Trittiko tablets instructions for use – analogues – doctors’ reviews – side effects

Trittico is a new generation antidepressant that has a mixed antagonistic and agonistic effect on serotonin metabolism. In addition, the drug belongs to a broad group of serotonin inhibitors. This effect on the structures of the central nervous system (CNS) makes trittico one of the most effective means of combating depression. It is the drug of choice in the treatment of young patients.

Release form

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.

Side effects

Episodes of suicidal directness of thought and suicidal behavior have been reported during trazodone therapy and shortly after its administration.

Also, patients who discontinued trazodone therapy showed a reduction in symptoms that are often associated with severe depression.

1 In patients with similar symptoms, the blood level and electrolyte balance in the body should be monitored.

2 Div. There is also a section “Peculiarities of stagnation”.

3 Trazodone is a sedative antidepressant, and drowsiness is sometimes experienced by patients during the first days of therapy, which means that the drug will continue to stagnate.

4 Animal studies have shown that trazodone has less cardiotoxicity and less toxicity than tricyclic antidepressants, and clinical data indicate that trazodone has less toxicity. cause cardiac arrhythmias in humans. Clinical data from patients with obvious heart disease indicate that trazodone may have an arrhythmogenic effect in some patients in this population.

5 It was reported about rare episodes of the influence of unnecessary influence, at the same time important, on the function of the liver.

6 Div. There is also a section “Peculiarities of stagnation”.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Trazodone is a triazolopyridine that has antidepressant and mild sedative and anxiolytic effects. It has no effect on MAO , unlike tricyclic antidepressants that inhibit MAO inhibitors .

Quickly acts on mental (irritability, insomnia , affective tension, fear) and somatic symptoms of anxiety (headache, palpitations , muscle pain, sweating, frequent urination, hyperventilation ).

The drug is also effective for sleep disorders in people with depression . 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 alcoholism , and improves mood. Not addictive. Helps increase libido and potency .

Trazodone has high affinity for a number of serotonin receptor subtypes, with which it interacts agonistically or antagonistically, and is also capable of causing serotonin .

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 is 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%).

Reviews

Irina M .: “I took Trittico about a year ago. At that time I was in a state of moderate depression. I didn’t want to do anything, I lost two sizes almost instantly, I had no appetite, I didn’t even have the desire to eat. I was tormented by insomnia, and the rare instances of sleep were accompanied by nightmares. Trittico was prescribed to me by a psychiatrist and I bought it with a prescription. I noticed the effect about a week after I started taking it. My sleep and appetite were the first to return. The nightmares no longer tormented me, my weight began to return to normal. After about a month of use, I noticed a significant improvement in my mood. To consolidate the effect, I took the drug for another month, and then gradually stopped. I still feel like a full-fledged, cheerful person.”

Denis M .: “I suffer from recurrent depressive disorder and periodically have to take antidepressants. I consider the worst side effect of all such drugs to be a decrease in libido. It is impossible to accept them and still feel like a full-fledged person. I stopped taking antidepressants many times for this reason, so the doctor prescribed me Trittico, saying that this drug did not have such an effect. Unfortunately, it has other undesirable properties. At the beginning of taking it, 15 minutes after taking the pill, I already wanted to sleep, so I could only take the medication in the evening. At the same time, I always had a headache in the morning, but it didn’t last that long. After a couple of weeks of taking these side effects, these side effects disappeared, I’ve been taking the drug for three months now and so far I’m happy with the effect.”

Review from a psychiatrist : “Trittiko is an antidepressant that has a multifaceted effect on the neurons of the brain. On the one hand, it allows you to fight depression and anxiety, on the other hand, it has virtually no effect on the autonomic nervous system. The remedy is not intended to combat severe depression, but mild to moderate depression is very effective in treating depression. In addition, it quickly removes the anxiety component and insomnia. We often use Trittico to treat young patients, especially men. This is one of the few drugs that does not reduce libido, which is important for many patients.”

Content

Indications for use

• Psychogenic depression (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 ( Alzheimer's disease, dementia, cerebral atherosclerosis ).
• Benzodiazepine addiction.
• Libido and potency disorders .

Contraindications

• Allergy to Trittico tablets.
• Lactation period.
• Pregnancy.
• Age less than 6 years.

Prescribe with caution to persons with AV block, ventricular arrhythmia , myocardial infarction, arterial hypertension, liver or kidney failure , as well as persons under 18 years of age, due to the risk of developing suicidal behavior (aggression, suicidal plans, anger).

Overdose

Use of the drug in doses exceeding therapeutic doses increases the risk of developing undesirable effects. The most common symptoms of Trittico overdose are nausea, headache and drowsiness. Less commonly, hypotension, decreased heart rate, or ventricular tachyarrhythmias occur. In severe cases, overdose is accompanied by impaired consciousness up to coma, convulsions and respiratory failure of central origin.

There is no specific antidote for trittico. In case of overdose, it is recommended to follow the same procedures as for any other poisoning. You should immediately call an ambulance station. Then - induce a gag reflex in the patient, give an enema or give a laxative. If possible, it is necessary to rinse the stomach. In severe cases, hospitalization in the intensive care unit is required.

Side effects

The drug may cause the following side effects:

• from the nervous system - fatigue, dizziness, agitation, headache, myalgia , weakness, paresthesia, tremor ;
• from the circulatory and hematopoietic systems - orthostatic hypotension, bradycardia, decreased pressure, conduction disturbances, arrhythmia ; neutropenia and leukopenia ;
• from the digestive system - nausea, dry mouth, diarrhea ;
• others – eye irritation, allergic reactions.

Instructions for Trittico (Method and dosage)

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.

Children aged 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.

libido disorders : daily dose 50 mg.

Therapy of erectile dysfunction : with monotherapy, the daily dose is up to 200 mg, with combination therapy - 50 mg.

Features of good stagnation

Conditioning for children and toddlers

Do not administer trazodone to children or children. In a clinical study involving children and adolescents, suicidal behavior (attempted suicide and planned suicide) and witchcraft (mainly aggressiveness, protest behavior and anger) were more often observed in the group receiving an antidepressant, and in the placebo group. In addition, according to daily data on the long-term safety of administering the drug to children and adolescents, looking at their growth, maturation and cognitive and behavioral development.

Suicide / suicidal ideation or clinical depression

Depression is associated with a high risk of suicidal ideation, the patient becoming self-conscious and suicidal (displaying suicidal behavior). This risk is preserved until the time of significant remission. It is possible that the day after day will continue to last the first few days of intensive therapy or longer. It is important to carefully monitor the patient's condition until such improvement occurs. The latest clinical evidence indicates a possible increase in the risk of suicide in the early stages of pregnancy.

It appears that patients with a history of suicidal behavior or patients who were at a significant stage of suicidal directness prior to treatment may be a greater risk for the development of suicidal ideation. Because of the attempt at self-destruction, then, at the hour of jubilation, there is a necessary vigilant gaze behind them. In a meta-analysis of placebo-controlled clinical studies of antidepressants in mental disorders, it was shown that among patients under 25 years of age there was a higher risk of suicidal behavior in small individuals in the antidepressant group, lower in the placebo group.

Therapy with this drug may be accompanied by close monitoring of patients, monitoring of individuals in the high risk group, especially on the beginning of the treatment and after changing the dose of the drug. Patients (and those who look after them) are monitored, so that they may show clinical signs of depression, suicidal behavior, or thoughts and unexpected changes in behavior. , and if they are diagnosed, immediately consult a doctor.

To minimize the potential risk of suicidality, especially early in therapy, the physician may prescribe trazodone to patients in the area during a skin visit.

It is recommended to carefully select the dosing regimen and carry out regular monitoring of patients for the following reasons:

• epilepsy, such patients should not sharply increase or change the dose;
• impairment of liver function or low, especially severe;
• heart disease, such as angina pectoris, impaired cardiac conduction or atrioventricular block of various stages; recent myocardial infarction;
• hyperthyroidism;
• impaired thyroid function, for example, with hypertrophy of the anterior muscle, although such problems do not occur, since the anticholinergic effect of trazodone is insignificant;
• gastrocutaneous glaucoma, movement of the internal eye pressure, although the systemic changes will not become noticeable, as the anticholinergic effect of trazodone is insignificant.

If the patient has a chronic illness, discontinue trazodone therapy.

When taking antidepressants in patients with schizophrenia or other psychotic disorders, psychotic symptoms may worsen. Paranoid thoughts may become more pronounced. During trazodone therapy, the depressive phase of manic-depressive psychosis may change to a manic phase. In such a situation, the stasis of trazodone has a trace.

During one-hour treatment with other serotonergic drugs, such as other antidepressants (for example, tricyclic antidepressants, selective serotonin suppression inhibitors, serotonin suppression inhibitors) well as norepinephrine and MAO inhibitors) and neuroleptics, drug interactions with the development of serotonin syndrome / neuroleptic malignant syndrome have been reported . Cases of neuroleptic malignant syndrome with fatal consequences have been reported after one-hour administration of antipsychotic drugs, for which this syndrome is known to have a possible unexpected reaction. More detailed information can be found in the sections “Interactions with other medicinal drugs and other types of interactions” and “Adverse reactions”.

Severe agranulocytosis can be clinically manifested by a flu-like appearance, a sore throat and an increase in body temperature; whenever these symptoms appear, check the results of a laboratory blood test.

Increased arterial hypotension, including orthostatic arterial hypotension and syncope, has been reported in patients on trazodone therapy. If antihypertensive drugs and trazodone are stopped overnight, the dosage of the antihypertensive drug may need to be changed.

Summer age patients are often more susceptible to the unwanted effects of antidepressants, especially orthostatic arterial hypotension, drowsiness and other anticholinergic effects.

It is necessary to pay attention to possible additive effects when simultaneously treated with other medicinal drugs, such as other psychotropic and antihypertensive drugs, or to the presence of risk factors, such as concomitant illness, such as You can experience such reactions.

It is recommended to provide information to the patient/individual regarding the possibility of such reactions and great caution for the occurrence of such effects after the beginning of therapy, before and after continued dosing. Nya.

Upon completion of a course of trazodone therapy, especially if this course is intermittent, it is recommended to incrementally change the dose until the drug is replaced again, in order to minimize the likelihood of symptoms of withdrawal, such as include tediousness, headaches and sickness.

There is no indication that trazodone hydrochloride is ringing.

During trazodone administration, very rare episodes of QT interval prolongation were reported, an effect that is also characteristic of other antidepressants. It is necessary to carefully administer trazodone at the same time as medicinal preparations, with reasonable care to maintain the QT interval. Use trazodone with caution in patients diagnosed with cardiovascular disease, including those associated with a prolonged QT interval.

In case of aphids, the effects of potent inhibitors of cytochrome CYP3A4 equal to trazodone in syringes may increase. More detailed information can be found in the section “Interactions with other medicinal agents and other types of interactions”

Like other drugs with alpha-adrenergic blocking activity, trazodone causes seizures in very rare cases. In this case, the culprit is due to the intracavernosal injection of an alpha-adrenergic agent, such as adrenaline or metaraminol. Such episodes of trazodone-induced priapism have been reported when surgical intervention was necessary or when the result was permanent state dysfunction. For patients suspected of having an unexpected reaction, trazodone should be taken off carefully.

The drug Trittico, extended-release tablets, containing sucrose. This drug should not be used in patients with rare episodes of illness such as fructose intolerance, glucose-galactose malabsorption syndrome or sucrase-isomaltose deficiency.

If you have an intolerance to certain drugs, consult your doctor first and take this medication first.

Pour in for section analysis

When used in an immunological test to detect drug use in humans, reactivity to the trazodone metabolite m-chlorophenylpiperazine (m-CPP), which is structurally similar to methylenedioxymethamphetamine (MDMA, ecstasy), may cause pseudo positive result for amphetamine. In this situation, it is recommended to carry out analysis to confirm the detection using mass spectrometry (MS).

Interaction

Trazodone enhances the effect of a number of antihypertensive drugs and requires a reduction in their doses.

Combined use with drugs that depress the nervous system ( clonidine , methylodopa ) activates the latter. Antihistamines and anticholinergic drugs enhance the anticholinergic effect of trazodone.

Trazodone enhances the anticholinergic and sedative effects of haloperidol , tricyclic antidepressants, loxapine, phenothiazine, maprotiline, pimozidane and tioxanthene .

Co-administration with MAO inhibitors increases the risk of side effects.

Increases the concentration of phenytoin and digoxin in the blood when used simultaneously.

CYP3A4 blockers may increase plasma of trazodone

Carbamazepine reduces the plasma levels of trazodone

special instructions

Since the drug has adrenolytic bradycardia may occur when taken , so patients with conduction disorders, AV block , or myocardial infarction must be careful.

The drug has sedative activity, so reaction speed and attention may be reduced. During the treatment period, you should refrain from activities that require increased attention and speed of psychomotor reactions.

Precautionary measures

During therapy using Trittico, it is important to adhere to some rules:

• Conduct blood tests periodically. Under the influence of the drug, changes in the indicators of leukocytes or neutrophils are possible.
• Male patients with prolonged and inadequate erections should consult a doctor to adjust the treatment regimen.
• If surgery is planned while taking the pills, the antidepressant should be discontinued in advance.
• One of the side effects is dry mouth, which can provoke the development of dental diseases. To prevent unpleasant consequences, it is recommended to use sugar-free candies or chewing gum during the course of therapy.
• Antidepressants reduce concentration, so during treatment it is worth eliminating any risks.

Analogs

Level 4 ATC code matches:
Pipofezin

Bethol

Incazan

Melitor

Azafen

Miaser

Velafax

Mirtazonal

Venlaxor

Remeron

Venlafaxine

Lerivon

Mirtazapine

Cymbalta

Velaxin

Coaxil

Pyrazidol

Deprim

Gelarium Hypericum

Negrustin

Analogs of the drug are Velaxin, Venlaxor, Melitor, Mirzaten, Mirtastadin, Prefaxin and others.

Trittiko price, where to buy

In Russia, the price of Trittico 150 mg No. 20 is 391-515 rubles, and in Ukraine, buying a drug of the same dosage will cost an average of 217 hryvnia.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine

ZdravCity

• Trittico tablets with controll.
  release 150 mg 20 pcs Aziende Chimiche Riunite Angelini Francesco ACRAFSpA 748 RUR order

Pharmacy Dialogue

• Trittico (tab. 150 mg No. 20)Aziende Chimiche Riunite Angelini Franchesco

  RUR 935 order

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Pharmacy24

• Trittico 75 mg No. 30 tablets Aziende Chimique Riunite Angelini Fracesco, Italy
  308 UAH.order
• Trittico 150 mg No. 20 tablets Aziende Chimique Riunite Angelini Frachesco, Italy

  387 UAH. order

• Trittico XR 300 mg N30 tablets Aziende Quimique Riunite Angelini Francesco A.C.R.A.F. S.p.A., Italy.

  722 UAH. order