Triamtel (Triamtel)

Composition Pharmacodynamics Indications Carefully Contraindications Dosing and Administration Side effects Form release / dosage
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Active substanceHydrochlorothiazide + TriamtereneHydrochlorothiazide + Triamterene
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    Apothec Inc.     Canada
  • Triamtel
    pills inwards 
    VALENTA PHARM, PAO     Russia
    • Dosage form: & nbspPills.
    Composition:
    One tablet contains
    active substances:
    Triamterene - 0.050 g
    Hydrochlorothiazide 0.025 g

    Excipients:
    cellulose microcrystalline, magnesium stearate, aerosil, potato starch, polyvinylpyrrolidone, milk sugar.
    Description:Tablets of yellow color of flat-cylindrical form with a facet.
    Pharmacotherapeutic group:Diuretic combination.
    ATX: & nbsp

    C.03.E.A.01   Hydrochlorothiazide in combination with potassium-sparing drugs

    Pharmacodynamics:
    Combined drug. Has a diuretic and hypotensive effect.
    Contains hydrochlorothiazide - a thiazide diuretic, whose diuretic effect is associated with a disruption of the reabsorption of sodium, chlorine, potassium, magnesium, water in the distal nephron; delays the excretion of calcium ions, uric acid. Has antihypertensive properties; the hypotensive effect develops due to the expansion of arterioles. Does not affect normal blood pressure. The diuretic effect of hydrochlorothiazide occurs in 1-2 hours, reaches a maximum after 4 hours and lasts for 6-12 hours.Antihypertensive effect occurs in 3-4 days, but it may take 3-4 weeks to achieve the optimal therapeutic effect.
    The second component, triamterene, a potassium-sparing diuretic, reduces the permeability of the cellular membranes of the distal tubules for sodium ions and enhances their excretion in the urine without increasing the release of potassium ions. The secretion of potassium ions in the distal tubules is reduced. In combination with hydrochlorothiazide, triamterene is able to reduce hypokalemia caused by thiazide diuretics and enhance the diuretic effect of hydrochlorothiazide.
    The diuretic effect of triamterene after ingestion is noted after 15-20 minutes. The maximum effect is 2-3 hours, the duration of the action is 12 hours.
    Pharmacokinetics:
    Hydrochlorothiazide is absorbed from the gastrointestinal tract incompletely (60-80% of the dose taken internally), however, rather quickly. Binding to plasma proteins is 40%, the apparent volume of distribution is -3-4 l / kg. The maximum concentration of hydrochlorothiazide in the blood plasma is 2 μg / ml. Half-life is about 3-4 hours. Hydrochlorothiazide does not undergo significant metabolism.The primary way of its isolation is renal excretion (filtration and secretion) of the unchanged drug. Hydrochlorothiazide penetrates the placental barrier.
    Triamterene quickly, but not completely (30-70%) of the dose taken is absorbed from the gastrointestinal tract. Moderately (67%) binds to blood plasma proteins. The maximum concentration in the blood plasma is achieved in 2-4 hours. Biotransformed in the liver with the formation of both active and inactive metabolites. The half-life of the drug is normally 1.5-2 hours (for anuria 10 hours), metabolites up to 12 hours. The connection with plasma proteins is 50%. The main way to excrete triamterene with bile and feces, secondary-bunches.
    Indications:
    - edematous syndrome of various genesis (heart failure, nephrotic syndrome, liver cirrhosis);

    - arterial hypertension.
    Contraindications:Hypersensitivity to the drug (including sulfanilamides), chronic renal failure, anuria, acute glomerulonephritis, severe hepatic insufficiency, precoma, hepatic coma, hyperkalemia, lactation, age under 18 (efficacy and safety not established), I trimester of pregnancy.
    Carefully:
    Diabetes mellitus, gout, patients with impaired liver and / or kidney function, deficiency of folic acid (in patients with cirrhosis of the liver).

    Dosing and Administration:
    Triamtel is taken orally, without chewing, with a small amount of water, after eating. With edematous syndrome, the initial dose is determined by the severity of water-electrolyte metabolism and is usually 1 tablet 2 times a day after meals, then it is possible to increase the dose to a maximum daily (3 tablets / day): 2 tablets after breakfast and 1 tablet after lunch. When compensating edema, they switch to maintenance therapy for 1 -2 tablets after 1 -2 days.
    With arterial hypertension - the initial dose of 1 tablet a day (in the morning, after breakfast), then gradually increase the dose. The maximum daily dose is 4 tablets.
    In patients with impaired renal function (creatinine clearance - 30-50 ml / min.), The maximum daily dose is 1 tablet.
    Side effects:Increased fatigue, muscle weakness, convulsions, palpitations, low blood pressure, rarely thrombosis, embolism, increased urea, nephrolithiasis, dry mouth, thirst, pain or discomfort in the epigastric region,nausea, vomiting, abdominal pain of a spastic nature, constipation, diarrhea, jaundice, hemorrhagic pancreatitis, acute cholecystitis, an increase in myopia, hyponatremia, hypomagnesemia, hypochloremia, hypo- or hyperkalemia, hypercalcemia, hyperuricemia, exacerbation of gout, hypertriglyceridemia, decreased glucose tolerance, hyperglycemia , sometimes anemia, allergic reactions: redness of the skin, itching, hives.
    Interaction:
    Medicines that bind intensively to blood proteins (indirect anticoagulants, clofibrate, non-steroidal anti-inflammatory drugs) increase the diuretic effect of the drug.
    The hypotensive effect is enhanced by vasodilators, barbiturates, phenothiazines, tricyclic antidepressants, ethanol.
    Triamtel enhances the neurotoxicity of salicylates, weakens the effect of oral hypoglycemic drugs, norepinephrine, epinephrine and antidotal drugs, increases the effects (including side effects) of cardiac glycosides, cardiotoxic and neurotoxic effects of lithium, the effect of curare-like muscle relaxants, reduces the excretion of quinidine. With the simultaneous administration of methyldopa, the risk of hemolysis increases.
    Kolestyramin reduces the absorption of Triamtel.
    Chlorpropamide with simultaneous application with Triamtel can lead to severe hypokalemia.
    When combined with non-steroidal anti-inflammatory drugs, it is possible to develop acute renal failure.
    Special instructions:
    With prolonged use of Triamtel, it is necessary to control the content of sodium, potassium, chlorine, urea, creatinine, glucose, uric acid, peripheral blood (in case of suspected folate deficiency) in the blood.
    At the beginning of treatment, the drug should avoid potentially dangerous activities requiring increased attention and speed of psychomotor reactions (against the background of lowering blood pressure - slowing the speed of psychomotor reactions).
    Do not take two doses of the drug at the same time, if the drug was missed.
    Form release / dosage:Pills.
    Packaging:10 tablets per contour cell package; on 20, 30, or 50 tablets in cans of glass mass or in cans of polymeric or in cans made of polystyrene.
    Storage conditions:List B. In a dry, protected from light and inaccessible to children place.
    Shelf life:2 years.Do not use after expiry of the expiration date on the package
    Terms of leave from pharmacies:On prescription
    Registration number:P N002253 / 01-2003
    Date of registration:14.08.2008
    The owner of the registration certificate:VALENTA PHARM, PAO VALENTA PHARM, PAO Russia
    Manufacturer: & nbsp
    Information update date: & nbsp23.09.2015
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