Trospium chloride is an m-anticholinergic blocker, which has some ganglioblocking and 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 decreases, and the increased activity of the detrusor of the bladder organ decreases. It is an antispasmodic, has a mild ganglioblocking effect. No central effects observed.
Pharmacokinetics of this drug
In the body of trospium chloride is absorbed by less than 10%, the degree of absorption is reduced if the medicine is taken together with fatty foods. The volume of distribution is about 365 liters, it penetrates into the central nervous system slightly. It binds to plasma proteins by 50-85%.
Biotransformed in liver tissues. The half-life is up to 20 hours. The average plasma concentration is about 3.5 ng/ml. 85% of metabolites are eliminated together with faeces,5, 8% - with urine. In patients suffering from chronic renal failure, the elimination half-life is doubled.
Indications for use
Trospium chloride is indicated for use in the following cases:
- Daytime, nocturnal enuresis.
- Nicturia, pollakiuria.
- Detrusor-sphincter-dyssynergy resulting from intermittent catheterism.
- Spastic disorders of the functionality of the bladder organ of a neurogenic nature (with neurogenic hyperreflexia, detrusor hyperactivity that arose against the background of parkinsonism, stroke, acquired and congenital pathologies of the spinal cord, spinal injuries, multiple sclerosis).
- Mixed forms of urinary incontinence.
- Hyperactivity of the bladder organ, accompanied by an increase in the frequency of urination, imperative urges, urinary incontinence.
Contraindications for use
Trospium chloride is contraindicated in patients with physiological and pathological conditions such as:
- Increased susceptibility to the active substance.
- Glucose-galactose malabsorption, lactase deficiency, lactose intolerance.
- Renal failure requiring dialysis.
- Children, adolescents under 14 years of age.
- 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, drugs based on trospium chloride should be taken according to the instructions with extreme caution. Among them:
- Pathologies of the vascular system and the heart, in which an increase in the heart rate is undesirable.
- Acute bleeding, arterial hypertension, mitral stenosis, IHD, chronic heart failure, tachycardia, atrial fibrillation.
- Thyrotoxicosis.
- Hiatal hernia, which is combined with reflux esophagitis, reflux esophagitis.
- Fever.
- Pyloric stenosis, achalasia.
- Intestinal obstruction of the paralytic type, intestinal atony in elderly patients, in debilitated patients.
- Age over 40, angle-closure glaucoma, open-angle glaucoma.
- Ulcerative colitis.
- Renal, liver failure.
- Dry mouth.
- Chronic forms of lung pathologies, in particular in debilitated patients and children of a younger age group.
- Tachycardia, central paralysis in pediatric patients.
- Down's disease.
- Head brain damage in children.
- Preeclampsia.
- Pathologies accompanied by obstructive changesurinary tract.
- Urine retention, predisposition to it.
- Prostate hypertrophy in the absence of obstructive urinary tract changes.
- Autonomic neuropathy.
Use in the lactation period, during pregnancy
Controlled clinical trials in these groups of patients have not been conducted. Animal tests have shown a negative effect of the substance on the fetus, resulting in a decrease in viability. There is no evidence that the substance passes into the breast milk of women, but it has been proven to be excreted in milk in rats.
The use of the product is justified only if the intended benefit to the mother outweighs the likely risk to the baby.
Use of trospium chloride
Adults and children over 14 years of age should take the drug orally. Tablets with a dosage of 15 mg should be taken three times a day, 1 piece each. The interval between doses should be 8 hours. Maximum per day is allowed to take 45 mg.
Pills with a dosage of 30 mg are indicated to be taken three times a day, ½ pieces, or in the morning - a whole tablet, and in the evening - ½. The daily dosage should not exceed 45 mg.
When treating patients suffering from renal insufficiency, no more than 15 mg of the drug substance is allowed to be used per day.
The average duration of the therapeutic effect is 2-3 months. If there is a need for longer treatment, the doctor should review the regimen.therapy every 3-6 months.
The dosage of trospium chloride must be strictly observed.
Negative effects of medication
During therapy, the patient may develop the following side effects:
- Hypertensive crisis, tachyarrhythmia, fainting, retrosternal pain - from the vascular system and the heart.
- Moderate or slight increase in transaminase activity, gastritis (in rare cases), bloating, diarrhea, abdominal pain, nausea, constipation, dyspeptic manifestations, dry mouth - from the digestive tract.
- Shortness of breath - from the side of the respiratory tract.
- Hallucinations, confusion - from the side 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 visual organs.
- Urine retention, impaired emptying of the bladder 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 the complete release of the bladder. This is done with a catheter. When vegetative disorders are the cause of bladder dysfunction, this should be determined prior to initiating therapy. It is also important to rule out urinary tract infection and carcinoma, as it requires etiotropic treatment. Need to excludepotentially hazardous activities that require increased attention and visual acuity (accommodation paralysis occurs).
Interaction with other drugs
Amantadine, tricyclic antidepressants, Quinidine, antihistamines and beta-adrenergic stimulants are more effective against the background of taking a medicinal substance.
Medicine storage place - dry, protected from light and inaccessible to children, temperature 15-25 °C. Shelf life 5 years.
Analogues
The main analogues of trospium chloride are "Spazmolit" and "Spazmeks". Medicines have certain contraindications and can provoke the development of negative consequences, and therefore the possibility of using them as a replacement should be discussed with the doctor.
Trospium chloride reviews
Patients note the high efficiency of the drug in the treatment of urinary incontinence and enuresis. The drug is quite well tolerated, however, patients have such a drawback as an extensive list of direct and relative contraindications. However, with careful implementation of medical recommendations and compliance with dosages, the medicine can eliminate the problem that has arisen. It is important to remember that any medication should be taken only as prescribed by a doctor. We reviewed the instructions for use for trospium chloride.
