Trilock
Generic Name
Trimetazidine Dihydrochloride
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| trilock 4 mg tablet | ৳ 6.04 | ৳ 84.56 |
Description
Overview of the medicine
Trilock 4 mg Tablet contains Trimetazidine Dihydrochloride, an anti-ischemic metabolic agent primarily used to prevent and manage angina pectoris in patients with coronary artery disease, often as an add-on therapy. It helps improve myocardial energy metabolism.
Uses & Indications
Dosage
Adults
Typically, 4 mg once daily. Dosage may be adjusted based on clinical response and tolerability, as directed by a physician. If it's a modified-release tablet, swallowing whole is crucial.
Elderly
Caution advised; start with 4 mg once daily and monitor renal function. Dosage adjustment may be required, especially if creatinine clearance is below 60 mL/min.
Renal_impairment
Reduced dosage recommended. For moderate renal impairment (CrCl 30-60 mL/min), consider 4 mg every other day. Not recommended for severe impairment (CrCl <30 mL/min) due to increased risk of adverse effects.
How to Take
Administer orally with water. It can be taken with or without food. If it is a modified-release tablet, it must be swallowed whole, not crushed, broken, or chewed, to ensure proper drug release.
Mechanism of Action
Trimetazidine works by optimizing myocardial energy metabolism during ischemia. It inhibits the beta-oxidation of fatty acids by blocking long-chain 3-ketoacyl CoA thiolase, which shifts energy production towards glucose oxidation. This reduces oxygen demand and improves cellular function in ischemic conditions, thereby preventing angina attacks.
Pharmacokinetics
Onset
Therapeutic effects are generally observed after a few days of regular administration, as it's a prophylactic drug with sustained metabolic action.
Excretion
Mainly via urine, predominantly as unchanged drug. Renal clearance correlates with creatinine clearance.
Half life
Approximately 4-6 hours.
Absorption
Rapidly absorbed after oral administration. Peak plasma concentration reached within 2 hours. Bioavailability is high (around 90%).
Metabolism
Minimally metabolized; primarily excreted unchanged by the kidneys.
Side Effects
Contraindications
- Hypersensitivity to Trimetazidine or any excipients of the tablet
- Parkinson's disease, Parkinsonian symptoms, tremors, restless leg syndrome, and other related movement disorders
- Severe renal impairment (creatinine clearance < 30 mL/min)
Drug Interactions
Levodopa
Concomitant use with Levodopa should be avoided as it may exacerbate Parkinsonian symptoms, particularly in elderly patients. If co-administration is unavoidable, close monitoring is required.
Other anti-anginal drugs
Generally safe to use with other anti-anginal medications. No significant pharmacokinetic interactions have been reported. However, monitor for additive effects on cardiovascular parameters.
Storage
Store in a cool, dry place below 30°C. Protect from direct sunlight and moisture. Keep out of reach and sight of children.
Overdose
Limited data are available regarding overdose with Trimetazidine. In case of an overdose, symptomatic treatment and supportive measures should be initiated. Gastric lavage may be considered if ingestion was recent. Monitor vital signs and neurological status.
Pregnancy & Lactation
Trilock 4 mg is not recommended during pregnancy due to insufficient data on human pregnancy and potential risks. Advise against use during lactation as excretion into breast milk and effects on the infant are unknown. A doctor's consultation is essential.
Side Effects
Contraindications
- Hypersensitivity to Trimetazidine or any excipients of the tablet
- Parkinson's disease, Parkinsonian symptoms, tremors, restless leg syndrome, and other related movement disorders
- Severe renal impairment (creatinine clearance < 30 mL/min)
Drug Interactions
Levodopa
Concomitant use with Levodopa should be avoided as it may exacerbate Parkinsonian symptoms, particularly in elderly patients. If co-administration is unavoidable, close monitoring is required.
Other anti-anginal drugs
Generally safe to use with other anti-anginal medications. No significant pharmacokinetic interactions have been reported. However, monitor for additive effects on cardiovascular parameters.
Storage
Store in a cool, dry place below 30°C. Protect from direct sunlight and moisture. Keep out of reach and sight of children.
Overdose
Limited data are available regarding overdose with Trimetazidine. In case of an overdose, symptomatic treatment and supportive measures should be initiated. Gastric lavage may be considered if ingestion was recent. Monitor vital signs and neurological status.
Pregnancy & Lactation
Trilock 4 mg is not recommended during pregnancy due to insufficient data on human pregnancy and potential risks. Advise against use during lactation as excretion into breast milk and effects on the infant are unknown. A doctor's consultation is essential.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture, when stored under recommended conditions.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
Clinical Trials
Trimetazidine has been extensively studied in numerous clinical trials, demonstrating its effectiveness in reducing angina attack frequency, improving exercise capacity, and enhancing quality of life in patients with stable angina pectoris, often as an add-on therapy.
Lab Monitoring
- Renal function tests (blood urea nitrogen, serum creatinine, creatinine clearance) especially in elderly or renally impaired patients
- Liver function tests (ALT, AST, bilirubin) if signs of hepatic dysfunction appear
Doctor Notes
- Regularly assess patients for the emergence or worsening of Parkinsonian symptoms, particularly in the elderly and those with a history of movement disorders. Discontinue if such symptoms occur.
- Monitor renal function before initiating treatment and periodically thereafter, especially in patients with pre-existing renal impairment, adjusting dosage as necessary.
- Emphasize to patients that Trilock 4 mg is a prophylactic agent for angina and should not be used for acute angina relief.
Patient Guidelines
- Take Trilock 4 mg exactly as prescribed by your doctor; do not alter the dose or stop without consultation.
- Understand that this medicine is for prevention and not for acute relief of angina attacks.
- Report any new or worsening symptoms, especially movement disorders like tremors, to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Trimetazidine may cause dizziness, drowsiness, or visual disturbances. Patients should be advised to exercise caution when driving or operating machinery if they experience these symptoms. If affected, avoid such activities.
Lifestyle Advice
- Maintain a heart-healthy diet low in saturated fats and cholesterol.
- Engage in regular, moderate physical activity as advised and tolerated.
- Avoid smoking and limit alcohol consumption to improve cardiovascular health.
- Manage stress effectively through relaxation techniques or other coping strategies.
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