Trimibelin 10 Hasan medicine for depression (4 blisters x 15 tablets)

Dosage form Box of 4 blisters x 15 tablets
Specifications Amitriptyline

Ingredient

Composition information	Content
Amitriptyline	10mg

Uses

indicated

trimibelin is indicated in the following cases:

Treatment depression , especially endogenous depression (psychiatric disorder). The drug has little effect on response depression.

Select treatment for some cases of bedwetting in older children (after eliminating urinary tract physical complications with appropriate tests).

Treatment of nerve pain.

Pharmacokinus

Amitriptylin is a three -round antidepressant, reducing anxiety and sedative effect.

The mechanism of action of amitriptylin is to inhibit the recovery of monoamine, serotonin and noradrenalin in monoaminergic neurons. Noradrenalin recovery effect is considered to be related to the antidepressant effect of the drug.

Amitriptylin also has anti -cholinergic effects in both central and peripheral nerves.

Pharmacokinetics

absorption

Amitriptylin absorbs quickly and completely after drinking 30-60 minutes, reaching the peak concentration in plasma about 6 hours after drinking.

Distribution

Amitriptylin is widely distributed throughout the body and binds high with plasma and tissue proteins. Amitriptylin can be placed in the placenta and distributed into breast milk.

Metabolism

Amitriptylin is first metabolized through the liver by reducing N-methyl by Cytochrom P450 ISOENZYM CYP3A4, CYP2C9 and CYP2D6 into Nortriptylin-active metabolites. Amitriptylin is also metabolized through hydroxylation by CYP2D6 and N-oxidation.

Elimination

With the usual dose, 30-50% of the drug is excreted within 24 hours. In fact, the entire remove dose is eliminated in the form of glucuronid or sulfate conjugate metabolites.

Before taking Trimibelin 10 Hasan medicine for depression (4 blisters x 15 tablets)

How to use

oral medication.

Dosage

Dosage varies depending on age, condition of the disease and response to treatment.

Treatment of depression

Adults

Initial dose: 25 - 100 mg/day, divided into 3-4 times/day or single dose 50 - 100 mg before bed.

Maintenance dose: 25 - 150 mg/day, single dose or divided into 3-4 times/day. A few patients treated at the hospital may need high doses of up to 300 mg/day.

Children

Under 12 years: Do not take the drug (due to inexperienced).

12 - 18 years: Initial doses: 10 mg/time x 3 times/day and 20 mg at bedtime. It is necessary to gradually increase the dose, but the dose usually does not exceed 100 mg/day.

Older people

Initial dose: 10 mg/time x 3 times/day and 20 mg at bedtime. Necessary can increase the dose gradually.

Note: The dose should be increased slowly. Increased dose is given priority in the afternoon or evening. For patients with high doses, they need to regularly monitor ECG, blood pressure and heart rate.

Effects of anxiety and sedation appear very quickly, the antidepressant effect may have within 3-4 weeks of treatment, even weeks later to see. Must continue treatment for a long time to be able to evaluate the results, usually at least 3 weeks. If the patient's condition does not improve within 1 month, it is necessary to see a specialist.

Once fully effective and the patient's condition has been improved, reducing the dose to the lowest dose possible to maintain the effect. Continue to maintain treatment for 3 months or longer to reduce the possibility of recurrence.

Stop treatment should gradually take steps and closely monitor because of the risk of recurrence.

nightburns in older children

Dose suggested

Children 6 - 10 years old: 10 - 20 mg, taken 30 minutes before going to bed.

Children over 11 years old: 25 - 50 mg, taken 30 minutes before going to bed.

Do not last for more than 3 months.

Treatment of neuralgia

Adults and children

First oral 10 mg in the evening, increasing if you need about 75 mg daily.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

Sleeping, confusion, convulsions (epilepsy), distracting, dilating pupils, fast, slow or abnormal heartbeat, hallucinations, agitation, shallow breathing, shortness of breath, weakness, fatigue, vomiting.

Handling

Mainly treat symptoms and support, including stomach wash with activated carbon in the form of mud many times; maintain respiratory, circulatory and body temperature function; monitor cardiovascular function, electrocardiogram (at least 5 days); Treatment of lidocaine arrhythmia, alkaline blood to pH 7.4 - 7.5 with intravenous sodium hydrocarbonate; Management of convulsions by using diazepam, paraldehyde, phenytoin or inhaling anesthetic to control seizures.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

Common, ADR> 1/100

Neuroscope: excessive sedation, loss of orientation, sweating, increasing appetite, dizziness, headache.

Cardiovascular: tachycardia, chest drum, changing electrocardiogram (flat or reverse wave), atrial block, lower blood pressure .

Mental: Reduce sex, impotence.

Digestive: Nausea, constipation, dry mouth, change taste.

Eyes: blurred vision, difficult to regulate, dilate pupils.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Contraindicated

trimibelin contraindicated in the following cases:

Hypersensitivity to the ingredients of the drug.

Simultaneously used with monoamin oxydase inhibitors (IMAO).

The recovery stage immediately after the acute myocardial infarction, heart failure, acute blood failure.

Operators operating trains and machinery.

Caution when using

uncontrolled seizures, urinary retention and prostate hypertrophy, liver function impairment, closed angle glaucoma, cardiovascular disease , elderly people, history of convulsions, hematuria disorders, hyperthyroidism or being treated with thyroid drugs.

Patients who have treated with monoamin oxydase inhibitors must stop taking this drug for at least 14 days to start treatment with amitriptylin.

Using 3 -round antidepressants along with anti -cholinergic drugs can increase the anti -cholinergic effect.

Elderly patients with dementia and brain damage tend to react against cholinergic resistance than middle -aged people, so they need to use lower doses.

Should reduce the dose slowly to reduce the risk of cessation syndrome.

The risk of suicide is still in the course of treatment until the disease has improved.

The treatment of depression accompanied by schizophrenia must always be coordinated with neuroleptics because 3 -round antidepressants can make symptoms of psychosis worse.

In Hung - depression, increased risk and prolonged the stage of manic. For patients with epilepsy, it is necessary to treat anti -epilepsy appropriately to compensate for the risk of increasing attacks during treatment.

The risk of sleep can cause accidents during labor, driving ...

Alcoholic sensitivity can increase during treatment. The risk of acute glaucoma may occur. The risk of tooth decay is a common complication of long -term treatment.

The ability to drive and operate machinery

Because the drug has a sedative effect, can cause dizziness, dizziness, so do not use the drug when operating the train and machinery.

Pregnancy

amitriptylin passes the placenta into the fetus. Amitriptylin causes sedation and urinary retention in newborns. The rate of reduction of symptoms from a few days to a few weeks depends on the rate of reducing drug concentration in newborns. Therefore, in the last 3 months of pregnancy, Amitriptylin is only used with strict indications, it is necessary to consider the benefits of the mother and the risk of pregnancy.

Lactation period

Amitriptylin excreted breast milk with a significant amount of children at the treatment dose. Amitriptylin should not be used during breastfeeding. If you find it too necessary for the mother, should stop breastfeeding during the time the mother takes medicine.

Interactive drug

Interaction between 3 -round antidepressants and Monoamine oxidase inhibitors is a potential interaction with the potential to cause death.

Coordinate with phenothiazine to increase the risk of seizures.

Because 3 -ring anti -depression drugs inhibit the liver enzyme, if combined with anticoagulants, there is a risk of increased anticoagulant effect to more than 300%.

Genital hormones, oral contraceptives increase the bioavailability of 3 -round antidepressants.

When using Physostigmin to reverse the effect of 3 -round antidepressants on the central nervous system (confusion, paranoia, coma) can cause heart blocking, impulse conduction disorders, causing arrhythmia.

With Levodopa, the anti -cholinergic anti -depression effect can cause the stomach to expel the food slowly, thus reducing Levodopa's bioavailability.

cimetidine Inhibits the metabolism of 3 -round antidepressants, increasing the concentration of these drugs in the blood that can lead to poisoning.

Clonidin, Guanethidin or Guanadrel are reduced blood pressure when used simultaneously with 3 -round antidepressants.

Simultaneously used with 3 -round antidepressants and sympathetic drugs that increase the effect on the heart can lead to arrhythmia, tachycardia, severe hypertension or high fever.

Increases the impact of alcohol, barbiturat.

Storage

Store in a dry place, less than 30 ° C.

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