Trichopol - instructions for use, reviews, analogs and forms of release (tablets 250 mg, suppositories or tablets vaginal 500 mg, solution) for the treatment of trichomoniasis, vaginosis and other infections in adults, children and pregnancy

In this article, you can read the instructions for using the drug Trichopol. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Trichopol 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 Trichopolum in the presence of available structural analogues. Use for the treatment of vaginosis,trichomoniasis and other infectious diseases in adults, children, as well as during pregnancy and lactation. The scheme of taking the drug.

Trichopol - antiprotozoal preparation with antibacterial activity, a derivative of 5-nitroimidazole. The mechanism of action is the biochemical reduction of the 5-nitro group of Metronidazole (the active substance of the drug Trichopolum) by intracellular transport proteins of anaerobic microorganisms and protozoa. The restored 5-nitro group of metronidazole interacts with the DNA of a cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of microorganisms.

In combination with Amoxicillin shows activity against Helicobacter pylori (amoxicillin suppresses the development of resistance to metronidazole).

Metronidazole has no bactericidal action against most bacteria and facultative anaerobes, fungi and viruses. In the presence of mixed flora (aerobes and anaerobes) metronidazole displays a synergy with antibiotics effective against conventional aerobes.

Metronidazole increases the sensitivity of tumors to irradiation, causes sensitization to ethanol (alcohol) (disulfiram-like action), stimulates reparative processes.

Pharmacokinetics

After taking the drug inside metronidazole quickly and almost completely absorbed from the digestive tract. Eating slows the absorption rate and Cmax of metronidazole in the serum. Metronidazole penetrates most tissues and body fluids, including lungs, kidneys, liver, skin, cerebrospinal fluid, brain, bile, saliva, amniotic fluid, abscess cavities, vaginal secretions, seminal fluid, breast milk, penetrates the BBB and the placental barrier. The main metabolite (2-oxymetronidazole) also has antiprotozoal and antibacterial action. Metronidazole is excreted by the kidneys - 60-80% (20% unchanged), through the intestine - 6-15%.

In elderly patients the excretion of metronidazole is reduced by the kidneys.

Indications

Treatment of infectious-inflammatory diseases caused by microorganisms sensitive to the preparation:

• trichomoniasis;
• bacterial vaginosis;
• all forms of amoebiasis (diseases of intestinal and extraintestinal localization, including amoebic liver abscess, amoebic dysentery, and asymptomatic amoebiasis);
• giardiasis;
• Periodontal infections (including acute ulcerative gingivitis, acute odontogenic infections);
• anaerobic bacterial infections (gynecological and abdominal CNS infections, bacteremia, sepsis, endocarditis, infections of bones and joints, skin and soft tissue, respiratory tract infections) caused by Bacteroides spp., Clostridium spp., Eubacterium spp., Peptococcus spp., Peptostreptococcus spp . and anaerobes sensitive to metronidazole;
• treatment of Helicobacter pylori infections in peptic ulcer of the stomach or duodenum combined with bismuth preparations and antibiotic, for example, amoxicillin;
• preventive appointment before surgery on the digestive tract and reproductive organs.

Forms of release

Tablets 250 mg.

Tablets vaginal (in the people for some reason called candles) 500 mg.

Instructions for use and dosing regimen

The drug is administered orally, during or after a meal, the tablets are taken without chewing.

Trichomoniasis

Adults and children over 10 years of age are prescribed 250 mg (1 tablet) 3 times a day or 500 mg (2 tablets) 2 times a day for 7 days. Women need to additionally appoint metronidazole in the form of vaginal suppositories or tablets. If necessary, you can repeat the course of treatment. Between the courses should be a break in 3-4 weeks with the conduct of repeated control laboratory tests.

An alternative regimen is the administration of 750 mg (3 tablets) in the morning and 1250 mg (5 tablets) in the evening or 2000 mg (8 tablets) per day once. Duration of treatment is 2 days. Treatment is carried out at the same time for both sexual partners.

Children aged 3 to 7 years are prescribed 125 mg (1/2 tablet) twice a day; at the age from 7 to 10 years - 125 mg (1/2 tablet) 3 times a day. The course of treatment is 7 days.

Bacterial vaginosis

Adults appoint 500 mg (2 tablets) 2 times a day for 7 days or 2000 mg (8 tablets) per day once. Simultaneous treatment of the sexual partner is not required.

Amebiasis

When invasive forms of intestinal amebiasis in susceptible patients (including amoebic dysentery), adults and children over 10 years of age are prescribed 750 mg (3 tablets) 3 times a day. Children aged 3 to 7 years - 250 mg (1 tablet) 4 times a day; at the age of 7 to 10 years - 375 mg (1.5 tablets) 3 times a day. The course of treatment is usually 5 days.

With amebiosis of the intestine in less susceptible patients and with chronic amoebic hepatitis, adults and children over 10 years of age are prescribed 375 mg (1.5 tablets) 3 times a day. Children aged 3 to 7 years - 125 mg (1/2 tablet) 4 times a day; at the age from 7 to 10 years - 250 mg (1 tablet) 3 times a day.The duration of treatment is 5-10 days.

In amoebic liver abscess and other forms of extra-intestinal amebiasis in adults and children over 10 years prescribed 375 mg (1.5 tablets) 3 times a day. Children aged 3 to 7 years - 125 mg (1/2 tablet) 4 times a day; at the age from 7 to 10 years - 250 mg (1 tablet) 3 times a day. The course of treatment is 5 days.

With asymptomatic carriage of cysts, adults and children over 10 years of age are prescribed 375-750 mg (1.5-3 tablets) 3 times a day. Children aged 3 to 7 years - 125 mg (1/2 tablet) 4 times a day; at the age from 7 to 10 years - 250 mg (1 tablet) 3 times a day. The duration of treatment is 5-10 days.

Lambliasis

Adults and children over 10 years of age are prescribed 500 mg (2 tablets) twice a day for 5-7 days; or 2000 mg (8 tablets) once a day for 3 days.

Children aged from 3 to 7 years of age - 250-375 mg (1-1.5 tablets) 1 times a day for 5 days, or 500-750 mg (2-3 tablets) 1 time per day for 3 days. Children aged 7 to 10 years - 250 mg (1 tablet) 2 times a day for 5 days, or 1000 mg (4 tablets) once a day for 3 days.

Infections caused by anaerobic bacteria

Treatment of anaerobic infections usually begins with IV infusions. As soon as possible, the treatment should be continued with metronidazole in the form of tablets.

Adults and children over 10 years of age are prescribed 500 mg (2 tablets) 3-4 times a day. The duration of treatment should not exceed 7 days.

Children under 10 years with the treatment of anaerobic infections are advised to use metronidazole in the form of infusion solutions.

Eradication of Helicobacter pylori

Assign 500 mg (2 tablets) 3 times a day for 7 days (as part of combination therapy, for example, with amoxicillin 2.25 g /).

Candles or vaginal tablets

Intravaginally (deep), having previously released the tablet from the contour pack and moistened it with boiled chilled water.

Trichomonas vaginitis: 1 table / day for 7-10 days in combination with taking the drug inside.

Nonspecific vaginitis, bacterial vaginosis: 1 table / day for 7 days (if necessary, combined with taking the drug inside). The course of treatment - no more than 10 days and no more than 2-3 times a year.

Side effect

• epigastric pain;
• nausea, vomiting;
• diarrhea, constipation;
• intestinal colic;
• decreased appetite;
• anorexia;
• a taste disorder;
• dry mouth;
• headache;
• dizziness;
• increased excitability, irritability, depression;
• sleep disturbance, drowsiness;
• hallucinations;
• convulsions;
• urinary incontinence;
• staining the urine in a red-brown color;
• excessive development of fungal flora of the vagina (including candidiasis of the vagina);
• skin rash, itching, urticaria;
• arthralgia;
• leukopenia, agranulocytosis, neutropenia, thrombocytopenia;
• pustular eruptions.

Contraindications

• leukopenia (including in the anamnesis);
• organic lesions of the central nervous system (including epilepsy);
• hepatic insufficiency (in case of prescribing the drug in high doses);
• 1 trimester of pregnancy;
• lactation period (breastfeeding);
• children under 3 years;
• increased sensitivity to metronidazole or other derivatives of nitroimidazole.

Application in pregnancy and lactation

Metronidazole penetrates the placental barrier, so Trichopolum is contraindicated for use in the first trimester of pregnancy. The use of the drug in the 2nd and 3rd trimesters is only possible if the intended benefit to the mother exceeds the potential risk to the fetus.

Since metronidazole is excreted in breast milk, reaching concentrations close to the concentration in the blood plasma, it is necessary to stop breastfeeding if Trichopol is needed during lactation.

special instructions

With care, Trichopol should be administered to patients with severe hepatic insufficiency, as a result of slowing metabolism, the concentration of metronidazole and its metabolites in plasma increases.

Caution is required when appointing Trichopolis to patients with oppression of bone marrow hematopoiesis and CNS functions, as well as elderly patients. The appearance of ataxia, dizziness and any other deterioration in the neurological status of patients requires discontinuation of treatment.

With prolonged therapy with metronidazole (more than 10 days), monitor the picture of peripheral blood and liver function.

With leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process.

Metronidazole should be avoided in patients with porphyria.

When treating trichomonadal vaginitis in women and trichomoniasis in men, it is necessary to abstain from sexual activity. It is necessary to simultaneously treat sexual partners. After trichomoniasis therapy, control tests should be performed for three consecutive cycles before and after menstruation.

After treatment of giardiasis, if symptoms persist, 3 feces analysis should be performed at intervals of several days in 3-4 weeks (in some successfully treated patients lactose intolerance caused by invasion can persist for several weeks or months, recalling the symptoms of giardiasis).

Patients should refrain from drinking alcohol during metronidazole therapy, and also for at least 48 hours after completion of treatment, because of the potential for developing disulfiram-like reactions: abdominal pain of a spastic nature, nausea, vomiting, headache, sudden rush of blood to face.

During treatment with metronidazole, urine may acquire a dark or reddish-brown color due to the presence of water-soluble dyes.

Trichopol can cause immobilization by treponem, which leads to Nelson's false positive test.

Use in Pediatrics

In combination with amoxicillin, Trichopol is not recommended in children and adolescents under the age of 18 years.

Impact on the ability to drive vehicles and manage mechanisms

When taking the drug should be avoided potentially hazardous activities,requiring increased concentration of attention, rapidity of psychomotor reactions, especially driving of vehicles and servicing mechanisms.

Drug Interactions

Metronidazole enhances the effect of Warfarin and other anticoagulants coumarin (with this combination requires a reduction in the doses of both drugs).

Cimetidine suppresses the metabolism of metronidazole, which can lead to an increase in its concentration in the blood plasma and an increased risk of developing adverse reactions.

Simultaneous administration of drugs stimulating the activity of microsomal liver enzymes (phenobarbital, phenytoin) can accelerate the elimination of metronidazole, which leads to a decrease in its concentration in the blood plasma.

In patients who receive long-term treatment with lithium preparations in high doses, with the administration of Trichopolum, an increase in the concentration of lithium in the blood plasma and the development of symptoms of intoxication are possible.

It is not recommended to combine metronidazole with nondepolarizing muscle relaxants (vecuronium bromide).

With the combined administration of Trichopol and cyclosporine, an increase in the concentration of cyclosporin in the blood plasma can be observed.

Metronidazole reduces the clearance of fluorouracil, which can cause an increase in toxicity of the latter.

With simultaneous use of metronidazole can increase plasma concentrations of bisulfane.

Sulfonamides increase the antimicrobial effect of metronidazole.

Similarly, Disulfiram causes Trichopol to be intolerant to ethanol (alcohol). The simultaneous use of Trichopolum with disulfiram can lead to the development of various neurological symptoms (the interval between the use of these drugs should be at least 2 weeks).

Analogues of the drug Trichopolum

Structural analogs for the active substance:

• Bacimex;
• Deflamon;
• Clion;
• Metrovagin;
• Metrogil;
• Metroxan;
• Metrolacker;
• Metron;
• Metronidazole;
• Metronidazole Nycomed;
• Metronidazole-AKOS;
• Metronidazole-Altpharm;
• Metronidazole-UBF;
• Metronidazole-ESCOM;
• Metronidal;
• Metroseptol;
• Orvagil;
• Rosamet;
• Rosex;
• Siptrogyl;
• Trichobrol;
• Trichosept;
• Flagel;
• Efloran.

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