Trospia chloride is an m-anticholinergic drug that has some ganglion-blocking and also antispasmodic effects. The substance does not have central effects.
The drug is able to block m-cholinergic receptors. Against the background of its intake, the tone of the smooth muscle structures of the urinary tract, the increased activity of the detrusor of the urinary organ decreases. It is an antispasmodic, characterized by a mild ganglion blocking effect. Central effects are not observed.
The pharmacokinetics of this drug
In the body, trospia chloride is absorbed by less than 10%, the degree of absorption decreases if you take the medicine together with fatty foods. The distribution volume is about 365 liters, it penetrates into the central nervous system slightly. With plasma proteins binds to 50-85%.
Biotransformed in the tissues of the liver. The elimination half-life reaches 20 hours. The average plasma concentration is about 3.5 ng / ml. 85% of metabolites are eliminated together with feces, 5.8% - with urine. In patients suffering from a chronic form of renal failure, the half-elimination period doubles.
Indications for use
Trospia chloride is indicated for use in the following cases:
- Daytime, nocturnal enuresis.
- Nocturia, pollakiuria.
- Detrusor-sphincter-dysinergy resulting from intermittent catheterism.
- Spastic disorders in the functionality of the urinary bladder organ of a neurogenic nature (with neurogenic hyperreflexia, detrusor hyperactivity caused by parkinsonism, stroke, acquired and congenital pathologies of the spinal cord, spinal trauma, multiple sclerosis).
- Mixed forms of urinary incontinence.
- Hyperactivity of the bladder organ, accompanied by an increase in the frequency of urination, peremptory urges, urinary incontinence.
Contraindications
Trospia chloride is contraindicated for patients who have such physiological and pathological conditions as:
- Increased susceptibility to the active substance.
- Glucose-galactose malabsorption, lactase deficiency, lactose intolerance.
- Renal failure requiring dialysis.
- Children, teenagers under 14 years old.
- Slowing down the process of evacuation of food from the stomach, as well as conditions that contribute to their development.
- Urinary retention.
- Myasthenic conditions.
- Tachyarrhythmia.
- Angle-closure glaucoma.
In addition, there are a number of conditions that are relative contraindications to the use of the substance. That is, in the presence of such pathologies, taking drugs based on trospium chloride according to the instructions should be taken with extreme caution. Among them:
- Pathologies of the vascular system and the heart, in which an increase in the frequency of contractions of the heart is undesirable.
- Acute bleeding, arterial hypertension, mitral stenosis, coronary heart disease, chronic heart failure, tachycardia, atrial fibrillation.
- Thyrotoxicosis.
- Hernia of the diaphragmatic esophageal opening, which is combined with reflux esophagitis, reflux esophagitis.
- Fever.
- Pyloric stenosis, achalasia.
- Bowel obstruction of the paralytic type, intestinal atony in elderly patients, in weakened patients.
- Age over 40 years old, angle-closure glaucoma, open-angle type.
- Nonspecific ulcerative colitis.
- Renal, liver failure.
- Dry mouth.
- Chronic forms of lung pathologies, in particular in debilitated patients and young children.
- Tachycardia, central paralysis in pediatric patients.
- Down's disease.
- Brain damage to the head in children.
- Gestosis.
- Pathologies that are accompanied by obstructive changes in the urinary tract.
- Urinary retention, predisposition to it.
- Hypertrophy of the prostate in the absence of obstructive changes in the urinary tract.
- Autonomic neuropathy.
Use in the lactation period, during pregnancy
Controlled clinical trials in patients of these groups have not been conducted. Animal tests have shown a negative effect on the fetus, resulting in reduced viability. There is no evidence that the substance passes into the breast milk of women, however, it has been proven by excretion with milk in rats.
Using the product is justified only if the intended benefit to the mother outweighs the likely risk to the child.
The use of trospium chloride
For adults and children from 14 years of age, the drug is indicated for oral administration. Tablets with a dosage of 15 mg should be taken three times a day for 1 piece. The interval between doses should be 8 hours. Maximum per day is allowed to take 45 mg.
Tablets with a dosage of 30 mg are shown to be taken three times a day for ½ pieces, or in the morning - a whole tablet, and in the evening - ½. The daily dosage should not exceed 45 mg.
In the treatment of patients suffering from renal failure, it is allowed to use no more than 15 mg of the drug per day.
The average duration of therapeutic effect is 2-3 months. If there is a need for longer treatment, the doctor should review the treatment regimen every 3-6 months.
The dosage of trospium chloride should be strictly observed.
Negative effects of the drug
During therapy, the patient may develop the following side effects:
- Hypertensive crisis, tachyarrhythmia, fainting, chest pain - from the vascular system and the heart.
- A moderate or slight increase in the activity of transaminases, gastritis (in rare cases), bloating, diarrhea, abdominal pain, nausea, constipation, dyspeptic symptoms, dry mouth - from the digestive tract.
- Shortness of breath - from the respiratory tract.
- Hallucinations, confusion - on the part of the National Assembly.
- Acute necrotic changes in skeletal muscles (in rare cases) - from the system of muscles and bones.
- Violation of accommodation - from the side of the visual organs.
- Urinary retention, violation of the emptying of the urinary organ - from the urinary system.
- Stevens-Johnson syndrome, anaphylactic reactions, skin rash.
Special recommendations
If there is a violation in the work of the sphincter, it is necessary to ensure complete emptying of the bladder. This is done with a catheter. When autonomic disorders are the cause of bladder dysfunction, this should be determined before starting therapy. It is also important to exclude infectious lesions of the urinary tract and carcinoma, as it requires etiotropic treatment. Potentially hazardous activities requiring increased attention and visual acuity must be excluded (paralysis of accommodation occurs).
Interaction with other drugs
Amantadine, tricyclic antidepressants, Quinidine, antihistamines and beta-adrenostimulants are more effective when taking the drug.
The place of storage of the medication is dry, protected from light and inaccessible to children, temperature 15-25 ° C. Shelf life 5 years.
Analogs
The main analogues of trospium chloride are Spazmolit and Spazmeks. Medicines have certain contraindications and can provoke the development of a negative consequence, and therefore the possibility of their use as a replacement should be discussed with the doctor.
Reviews on trospia chloride
Patients note the high efficiency of the drug in the treatment of urinary incontinence and enuresis. The drug is fairly well tolerated, however, patients have such a drawback as an extensive list of direct and relative contraindications. However, with careful follow-up of medical recommendations and compliance with dosages, the medicine eliminates the problem. It is important to remember that any medications should be taken only as directed by a doctor. We have reviewed the instructions for use with trospium chloride.