Tricalm
Generic Name
Alprazolam
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tricalm 2 mg tablet | ৳ 5.00 | ৳ 50.00 |
| tricalm 5 mg tablet | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Tricalm (Alprazolam) is a benzodiazepine used for the short-term management of anxiety disorders, panic disorder, and anxiety associated with depression.
Uses & Indications
Dosage
Adults
For GAD: Initially 0.25-0.5 mg three times daily; gradually increase to a maximum of 4 mg daily in divided doses. For Panic Disorder: Initially 0.5 mg three times daily; gradually increase to a maximum of 10 mg daily in divided doses.
Elderly
Lower initial doses (e.g., 0.25 mg two to three times daily) should be used in elderly or debilitated patients to avoid oversedation.
Renal_impairment
Use with caution; dosage adjustment may be necessary. No specific guidelines, generally start with lower doses.
How to Take
Take orally with or without food. Do not crush, chew, or break extended-release tablets.
Mechanism of Action
Alprazolam selectively binds to benzodiazepine receptors on the GABA-A receptor complex in the central nervous system. This enhances the inhibitory effects of GABA, leading to sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant properties.
Pharmacokinetics
Onset
Onset of action within 30-60 minutes.
Excretion
Metabolites are primarily excreted in the urine.
Half life
Plasma elimination half-life is approximately 11-15 hours.
Absorption
Rapidly absorbed after oral administration, peak plasma concentrations occur within 1-2 hours.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 3A4 (CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Known hypersensitivity to alprazolam or other benzodiazepines
- Acute narrow-angle glaucoma
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole)
- Severe respiratory insufficiency
- Sleep apnea
- Severe hepatic insufficiency
Drug Interactions
Alcohol
Increased CNS depressant effects.
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole, Fluvoxamine)
Increased alprazolam plasma concentrations, potentially leading to increased adverse effects.
Other CNS Depressants (e.g., Antidepressants, Antihistamines, Antipsychotics)
Additive CNS depressant effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, confusion, impaired coordination, diminished reflexes, and coma. Management is primarily supportive; flumazenil may be considered in severe cases, but with caution due to risk of withdrawal seizures.
Pregnancy & Lactation
Pregnancy Category D: May cause fetal harm. Avoid use during pregnancy. Alprazolam is excreted in breast milk and may cause sedation in the infant; therefore, breastfeeding is not recommended.
Side Effects
Contraindications
- Known hypersensitivity to alprazolam or other benzodiazepines
- Acute narrow-angle glaucoma
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole)
- Severe respiratory insufficiency
- Sleep apnea
- Severe hepatic insufficiency
Drug Interactions
Alcohol
Increased CNS depressant effects.
Opioids
Increased risk of sedation, respiratory depression, coma, and death.
CYP3A4 Inhibitors (e.g., Ketoconazole, Itraconazole, Fluvoxamine)
Increased alprazolam plasma concentrations, potentially leading to increased adverse effects.
Other CNS Depressants (e.g., Antidepressants, Antihistamines, Antipsychotics)
Additive CNS depressant effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include somnolence, confusion, impaired coordination, diminished reflexes, and coma. Management is primarily supportive; flumazenil may be considered in severe cases, but with caution due to risk of withdrawal seizures.
Pregnancy & Lactation
Pregnancy Category D: May cause fetal harm. Avoid use during pregnancy. Alprazolam is excreted in breast milk and may cause sedation in the infant; therefore, breastfeeding is not recommended.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved
Patent Status
Generic available
Clinical Trials
Extensive clinical trials have established the efficacy and safety of alprazolam for its approved indications. Ongoing research may explore new uses or formulations.
Lab Monitoring
- No routine lab monitoring required. Liver and kidney function tests may be considered in patients with hepatic or renal impairment.
Doctor Notes
- Prescribe for the shortest effective duration.
- Gradually taper the dose when discontinuing to minimize withdrawal symptoms.
- Monitor for signs of abuse, misuse, and addiction.
Patient Guidelines
- Do not stop taking Tricalm abruptly without consulting your doctor, as this can lead to withdrawal symptoms.
- Avoid alcohol consumption while taking this medicine.
- Be aware of potential drowsiness and impaired judgment; avoid driving or operating heavy machinery.
- Take exactly as prescribed by your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up.
Driving Precautions
Tricalm can cause drowsiness, dizziness, and impaired concentration. Patients should be warned not to drive or operate hazardous machinery until they are reasonably certain that Tricalm does not adversely affect them.
Lifestyle Advice
- Practice stress reduction techniques (e.g., meditation, yoga).
- Maintain a regular sleep schedule.
- Avoid caffeine and other stimulants.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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