 pieces. - blisters (6) - cardboard packs.
20 pcs. - blisters (1) - cardboard packs.
20 pcs. - blisters (3) - cardboard packs.
The description of the drug is based on the officially approved instructions for use.
Pharmacological action of Trittico
Antidepressant. Trazodone, being a triazolopyridine derivative, has a predominantly antidepressant effect, with some sedative and anxiolytic effects. Trazodone has no effect on MAO, which distinguishes it from MAO inhibitors and tricyclic antidepressants.
The mechanism of action of trazodone is associated with the high affinity of the drug for certain subtypes of serotonin receptors, with which trazodone enters into an antagonistic or agonistic interaction depending on the subtype, as well as with the specific ability to cause inhibition of serotonin reuptake.
Quickly affects mental (affective tension, irritability, fear, insomnia) and somatic symptoms of anxiety (palpitations, headache, muscle pain, frequent urination, sweating, hyperventilation).
Trazodone is effective for sleep disorders in patients with depression, increases the depth and duration of sleep, and restores its physiological structure and quality.
Trittico stabilizes the emotional state, improves mood, reduces pathological craving for alcohol in patients suffering from chronic alcoholism during the period of alcohol withdrawal syndrome, also in remission. For withdrawal symptoms in patients suffering from dependence on benzodiazepine derivatives, trazodone is effective in the treatment of anxiety, depression and sleep disorders. During remission, benzodiazepines can be completely replaced by trazodone.
Helps restore libido and potency in both depressed and non-depressed patients.
The drug is not addictive. The neutral uptake of norepinephrine and dopamine has little effect.
Does not affect body weight.
Pharmacokinetics of the drug.
Suction
Absorption of the drug from the gastrointestinal tract after oral administration is high. Taking trazodone during or immediately after a meal slows down the rate of absorption, reduces Cmax of the drug in blood plasma and increases Tmax. Cmax in blood plasma is achieved 0.5-2 hours after oral administration.
Distribution
Plasma protein binding – 89–95%. Penetrates through histohematic barriers, as well as into tissues and liquids (bile, saliva, breast milk).
Metabolism
Trazodone is metabolized in the liver, the active metabolite is 1-m-chlorophenylpiperazine.
Removal
T1/2 is 3-6 hours, in the second phase - 5-9 hours. Most of the metabolized drug is excreted by the kidneys - about 75%, and is completely completed 98 hours after administration; About 20% is administered with bile.
Indications for use:
Anxiety and depressive states of endogenous nature (including involutional depression);
Psychogenic depression (including reactive and neurotic depression);
Anxiety and depressive states against the background of organic diseases of the central nervous system (dementia, Alzheimer's disease, cerebral atherosclerosis);
Depressive states with prolonged pain syndrome;
Alcoholic depression;
Benzodiazepine addiction;
Disorders of libido and potency.
Dosage and method of administration of the drug.
The drug is taken orally 30 minutes before meals or 2-4 hours after meals. The prescribed dose of the tablet should be taken whole, without chewing and with a sufficient amount of water.
Adults are prescribed an initial dose of 100 mg 1 time / day after meals before bedtime. On the 4th day you can increase the dose to 150 mg. Subsequently, in order to achieve the optimal therapeutic effect, the dose is increased by 50 mg/day every 3-4 days until the optimal dose is reached. A daily dose of more than 150 mg should be divided into 2 doses, with the smaller dose taken after lunch and the main dose before bedtime.
The maximum daily dose for outpatients is 450 mg.
The maximum daily dose for inpatients is 600 mg.
When treating impotence, in the case of monotherapy with the drug, the recommended daily dose is more than 200 mg, with combination therapy - 50 mg.
When treating benzodiazepine dependence, the recommended treatment regimen is based on a gradual, sometimes over several months, reduction of the benzodiazepine dose. Each time, reducing the dose of benzodiazepine by 1/4 or 1/2 tablet, 50 mg of trazodone is simultaneously added. This ratio is left unchanged for 3 weeks, then a further gradual reduction in the dose of benzodiazepines is started until they are completely discontinued. After this, reduce the daily dose of trazodone by 50 mg every 3 weeks.
For elderly and debilitated patients, the initial dose is up to 100 mg/day in fractional doses or 1 time/day before bedtime. The dose may be increased under medical supervision, depending on the effectiveness and tolerability of the drug. Usually no dose exceeding 300 mg/day is required.
Children aged 6–18 years: initial daily dose of 1.5–2 mg/kg/day, divided into several doses. If necessary, the dose is gradually increased to 6 mg/kg/day at intervals of 3-4 days.
Side effects of Trittico:
From the central nervous system and peripheral nervous system: increased fatigue, drowsiness, agitation, headache, dizziness, weakness, myalgia, incoordination, paresthesia, disorientation, tremor.
From the cardiovascular system: decreased blood pressure, orthostatic hypotension (especially in individuals with vasomotor lability) due to the adrenolytic effect of the drug, arrhythmia, conduction disturbances, bradycardia, leukopenia and neutropenia (usually minor).
From the digestive system: dry and bitter mouth, nausea, vomiting, diarrhea, loss of appetite.
Other: allergic reactions, eye irritation, priapism (patients who experience this side effect should immediately stop taking the drug and consult a doctor).
Contraindications to the drug:
Pregnancy;
Lactation period;
Children under 6 years of age;
Hypersensitivity to the components of the drug.
The drug should be prescribed with caution to patients with AV block, myocardial infarction (early recovery period), arterial hypertension (dose adjustment of antihypertensive drugs may be required), ventricular arrhythmia, a history of priapism, renal and/or liver failure, patients under the age of 18 years.
Use during pregnancy and lactation.
The drug is contraindicated for use during pregnancy and lactation (breastfeeding).
Special instructions for the use of Trittico.
Since the drug has some adrenolytic activity, bradycardia and a decrease in blood pressure may develop. Therefore, the drug should be prescribed with caution to patients with cardiac conduction disorders, AV block of varying severity, and patients with a recent myocardial infarction.
When using trazodone, a slight decrease in the number of leukocytes is possible, which does not require specific treatment, except in cases of severe leukopenia. Therefore, during the treatment period, it is recommended to conduct peripheral blood tests, especially in the presence of pain in the throat when swallowing and the appearance of fever.
The drug does not have an anticholinergic effect, so it can be prescribed to elderly patients suffering from prostatic hypertrophy, angle-closure glaucoma, and cognitive impairment.
If prolonged and inadequate erections occur, the patient should consult a doctor.
During the treatment period, the patient must abstain from drinking alcohol.
Use in pediatrics
There have been no relevant studies on the effectiveness of the drug in pediatrics, so the drug should be used with caution in children and adolescents under the age of 18 years. Doses for children under 6 years of age have not been established.
Impact on the ability to drive vehicles and operate machinery
Since the drug has anxiolytic and sedative activity, a decrease in the ability to concentrate and the speed of psychomotor reactions is possible. During treatment, the patient should avoid engaging in potentially hazardous activities, incl. driving vehicles and operating machinery.
Drug overdose:
Symptoms: nausea, drowsiness, hypotension, increased frequency and severity of side effects.
Treatment: there is no specific antidote for the drug. In cases of overdose, symptomatic treatment is carried out (including gastric lavage, forced diuresis).
Interaction of Trittico with other drugs.
Trazodone may enhance the effect of some antihypertensive drugs and usually requires a dose reduction.
Simultaneous administration with drugs that depress the central nervous system (including clonidine, methyldopa) enhances the effect of the latter.
Antihistamines and drugs with anticholinergic activity enhance the anticholinergic effect of trazodone.
Terms of sale in pharmacies.
The drug is available with a prescription.
Terms of storage conditions for the drug Trittico.
List B. The drug should be stored out of the reach of children at a temperature not exceeding 25°C. Shelf life: 3 years.
