Trigrim - instructions for use, analogs, reviews and release forms (2 mg, 5 mg and 10 mg tablets) diuretic for the treatment of edema, heart failure and hypertension in adults, children and pregnancy. Composition

In this article, you can read the instructions for using a diuretic medicine Trigrim. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Trigrim in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Trigrim in the presence of existing structural analogues.Use for the treatment of edema, heart failure and hypertension in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Trigrim - Diuretic preparation. The main mechanism of action is due to the reversible binding of torasemide (the active substance of the preparation Trigrim) to the Na / Cl / K transporter located in the apical membrane of the thick segment of the ascending loop of Henle, as a result of which the reabsorption of sodium ions decreases or completely inhibits, which leads to a decrease in the osmotic pressure of the intracellular fluid and reabsorption of water.

At the same time, due to the antialdosteron effect, torasemide is less likely than Furosemide to cause hypokalemia, with greater activity and duration of action.

Composition

Torasemide + auxiliary substances.

Pharmacokinetics

After intake Trigrim quickly and almost completely absorbed from the digestive tract. Bioavailability is about 80-91% or more with swelling. Eating does not affect the absorption of the drug. Binding to blood plasma proteins - 99%. Metabolised in the liver with the participation of isoenzymes of the cytochrome P450 system with the formation of 3 metabolites M1, M3 and M5.On average, 80-83% of the dose is excreted by the kidneys through tubular secretion in an unchanged form (24-25%) and in the form of metabolites (M1 - 11-12%, M3 - 3%, M5 - 41-44%).

Indications

• edema caused by heart failure, liver, kidney and lung diseases;
• primary arterial hypertension (used as a monotherapy or in combination with other antihypertensive drugs).

Forms of release

Tablets 2.5 mg, 5 mg and 10 mg.

Instructions for use and dosage

The drug is prescribed to adults, inside, regardless of food intake.

With swelling, the drug is prescribed in a dose of 5 mg once a day. If necessary, the dose can be gradually increased to 20 mg once a day. In some cases, up to 40 mg per day is recommended.

When edema associated with congestive heart failure is prescribed in a dose of 5-20 mg once a day. If necessary, the daily dose can be gradually increased, doubling it, a maximum of 200 mg.

In edema associated with chronic renal failure, the initial dose is 20 mg per day. If necessary, this dose can be gradually increased, doubling it, until the optimal diuretic effect is achieved. The maximum daily dose is 200 mg.

When edema associated with cirrhosis of the drug is prescribed in a dose of 5-10 mg once a day.If necessary, this dose can be gradually increased, doubling it, until an appropriate diuretic action is achieved. Appropriate studies were not conducted in patients with liver disease with doses greater than 40 mg per day.

With primary arterial hypertension, the dose is 2.5 mg once a day. If necessary, the dose can be gradually increased to 5 mg per day. According to studies, a dose of more than 5 mg per day does not lead to a further decrease in blood pressure. The maximum effect is achieved after approximately 12 weeks of continuous treatment.

Older patients do not need a dose adjustment.

Side effect

• decrease in the number of red blood cells and leukocytes, as well as platelets;
• violation of the electrolyte balance;
• hypokalemia;
• increased serum levels of uric acid, glucose and lipids;
• circulatory disorders;
• thromboembolism (due to dehydration);
• a decrease in blood pressure;
• symptoms of gastrointestinal dysfunction;
• loss of appetite;
• dry mouth;
• pancreatitis;
• acute urinary retention;
• increased levels of urea and creatinine in plasma;
• headache;
• dizziness;
• weakness;
• drowsiness;
• confusion of consciousness;
• convulsions, paresthesias in the limbs;
• visual impairment;
• noise in ears;
• deafness;
• itching;
• rashes;
• photosensitization.

Contraindications

• anuria;
• hepatic coma and precomatosis;
• chronic renal failure with increasing azotemia;
• arrhythmia;
• arterial hypotension;
• pregnancy;
• lactation period (no data on lactation use);
• age under 18 years (effectiveness and safety not established);
• hypersensitivity to torasemide and sulfonamides.

Application in pregnancy and lactation

The drug Trigrim is contraindicated in pregnancy and lactation (breastfeeding).

Use in children

Contraindicated in children and adolescents under the age of 18 years (efficacy and safety not established).

Application in elderly patients

Older patients do not need a dose adjustment.

special instructions

With prolonged treatment, it is recommended to monitor electrolyte balance, glucose, uric acid, creatinine and lipids in the blood.

With hypokalemia, hyponatremia, hypovolemia, or urinary disorders before Trigrim is administered, all of these conditions are eliminated.

If you have diabetes, you need to monitor carbohydrate metabolism.

When thrombocytopenia or oppression of bone marrow function, as well as skin rashes should be canceled drug.

Impact on the ability to drive vehicles and manage mechanisms

At the initial stage of admission, it is not recommended to drive vehicles and maintain machinery due to the possibility of dizziness.

Drug Interactions

Trigrim increases the sensitivity of the myocardium to cardiac glycosides with potassium or magnesium deficiency.

With simultaneous administration with mineral- and glucocorticoids, laxatives, an increase in the excretion of potassium is possible.

Trigrim enhances the effect of antihypertensive drugs.

In high doses, Trigrim can enhance the toxic effects of aminoglycosides, antibiotics, cisplatin; nephrotoxic effect of cephalosporins, as well as cardio- and neurotoxic effects of lithium.

Torasemide can enhance the action of curare-like muscle relaxants and theophylline.

When salicylates are used in high doses, their toxic effect may be increased, and the action of antidiabetics, on the contrary, is weakened.

Sequential or simultaneous administration of torasemide with ACE inhibitors can lead to a transient drop in blood pressure. This can be avoided by decreasing the initial dose of ACE, or by lowering the dose of torasemide (or temporarily abolishing it).

Torasemide reduces the effect of vasoconstrictor (epinephrine and norepinephrine).

Nonsteroidal anti-inflammatory drugs (NSAIDs) and probenecid can reduce the diuretic and hypotensive effect of torasemide.

Kolestyramin is able to reduce the absorption of torasemide from the gastrointestinal tract (in experimental studies on animals).

Analogues of the drug Trigrim

Structural analogs for the active substance:

• Britomar;
• Diver;
• Torasemide.

Analogues for the pharmacological group (diuretics):

• Aquaphor;
• Acrypamide;
• Aldactone;
• Arindap;
• Arifon;
• Arifon retard;
• Brinaldiks;
• Brinerdin;
• Britomar;
• Brusniver;
• Bufenox;
• Verospilactone;
• Veroshpiron;
• Hydrochlorothiazide;
• Hypothiazide;
• Diazide;
• Diakarb;
• Diver;
• Isobar;
• Indap;
• Indapamide;
• Inder;
• Ionik;
• Kanefron H;
• Clopamid;
• Lasix;
• Lauras;
• Mannitol;
• Mannitol;
• Urea;
• Diuretic collection;
• Niebelong H;
• Normatens;
• Oxodoline;
• Pamid;
• Retapres;
• Spironaxan;
• Spironolactone;
• Tenzar;
• Torasemide;
• Triamtel;
• Urakton;
• Urological (diuretic) collection;
• Phytonefrol (Urological collection);
• Furosemide;
• Fursemide;
• Cimalon.

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