Triquin
Generic Name
Ciprofloxacin + Tinidazole + Dicyclomine Hydrochloride
Manufacturer
Aristopharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| triquin 001 4 cream | ৳ 200.00 | N/A |
Description
Overview of the medicine
Triquin is a combination medicine containing Ciprofloxacin (an antibiotic), Tinidazole (an antiprotozoal/antibiotic), and Dicyclomine (an antispasmodic). It is used to treat various bacterial and protozoal infections associated with abdominal cramps or spasms.
Uses & Indications
Dosage
Adults
One tablet twice daily for 5-7 days, or as directed by a physician.
Elderly
Dose adjustment may be necessary in elderly patients, especially with renal impairment. Use with caution due to anticholinergic effects of dicyclomine.
Renal_impairment
Significant dose reduction required for Ciprofloxacin and Tinidazole components. Avoid in severe renal impairment (CrCl <30 mL/min). Consult a physician.
How to Take
Oral administration. Take with or without food, but avoid taking with dairy products or antacids containing magnesium/aluminum due to ciprofloxacin interaction. Swallow the tablet whole with water.
Mechanism of Action
Ciprofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, essential for bacterial DNA replication. Tinidazole works by damaging bacterial and protozoal DNA. Dicyclomine is an anticholinergic that relaxes smooth muscles in the gastrointestinal tract, relieving spasms.
Pharmacokinetics
Onset
Varies for each component; Ciprofloxacin's antibacterial effect typically within hours, Dicyclomine's antispasmodic effect within 1-2 hours.
Excretion
Ciprofloxacin: Primarily renal. Tinidazole: Renal (unchanged & metabolites), some fecal. Dicyclomine: Urine and feces.
Half life
Ciprofloxacin: 3-5 hours. Tinidazole: 12-14 hours. Dicyclomine: 1.8 hours (biphasic).
Absorption
Ciprofloxacin: Rapidly absorbed (bioavailability 70-80%). Tinidazole: Rapidly and completely absorbed orally. Dicyclomine: Rapidly absorbed, peak plasma levels within 60-90 min.
Metabolism
Ciprofloxacin: Hepatic (partially to active metabolites). Tinidazole: Partially hepatic. Dicyclomine: Extensively hepatic.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin, other fluoroquinolones, tinidazole, other nitroimidazoles, dicyclomine, or any excipients. History of tendinopathy with fluoroquinolones. Myasthenia gravis. Obstructive uropathy, paralytic ileus, severe ulcerative colitis, glaucoma. Pregnancy (especially 1st trimester for tinidazole) and lactation.
Drug Interactions
Alcohol
Tinidazole causes a disulfiram-like reaction (nausea, vomiting, flushing, tachycardia) with alcohol. Avoid alcohol during and for at least 72 hours after treatment.
Warfarin
Increased anticoagulant effect with Ciprofloxacin and Tinidazole.
Tizanidine
Concomitant use with Ciprofloxacin is contraindicated due to increased risk of hypotension and somnolence.
Other Anticholinergics
Dicyclomine's effects may be enhanced.
Antacids/Dairy/Iron/Zinc
Reduces absorption of Ciprofloxacin. Take Ciprofloxacin 2 hours before or 6 hours after.
Storage
Store in a cool, dry place, away from light and moisture, below 30°C. Keep out of reach of children.
Overdose
Symptoms may include headache, dizziness, confusion, seizures (ciprofloxacin), nausea, vomiting, metallic taste (tinidazole), dry mouth, blurred vision, difficulty urinating, delirium (dicyclomine). Management involves symptomatic and supportive care, gastric lavage, and activated charcoal if appropriate.
Pregnancy & Lactation
Contraindicated during pregnancy, especially in the first trimester (due to Tinidazole). Not recommended during lactation as components are excreted in breast milk and may cause adverse effects in infants.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin, other fluoroquinolones, tinidazole, other nitroimidazoles, dicyclomine, or any excipients. History of tendinopathy with fluoroquinolones. Myasthenia gravis. Obstructive uropathy, paralytic ileus, severe ulcerative colitis, glaucoma. Pregnancy (especially 1st trimester for tinidazole) and lactation.
Drug Interactions
Alcohol
Tinidazole causes a disulfiram-like reaction (nausea, vomiting, flushing, tachycardia) with alcohol. Avoid alcohol during and for at least 72 hours after treatment.
Warfarin
Increased anticoagulant effect with Ciprofloxacin and Tinidazole.
Tizanidine
Concomitant use with Ciprofloxacin is contraindicated due to increased risk of hypotension and somnolence.
Other Anticholinergics
Dicyclomine's effects may be enhanced.
Antacids/Dairy/Iron/Zinc
Reduces absorption of Ciprofloxacin. Take Ciprofloxacin 2 hours before or 6 hours after.
Storage
Store in a cool, dry place, away from light and moisture, below 30°C. Keep out of reach of children.
Overdose
Symptoms may include headache, dizziness, confusion, seizures (ciprofloxacin), nausea, vomiting, metallic taste (tinidazole), dry mouth, blurred vision, difficulty urinating, delirium (dicyclomine). Management involves symptomatic and supportive care, gastric lavage, and activated charcoal if appropriate.
Pregnancy & Lactation
Contraindicated during pregnancy, especially in the first trimester (due to Tinidazole). Not recommended during lactation as components are excreted in breast milk and may cause adverse effects in infants.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacturing date.
Availability
Available in all retail pharmacies in Bangladesh
Approval Status
DGDA approved
Patent Status
Generics available (off-patent)
Clinical Trials
Clinical trials have established the efficacy and safety of its individual components and various combinations for their respective indications. Specific trials for this exact branded combination may be available upon request from the manufacturer.
Lab Monitoring
- Renal function tests (especially in elderly or renally impaired patients)
- Liver function tests
- Blood counts (for long-term use)
Doctor Notes
- Emphasize the importance of completing the full course.
- Advise patients about the potential for tendon issues and CNS effects from ciprofloxacin.
- Warn against alcohol consumption.
Patient Guidelines
- Complete the full course of treatment even if symptoms improve.
- Avoid alcohol during and for 3 days after treatment.
- Stay hydrated and avoid excessive sun exposure.
- Report any tendon pain, numbness, tingling, or severe diarrhea immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medicine may cause dizziness, lightheadedness, or blurred vision. Patients should exercise caution when driving or operating machinery until they are aware of how the medicine affects them.
Lifestyle Advice
- Maintain good hygiene to prevent reinfection.
- Follow a balanced diet and stay hydrated.
- Avoid driving or operating machinery if experiencing dizziness or blurred vision.
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