Description

Buy Trittico XR Trazodone 300mg tablets #30

Description of Trittico XR 300 mg tablets #30:

Trittico XR tablets are used for the following indications: depressive disorders with / without anxiety.

Ingredients:

Active substance: trazodone hydrochloride 300 mg;;
Excipients: hypromelose, anhydrous silica dioxide, sodium stearyl fumarate, pregelatinizing modification starch (E 1442).

Pharmacodynamics of Trittico XR 300 mg tablets #30:

Trazodone is a triazolepyridine derivative. It is effective for the treatment of depressive conditions, including depression associated with anxiety and sleep disorders, and has a rapid onset of action (about 1 week).

Trazodone is a serotonin reuptake inhibitor and an antagonist of 5-HT2 receptors, the activation of which is usually associated with insomnia, anxiety, psychomotor agitation and changes in sexual function.

Unlike other psychotropic drugs, trazodone is not contraindicated in glaucoma and urinary disorders, it does not have extrapyramidal effects and does not potentiate adrenergic transmission. Trazodone lacks anticholinergic activity and therefore does not exhibit the typical effects of tricyclic antidepressants on cardiac function.

Pharmacokinetics of Trittico XR 300 mg tablets #30:

After taking trazodone hydrochloride (in the form of spit-coated tablets, prolonged release) at an equal concentration (up to 300 mg per dose for 11 consecutive days), Cmax (maximum concentration) is achieved in blood plasma at equal concentration) 2068.0 ± 635.7 ng /ml with tmax (hour before reaching the maximum concentration) 7.57 ± 2.3 and AUC (area under the pharmacokinetic curve at equal concentration), which becomes 31671.32 ± 10120.98.

In vitro studies with human liver microsomes have shown that trazodone is primarily metabolized by cytochrome P450 3A4 (CYP3A4).

Indications for use of Trittico XR 300 mg tablets #30:

Depressive disorders with or without anxiety.

Contraindications of Trittico XR 300 mg tablets #30:

Known hypersensitivity to the drug or its components. Alcohol intoxication and intoxication with sleeping pills. Acute myocardial infarction.

Interactions:

Are common

The sedative effects of antipsychotics, hypnotics, anxiolytics and antihistamines may be enhanced. It is recommended to reduce the dose of these drugs.
Oral contraceptives, phenytoin, carbamazepine and barbiturates, due to their effects on the liver, accelerate the metabolism of antidepressants. Cimetidine and other antipsychotics slow down the metabolism of antidepressants.

CYP3A4 inhibitors

Data from in vitro drug metabolism studies indicate the potential for drug interactions when trazodone is used concomitantly with inhibitors of cytochrome CYP3A4, such as erythromycin, ketoconazole, itraconazole, ritonavir, indinavir and nefazodone. The use of CYP3A4 inhibitors may lead to a significant increase in trazodone plasma concentrations. In vivo studies in healthy volunteers confirmed that following administration of ritonavir 200 mg twice daily, trazodone plasma levels increased more than 2-fold, resulting in nausea, syncope and hypotension. Therefore, when using trazodone concomitantly with a strong CYP3A4 inhibitor, it would be advisable to reduce the dose of trazodone.
However, if possible, concomitant use of trazodone and strong CYP3A4 inhibitors should be avoided altogether.

Carbamazepine

When trazodone is used concomitantly with carbamazepine, plasma concentrations of trazodone decrease. When used simultaneously with carbamazepine at a dose of 400 mg/day, plasma concentrations of trazodone and its active metabolite m-chlorophenylpiperazine decreased by 76% and 60%, respectively. The patient’s condition should be carefully monitored regarding the need to increase the dose of trazodone.

Tricyclic antidepressants

There is a risk of drug interaction, so concomitant use with trazodone should be avoided. With simultaneous use, the development of serotonin syndrome and adverse reactions from the cardiovascular system should be expected.

Fluoxetine

Rare cases of increased trazodone plasma levels and adverse effects have been reported during concomitant use of trazodone with fluoxetine (a CYP1A2/2D6 inhibitor). The mechanism underlying this pharmacokinetic interaction is not fully understood. A pharmacodynamic interaction (serotonin syndrome) cannot be excluded.

Monoamine oxidase inhibitors (MAO)

Isolated cases of interaction between trazodone and MAO inhibitors have been reported. Although some doctors practice the simultaneous use of these drugs, it is not recommended to use trazodone simultaneously with MAO inhibitors or within 2 weeks after their discontinuation. It is also not recommended to begin therapy with MAO inhibitors within 1 week after discontinuation of trazodone.

Phenothiazines

When used concomitantly with phenothiazines, such as chlorpromazine, fluphenazine, levomepromazine, perphenazine, cases of severe orthostatic arterial hypotension have been observed.

Anesthetics/muscle relaxants

Trazodone hydrochloride may enhance the effects of muscle relaxants and volatile anesthetics. Such combinations should be used with caution.

Alcohol

The sedative effects of alcohol under the influence of trazodone become more pronounced. During trazodone therapy, the patient should avoid drinking alcohol.

Levodopa

Antidepressants may speed up the metabolism of levodopa.

Other means

When trazodone is used concomitantly with drugs known to prolong the QT interval, the risk of ventricular arrhythmias, including torsade de pointes, may increase. Use these agents concomitantly with trazodone with caution.

Trazodone is only a very weak norepinephrine reuptake inhibitor and does not affect the blood pressure response to tyramine therapy, so an effect of trazodone on the hypotensive effects of guanethidine compounds should not be expected. However, studies in laboratory animals have shown that trazodone can inhibit most of the acute effects of clonidine.

Although drug interactions have not been reported when other types of antihypertensive drugs are used concomitantly with trazodone, the possibility of potentiation of effects should be considered.

The incidence of adverse effects may increase when trazodone is used concomitantly with preparations containing common St. John’s wort (Hypericum perforatum).

Oral anticoagulants and/or antiplatelet agents: Rarely, effects on the anticoagulant effect (abnormal laboratory values and/or clinical signs and symptoms) with increased bleeding have been reported.

Cases of changes in prothrombin time values have been reported in patients who used trazodone and warfarin concomitantly.

Serum levels of digoxin or phenytoin may be increased when these drugs are used concomitantly with trazodone. Serum levels of the above-mentioned agents should be monitored in patients receiving such therapy.

Application Features

The medicinal drug Trittico XR in the form of tablets, sealed with a spit-coated film, prolonged release, should be taken before taking the hedgehog, in addition to other medicinal forms of the drug Trittiko, which is required to be taken in go immediately after.

When switching from stagnation of other dosage forms of the drug Trittico to treatment with Trittico XR in the form of tablets, spit-coated, extended-release, the drug must re-evaluate the dosing regimen and method of stasis, and also carry out monitoring Monitoring the clinical status of the patient until stabilization.

Pregnant

Pregnant women should use this preparation with caution. If trazodone is used by a pregnant woman, the baby’s condition should be monitored after childbirth to identify a possible withdrawal syndrome, taking into account the benefit to the mother / risk to the fetus ratio.

Limited data indicate that trazodone passes into breast milk in small quantities, but the content of the active metabolite is unknown. Due to insufficient data, the decision to prolong / discontinue breastfeeding or to continue / discontinue trazodone therapy should be made taking into account the benefits of breastfeeding for the baby and the benefits of trazodone therapy for the mother.

Children

Do not use for children.

Drivers

Slight to moderate trazodone affects the ability to drive and operate other machinery. Patients should be warned that, before driving and operating other mechanisms, it is necessary to make sure that there is no drowsiness, sedation, dizziness, confusion or blurred vision while taking trazodone.

Overdose of Trittico XR 300 mg tablets #30:

There is no specific antidote. Adults who have taken more than 1 g of trazodone, or children who have taken more than 150 mg of trazodone, should be given activated charcoal within 1 hour after an overdose is detected. In other cases, in adults, gastric lavage may be appropriate for 1 hour after taking potentially life-threatening doses.

It is necessary to monitor the patient’s condition for at least 6 hours after taking the preparation (or 12 hours when taking a sustained-release preparation). Blood pressure, pulse, and the Glasgow Coma Scale (GCS) should be monitored. In case of a decrease in the number of points on the GCS, the oxygen saturation of the blood should be monitored.

In symptomatic patients, cardiac monitoring is necessary.

When some short-term seizures appear, treatment is not required. For frequent or prolonged seizures, intravenous diazepam (0.1-0.3 mg / kg body weight) or lorazepam (4 mg for adults and 0.05 mg / kg for children) is prescribed.

If these measures do not control seizures, intravenous infusion of phenytoin may be appropriate. If necessary, oxygen is used and the acid-base balance and metabolic disorders are corrected.

In the case of arterial hypotension and excessive sedation, symptomatic and supportive therapy is used. If severe arterial hypotension persists, the advisability of using inotropic preparations, for example, dopamine or dobutamine, should be weighed.

Treatment of overdose

There is no specific antidote. Adults who have taken more than 1 g of trazodone or children who have taken more than 150 mg of trazodone should be given activated charcoal within 1 hour of detection of an overdose. In other cases, in adults, gastric lavage may be advisable within 1 hour of taking potentially life-threatening doses.

It is necessary to monitor the patient’s condition for at least 6 hours after taking the drug (or 12 hours when taking a slow-release drug). Blood pressure, pulse and Glasgow Coma Scale (GCS) should be monitored. If the GCS score decreases, blood oxygen saturation should be monitored.

In symptomatic patients, cardiac monitoring is necessary.

If isolated short-term seizures occur, treatment is not required. For frequent or prolonged convulsions, prescribe intravenous diazepam (0.1-0.3 mg/kg body weight) or lorazepam (4 mg for adults and 0.05 mg/kg for children).

If these measures do not control seizures, intravenous phenytoin infusion may be appropriate. If necessary, give the patient oxygen and correct the acid-base balance and metabolic disorders.

For arterial hypotension and excessive sedation, use symptomatic and supportive therapy. If severe hypotension persists, the use of inotropic agents such as dopamine or dobutamine should be considered.

Side effects:

Cases of suicidal ideation and suicidal behavior have been reported during or shortly after trazodone therapy.
The introductory part of the instructions is given, read the full instructions inside the package.

Storage:

Store below 25°C in original packaging. Keep out of the reach of children.

Shelf life:

4 years.