Pathological conditions with essential hypertension and heart failure are accompanied by swelling of the soft tissues and internal organs, which are dangerous for humans. To remove excess fluid from the body, diuretics are used that increase the volume of urine and excrete minerals. One of these diuretics is the drug "Trifas".
Description of the drug
The preparation contains an active component of torasemide, the basis of which is sulfamonanthranilic acid. This substance belongs to saluretics, which have an inhibitory effect on the reabsorption of chlorine and sodium ions in the kidneys.
Release form
There are several modifications of the drug "Trifas", instructions for using solid and liquid dosage forms . In each of them, the physicochemical properties of tablets and solutions are described.
The tablet form of the drug is sold under the trade name "Trifas 10" with a dosage of torasemide 10 mg and "Trifas COR" with a dosage of torasemide 5 mg. The description indicates that the white tablets are round with a risk for dividing on one side at a larger dosage.
The liquid form of the drug “Trifas” is described by the manual as an injection solution at a dosage of 10 mg per 2 ml of torasemide and 20 mg per 4 ml, an infusion solution at a dosage of 200 mg per 20 ml of liquid. According to the description, these are colorless transparent solutions in which there is practically no inclusion of particles.
Description of the composition of the tablets
For one tablet of the Trifas preparation, the instruction describes the composition: the content of the active component of torasemide in the amount of 10 mg or 5 mg, there are also inactive substances that maintain the structure of the tablet, its solubility and safety for the specified period. These include milk sugar, corn starch, magnesium stearate and anhydrous aerosil.
Description of the composition of the solutions
In ampoules with 2 ml of injection, 10.631 mg of sodium torasemide is included, which is equivalent to 10 mg of torasemide.
In ampoules with 4 ml of solution for injection contains sodium torasemide in an amount of 21.262 mg, which is equivalent to 20 mg of torasemide.
In ampoules with 20 ml of infusion solution, torasemide sodium is included in an amount of 212.62 mg, which is equivalent to 200 mg of torasemide.
In addition to the active substance, a small amount of sodium hydroxide, polyethylene glycol 400, trometamol is dissolved in injection water.
Mechanism of action
For the “Trifas 10” preparation, the instructions for use contain a description of the binding in the lumen of the nephron of the received torasemide with the Na-K-Cl-cotransporter, which is a protein located in the surface membrane of the cell, which inhibits the transport of K + , Na + and Cl - through the lumen of the channel.
The diuretic effect of the tablets develops after 3 hours and lasts about 12 hours. The drug works even when there is no effect from other diuretics, for example, thiazide. By decreasing the total peripheral resistance of blood vessels by leveling the balance of electrolytes and binding of free calcium ions in the smooth muscles of the arterial wall, the medication lowers blood pressure.
What heals the drug
The tablets of the drug “Trifas” have been used for essential hypertension, for the treatment and prevention of the occurrence of edematous conditions or effusions accompanying heart failure.
An intravenous solution is administered for pulmonary edema, and infusion solutions are used in patients with reduced renal function, when the rate of creatinine excretion is less than 20 ml per minute.
How to take pills
For essential hypertension, the drug “Trifas” is used, the instructions for use of the tablet recommends dividing into four parts and starting treatment with a daily dosage of 2.5 mg of torasemide. Pressure reduction does not occur immediately, but during the first week, the maximum effect occurs no later than 12 weeks. In the absence of an antihypertensive effect, after three months the daily dose of the drug “Trifas” is increased, the instructions for use of the pill are advised to be divided in half, each half contains 5 mg of torasemide.
With arterial hypertension, when the diastolic pressure exceeds 115 mmHg, and limited renal function, an additional antihypertensive effect may occur.
For edema or effusion per day, 5 mg of torasemide or ½ part of the Trifas 10 tablet is used, the instructions for use have information about the need to increase the dosage to 20 mg of torasemide in the absence of effect, which corresponds to two tablets of the drug. They drink the medicine in the morning, without violating the integrity and washing down with liquid. Eating does not affect the digestibility of the tablets, and the duration of therapy is associated with the nature and course of the disease.
How to use injection
For the treatment of adults with the drug "Trifas", the instructions for use include recommendations on the use of a single daily dosage of 2 ml, which contains 10 mg of torasemide. If necessary, the daily dosage is increased to 4 ml, which corresponds to 20 mg of the active substance. If the effect is insufficient, a daily dosage of 8 ml is used, equivalent to 40 mg of torasemide, but not more than 3 days.
The condition of acute pulmonary edema is eliminated by the introduction of 4 ml of an ampouled solution with a dosage of 10 mg of torasemide. With insufficient effectiveness, after half an hour, re-administer 4 ml of the drug solution. It is undesirable to exceed the dose of 100 mg of torasemide per day, which corresponds to 20 ml of Trifas solution.
How to use infusion solution
The instructions also describe the use of an infusion form for adults. The condition of the patient with kidney failure determines the dose of the drug. Use begins with a daily dosage of 5 ml, which contains 50 mg of torasemide. If such a dose does not enhance urination, it is increased to 10 ml. The maximum increase to 20 ml of the infusion solution of the drug "Trifasa 200", which contains 200 mg of torasemide, is acceptable. Repeated intravenous administration is carried out after 1 hour, using a perfuser to establish an infusion rate of 0.4 ml per minute. For convenience, 1 ampoule is diluted with 500, 250, 125 or 30 ml of a 0.9% sodium chloride solution or 5% glucose solution. Such a mixture must be used immediately, pour out the residue.
Intravenous treatment should not exceed one week, it is advisable to switch to taking pills as soon as possible.
Application features
The long-term use of the drug “Trifas” is described by the instructions for use as a condition requiring regular monitoring of the balance of electrolytes, especially potassium ions in the blood serum. Glucose, creatinine, uric acid and fats - all these indicators need to be measured in order to timely detect the development of diabetes. During treatment, monitoring of the patient's blood counts is needed.
During pregnancy and lactation, it is better not to use the drug, since there is no reliable data on the safety of torasemide for a child.
The effect of the medication can reduce the activity of a person while driving a car and other mechanisms that require attention. Do not combine it with alcoholic beverages.
Who is contraindicated in treatment
Not everyone can take the drug "Trifas", instructions for use lists the conditions in which therapy is contraindicated.
Do not use:
- with increased sensitivity to torasemide and its derivatives in the past;
- with hypotension;
- with renal failure;
- with anuria;
- with a serious violation of the liver, including coma or prekom;
- with a decrease in the volume of moving blood;
- with a reduced content of sodium and potassium in the blood;
- with impaired urination due to an increase in the prostate gland;
- with excessive deposition of oxalates in the joints;
- with increased excitability and conduction of the heart muscle;
- with disturbed acid-base balance;
- with anemia and a small number of platelets;
- with violations of the kidneys;
- in children under 12 years of age.
Undesirable consequences
The list of side effects includes instructions for the drug "Trifas". Patient reviews indicate the frequency of certain adverse effects.
The drug acts on the cardiovascular system in violation of the water-electrolyte balance, leading to hypovolemia, hypokalemia, hyponatremia, alkalosis, headache, dizziness, increased fatigue, muscle cramps, with strong urination to hypotension, blurred consciousness, cerebral thrombosis, cardiac and cardiac ischemia, heart rhythm disturbance, angina pectoris, acute heart muscle infarction, fainting.
Torasemide acts on the digestive system with the manifestation of constipation, lack of need for food, nausea, vomiting, pain in the stomach, diarrhea.
Patients with urinary disorders associated with prostatic hypertrophy, with intensive formation of urine, feel its delay and excessive stretching of the walls of the bladder.
The drug affects metabolic processes, in violation of which in the blood plasma uric acid, glucose, triglycerides and cholesterol begin to linger, which increases their concentration.
When exposed to the liver, the content of its enzymes, for example, gamma-glutamyl transpeptidase, may increase.
Under the influence of the drug in the blood, the number of platelet, erythrocyte and leukocyte cells decreases.
Undesirable consequences from the action of torasemide are associated with increased sensitivity of the body, manifested by itching, exanthema, photosensitivity. Sometimes a state of anaphylactic shock from the introduction of a solution intravenously may develop, which requires an urgent reaction.
Analogs
The manufacturer of the original Trifas drug is the German company Berlin-Chemie AG Menarini Group, which produces a liquid and solid form of this medication. On the Russian pharmaceutical market you can find generic drugs that contain torasemide. All of them have diuretic properties, the same mechanism of action and similar adverse reactions due to the active substance.
The drug "Trifas" analogues are available both in the form of tablets for oral administration, and in the form of solutions for injection and infusion.
One of the synonyms is the Diuver medicine, manufactured by the Croatian company Pliva Hrvatskaya doo. Presents the drug in tablets of 5 and 10 mg torasemide dosage.
The German analogue is the medication “Torasemide Sandoz”, manufactured by the company “Salutas Pharma GmbH”. It is available in the form of tablets with the content of torasemide 200 mg, 100 mg, 50 mg, 20 mg, 10 mg, 5 mg and 2.5 mg.
Britamor tablets with prolonged action are produced by the Spanish company Ferrer International S.A. This analogue contains 5 mg and 10 mg of torasemide.
The drug “Toradiv” of the Ukrainian company “Pharmex Group LLC” is available in tablets of 5 mg, 10 mg of torasemide and as a solution for injection of 5 mg of torasemide in 2 ml or 4 mg of liquid.
Reviews
Useful information for patients contains instructions for use on the drug "Trifas". Reviews of patients taking this drug indicate the effectiveness of the drug in edema. A daily intake of torasemide helps reduce the effect of excess fluid on the myocardium in heart disease. With proper therapy, patients regularly take tests to assess the effect of the drug on the body.
About the treatment with the drug "Trifas 10", the instruction manual describes more positive than negative statements. Undesirable actions are extremely rare, but many patients, after reading the section "Adverse reactions", are afraid to take the drug. And in vain, side effects do not have to occur, but torasemide will help relieve swelling, remove excess fluid and lower blood pressure. Reducing the amount of fluid will normalize all vital processes, water-salt balance and improve the condition of the patient with heart failure.
There are reviews about the ineffectiveness of the drug with swelling of the body. In this case, the attending physician should choose the appropriate treatment with similar drugs, but not containing torasemide.