Triovix
Generic Name
triovix-150-mg-tablet
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| triovix 150 mg tablet | ৳ 70.00 | ৳ 700.00 |
Description
Overview of the medicine
Triovix 150 mg Tablet contains Fluconazole, an antifungal medication used to treat various fungal infections including vaginal yeast infections, oral thrush, esophageal candidiasis, and cryptococcal meningitis.
Uses & Indications
Dosage
Adults
For Vaginal Candidiasis: A single oral dose of 150 mg. For Oropharyngeal Candidiasis: 50-100 mg once daily for 7-14 days. For Esophageal Candidiasis: 100-200 mg once daily for 14-30 days. For Systemic Candidiasis: Loading dose of 400 mg on day 1, then 200-400 mg once daily. For Cryptococcal Meningitis: Loading dose of 400 mg on day 1, then 200-400 mg once daily for 10-12 weeks after CSF culture becomes negative.
Elderly
No dosage adjustment is usually required in elderly patients with normal renal function. If renal impairment is present, adjust dosage as per renal impairment guidelines.
Renal_impairment
Dosage should be adjusted based on creatinine clearance (CrCl). For CrCl < 50 mL/min, the dose should be reduced by 50% for multiple-dose therapy. A single 150 mg dose for vaginal candidiasis does not require adjustment.
How to Take
Triovix 150 mg Tablet should be taken orally, with or without food. Swallow the tablet whole with a glass of water.
Mechanism of Action
Fluconazole inhibits the fungal cytochrome P450-dependent 14-alpha-demethylation of lanosterol, which is an essential step in fungal ergosterol biosynthesis. Ergosterol is a vital component of the fungal cell membrane, and its inhibition leads to increased fungal cell membrane permeability, leakage of cellular contents, and eventually fungal cell death.
Pharmacokinetics
Onset
Peak plasma levels typically within 1-2 hours after oral administration.
Excretion
The primary route of elimination is renal, with approximately 80% of the administered dose excreted unchanged in the urine. Renal clearance is proportional to creatinine clearance.
Half life
The plasma elimination half-life is approximately 30 hours, allowing for once-daily dosing in most indications.
Absorption
Fluconazole is well absorbed orally, with a bioavailability of over 90% that is not significantly affected by food. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Fluconazole undergoes minimal hepatic metabolism, with approximately 11% of the dose being metabolized. It is a potent inhibitor of CYP2C9 and a moderate inhibitor of CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to Fluconazole or other azole antifungal agents.
- Co-administration with drugs known to prolong the QT interval and which are metabolized by CYP3A4 (e.g., terfenadine, cisapride, astemizole, pimozide, quinidine, erythromycin) in patients receiving multiple doses of fluconazole.
Drug Interactions
Statins
Increased risk of myopathy/rhabdomyolysis; monitor for muscle pain.
Rifampin
Decreases fluconazole plasma concentrations; consider increasing fluconazole dose.
Warfarin
Fluconazole increases prothrombin time; monitor INR closely.
Phenytoin
Increases phenytoin levels; monitor for toxicity.
Hydrochlorothiazide
Increases fluconazole plasma concentrations; adjust fluconazole dose if necessary.
Drugs that prolong QT interval
Increased risk of serious cardiac arrhythmias (e.g., terfenadine, cisapride, astemizole, pimozide, quinidine, erythromycin) - contraindicated for co-administration with multiple dose fluconazole.
Oral Hypoglycemics (sulfonylureas)
Increases risk of hypoglycemia; monitor blood glucose.
Cyclosporine, Tacrolimus, Sirolimus
Increases levels of these immunosuppressants; monitor drug levels.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of overdose, supportive treatment should be initiated. Gastric lavage may be considered if recent ingestion. Hemodialysis significantly reduces fluconazole plasma levels (approximately 3 hours for 50% reduction).
Pregnancy & Lactation
Pregnancy Category C (single dose for vaginal candidiasis) and D (for high/repeated doses in 1st trimester). Avoid use in pregnancy except for severe or life-threatening fungal infections where the benefits outweigh the risks. Fluconazole is excreted in breast milk; a single 150 mg dose is considered compatible with breastfeeding, but repeated high doses are not recommended.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, depending on the manufacturer's specifications.
Availability
Pharmacies, Hospitals
Approval Status
Approved (for Fluconazole)
Patent Status
Off-patent (Generic Fluconazole available)
WHO Essential Medicine
YesClinical Trials
Fluconazole has undergone extensive clinical trials supporting its efficacy and safety for various fungal infections. Ongoing research continues to explore its use in new indications and in combination therapies.
Lab Monitoring
- Liver Function Tests (ALT, AST, ALP, Bilirubin) - particularly for patients receiving prolonged therapy or with underlying liver disease.
- Renal Function Tests (Creatinine, BUN) - especially in patients with pre-existing renal impairment or those on high doses.
- Electrolyte levels (Potassium, Magnesium, Calcium) - if there's a risk of QT prolongation.
Doctor Notes
- Ensure proper diagnosis of fungal infection before initiating therapy.
- Monitor liver function tests periodically, especially in patients on prolonged treatment or with pre-existing hepatic conditions.
- Counsel patients on potential drug interactions and the importance of completing the full course of treatment.
Patient Guidelines
- Complete the full course of treatment as prescribed, even if symptoms improve.
- Report any new or worsening symptoms, especially rash, severe abdominal pain, dark urine, or yellowing of the skin/eyes, to your doctor immediately.
- Inform your doctor or pharmacist about all other medications, including over-the-counter drugs, herbal supplements, and vitamins, to avoid potential drug interactions.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.
Driving Precautions
Triovix may cause dizziness or seizures in some individuals. Patients should be advised not to drive or operate machinery if they experience these effects.
Lifestyle Advice
- Maintain good personal hygiene to help prevent recurrence of fungal infections.
- Avoid wearing tight, non-breathable clothing if you are prone to yeast infections.
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