Pharmacological action:
The active substance Trichopolum - metronidazole - active against protozoa and anaerobic aerobic. In vivo metronidazole restores nitro may then damage the DNA of microorganisms.
To Trichopolum sensitive Giardia, Trichomonas, balantidium amoeba, Bacteroides, fuzobakterii, Clostridium.
Trichopolum fairly rapidly absorbed in the digestive tract and reaches its maximum concentration after 1.5-3 hours after administration, reaching a maximum speed of concentration dose-dependent. Reception Trichopolum simultaneously with food may worsen the process of absorption and increase the time required to achieve maximum plasma concentration. Trichopolum penetrates the blood-brain barrier and the placental sufficiently uniformly distributed in the body getting into the bile, vaginal secretions, saliva, semen, cerebrospinal fluid and peritoneal, in the liver tissue of the brain. Trichopolum metabolism occurs in the liver, active metabolites are also capable of acting antibacterial and antiprotozoal. The half-life is 6-8 hours Trichopolum, with severe liver pathologies half-life may increase. Excretion occurs mainly Trichopolum kidneys (80 %). When treating Trichopolum may change urine color to red- brown or dark color, which can be explained by the presence of dyes formed from the metabolism of the drug.
Indications for use:
- Trichomoniasis;
- Amebiasis;
- Giardiasis;
- Vaginitis caused by microorganisms sensitive to Trichopolum;
- Surgical infections caused by susceptible microorganisms to Trichopolum;
- In the complex therapy for eradication of Helicobacter pylori;
- Other infections caused by susceptible microorganisms.
Method of application:
1. Anaerobic infections:
prophylaxis: initial dose of 1-1.5 g once, followed by 0.75 g per day, dividing the daily dose into 3 doses.
- Treatment: 0.75-1.5 g per day, dividing the daily dose into 3 doses for children 6 to 12 years 0.375 g, divided into 3 doses.
Trichopolum advised to take during or immediately after a meal, therapy usually does not last more than a week. Trichopolum appointed as a part of complex therapy or as monotherapy.
2. Treatment of trichomoniasis:
For successful treatment of trichomoniasis treatment of both partners is necessary.
- treatment of trichomoniasis in women: 1 tablet twice a day and one vaginal suppository once a day for 10 days.
- treatment of trichomoniasis in men: 1 tablet twice a day, for 10 days. There are other schemes: 3 tablets ( 0.75g) tablets in the morning and 5 (1.25 g) in the evening for 2 days or 8 tablets (2 g) Trichopolum once.
3. Bacterial vaginitis: 1 g per day in 2 divided doses ( morning and 0.5 g of 0.5 g in the evening) for two weeks or once g.
4. Amebiasis: by 0.5 g three times a day for a week, for children whose weight is more than 20 kg the dose is calculated according to the weight, single dose of 10 mg per kilogram of body weight three times a day, the course of therapy usually lasts a week.
5. Eradication of Helicobacter pylori. Trichopolum included in the scheme eradication Helicobacter pylori, the recommended daily dose of 0.5 g, divided into 2 doses, 1-2 weeks course.
Patients with hepatic impairment, need special scheme destination Trichopolum as biotransformation occurs in the liver and liver failure can lead to accumulation of metronidazole and hepatic coma. Such patients should be applied Trihopol at a dose that is 30 % of normal.
Patients with renal insufficiency not usually require dose adjustment in case of passing hemodialysis after the procedure, reception Trichopolum be repeated.
For elderly patients required dose reduction Trichopolum, when using the drug in average daily doses requires careful medical supervision, administration of metronidazole at high doses in these patients is undesirable.
Side effects:
On the part of the digestive system: dyspepsia, dry and / or metallic taste in the mouth, stomatitis, pancreatitis drug (which is reversible for to remove the drug), changes in liver function tests, hepatitis ( rarely).
From the nervous system and sensory organs: neuropathy, myopia, diplopia, headache, ataxia, dizziness, cerebellar syndrome.
From the side of hematopoiesis: there may be a decrease in the amount of blood cells: anemia, thrombocytopenia, agranulocytosis.
Other side effects include allergic reactions ( rash, anaphylactic shock, angioedema), change in urine color to red-brown.
Contraindications:
Contraindication is the children's age (up to 6 years), intolerance to metronidazole, or other components of the drug, up to 12 weeks of pregnancy, breast-feeding.
Pregnancy:
Absolute contraindication for Trichopolum destination, duration of pregnancy up to 12 weeks. In more than 12 gestation weeks Trihopol can be used under strict indications and under strict medical supervision.
Interaction with other drugs:
Trichopolum may increase the effects of coumarin derivatives, so their joint appointment requires dose adjustment of the anticoagulant.
Drugs affecting microsomal liver enzymes may increase or decrease the action Trichopolum so inducers of microsomal enzymes (phenobarbital, phenytoin) may reduce the effect Trichopolum, due to more rapid clearance of the drug; inhibitors (cimetidine) may lengthen the opposite Trichopolum isolation from the body, which leads to an increase in its concentration.
With simultaneous application Trichopolum lithium preparations, should be carefully monitored the concentration of lithium in the blood, as it may increase the toxic effect.
Trichopolum may enhance the toxic effect of terfenadine, astemizole, and on the conducting system of the heart, extending the interval Q-T, which increases the risk of arrhythmias, including fatal.
Metronidazole enhances the side effects of disulfiram (psychosis, disorientation), so their joint application is impossible. Metronidazole should be appointed at the end of 2 weeks after discontinuation of disulfiram.
Trichopolum may increase the toxicity of fluorouracil.
Overdose:
Overdose symptoms may include nausea, vomiting, convulsions, ataxia. Treatment of an overdose is directed to the early elimination of the drug (possible hemodialysis), and relief of symptoms.
Form:
250 mg tablets, 20 tablets per pack.
Vaginal tablets 500 mg, 10 tablets per pack.
Storage conditions:
Trichopolum should be stored in dry, well -ventilated place, protected from direct sunlight at room temperature.
Synonyms:
Gravagin, Metrogil vaginal cream, Metrogil gel Efloran.
Extras:
While receiving Trichopolum forbidden alcohol, as development disulfiramopodobnyh reactions ( sharp epigastric pain, a sensation of heat, headache, etc.).
Caution must be exercised when prescribing to patients with pathologies Trichopolum CNS. If you have side effects from the nervous system, should reconsider the advisability of appointing the drug.
When liver failure Trihopol be prescribed under strict indications and under strict medical supervision, because of the possible accumulation of the drug and the deterioration of the patient up to hepatic coma.
If the application Trichopolum patient experience side changes from the side of the blood, all subsequent applications metronidozola should be overseen hemogram. After application of a preparation requires control of the analysis of blood during 10 days.
After applying Trichopolum may cause candidiasis of the oral mucosa, genitalia, digestive tract, this condition requires the use of antifungal agents.
During application Trichopolum may be some deviation in biochemical assays: changes in the level of transaminases, glucose, triglycerides.
Metronidazole is able to penetrate into breast milk, so if its reception is required, it should temporarily stop breastfeeding.
During therapy Trichopolum should avoid working with complex mechanisms and control vehicles because of the risk of dizziness, confusion, seizures.
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