Triampur - instructions, application, reviews. The legal entity in whose name the RU was issued. General characteristics. Compound

pharmachologic effect

Combination drug, the effect of which is determined by the components included in its composition. It has a diuretic and hypotensive effect.

Hydrochlorothiazide is a moderate-strength diuretic.

Triamterene is a potassium-sparing diuretic.

Combination of these medicines increases urinary excretion of Na +, Cl -, water, bicarbonate, with virtually no effect on the excretion of K + and Mg 2+.

The diuretic effect occurs within 1 hour (maximum after 2-3 hours) and lasts up to 7-9 hours.

Pharmacokinetics

Hydrochlorothiazide

Suction

Rapidly absorbed from the gastrointestinal tract, absorption is 80% of the dose taken orally. Cmax in plasma after taking 25 mg of hydrochlorothiazide is achieved after 2-5 hours and is 142 ng/ml. Bioavailability is 70%.

Distribution

Binding to blood plasma proteins is 60-80%. In the therapeutic dose range average value The area under the AUC curve increases in direct proportion to increasing dose. With a single daily dose of hydrochlorothiazide, accumulation is insignificant. Penetrates the placental barrier and is excreted in breast milk.

Removal

T 1/2 - 6-8 hours. Not metabolized. Excreted through the kidneys - 95% unchanged and about 4% in the form of hydrolyzate-2-amino-4-chloro-m-benzenedisulfonamide by glomerular filtration and active tubular secretion in proximal part nephron.

60 minutes after oral administration it is observed in the urine and within 24 hours up to 50-70% of the administered dose is excreted.

Triamterene

Suction

Triamterene is rapidly absorbed from the gastrointestinal tract (80% of dose taken). Cmax in blood plasma is reached after 2-4 hours.

Distribution and metabolism

About 60% binds to blood plasma proteins. Metabolized in the liver. The main active metabolite is 4-hydroxytriamterene.

Removal

T1/2 of the active metabolite is 2-3 hours, T1/2 of triamterene is 4-7 hours. With liver cirrhosis, T1/2 can increase 4 times.

Triamterene is excreted unchanged and in small quantities in urine and bile; active metabolite - mainly by the kidneys and a small part - with bile.

Indications

- edematous syndrome (CHF, nephrotic syndrome, liver cirrhosis, toxicosis on later pregnancy, chronic venous insufficiency);

- arterial hypertension.

Dosage regimen

Inside, without chewing, without drinking big amount water after meals.

At edema syndrome the size of the initial dose is determined by the severity of water disorders electrolyte metabolism and amounts to 2-4 tablets. (caps.) daily, then switch to maintenance therapy 1-2 tablets. (caps.) in 1-2 days.

At chronic venous insufficiency course of treatment - no more than 14 days.

U patients with impaired renal function(CC 30-50 ml/min) daily dose - 1 tablet. (caps.).

Side effect

Fatigue, muscle weakness, cramps, palpitations, marked decrease in blood pressure, thrombosis, thromboembolism, increased urea concentration, nephrourolithiasis, dry mouth, thirst, pain or discomfort in epigastric region, nausea, vomiting, abdominal pain of a spastic nature, constipation or diarrhea, jaundice, hemorrhagic pancreatitis, acute cholecystitis, increasing myopia, hyponatremia, hypomagnesemia, hypochloremia, hypo- or hyperkalemia, hypercalcemia, hyperuricemia, gout, hypertriglyceridemia, decreased glucose tolerance, hyperglycemia , allergic reactions.

Contraindications for use

- hypersensitivity (including to sulfonamides);

- anuria;

— acute glomerulonephritis;

— liver failure;

- precoma;

— hepatic coma;

- hyperkalemia;

- lactation period.

C caution: diabetes mellitus, gout, risk of developing respiratory or metabolic acidosis.

Use during pregnancy and breastfeeding

Contraindicated during lactation.

Use in children

The drug is prescribed with caution to children and adolescents under 18 years of age (efficacy and safety have not been established).

Overdose

Symptoms: frequent urge to urination, weakness, fatigue, confusion, paresthesia, marked decrease in blood pressure, cardiac arrhythmias, convulsions.

Treatment: gastric lavage and symptomatic therapy are indicated.

Drug interactions

Medicines that intensively bind to blood proteins (indirect anticoagulants, clofibrate, NSAIDs) displace the protein and enhance the diuretic effect.

When combined with NSAIDs, acute renal failure may develop.

The hypotensive effect is enhanced by vasodilators, barbiturates, phenothiazines, tricyclic antidepressants, and ethanol.

Increases the neurotoxicity of salicylates, the effects (including side effects) of cardiac glycosides, curare-like muscle relaxants, the cardiotoxic and neurotoxic effects of lithium preparations.

Weakens the effect of oral hypoglycemic drugs, norepinephrine, epinephrine and anti-gout drugs; reduces the excretion of quinidine.

When taking methyldopa simultaneously, the risk of hemolysis increases.

Cholestyramine reduces absorption.

Chlorpropamide can lead to the development of hypokalemia.

Storage conditions and periods

List B. The drug should be stored at a temperature not exceeding 30°C. Shelf life - 3 years.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Use for liver dysfunction

Contraindicated in liver failure.

Use for renal impairment

Contraindicated in chronic renal failure, anuria, acute glomerulonephritis.

special instructions

At long-term use it is necessary to control the concentration of K + , Na + , Cl - , urea, creatinine, glucose in the blood, uric acid, picture peripheral blood(if a deficiency is suspected folic acid).

At the beginning of treatment with the drug, you should avoid potentially hazardous activities that require increased attention and the speed of psychomotor reactions (against the background of a decrease in blood pressure - a slowdown in the speed of reactions).

Name: TRIAMPUR® COMPOSITUM, Teva

pharmacodynamics. Both triamterene and hydrochlorothiazide are diuretics with moderate effects, the pharmacological and clinical properties of which have been well studied, which enhance each other's effect on the water and electrolyte balance in the body, and also complement each other.
Hydrochlorothiazide reduces the reabsorption of sodium ions in the initial part of the distal tubules of the kidneys. The primary outcome is associated with increased excretion of electrolytes, and the secondary outcome is associated with increased urinary output caused by osmotically bound water. The main effect is due to the increased excretion of Na+, Cl- and water; in addition, the excretion of K+ increases, and with prolonged use the excretion of Ca2+ from the body is delayed. Due to the inhibition of carbonic anhydrase, when using hydrochlorothiazide in high doses, the excretion of bicarbonates from the body may be increased.
Triamterene belongs to the group of potassium-sparing saluretics that act in the terminal part of the distal tubules. Regardless of aldosterone, it inhibits the exchange of Na+ ions for K+ and H+ ions in this area, resulting in a retention of potassium ions in the body. Sodium is excreted only in small quantities and has no effect on the excretion of uric acid.
When combining hydrochlorothiazide and triamterene in a 1:2 ratio, their natriuretic and diuretic results are significantly enhanced. The opposite effect of both substances on kaliuresis leads to the desired compensation and neutralization of potassium balance.
Mechanism hypotensive effect saluretics are explained by a change in sodium balance, a decrease in the intracellular volume of water and plasma, a change in renal vascular resistance, as well as a reduced response to angiotensin II.
Pharmacokinetics. After oral administration, approximately 80% is rapidly absorbed into digestive tract. Its bioavailability is approximately 70%. Two-thirds of hydrochlorothiazide is bound to plasma proteins. Its effect depends on the dosage within therapeutic limits, beyond these limits the dosage curve - the effect quickly subsides, therefore, it is impossible to achieve a significant increase in the effect by further increasing the dosage. The diuretic effect is expressed 1-2 hours after taking hydrochlorothiazide, reaches a maximum after 4 hours and, depending on the dosage, lasts 10-12 hours due to reabsorption in the renal tubules. The hypotensive result lasts longer, up to approximately 24 hours. T½ is 6-8 hours. Thiazides are not metabolized in the liver. In quantitative terms, hydrochlorothiazide in unchanged form is completely excreted from the body by the kidneys by glomerular filtration and tubular secretion. In patients with renal failure, the clearance of hydrochlorothiazide is reduced.
Triamterene is rapidly absorbed from the gastrointestinal tract. Resorption occurs at approximately 80%. Bioavailability is reduced by 50% due to the first pass effect through the liver. About 60% of triamterene is bound to plasma proteins. The diuretic effect is expressed 1-2 hours after administration, the maximum effect is noted after 4 hours. The retention of potassium ions in the body can last up to 24 hours. T½ is 4-7 hours. In patients with liver cirrhosis, T½ can be extended by 4 times. Triamterene is rapidly metabolized in the liver. The main metabolite is considered to be 4-hydroxytriamterene, which retains pharmacological activity with T½ 2-3 hours. A small part of triamterene unchanged is excreted from the body along with urine and bile, most of the main metabolite is eliminated by the kidneys, and a small part of it is excreted along with bile.

Composition and release form

table fl., No. 50

Other ingredients: lactose monohydrate, potato starch, povidone, anhydrous colloidal silicon dioxide, sodium starch glycolate (type A), magnesium stearate.

No. UA/10076/01/01 from 07/29/2014 to 07/29/2019

Indications

AG.
Edema syndrome caused by diseases of the heart, liver or kidneys, usually in cases where it is necessary to avoid loss of potassium in the body.
In case of heart failure in combination with cardiac glycosides, if additional fluid removal and a decrease in potassium excretion from the body are necessary.

Application

Side effects

from the blood and lymphatic system : aplastic, inhibition of hematopoiesis, neutropenia, megaloblastic anemia if there was a pre-existing folic acid deficiency, hemolysis, thrombosis and embolism due to hemoconcentration.
From the cardiovascular system: ECG changes, decreased blood pressure, . Possible disturbance of orthostatic regulation with dizziness, impaired consciousness or tendency to loss of consciousness.
From the outside nervous system : lethargy, drowsiness, dry mouth, thirst, headache, dizziness, nervousness, convulsions, confusion, vascular collapse, shock, disorientation, mood changes.
From the side of the organ of vision: minor violations vision and color perception (vision in yellow light, worsening existing or decreased tear production (especially when wearing contact lenses).
From the organ of hearing and labyrinth: disturbance of orthostatic regulation with dizziness, loss of consciousness or tendency to collapse.
From the outside respiratory system : interstitial, respiratory distress syndrome.
From the outside digestive system : nausea, vomiting, diarrhea, epigastric pain, seizure symptoms in the abdominal area, dry mouth, thirst,. These side effects can generally be avoided if the drug is taken after meals. Possible adynamia of the smooth muscles of the digestive tract with constipation and partial intestinal obstruction to paralytic intestinal obstruction.
Hepatobiliary system:, hemorrhagic pancreatitis and with existing cholelithiasis - acute, increased levels of liver enzymes.
From the kidneys and urinary tract : generally at the beginning of treatment, a temporary increase in the level of urea and blood creatinine may be observed; taking large doses of medication and/or excessive diuresis may cause hemoconcentration due to dehydration and hypovolemia; increased symptoms of acute renal failure and non-bacterial interstitial followed by acute renal failure, nephrolithiasis.
From the skin: allergic skin disorders such as purpura, pruritus, urticaria, rash, cutaneous erythematosis, photoallergic skin rash, fever, toxic epidermal necrolysis, .
From the musculoskeletal system and muscles: skeletal muscles, muscle cramps, muscle tension, muscle deformation, calf muscle cramps.
Metabolism: worsening prediabetic or diabetic condition due to increased blood levels; hyperkalemia, hypokalemia, hyponatremia, hypochloremia, hypercalcemia and metabolic (in case of long-term continuous use), electrolyte imbalance. In predisposed patients, depending on the accepted general dosage Blood lipid levels may increase. At the beginning of treatment, there may sometimes be a temporary increase in creatinine and uric acid in the blood, which can trigger gout attacks in some patients who are prone to this.
From the immune system: anaphylactic/anaphylactoid reactions, shock, sudden pulmonary edema (systemic anaphylactic reactions caused by circulating immune complexes), necrotizing vasculitis, exacerbation of systemic lupus erythematosus.
From the outside reproductive system : sexual dysfunction, decreased libido.
General disorders: increased fatigue, weakness, exhaustion, pain.
It has been reported that taking triamterene is considered to cause reactions such as increased photosensitivity, increased uric acid concentrations and pathological changes in the blood count. Patients with hypersensitivity to the drug may experience kidney stones and megaloblastic anemia.
It has been reported that hydrochlorothiazide can reduce glucose tolerance, cause glycosuria, manifestations of latent diabetes, sialadenitis, the development of Stevens-Johnson syndrome, shock, hyperchloremic alkalosis, which, in turn, can cause hepatoencephalopathy and hepatic coma.

special instructions

Triampur compositum should be prescribed with caution to patients with:

• kidney stones;
• mild to moderate liver dysfunction;
• , since treatment with thiazide diuretics can cause hyperglycemia and glycosuria. Thus, periodic monitoring of blood glucose levels is suggested;
• suspected deficiency of folic acid in the body (in particular, with cirrhosis of the liver caused by chronic alcohol abuse, pregnancy). Regular blood monitoring is needed because triamterene is considered a weak folic acid antagonist, which can lead to the development of megaloblastic anemia;
• moderate renal impairment (creatinine clearance >30 ml/min), since renal function is likely to deteriorate or azotemia may occur. Thus, it is necessary to periodically monitor the level of urea and creatinine in the blood plasma.

Avoid simultaneous use of the drug with other potassium-sparing drugs (in particular amiloride) or potassium salts due to increased risk development of hyperkalemia.
Before steam function tests thyroid gland and at least 3 days before the sugar load test, the use of Triampur compositum should be stopped.
Hyperkalemia, hyponatremia, and other electrolyte imbalances: The potential for electrolyte imbalance should be taken into account when treated with the triamterene/hydrochlorothiazide combination, especially when using high doses. It is necessary to periodically monitor the level of electrolytes in the blood plasma during treatment.
During long-term treatment with the drug, the concentration of potassium in the blood plasma should be monitored before starting treatment and after 3-4 weeks of treatment. If potassium concentration does not change, follow-up monitoring should be carried out every 4-6 months. In cases of hyperkalemia, the drug should be discontinued.
During therapy with the drug, potassium concentrations should be monitored at short intervals, especially in elderly patients or during simultaneous treatment with cardiac glycosides, corticosteroids, and laxatives.
Thiazide diuretics increase magnesium excretion, thereby causing hypomagnesemia.
Thiazide diuretics may decrease calcium excretion and cause a temporary increase in plasma calcium levels.
Significant hypercalcemia may be a manifestation of latent hyperparathyroidism.
Triamterene can lead to the development of metabolic acidosis.
Hyperuricemia and gout: Triamterene/hydrochlorothiazide may cause an increase in blood urea levels. Plasma concentrations of uric acid may be increased in patients treated with thiazide diuretics and result in severe clinical signs of gout. Thus, periodic monitoring of plasma uric acid levels during treatment is necessary.
Lipid status: Long-term treatment with thiazide diuretics can cause small and partially reversible increases in the level of total cholesterol, TG, and LDL cholesterol.
System red: Thiazides can aggravate or activate systemic lupus erythematosus, which should be taken into account when treating with drugs containing a combination of triamterene and hydrochlorothiazide.
Patients who use thiazides may experience thrombocytopenia, agranulocytosis, and so regular blood tests should be performed.
The use of Triampur compositum may lead to positive doping test results.
As with other antihypertensive drugs, symptomatic hypotension may occur in some patients. Patients should be closely monitored in order to detect Clinical signs violations water-salt balance(in particular hypovolemia, hyponatremia, hypochloremic alkalosis, hypomagnesemia or hypokalemia), which may develop in the case of simultaneous diarrhea or vomiting. In such patients, it is necessary to periodically monitor the level of electrolytes in the blood plasma. In warmer months, patients with edema may experience hyponatremia due to blood thinning.
When treated with thiazide diuretics, a decrease in glucose tolerance is likely. Dosage modifications of antidiabetic agents, including insulin, may need to be modified. During therapy with thiazide diuretics, latent diabetes mellitus may manifest.
Thiazides can cause intrahepatic, and minimal changes in water-salt balance can provoke the development of hepatic coma.
Patients who use thiazides may develop hypersensitivity reactions if they have a history of allergies or asthma, as well as in patients who have not previously been diagnosed with these diseases.
The drug may affect the results of the following laboratory tests:

• the drug may reduce the level of protein-bound iodine in the blood plasma;
• treatment with the drug should be stopped before laboratory examination to evaluate the function parathyroid gland;
• the drug is able to increase the concentration of free bilirubin in the blood plasma.

Patients with rare hereditary intolerance galactose, lactase deficiency or impaired absorption of glucose and galactose should not take Triampur compositum.
Use during pregnancy and breastfeeding. Triampur compositum is contraindicated for use during pregnancy and breastfeeding. The components of the drug penetrate the placental barrier and into breast milk, which disrupts the homeostasis of the fetus and child’s body. If treatment is necessary for health reasons, breastfeeding should be stopped.
Children. The drug is not used in children under 14 years of age.
Impact on reactions during control vehicles or other mechanisms. When using the medicine, motor reactions may be impaired in some patients; taking this into account, it is not recommended to prescribe it to vehicle drivers and machine operators. Dizziness and a slower reaction are likely to occur at the beginning of treatment, when the dosage of the drug is increased and the treatment regimen is changed.

Interactions

at simultaneous use combinations of Triampur compositum with other antihypertensive, diuretic, vasodilator, sedative (in particular with barbiturates) drugs, as well as drugs that depress the central nervous system (phenothiazines) or tricyclic antidepressants, increase the hypotensive effect. With the additional use of ACE inhibitors at the beginning of treatment, quite a sharp decline HELL. Therefore, ACEs should be prescribed with caution.
Treatment with diuretics should be stopped 2-3 days before starting treatment with ACE inhibitors to reduce the risk arterial hypotension.
When interacting with antiepileptic drugs (), hyponatremia is possible.
The diuretic and hypotensive effects of hydrochlorothiazide may weaken the effect of painkillers, NSAIDs and antirheumatic drugs (in particular salicylates, indomethacin). Concomitant use of these drugs (especially indomethacin) may reduce the diuretic and hypotensive effects of hydrochlorothiazide and even cause acute renal failure in dehydrated patients.
and oral antidiabetic agents: Dosage adjustments of insulin and oral antidiabetic agents may be necessary due to changes in glucose tolerance. use with caution, given the risk of lactic acidosis due to possible hydrochlorothiazide-induced functional renal failure.
Concomitant use with chlorpropamide may result in a risk of severe hyponatremia.
Hydrochlorothiazide may increase the incidence of hypersensitivity reactions to. This reduces the effect of uricosuric drugs.
Cholestyramine and colestipol reduce the absorption of hydrochlorothiazide in the digestive tract, which leads to a weakening of the effect and an increase in the concentration of potassium in the blood.
When Triampur compositum was used simultaneously with methyldopa, blood disorders (hemolysis resulting from the appearance of autoantibodies to hydrochlorothiazide in the blood) were rarely observed. Very high levels of potassium in the blood can occur when taking potassium salts, when treating with potassium-sparing drugs or certain antihypertensive medications(ACE inhibitors).
Very low blood potassium levels may occur when simultaneous treatment adrenal hormones (GCS) or laxatives (if abused).
Simultaneous use antitumor drugs(cyclophosphamide, ) with thiazides may reduce their renal excretion and enhance the myelosuppressive effect.
Anticholinergics (, biperiden): the bioavailability of thiazide diuretics can be increased by reducing gastrointestinal motility.
Concomitant use of vitamin D with hydrochlorothiazide may reduce urinary excretion of calcium and increase plasma calcium.
Cyclosporines: There is an increased risk of developing hyperuricemia and gout-type symptoms.
The anticoagulant effect of heparin may be reduced as a result of a decrease in blood plasma volume.
Concomitant use of the drug with other potassium-sparing drugs (in particular spironolactone, amiloride) or potassium salts should be avoided due to the increased risk of developing hyperkalemia.
Triampur compositum, when used simultaneously with other drugs, can cause:

• weakening the effect of drugs used to treat diabetes and gout, as well as norepinephrine or epinephrine;
• increased undesirable side effects of lithium with simultaneous use of lithium preparations in high doses;
• increased side effects of salicylates on the central nervous system when used simultaneously in high doses;
• enhancing the effect of muscle relaxants (curare-like);
• increased effect and side effects of cardiac glycosides in the presence of potassium and/or magnesium deficiency in the body;
• decreased excretion of quinidine from the body during simultaneous treatment with quinidine medications;
• enhancing the effect of cytostatics that inhibit bone marrow function when used simultaneously;
• impaired potency while taking β-adrenergic receptor blockers (cardiovascular drugs).

Periodic monitoring of plasma potassium levels and an ECG study are suggested if hydrochlorothiazide is taken concomitantly with drugs whose effects are influenced by changes in plasma potassium levels (in particular digitalis glycosides and antiarrhythmic drugs) and drugs that cause torsade de pointes (TdP). (ventricular tachycardia) (including some antiarrhythmic drugs), since hypokalemia is considered a factor contributing to the development of torsades de pointes: for intravenous administration, halofantrine, mizolastine, pentamidine, terfenadine, vincamine for intravenous administration).

Thiazide diuretics increase plasma calcium levels by reducing its excretion. If you need to prescribe calcium supplements food additives, it is necessary to monitor the level of calcium in the blood plasma and adjust the calcium dose accordingly.
Diuretic-induced dehydration increases the risk development of surge arresters, mainly when using high doses of iodinated contrast agents. Patients need to be rehydrated before administering iodine-containing medications.
Hydrochlorothiazide when taken simultaneously with amphotericin B (for parenteral administration), corticosteroids and ACTH enhance electrolyte imbalance, mainly hypokalemia.
NSAIDs, including selective inhibitors COX-2, >3 g/day and non-selective NSAIDs: when taken concomitantly, NSAIDs may weaken the antihypertensive effect of hydrochlorothiazide and enhance its effect on plasma potassium levels.
Concomitant use of thiazide diuretics, including hydrochlorothiazide, with beta-adrenergic blockers may increase the risk of hyperglycemia. Thiazide diuretics, including hydrochlorothiazide, may enhance the hyperglycemic effects of diaxoside.
Thiazides, including hydrochlorothiazide, may increase the risk of side effects from amantadine.
Alcohol and drugs may worsen orthostatic hypotension.

Overdose

symptoms. In case of acute overdose, a decrease in blood pressure may occur (in the most severe cases orthostatic collapse is possible).
At chronic overdose Severe electrolyte imbalances (eg hypo- or hyperkalemia) may occur. Nausea and weakness may also occur.
Treatment with the drug is immediately discontinued at the first symptoms of overdose, such as prolonged diuresis, increased fatigue, confusion, increased neuromuscular irritation, cardiac arrhythmia, ECG abnormalities similar to those observed with hypo- or hyperkalemia. Also, in case of overdose, symptoms such as tachycardia, dizziness, muscle spasms, paresthesia, disturbances of consciousness, nausea, vomiting, thirst, anuria, hyponatremia, hypochloremia, increased levels of urea nitrogen in the blood (usually renal failure) .
In the most severe cases, adynamia, spastic attacks, states of agitation, alkalosis or acidosis may appear.
A diuretic component is considered dangerous when diabetes mellitus, with previous damage to the kidneys or liver (coma is possible), as well as with simultaneous saturation with cardiac glycosides.
Treatment. There is no specific antidote.
If there are signs of an overdose, you should immediately stop the drug, induce vomiting or rinse the stomach, and take it to reduce absorption.
Electrolyte and water balance, acid-base balance, blood glucose, substances that are excreted in the urine, and blood circulation.
In case of hypovolemia, sufficient fluid intake should be ensured to prevent crystallization of triamterene in the kidneys. In case of hypokalemia, acute acidosis can be quickly compensated by administering isotonic solution sodium bicarbonate. For hyperkalemia: administration of glucose and insulin (if necessary, with the addition of sodium bicarbonate), drugs for ion exchange orally or rectally, hemo- or peritoneal dialysis in patients with renal failure. For cases that cannot be treated, temporary therapy with a pacemaker should be carried out. In case of arterial hypotension and shock, administration of fluids and electrolytes (potassium, sodium, magnesium) is recommended. With vascular collapse ( state of shock patient): antishock therapy. To normalize the patient's condition, monitoring of fluid and electrolyte balance and renal function is necessary.

Storage conditions

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pharmachologic effect

A combination drug containing hydrochlorothiazide and triamterene. It has a diuretic and hypotensive effect.
Hydrochlorothiazide is a diuretic of moderate effectiveness. Increases the excretion of sodium, chlorine and equivalent amounts of water from the body. It also increases the excretion of potassium, magnesium, and bicarbonate ions.
Triamterene belongs to the group of potassium/magnesium-sparing diuretics. When combined with hydrochlorothiazide, it prevents the development of hypokalemia and hypomagnesemia.

Indications

Arterial hypertension;
- edematous syndrome of various origins (with chronic heart failure / including as part of combination therapy severe forms with resistant edema/; for diseases of the liver, kidneys);
- swelling in chronic venous insufficiency (short course, with simultaneous physiotherapy).

Dosage regimen

Adults and adolescents weighing more than 50 kg at arterial hypertension prescribed in an initial dose of 2 tablets. 2 times/day (morning and afternoon). When carrying out long-term maintenance treatment, the dose is reduced to 2 tablets/day (2 tablets in the morning or 1 tablet in the morning and afternoon). In case of simultaneous use of other antihypertensive drugs, the daily dose of Triampur Compositum is also 2 tablets.
For treatment edema syndrome prescribed in an initial dose of 2 tablets. 2 times/day. If the diuretic effect is insufficient, the single dose can be increased to 4 tablets. Depending on the diuretic response and the dynamics of the patient's condition during long-term treatment, the dose may vary.
When carrying out long-term maintenance treatment of patients with edematous syndrome, as a rule, 1 tablet is prescribed. in the morning daily or 2 tablets. every other day (you can take 2 tablets 1 time/day in the morning or 1 tablet in the morning and afternoon). If necessary, the dose can be increased to 2 tablets. 2 times/day.
The duration of the course of treatment is determined individually.
When edema in chronic venous insufficiency course of treatment - no more than 14 days.
For patients with impaired renal function(serum creatinine concentration 1.5-1.8 mg/100 ml or creatinine clearance 50-30 ml/min) daily dose should not exceed 1 tablet.
Triampur Compositum tablets should be taken whole, without chewing, with a small amount of liquid.

Side effect

From the side of water-electrolyte and acid-base balance: dry mouth, thirst; hypokalemia may develop (manifested by symptoms such as fatigue, muscle weakness, cramps). With prolonged use, hyponatremia, hypomagnesemia, hypochloremia, hypo- or hyperkalemia are possible; rarely - hypercalcemia; metabolic acidosis.
Metabolism: with long-term use, hyperuricemia may develop (rare cases of exacerbation of gout have been described); rarely - decreased glucose tolerance, increased blood glucose levels; deterioration carbohydrate metabolism in patients with diabetes mellitus.
In predisposed patients, blood lipids may increase.
From the cardiovascular system: palpitations, excessive decrease in blood pressure, orthostatic hemodynamic disorders. Patients with venous diseases have an increased risk of thrombosis and embolism.
From the urinary system: sometimes, at the beginning of treatment, a reversible increase in the level of nitrogen-containing substances (urea, creatinine) in the blood is possible; rarely - the formation of stones in the urinary tract.
From the side of the central nervous system: sometimes - headaches, nervousness; rarely - worsening myopia.
From the digestive system: possible pain or discomfort in the epigastrium, nausea, vomiting, cramping abdominal pain, constipation or diarrhea; rarely - jaundice, hemorrhagic pancreatitis; in patients with cholelithiasis- acute cholecystitis.
From the hematopoietic system: anemia, leukopenia, thrombocytopenia; megaloblastic anemia with pre-existing folic acid deficiency.
Allergic reactions: urticaria, purpura, dermatitis with or without photosensitivity; necrotizing vasculitis; spicy interstitial nephritis; drug fever.
Isolated cases of sudden development of pulmonary edema with symptoms of shock have been described (apparently associated with an allergic reaction to hydrochlorothiazide).

Contraindications

Renal failure, anuria;
- acute glomerulonephritis;
- severe liver dysfunction (precoma and hepatic coma);
- disorders of electrolyte metabolism that cannot be corrected: hypokalemia, hyperkalemia, hypercalcemia, hyponatremia;
- increased sensitivity to sulfonamides (due to the danger of cross-linking allergic reactions);
- lactation (breastfeeding).

Pregnancy and lactation

During pregnancy, Triampur Compositum is prescribed only for strict indications; Long-term use of the drug should be avoided.
If it is necessary to use Triampur Compositum during lactation, the issue of stopping breastfeeding should be decided.

special instructions

Caution should be exercised when prescribing Triampur Compositum to patients with gout and diabetes mellitus; with impaired renal and/or liver function; if you suspect a lack of folic acid.
Patients with impaired renal function, cirrhosis of the liver, as well as pregnant women have an increased risk of developing severe violations electrolyte metabolism.
If folic acid deficiency is suspected, regular monitoring of peripheral blood patterns is necessary.
Control laboratory parameters
During therapy with Triampur Compositum, the blood levels of potassium, sodium, chlorine, urea, creatinine, glucose and uric acid should be systematically monitored.
Use in pediatrics
Clinical experience The use of the drug in children is insufficient.
Impact on the ability to drive vehicles and operate machinery
When treated with Triampur Compositum, especially at the beginning of treatment and when changing antihypertensive drugs, the speed of psychomotor reactions may slow down, which is associated with changes in blood pressure. This, first of all, should be taken into account by persons involved in potential dangerous species activities requiring increased attention and speed of psychomotor reactions.

Overdose

Currently, no cases of overdose of Triampur Compositum have been reported.

Drug interactions

With the simultaneous use of Triampur Compositum and other antihypertensive drugs (in particular, ACE inhibitors), diuretics, barbiturates, phenothiazines, tricyclic antidepressants, vasodilators, as well as ethanol-containing drugs, an increase in the hypotensive effect of Triampur is noted.
With the simultaneous use of Triampur Compositum with potassium salts, potassium-sparing diuretics (for example, veroshpiron), as well as with ACE inhibitors, hyperkalemia may occur.
With the simultaneous use of Triampur Compositum and glucocorticoids, laxatives in high doses, hypokalemia may develop.
With simultaneous use of NSAIDs(for example, indomethacin), the diuretic and hypotensive effect of Triampur Compositum may be reduced. With simultaneous use of Triampur Compositum with indomethacin, the risk of developing renal failure increases. With the simultaneous use of Triampur Compositum with salicylates in high doses, the risk of toxic manifestations from the central nervous system increases.
With simultaneous use, Triampur Compositum helps to enhance and prolong the action of curare-like muscle relaxants.
With simultaneous use, Triampur Compositum may enhance the cardiotoxic and neurotoxic effects of lithium; weaken the effect of hypoglycemic and anti-gout drugs, norepinephrine and adrenaline; slow down the elimination of quinidine.
With the simultaneous use of Triampur Compositum and cholestyramine, the absorption of hydrochlorothiazide is reduced.
With the simultaneous use of methyldopa and Triampur Compositum, hemolysis may develop.

Storage conditions and periods

The drug should be stored at room temperature. Shelf life - 5 years.
Conditions for dispensing from pharmacies
The drug is available with a prescription.

• Instructions for use TRIAMPUR COMPOSITUM
• Composition of the drug TRIAMPUR COMPOSITUM
• Indications for the drug TRIAMPUR COMPOSITUM
• Storage conditions for the drug TRIAMPUR COMPOSITUM
• Shelf life of the drug TRIAMPUR COMPOSITUM

ATX code: Cardiovascular system (C) > Diuretics (C03) > Combination of diuretics with potassium-sparing drugs (C03E) > Diuretics acting on the cortical segment of the loop of Henle, in combination with potassium-sparing drugs (C03EA) > Hydrochlorothiazide in combination with potassium-sparing drugs (C03EA01)

Release form, composition and packaging

Pills yellow color, uniform, round, with a smooth surface and intact edges, with a risk for breaking and a chamfer on one side.

Excipients: lactose monohydrate, potato starch, polyvidone K25, highly dispersed silicon dioxide, carboxymethyl starch sodium salt, magnesium stearate.

50 pcs. - glass bottles (1) - cardboard packs.

Description medicinal product TRIAMPUR COMPOSITUM based on officially approved instructions for use of the drug and made in 2015.

pharmachologic effect

A combination drug, a diuretic containing triamterene and hydrochlorothiazide, belongs to the group of tubular diuretics.

Hydrochlorothiazide reduces the reabsorption of sodium ions in the initial part of the distal tubules of the kidneys. The primary effect is increased excretion of electrolytes, and the secondary effect is increased urine output caused by osmotically bound water.

The main effect is manifested by increased excretion of sodium, chlorine and water ions, the drug also causes increased secretion potassium, and with long-term use - a decrease in the release of calcium from the body. The secretion of uric acid decreases, and the excretion of magnesium increases. Due to inhibition of carbonic anhydrase, the use of hydrochlorothiazide in high doses may increase the excretion of bicarbonate from the body.

The diuretic effect appears 1-2 hours after administration and lasts 10-12 hours. The hypotensive effect lasts 24 hours.

Triamterene belongs to the group of potassium-sparing saluretics acting in the terminal part of the distal tubules. Regardless of aldosterone, it inhibits in this area the exchange of sodium ions for potassium and hydrogen ions, resulting in the retention of potassium ions and a slight excretion of sodium from the body. The drug does not affect the secretion of uric acid.

The diuretic effect occurs within 1 to 2 hours. The potassium-sparing effect of triamterene can last up to 24 hours.

At combining hydrochlorothiazide and triamterene in quantitative ratio 1:

• 2 their natriuretic and diuretic effects are clearly enhanced. The opposite effect of both drugs on potassium excretion leads to the desired compensation and neutralization of potassium balance.

In the mechanism of the hypotensive effect of the drug Triampur compositum, an important role is played by the increased secretion of sodium ions, which results in a decrease in the volume of extracellular fluid and blood plasma, a change in the resistance of the renal vessels, as well as decreased sensitivity receptors vascular wall to norepinephrine and angiotensin II.

Pharmacokinetics

After oral administration, 80% of triamterene is rapidly absorbed from the gastrointestinal tract. Bioavailability is reduced by 50% due to the “first pass” effect through the liver.

The binding of triamterene to plasma proteins is about 60%. T1/2 in blood plasma is 4-7 hours.

Triamterene is metabolized in the liver. A small part is excreted unchanged from the body with urine and bile, most of the main metabolite is eliminated by the kidneys, and a small part is excreted in the bile.

After oral administration, approximately 80% of hydrochlorothiazide is absorbed from the gastrointestinal tract. Bioavailability is 70%. 2/3 of the dose of hydrochlorothiazide is bound to plasma proteins. T1/2 in plasma is 6-8 hours.

Thiazides are not metabolized in the liver. Hydrochlorothiazide, unchanged, is almost completely excreted by the kidneys.

Indications for use

• arterial hypertension;
• edema caused by diseases of the heart, liver or kidneys, mainly in cases where it is necessary to avoid loss of potassium by the body;
• heart failure, if additional fluid removal and a decrease in potassium excretion from the body is required (in combination with cardiac glycosides) .

Dosage regimen

The dose of the drug is selected by the doctor individually for each patient.

For adults and adolescents weighing more than 50 kg The following drug dosage regimens exist.

Arterial hypertension

The initial dose of the drug is 2 tablets. in the morning and 2 tablets. at noon. When additionally taking other antihypertensive drugs or for long-term therapy, 2 tablets per day is sufficient (1 tablet in the morning and at noon).

Edema of any etiology

At the beginning of treatment, 2 tablets are prescribed in the morning and at noon. drug. If the diuretic effect is insufficient, the single dose can be increased to 4 tablets. Further doses are prescribed depending on the degree of dehydration. The maintenance dose is 1 tablet/day, taken every day in the morning, or 2 tablets. every other day (1 tablet in the morning and at noon). If necessary, the maintenance dose can be increased to 4 tablets/day (2 tablets in the morning and at noon).

Concomitant therapy in the treatment of heart failure with glycosides

Doses of the drug are selected depending on the patient’s examination data. On average, 2 tablets per day are prescribed, if necessary, a maximum of 4 tablets per day is given (1 tablet or maximum 2 tablets in the morning and at noon).

At impaired renal function (serum creatinine 1.5-1.8 mg/dl or creatinine clearance 50-30 ml/min) daily dose, which is 1 tablet, should not be exceeded.

The tablets are taken after meals, without chewing and with a small amount of liquid. During treatment with Triampur compositum there is no need to limit fluid intake.

For children the drug is prescribed at a dose of 1-2 mg/kg body weight 2 times a day.

The duration of the course of treatment is determined by the doctor.

After long-term treatment Triampur compositum should not be discontinued suddenly. Discontinuation of the drug should be carried out with a gradual dose reduction.

Side effect

Use during pregnancy and breastfeeding

Due to electrolyte imbalance in a pregnant woman, negative subsequent effects on the fetus are possible, as well as decreased blood supply to the placenta. Therefore, the prescription of the drug is possible only from the second half of pregnancy for strict health reasons.

While taking the drug, you should refrain from breastfeeding.

Use for renal impairment

Contraindicated in severe renal failure, anuria, acute glomerulonephritis.

With reduced renal function (serum creatinine 1.5-1.8 mg/dl or creatinine clearance 50-30 ml/min), the daily dose of 1 tablet should not be exceeded.

Contraindication: severe renal failure (CR1.8 mg/dl);

special instructions

Caution should be used in patients with gout, patients with impaired renal function with serum creatinine between ULN and 1.8 mg/dL or a slight decrease in creatinine clearance (30-60 ml/min), kidney stones, hepatic dysfunction, diabetes mellitus and suspected folic acid deficiency .

When carrying out long-term treatment with Triampur compositum, it is necessary to periodically monitor laboratory blood parameters ( residual nitrogen, concentration of electrolytes, especially potassium, creatinine, lipids, glucose and uric acid).

In elderly patients or during simultaneous treatment with cardiac glycosides, adrenal hormones or laxatives, the concentration of potassium, creatinine and glucose in the blood is determined more often.

If you suspect a deficiency of folic acid in the body, regular blood tests should be performed, because triamterene is a weak antagonist of folic acid and can cause the development of megablastosis.

Before testing the function of the parathyroid gland and at least 3 days before the test with a sugar load, treatment with Triampur compositum is interrupted, because V otherwise False readings may be obtained.

With chronic abuse of diuretics, pseudo-Bartter's syndrome with edema may appear as a consequence. Edema is accompanied by a pronounced increase in renin, as a result of which secondary hyperaldosteronism develops.

The drug contains lactose, so the drug should not be taken by patients with hereditary galactose intolerance, lapp-lactase enzyme deficiency, or glucose/galactose malabsorption.

Impact on the ability to drive vehicles and operate machinery

Overdose

Symptoms: In case of acute overdose, blood pressure may drop (up to orthostatic collapse). In case of chronic overdose, threatening fluid loss and electrolyte imbalance are possible. The drug should be discontinued immediately at the first signs of overdose:

• frequent urge to urinate, weakness, fatigue, confusion, paresthesia, impaired consciousness, increased neuromuscular excitability, drop in blood pressure, cardiac arrhythmias with changes in the ECG, as well as hypo- and hyperkalemia, convulsions. In extreme cases, adynamia, a state of agitation, alkalosis or acidosis may appear.

Intoxication with a diuretic component is dangerous in diabetes mellitus, with previous damage to the kidneys or liver (coma is possible), as well as when taken simultaneously with cardiac glycosides.

Treatment: induce vomiting and rinse the stomach; treatment is symptomatic; there is no specific antidote. Must be carefully monitored and adjusted if necessary electrolyte balance, acid-base balance, blood glucose, substances that must be excreted in urine, and blood circulation. Sufficient fluid intake should be ensured in order to prevent crystallization of triamterene in the kidneys. Acute acidosis can be quickly corrected by administering an isotonic sodium bicarbonate solution.

Drug interactions

With simultaneous use of Triampur compositum with other antihypertensive, diuretic, vasodilator, central nervous system depressant (barbiturates, phenothiazines) or anti-depression (tricyclic antidepressants) drugs, the hypotensive effect is enhanced.

At additional use ACE inhibitors at the beginning of treatment may be observed sharp drop HELL.

The hypotensive and diuretic effect of the active substance hydrochlorothiazide may be weakened by the influence of analgesics, NSAIDs and other antirheumatic drugs. Concomitant use of indomethacin with Triampur compositum may adversely affect renal function (decreased glomerular filtration).

Cholestyramine and colestipol reduce absorption active substance hydrochlorothiazide in the gastrointestinal tract, which leads to a weakening of its effect and an increase in the concentration of potassium in the blood.

When the drug was used simultaneously with methyldopa, the appearance of antibodies to hydrochlorothiazide was rarely observed.

Too high levels of potassium in the blood can occur when taking potassium salts, when treating with potassium-sparing drugs or certain antihypertensive drugs(ACE inhibitors). Too low levels of potassium in the blood may occur with simultaneous treatment with glucocorticoids or laxatives (if abused).

In case of possible interaction of the drug Triampur compositum with other drugs, the following effects may occur:

• weakening the effect of drugs used to treat diabetes and gout, drugs containing norepinephrine (norepinephrine) and adrenaline (epinephrine);
• increased cardiotoxic and neurotoxic effects of lithium with simultaneous use of lithium preparations in high doses;
• increased side effects of salicylates on the central nervous system when administered simultaneously in high doses;
• enhancing the effect of muscle relaxants (curare-like);
• enhanced action and side effects cardiac glycosides in the presence of potassium and/or magnesium deficiency in the body;
• decreased excretion of quinidine from the body during simultaneous treatment with quinidine preparations;
• bone marrow damage during simultaneous treatment with cytostatics;
• impaired potency when taken simultaneously with beta-blockers.

This information is relevant for medications taken shortly before starting treatment with Triampur compositum.

How effective is the use of a medicine such as Triampur Compositum for weight loss? Reviews talk about the possibility of quickly losing weight without much effort. But the drug does not have direct indications for weight loss; isn’t this dangerous for health?

What is Triampur Compositum?

The drug "Triampur Compositum" is classified as a diuretic, a medication that has diuretic properties and is intended to be removed from the body. excess liquid. Their direct effect is aimed at the kidneys and inhibiting the reabsorption of sodium ions in the renal canals, due to which excess water is removed from the body.

In general, diuretics are used to combat edema, to normalize kidney function and to reduce blood pressure. Such drugs can also be used for poisoning, since they have the property of binding and removing toxins.

Indications for use

Direct indications for use, according to the instructions, are:

• swelling caused by heart disease, impaired kidney or liver function;
• excess potassium in the body;
• increased blood pressure;
• the presence of vegetative-vascular dystonia.

With diseases of the heart and diuretic system, sodium accumulates in the body, which contributes to the occurrence of swelling. Excess sodium also constricts blood vessels, which increases blood pressure and causes headaches. Triampur Compositum removes excess sodium from the body along with fluid, which quickly reduces blood pressure and eliminates swelling.

In case of poisoning, the main impact is on the kidneys, which cannot cope with large amounts of toxins. Taking Triampur Compositum helps remove toxic substances. The drug is quickly absorbed into the blood, so the result from taking it occurs after one to two hours, while the effect of the drug continues throughout the day.

How to take Triampur Compositum?

The method of using Triampur Compositum depends on the indications and body weight. If you weigh more than 50 kilograms, two tablets are usually prescribed twice a day, in the morning and at lunch. Treatment is completed by reducing the dosage and taking first one tablet at a time, and then one tablet per day.

When used simultaneously with medications for hypertension, heart disease or poisoning, Triampur Compositum is taken in an amount of no more than two tablets per day.

For swelling, the remedy is taken in the morning and at lunch, one or two tablets at a time, depending on the intensity of the problem. Availability kidney diseases involves taking no more than one tablet per day.

Triampur Compositum is prescribed by a doctor, who also determines the dosage of the drug and the duration of its use. With long-term use, in no case should you suddenly stop using it; you must gradually reduce the dose, otherwise problems with fluid excretion and kidney function may occur.

"Triampur Compositum" for weight loss

Triampur Compositum is often used by athletes. The drug is especially often used in sports that require strict weight control, such as equestrianism or gymnastics. Bodybuilders often use this product to remove “excess” water from the body.

Triampur Compositum is used and ordinary people when you need to quickly get rid of several extra pounds in anticipation important event. And indeed, rapid weight loss is observed - in a few days you can lose up to 3-5 kilograms. However, do not forget that body weight decreases due to the removal of fluid, the lack of which can provoke health problems. In addition, there are many contraindications to taking the drug.

Contraindications for use

Despite the effectiveness of Triampur Compositum, there are certain contraindications to its use, in particular:

• hypersensitivity to the components of the drug, which becomes a direct contraindication for use;
• severe liver or kidney damage, glomerulonephritis ( inflammatory process in the kidneys), anuria (urinary retention), hepatic coma;
• increased concentration of potassium in the body;
• hypovolemia (decrease in total blood volume and imbalance in its constituent elements and plasma);
• gout;
• pregnancy, since the medicine easily penetrates the placental barrier and negatively affects the fetus;
• breastfeeding, as taking the product may harm the baby.

Side effects

Triampur Compositum should not be taken on an empty stomach, as this may cause nausea, vomiting or diarrhea. In some cases, taking the drug may be accompanied by side effects, such as:

• fast fatiguability;
• nervousness;
• voltage;
• dry mouth:
• headache;
• thirst;
• blurred vision;
• heart rhythm disturbance;
• muscle cramps or weakness;
• diarrhea or constipation;
• allergic reactions.

Adverse reactions in most cases are caused by improper use of the drug. This may be taken on an empty stomach, combined with other medications, or used with obvious contraindications. The occurrence of any adverse reaction requires immediate discontinuation of the drug until the provoking cause is determined.

Interaction of Triampur Compositum with other drugs

Triampur Compositum should be taken with extreme caution in combination with other medications. So simultaneous administration with diuretics, hypertensives, sedatives or vasodilators may provoke sharp decline blood pressure.

Combination with painkillers can negatively affect the kidneys, reducing glomerular filtration. In addition, by reducing the absorption of certain substances in the gastrointestinal tract, the concentration of potassium in the blood may increase.

The combination with cardiovascular diseases contributes to the emergence of potency. It is highly undesirable to take Triampur Compositum in combination with drugs containing lithium, as this can cause toxic damage to the body. Simultaneous use with adrenaline-containing drugs reduces the effectiveness of the latter.

What should you pay special attention to?

When deciding to take Triampur Compositum, you should pay attention to the following points:

• You should not take the drug if you are prone to the formation of kidney stones, since colloid imbalance due to taking Triampur can lead to changes in the kidney parenchyma and the formation of stones;
• in case of diabetes mellitus, Triampur can cause hyperglycemia and increased blood glucose;
• taking the drug is undesirable if there is a lack of folic acid, which can be observed in liver cirrhosis or alcohol abuse;
• when taking Triampur for a long time, it is advisable to periodically check the concentration of potassium in the blood; diuretics can also provoke hypomagnesemia and an increase in calcium in the blood plasma;
• taking medication for gout may increase the level of urea in the blood;
• taking Triampur Compositum may slightly change some test results, in particular blood tests, thyroid examination, bilirubin level;
• When taking Triampur, it is advisable to avoid using complex equipment and driving a car, since a violation of the motor reaction may be observed.

Overdose

An overdose of Triampur Compositum may be accompanied by symptoms such as:

• a sharp decrease in blood pressure;
• dehydration and electrolyte imbalance, accompanied by nausea and weakness;
• asthenia, prolonged diuresis, increased fatigue, cardiac dysfunction, nervous breakdown;
• dizziness and kidney failure;
• diuretic intoxication.

As such, there is no treatment for overdose. It is necessary to stop taking the drug. To improve your health as quickly as possible, it is recommended to induce vomiting or take Activated carbon, which will prevent the absorption of drug components into the blood.

So is it worth taking Triampur for weight loss? Reviews about it, of course, indicate its effectiveness this method, but the presence of serious contraindications and the likelihood of side effects casts doubt on the advisability of this method of weight loss. Still, Triampur Compositum is not intended for weight loss and cannot guarantee health safety.

Reviews

Anastasia Orlova, 27 years old, Kostroma:

I have known for a long time that diuretics help with weight loss. Therefore, when I needed to lose weight quickly, I decided to take Triampur Compositum. Within a week of use, body weight decreased by 3 kg. Of course, this can hardly be called healthy weight loss and it is clear that adipose tissue there is no impact, but how emergency method taking Triampur may be useful.

Sofia Becker, 33 years old, Kaliningrad:

I don’t have any particular problems with weight, but my “headache” was swelling; in the mornings a swollen woman with “bags” under her eyes would look at me from the mirror. Because of this, I even had to wake up for work 2-3 hours earlier in order to somehow get myself in good shape. The pharmacist at the pharmacy advised me to take Triampur Compositum when I shared my sorrows with her. I took it for two weeks, and gradually reduced its use in the third or fourth week. The drug really helped at least, so far there is no swelling, although the amount of liquid I consume remains the same.

Elena Korobova, 29 years old, Saratov:

I took Triampur Compositum on the advice of a friend who is actively involved in fitness and often visits the gym. According to her stories, many of those who play sports and watch their figure take this drug for quick drying. I took the medicine for three weeks, during which time the volumes really decreased - the waist became narrower and the stomach became smaller. I think that it is advisable to take the drug in combination with strength loads so that the results are maintained. I think I’ll decide to take the product again as soon as it appears free time for regular trips to the gym.

Marina Saenko, 26 years old, Tomsk:

I lost weight with Triampur; my colleagues’ craze for this drug had an effect, and they praised it as some kind of miracle remedy. My impressions of it are extremely contradictory - on the one hand, the product cannot be called ineffective, the weight actually decreases by several kilograms, but on the other hand, there is a completely uncomfortable state; personally, throughout the entire use, I was constantly accompanied by extreme thirst and severe weakness. Despite the effectiveness of the drug, I would not recommend its use to anyone.

Olga Mayer, 31 years old, Volgograd:

I once took Triampur Compositum as prescribed by a doctor. The drug is really good and helped a lot in treating my disease. However, I did not notice any weight loss from taking it. It may be good for eliminating edema, but it’s probably not worth taking as a means of losing weight. Before prescribing it, the doctor carefully examined me and monitored my health throughout the course, since there were no contraindications and side effects. of this medicine so many.

Raisa Pyanzina, 30 years old, Perm:

I heard that Triampur Compositum helps you lose weight quickly, and since I don’t have time to go to the gym, I decided to use this tool. Almost from the very first days I noticed that I began to get tired faster and often felt dizzy. By the end of the week of treatment, I almost constantly felt weak in my body, and I was also very tired of endless trips to the toilet, although I drank very little water. After taking the drug for a week and a half, I stopped using it, because no amount of beauty is worth such a mockery of one’s health.

Irina Dubravina, 32 years old, Lipetsk:

I took Triampur Compositum for the purpose of losing weight for two weeks. During this time I managed to lose almost 4 kg. But after I stopped taking the drug, the weight returned quite quickly. Just two weeks later, my 4 kg returned. That's why I don't consider Triampur suitable method weight loss. Rather, you can consider it an “ambulance” when 2-3 kg prevents you from getting into your favorite dress. In addition, the use of the drug is accompanied by frequent urination and constant thirst, which does not at all contribute to good health.

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