New Revised MRP, 100% GST benefit passed TRICINOD 5/12.5MG TABLET 10'S
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Introduction About TRICINOD
TRICINOD is a combination of Chlorthalidone, Cilnidipine and Telmisartan which belongs to the group of medicines called Antihypertensive drugs. It is used to manage essential hypertension in adults. High blood pressure that is not caused by any other condition is called essential hypertension. Symptoms of essential hypertension include early morning headaches, nosebleeds, irregular heartbeat, vision changes, buzzing in the ears, fatigue (feeling overtiredness), nausea, vomiting, confusion, anxiety, chest pain and muscle tremors (shakiness).
TRICINOD is not recommended for use in patients with liver, kidney and heart disease. TRICINOD is not recommended in early pregnancy and must not be taken when more than 3 months pregnant, as it may cause serious harm to the baby if used after 3 months of pregnancy. TRICINOD is not suitable for use by breastfeeding women. TRICINOD is not recommended for use in children and adolescents (under 18 years of age). Consult your doctor before taking this medicine.
TRICINOD and it should be used with caution in elderly patients. The most common side effects of taking TRICINOD are dizziness, nausea, headache, constipation, fever and chills. Consult your doctor if the above-mentioned symptoms are not improving.
Uses Of TRICINOD
- Manage essential hypertension (high blood pressure) in adults
- Lowers the risk of stroke and heart attack
How TRICINOD Works
TRICINOD effectively reduces the blood pressure where Chlorthalidone acts by enhancing the excretion of sodium (which is necessary for constriction of blood vessels) and water from the body causing blood vessels to relax and Cilnidipine makes the blood vessels relax and thus lowers the blood pressure by blocking the calcium entry in blood vessels which is necessary for the smooth muscle contraction. Telmisartan acts by blocking the effects of Angiotensin II (a substance produced in your body which causes the narrowing of blood vessels).
How to use TRICINOD
Take TRICINOD as advised by your physician. Swallow this medicine, do not crush or chew the medicine. The correct dosage and duration of medicine to be taken will be prescribed by your doctor depending on your age, body weight and disease condition.
Side Effects Of TRICINOD
Common
- low blood pressure
Uncommon
- signs of urinary tract infection (bladder pain, foul smell, cloudy urine, frequent urination)
- signs of upper respiratory tract infection (sore throat, inflamed sinuses, common cold)
- anemia
- insomnia
- depression
- fainting
- feeling of spinning (vertigo)
- slow heart rate
- cough
- low blood pressure while standing up from a sitting position
- shortness of breath
- abdominal pain, abdominal discomfort, bloating
- diarrhea
- vomiting
- itching
- increased sweating
- drug rash
- back pain
- muscle cramps, muscle pain
- chest pain
- feeling of weakness
Rare
- signs of high eosinophil count in blood (fever, night sweats, swelling, weakness)
- signs of low platelet count (easy bleeding or bruising)
- severe allergic reaction (anaphylactic reaction)
- allergic reaction (Ex. rash, itching, wheezing, rapid swelling of the face and mucosa (angioedema)
- low sugar level in the blood (in diabetic patients)
- feeling anxious
- sleepiness
- impaired vision
- fast heartbeat (tachycardia)
- dry mouth, dysgeusia (impaired sense of taste)
- eczema (a skin condition with der, red, itchy, irritated skin)
- pain in joints(arthralgia), extremities, tendon
- flu-like-illness
- severe pain in joints, joint stiffness, slurred speech
Stop taking TRICINOD and contact your doctor immediately if you experience any of the following side effects:
- sepsis (the body's life-threatening response to infection which can lead to death and organ failure)
- angioedema (rapid swelling of the skin and mucosa)
How To Manage Side Effects
Vomiting:
Take this medicine with or just after meals. Stick to simple meals. Avoid eating oil-rich or spicy foods, sugary snacks and drinks. Avoid drinking too much liquid along with your meals, drink slowly in between meals. Consult your doctor if your symptom does not improve.
Diarrhea:
Drink lots of fluids, such as water or fruit juice to keep yourself hydrated. Do not consume any medicine on your own without consulting your doctor.
Stomach pain:
Try to rest and relax. Try to have smaller and more frequent meals. Keep a heating pad on your stomach. If the symptom does not improve, contact your doctor.
Dizziness:
When you feel dizzy, lie or sit down immediately. if you're experiencing a severe episode of vertigo, lie in a dark and quiet place with your eyes closed. Vehicle driving should be avoided if you experience frequent dizziness without warning. Talk to your doctor if the symptom worsens.
Skin rash:
Try to avoid hot showers because they may cause skin irritation. Avoid frequent contact and rubbing over the affected area. Use sunscreen and protective clothing when outdoors. If this symptom does not get better, speak to a doctor.
Warning & Precautions
Pregnancy
TRICINOD is not recommended in early pregnancy and must not be taken when more than 3 months pregnant, as it may cause serious harm to the baby if used after 3 months of pregnancy. Consult your doctor for advice.
Breastfeeding
TRICINOD is not recommended for use in breastfeeding women as it may pass through the breast milk to the baby. Your doctor may choose another management especially if you want to breastfeed when your baby is a new born or born prematurely. Consult your doctor for advice before taking TRICINOD.
Driving and Using Machines
Do not drive or operate any machines if you feel dizzy or tired after taking TRICINOD. Consult your doctor before taking TRICINOD.
Alcohol
Avoid alcohol consumption as it may aggravate the side effects of TRICINOD.
Kidney
TRICINOD is not recommended for use in patients with kidney failure. It should be taken with caution in patients with kidney disease, kidney artery stenosis (narrowing of blood vessels to one or both the kidneys) and kidney transplant. Consult your doctor before taking TRICINOD.
Liver
TRICINOD is not recommended for use in patients with liver failure or severe liver problems such as cholestasis or biliary obstruction (flow of bile from the liver stops or slows) and it should be used with caution in patients having progressive liver disease. Consult your doctor before taking TRICINOD.
Allergy
TRICINOD is not recommended for use if you are allergic to Chlorthalidone, Cilnidipine or Telmisartan.
Heart Disease
TRICINOD is not recommended for use in patients with cardiogenic shock heart cannot pump sufficient blood to other organs), myocardial infarction (heart attack), acute unstable angina and aortic stenosis (blocked blood supply in the heart) and taken with caution in patients with low blood pressure (due to dehydration problems, low-salt intake, diarrhoea or vomiting). Consult your doctor for advice.
Others
TRICINOD is not recommended for use if you:
- decreased levels of potassium and sodium (hypokalaemia, hyponatraemia) and increased levels of calcium and urea (hypercalcaemia, hyperuricaemia)
- gout or uric acid calculi
- addison’s disease
Before taking TRICINOD, inform your doctor if you have:
- diabetes
- low blood pressure
- signs of high potassium in the body (muscle weakness or numbness in limbs, irregular or fast heartbeat)
- signs of raised aldosterone levels (extreme thirst, muscle spasms)
Use in pediatrics:
TRICINOD is not recommended for use in children and adolescents (under 18 years of age). Consult your doctor before taking this medicine.
Use in geriatrics:
TRICINOD is used with caution in elderly patients of 65years and above with regular monitoring. Before taking TRICINOD, consult your doctor.
Interactions
A. Drug-Drug interactions:
- digoxin (a medicine used to manage heart failure and abnormal heart rhythm)
- cimetidine (a medicine used for stomach ulcers)
- rifampicin (a medicine used to manage tuberculosis)
- itraconazole, miconazole (medicines used to manage fungal infections)
- angiotensin-converting enzyme inhibitors used to manage high blood pressure (Ex. enalapril, lisinopril, ramipril)
- aliskiren (a medicine used to manage high blood pressure)
- medicines containing lithium (used to manage some types of depression)
- medicines that may increase blood potassium levels such as salt substitutes containing potassium, potassium-sparing diuretics (Ex. amiloride, spironolactone)
- non-steroidal anti-inflammatory drugs - medicines used to manage pain and inflammation (Ex. aspirin, ibuprofen)
- heparin (a medicine used to manage blood clots)
- immunosuppressive agents such as ciclosporin or tacrolimus (used to manage organ rejection after transplant)
- antibiotic trimethoprim (a medicine used to manage urinary tract infections)
- diuretics such as furosemide, hydrochlorothiazide (used to manage oedema or high blood pressure)
- corticosteroids such as dexamethasone, hydrocortisone which are involved in stress, immune response
- baclofen (a medicine used for muscle spasms)
- amifostine (a medicine used in cancer chemotherapy)
- barbiturates (medicine that acts as a central nervous system depressant) such as phenobarbital, pentobarbital
- antidepressants such as citalopram, fluoxetine and paroxetine (a medicine used to manage depression)
- narcotics such as morphine and codeine (a medicine used to manage moderate to severe pain)
B. Drug - Food interaction:
Avoid drinking grapefruit juice while taking TRICINOD as it may increase the levels of this medication in the body.
Overdosage:
If you or anyone else accidentally take too much of TRICINOD, consult your doctor immediately or visit the nearby hospital as it may increase the risk of side effects. Signs and symptoms of overdosage include low blood pressure, dizziness, nausea, sleepiness, elevated creatinine levels, sudden kidney failure, electrolyte disturbances associated with cardiac arrhythmias (irregular heartbeat) and muscle stiffness.
Synopsis
| Drug | : | Chlorthalidone, Cilnidipine, Telmisartan |
| Pharmacological Category | : | Diuretics, Calcium Channel Blockers, Angiotensin II receptor antagonist |
| Therapeutic Indication | : | High Blood Pressure |
| Dosage Forms | : | Tablet |
More Information
- Keep TRICINOD out of reach from children
- Store at a temperature not exceeding 30°C
FAQs About TRICINOD
What is TRICINOD and why is it given?
TRICINOD is used to manage essential hypertension (blood pressure not caused by any other condition called essential hypertension) in adults.
Is TRICINOD safe for pregnant women?
TRICINOD is not recommended in early pregnancy and must not be taken when more than 3 months pregnant, as it may cause serious harm to the baby if used after 3 months of pregnancy. Consult your doctor for advice.
Can TRICINOD cause anxiety?
Yes. TRICINOD may make you feel anxious. However, it does not affect every individual. Try to rest and relax. Meditation and breathing exercises can work. If your symptom worsens, please consult your doctor.
Can TRICINOD be given to children?
TRICINOD is not recommended for use in children and adolescents (under 18 years of age). Consult your doctor before taking this medicine.
What precautions do I need to follow while taking TRICINOD?
Patients taking TRICINOD must inform their doctor about their pre-existing disease conditions like kidney, heart or liver problems. Consult your doctor immediately if you experience any unusual symptoms after taking TRICINOD.
References
1. KD Tripathi. Diuretics, Drugs Affecting Renin Angiotensin System. Essentials of medical pharmacology. Eighth edition. 2019. Page – 630-632, 535-538.
2. Connor C. Kerndt; Jayesh B. Patel. Chlorthalidone. National Library of Medicine, National center for biotechnology information. Revised in May 2022. [Accessed 8th May 2022] https://www.ncbi.nlm.nih.gov/books/NBK553174/#:~:text=Mechanism%20of%20Action,-Chlorthalidone%20exerts%20its&text=Chlorthalidone%20inhibits%20sodium%20reabsorption%20at,retains%20a%20higher%20sodium%20content.
3. A Prem Kumar, Anirudra Ghorai, Vasudev Kriplani, Rabindra Kumar Dash, J Aravinda, Paramesh Shamanna, TK Sabeer, Abdul Hannan and Santosh Revankar. Clinical data analysis of telmisartan for hypertension management in Indian population. NIH National Library of Medicine, National center for biotechnology information. PubMed Central June 2021. [Accessed 17th June 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819792/
4. Prabhakar Adake, H.S. Somashekar, P. K. Mohammed Rafeeq, Dilshad Umar, Bahija Basheer and Kusai Baroudi. Comparison of amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in mild to moderate hypertensive individuals: A prospective study. NIH National Library of Medicine, National center for biotechnology information. PubMed Central June 2015. [Accessed 17th June 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397623/
5. J. B. Chemicals & pharmaceuticals ltd. [Revised in November 2021] [Accessed 8th May 2022] https://jbpharma.com/wp-content/uploads/2021/11/CILACAR-C-12.5_PI_India_November-2021.pdf
6. Accord Healthcare Ireland Limited. Health Products Regulatory Authority (HPRA). [Revised in July 2021] [Accessed 9h May 2022] http://www.hpra.ie/img/uploaded/swedocuments/8c0fc811-cf88-4bd5-818e-609e07fe1190.pdf
7. Hetero Labs Limited. U.S. Food & Drug Administration. [Revised in August 2015] [Accessed 9th May 202] https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/205901Orig1s000lbl.pdf
Useful Diagnostic Tests
- Kidney function test
- Serum electrolyte test
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