Modern diuretics on the market, in addition to the main effect - the removal of excess fluid - disrupt the water-electrolytic balance, depriving the body of the necessary elements. "Triampur Composite" - a drug that is prescribed for edematous syndromes, helps to remove water, but does not cause an outflow of potassium ions. Despite the relative safety of the drug, the patient needs to familiarize themselves with the attached instructions in detail.
Material Content:
Composition (active substance) Triampur Compositum
“Triampur Composite” is produced by the manufacturer in the form of small tablets of a yellowish tint. On the surface of each there is a shallow feature for a fault.
The main activity is shown by two components:
- triamteren, 0.25 g;
- hydrochlorothiazide, 0.125 g.
Due to the multicomponent composition, the drug is considered a combined diuretic. Other components of the drug provide its pharmaceutical form and shelf life.
Pharmacological properties
The pharmaceutical product has a double effect on the body - diuretic (removal of excess fluid) and hypotensive (lowering blood pressure).
The effect is due to the work of two components: triamteren - a potassium-sparing diuretic, and hydrochlorothiazide, which, in addition to diuretic properties, is capable of changing blood pressure.
The first substance affects the state of the cell membrane: it becomes more durable and loses its ability to pass Na ions.Their excretion in the urine increases, but without loss of K. ions. The secretion of the latter in the distal tubules decreases. This property helps to fight hypokalemia (K deficiency) when using other diuretics.
The advantage of the component is speed. The result is palpable after 20 minutes.
- The highest concentration indicators are observed after 2.5 - 3 hours and persist for up to half a day.
- The bioavailability of the element is 80%.
- It binds to proteins in the blood by 60%.
- The processing takes place in the liver, resulting in the formation of 4-hydroxytriamteren, a metabolic product that exhibits significant activity.
- Half displayed in the period from 4 to 7 hours. Violations in the activity of the liver increase the indicator by 3 to 4 times. The substance is excreted in the urine and bile.
The second component of the drug is hydrochlorothiazide. Already on the basis of the name, it becomes clear that it refers to thiazide diuretics. Acts on the principle of violation of the function of reverse absorption of ions of Cl, Na, Mg and water in the nephron. The antihypertensive effect is due to an increase in arterioles, so the substance practically does not affect normal pressure, but it can help with increased.
The diuretic effect is observed 1 or 2 hours after ingestion, a maximum of the fourth hour. Diuretic effect lasts for 9 to 12 hours, antihypertensive - more than a day.
- The bioavailability level is 70%.
- Plasma protein binding is from 60 to 80%.
- The elimination half-life is up to 8 hours.
- The component is excreted in a pure (unchanged) form using the kidneys (about 95% of the taken single dose).
- Found in urine 60 minutes after ingestion.
The combination of the two main components in a special proportion (12.5 mg + 25 mg) allows you to actively remove excess fluid to reduce the load on the heart. In this case, the necessary K ions are not lost and, as a result, there is no risk of hypokalemia.
What pills help
Indications for the use of pharmaceuticals include, first of all, edema of various genesis, which developed, for example, against the background of pathologies of the heart, cirrhosis of the liver (especially with complications), and nephrotic syndrome. It is also used to relieve stress on the heart with hypertension.
It is used to unload blood vessels from excess fluid and additional accumulation of potassium in heart failure.
Method of application, dosage
Take "Triampur" is permissible exclusively at the direction of a doctor in a special dosage, depending on the type of disease, its severity and the presence of related factors.
- In case of edematous syndrome, a daily dose of 75 mg of active ingredients (2 Triampur Compositum tablets) is standardly prescribed, it is divided into two doses. If the disease is in an advanced state, it is possible to use the maximum daily allowance, which is 150 mg (4 tablets). If acute symptoms do not bother the patient, it is recommended to switch to maintenance treatment: 1 or 2 tablets with an interval of 1 or 2 days.
- In case of arterial hypertension, they adhere to the principle of methodically increasing the amount of the drug taken, starting with the daily intake of 37.5 mg of diuretics (1 tablet), ending with the maximum, which corresponds to the norm in edematous syndrome. In the presence of kidney disease, do not take more than 1 tablet per day.
Dragee should be swallowed by drinking no more than ½ cup of water. The best time is in the morning and in the middle of the day. Evening receptions are also allowed, but always after eating.
Use during pregnancy and lactation
The use of "Triampura Composite" when carrying a child is strictly prohibited.
Components (mainly hydrochlorothiazide) tend to penetrate the placenta and affect the fetal development process. When using "Triampur" during pregnancy, pathologies in the child are possible, associated with violations of the water-salt balance, heart disease, and more.
According to some reports, diuretics are prescribed to treat toxicosis during pregnancy. But there is no confirmation of this information, and the likelihood of congenital diseases of the child is extremely high.
During lactation, drug-based therapy should also not be used - the active substances penetrate the mother’s milk, and then into the baby’s body. It is recommended either to find a less dangerous analogue or to refuse breastfeeding during treatment.
Interaction with other drugs
Diuretics are active substances that easily react with other active ingredients. The effect of the combination is presented below.
| A drug | Action in conjunction with Triampur Compositum |
|---|---|
| ACE inhibitors | At the beginning of therapy, a significant decrease in blood pressure is likely |
| "Colestyramine" | Reducing the effect of hydrochlorothiazide |
| NSAIDs (non-steroidal anti-inflammatory drugs) | Less pronounced antihypertensive and diuretic effects of the drug |
| Lithium preparations | Increased toxic properties of lithium |
| Other potassium-sparing diuretics | Hyperkalemia |
| Methyldopa | Hemolysis (destruction of red blood cells) |
| Curariform muscle relaxants | Strengthening the action of relaxants |
| Cardiac Glycosides | With increasing doses, the negative effects of heart medications increase |
| Glucocorticoids | Hypokalemia |
| Hypoglycemic agents, anti-gout drugs | The weakening of their effect on the body |
| Beta blockers | High risk of decreased potency |
| Other diuretics, antihypertensives, vasodilators, tricyclic antidepressants | Enhanced Effect of Triampur on Blood Pressure |
Contraindications, side effects and overdose
Before taking the drug, it is important to study contraindications, which include:
- severe pathologies of the excretory system: glomerulonephritis, anuria, renal failure;
- hepatic coma;
- hypovolemia (lack of circulating blood);
- pathological disorders in the blood composition that are not amenable to treatment: increased or decreased content of calcium, potassium, sodium;
- allergic reactions to the drug or one of its components.
A preliminary consultation with a doctor will be required for people with urolithiasis, kidney and liver dysfunction, with gout and high sugar, folic acid deficiency.
The reaction to the drug in patients under 18 years of age has not been studied, therefore, children's age also refers to contraindications.
Side effects can be observed from any of the body systems.
| The system affected by the tool | Side effect |
|---|---|
| Nervous system | Nervousness, headaches, asthenia (general fatigue), lack of coordination of movements, disorientation |
| Heart and blood vessels | Arrhythmia, low blood pressure, rarely - thromboembolism |
| The immune system and skin reaction | Itching, redness on the skin, fever, lupus erythematosus, inflammation of the kidneys and blood vessels, rarely - pulmonary edema |
| Digestive organs | Dyspeptic disorders, less intense salivation, rarely develop pancreatitis or cholecystitis |
| Musculoskeletal system | Cramps, muscle weakness, strain |
| Blood analysis | Imbalances in the electrolyte balance: excess or deficiency of chlorine, magnesium, calcium, sodium in the blood, abnormal amount of nitrogenous substances in the plasma, lipid levels rarely increase, excess glucose in the blood is concentrated, causing the early stages of diabetes mellitus or exacerbating it |
| Other violations | Yellowish color of the skin and eye proteins, visual and hearing impairment, dry eyes |
In case of an overdose, symptoms are observed:
- tachycardia or extrasystole;
- fatigue;
- frequent urination
- abnormal decrease in blood pressure;
- dizziness;
- cramps.
When taking an increased dose of the drug, it is important to consult a doctor immediately. The patient is shown gastric lavage, and then symptomatic treatment.
Analogues of combined diuretic
The described drug stands out among others with a combined composition. It is difficult to find structural analogues of Triampura Composite containing the same active components.
There is a Belgian medicine that almost completely repeats the composition of Triampur - Diuretidine. According to indications, contraindications and side effects, the drugs are the same, but the advantage of the Belgian counterpart in the possibility of treating children from 14 years of age.
Other combined diuretics are also available:
- Triamtel;
- Apo-Triazide;
- Triam-Co;
- "Vero-Triamtezid";
- Triamtezid.
The differences are in the name and country of origin.
Another drug is Moduretic, which combines hydrochlorothiazide with hydrochloride amiloride. It is not a potassium-sparing agent, although the indications for its intake coincide with those of the drug under discussion. Other symptoms are added to the list of negative effects caused by the body's reaction to the second active component. Such a diuretic is prohibited for the treatment of pregnant women, breast-feeding and children under 18 years of age.
"Triresid" is used only for the treatment of hypertension. It causes the outflow of excess fluid, "unloading" the heart. But the composition of this diuretic is more complex, therefore, it is impossible to call the tool a full-fledged analogue of Triampur Composite.
Diuretics must be taken carefully, having previously read the instructions for use. Triampur Compositum, despite the complex but seemingly harmless composition, can have a negative effect on the body, so it is extremely important to monitor not only the dose received by the patient, but also his general condition during the treatment period.
