Description
Trigrim Pharmacodynamics
The main mechanism of action of the drug is determined by the reversible binding of thorasemide to the Na+/2Cl-/K+ transporter, located in the apical membrane of the thick segment of the ascending loop of Genle. As a result, reabsorption of sodium ions is reduced or completely inhibited, thereby reducing the osmotic pressure of intracellular fluid and water reabsorption.
At the same time, due to anti-aldosterone action, thorasemide causes hypokalemia to a lesser extent than furosemide, with greater activity and duration of action.
Indications
– Oedema caused by heart failure, liver, kidney and lung diseases.
– Primary hypertension (used in monotherapy or in combination with other hypotensive drugs).
Contraindications
– Hypersensitivity to thorasemide and sulfonamides;
– anuria;
– hepatic coma and precoma;
– Chronic renal failure with increasing azotemia;
– arrhythmia;
– arterial hypotension;
– pregnancy;
– Breast-feeding (no data on use during breast-feeding);
– Age under 18 years (effectiveness and safety have not been established).
With caution: diabetes mellitus, gout, water-electrolyte balance disorders, liver dysfunction, cirrhosis, predisposition to hyperuricemia.
Application during pregnancy and lactation
Pregnancy
Torasemide has no teratogenic effect and fetotoxicity, penetrates the placental barrier, causing disorders of water-electrolyte metabolism and thrombocytopenia in the fetus.
Controlled studies on the use of thoracemide in pregnant women have not been conducted, the drug is not recommended for use during pregnancy.
Breast-feeding period
It is not known whether thoracemide penetrates into breast milk. If it is necessary to use thorasemide during lactation, breastfeeding should be stopped.
Dosage and administration
- Oral.
- Adults:
- Oedema:
- 5 mg once daily. If necessary, the dose may be gradually increased to 20 mg once daily. In individual cases, up to 40 mg of Trigrim per day is recommended.
- Congestive heart failure:
- 5 to 20 mg once daily. If necessary, the daily dose may be gradually increased (doubling it), up to a maximum of 200 mg.
- Chronic renal failure:
- The initial dose is 20 mg per day. If necessary, this dose may be gradually increased (doubling it), until an appropriate diuretic effect is achieved. The maximum daily dose is 200 mg.
- Liver cirrhosis:
- 5 – 10 mg once daily. If necessary, this dose may be gradually increased (doubling it) until appropriate diuretic action is achieved.
- There have been no appropriately controlled studies in patients with liver disease using doses greater than 40 mg daily.
- Primary arterial hypertension:
- 2.5 mg orally once daily. If necessary, the dose may be gradually increased to 5 mg daily. According to studies, a dose over 5 mg daily does not lead to further reduction of blood pressure. The maximum effect is reached after about twelve weeks of continuous treatment.
- Elderly patients:
- Elderly patients do not require special dose adjustment.
- Children:
- There are no data regarding the use of Trigrim in children.
- Food has no effect on absorption of Trigrim, so the drug can be taken regardless of meals.
