{"id":58885,"date":"2024-02-28T05:33:00","date_gmt":"2024-02-28T05:33:00","guid":{"rendered":"https:\/\/medsname.com\/trivastal-la\/"},"modified":"2026-05-01T10:49:14","modified_gmt":"2026-05-01T10:49:14","slug":"trivastal-la","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/trivastal-la\/","title":{"rendered":"Trivastal LA"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

Trivastal LA<\/strong> je peror\u00e1ln\u00ed piribedil<\/strong> (50 mg s prodlou\u017een\u00fdm \u00fa\u010dinkem) tableta \u2014 neergotov\u00fd dopaminov\u00fd agonista<\/strong> pou\u017e\u00edvan\u00e1 k l\u00e9\u010db\u011b Parkinsonova choroba<\/strong> (a jako dopl\u0148kov\u00e1 l\u00e9\u010dba chronick\u00fdch vaskul\u00e1rn\u00edch kognitivn\u00edch p\u0159\u00edznak\u016f na n\u011bkter\u00fdch trz\u00edch). P\u0159\u00edmo stimuluje dopaminov\u00e9 receptory D2\/D3 v mozku, \u010d\u00e1ste\u010dn\u011b nahrazuje dopamin, kter\u00fd ji\u017e nen\u00ed produkov\u00e1n. Piribedil je \u0161iroce pou\u017e\u00edv\u00e1n v Evrop\u011b a Asii, ale m\u00e9n\u011b \u010dasto p\u0159edepisov\u00e1n v USA a Velk\u00e9 Brit\u00e1nii. M\u00e1 dal\u0161\u00ed \u03b12 noradrenergn\u00ed antagonismus, kter\u00fd m\u016f\u017ee zlep\u0161it pozornost a kognitivn\u00ed p\u0159\u00edznaky. Kritick\u00e9 bezpe\u010dnostn\u00ed sign\u00e1ly:<\/strong> poruch impulzivn\u00ed kontroly<\/em> (gambling, hypersexualita, z\u00e1chvatov\u00e9 p\u0159ej\u00edd\u00e1n\u00ed, nutkav\u00e9 nakupov\u00e1n\u00ed), n\u00e1hl\u00fd n\u00e1stup sp\u00e1nku<\/em> (z\u00e1chvaty sp\u00e1nku p\u0159i \u0159\u00edzen\u00ed) a ortostatick\u00e1 hypotenze. D\u00e1vkov\u00e1n\u00ed mus\u00ed b\u00fdt pomalu zvy\u0161ov\u00e1no a postupn\u011b sni\u017eov\u00e1no \u2014 nikdy nesm\u00ed b\u00fdt n\u00e1hle p\u0159eru\u0161eno.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Co je Trivastal LA?<\/h2>\n

Trivastal LA je peror\u00e1ln\u00ed tableta obsahuj\u00edc\u00ed piribedil 50 mg s prodlou\u017een\u00fdm \u00fa\u010dinkem<\/strong>. Piribedil je neergotov\u00fd agonista dopaminov\u00fdch receptor\u016f D2\/D3<\/strong>, p\u016fvodn\u011b uveden\u00fd jako Trivastal Retard<\/strong>. Trivastal LA je vyr\u00e1b\u011bn ve v\u00fdrobn\u00edm za\u0159\u00edzen\u00ed certifikovan\u00e9m WHO-GMP a je bioekvivalentn\u00ed k origin\u00e1ln\u00ed zna\u010dce ve stejn\u00e9 s\u00edle.<\/p>\n

Piribedil je ne-ergotn\u00ed dopaminov\u00fd agonista se sm\u00ed\u0161enou farmakologi\u00ed: stimuluje dopaminov\u00e9 receptory D2 a D3 a nav\u00edc blokuje<\/em> presynaptick\u00e9 alfa2-adrenergn\u00ed receptory. Antagonismus alfa2 m\u016f\u017ee m\u00edt m\u00edrn\u00e9 p\u0159\u00edzniv\u00e9 \u00fa\u010dinky na pozornost, kognici a n\u00e1ladu, kter\u00e9 jsou u jin\u00fdch dopaminov\u00fdch agonist\u016f m\u00e9n\u011b v\u00fdrazn\u00e9. Je \u0161iroce p\u0159edepisov\u00e1n v Evrop\u011b a Asii. N\u011bkdy se tak\u00e9 pou\u017e\u00edv\u00e1 u vaskul\u00e1rn\u00edch kognitivn\u00edch p\u0159\u00edznak\u016f u star\u0161\u00edch pacient\u016f, a\u010dkoli d\u016fkazy pro toto pou\u017eit\u00ed jsou slab\u0161\u00ed ne\u017e u Parkinsonovy choroby.<\/p>\n

Jak Trivastal LA (piribedil) funguje?<\/h2>\n

Piribedil stimuluje dopaminov\u00e9 receptory D2 a D3 ve striatu a limbick\u00e9m syst\u00e9mu, \u010d\u00e1ste\u010dn\u011b nahrazuje chyb\u011bj\u00edc\u00ed dopamin. V\u00fdrazn\u011b tak\u00e9 blokuje presynaptick\u00e9 alfa2 adrenergn\u00ed receptory \u2014 to deinhibuje noradrenergn\u00ed neurony a m\u00edrn\u011b zvy\u0161uje uvol\u0148ov\u00e1n\u00ed noradrenalinu v prefront\u00e1ln\u00ed k\u016f\u0159e. \u010cist\u00fd efekt: dopaminergn\u00ed \u00faleva od motorick\u00fdch p\u0159\u00edznak\u016f plus m\u00edrn\u00fd noradrenergn\u00ed boost na pozornost a bd\u011blost. Neovliv\u0148uje receptory 5-HT2B, tak\u017ee nezp\u016fsobuje fibr\u00f3zu srde\u010dn\u00edch chlopn\u00ed.<\/p>\n

Pro koho je Trivastal LA ur\u010den?<\/h2>\n

Trivastal LA je vhodn\u00fd pro dosp\u011bl\u00e9 s Parkinsonovou chorobou (jako monoterapie v ran\u00e9m st\u00e1diu choroby nebo jako dopln\u011bk k levodop\u011b v pokro\u010dil\u00e9m st\u00e1diu). Zvl\u00e1\u0161t\u011b se zva\u017euje u pacient\u016f s v\u00fdraznou \u00fanavou, \u0161patnou pozornost\u00ed nebo apati\u00ed, kde m\u016f\u017ee pomoci antagonismus alfa2. Pou\u017e\u00edv\u00e1 se tak\u00e9 (p\u0159edev\u0161\u00edm v Evrop\u011b a Asii) u chronick\u00fdch perifern\u00edch arteri\u00e1ln\u00edch ob\u011bhov\u00fdch probl\u00e9m\u016f a dopl\u0148kov\u00fdch vaskul\u00e1rn\u00edch kognitivn\u00edch p\u0159\u00edznak\u016f \u2014 a\u010dkoli hlavn\u00ed indikac\u00ed z\u016fst\u00e1v\u00e1 Parkinsonova choroba.<\/p>\n

D\u00e1vkov\u00e1n\u00ed a titrace<\/h2>\n

Terapie dopaminov\u00fdmi agonisty mus\u00ed<\/strong> b\u00fdt titrov\u00e1na postupn\u011b po dobu n\u011bkolika t\u00fddn\u016f, aby se p\u0159ede\u0161lo nesnesiteln\u00e9 nevolnosti, ortostatick\u00e9 hypotenzi a ospalosti. N\u00ed\u017ee uveden\u00e9 d\u00e1vkov\u00e1n\u00ed je typick\u00fd v\u00fdchoz\u00ed r\u00e1mec \u2014 v\u00e1\u0161 neurolog jej uprav\u00ed podle va\u0161\u00ed reakce.<\/p>\n\n\n\n\n\n\n\n\n
F\u00e1ze<\/th>\nD\u00e1vka<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
Zah\u00e1jen\u00ed l\u00e9\u010dby (1. t\u00fdden)<\/td>\n50 mg jednou denn\u011b po j\u00eddle<\/td>\nTableta s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm, polykat celou<\/td>\n<\/tr>\n
2.\u20133. t\u00fdden<\/td>\n50 mg dvakr\u00e1t denn\u011b<\/td>\nPo rann\u00edm a ve\u010dern\u00edm j\u00eddle<\/td>\n<\/tr>\n
Udr\u017eovac\u00ed d\u00e1vka<\/td>\n150\u2013250 mg\/den v 3\u20135 d\u00edl\u010d\u00edch d\u00e1vk\u00e1ch<\/td>\nV\u017edy s j\u00eddlem<\/td>\n<\/tr>\n
Maxim\u00e1ln\u011b<\/td>\n300 mg\/den<\/td>\nJako 6 \u00d7 50 mg nebo dle neurologa<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Tablety Trivastal LA se mus\u00ed polykat cel\u00e9 \u2014 nedrtit, ned\u011blit ani ne\u017ev\u00fdkat, proto\u017ee by do\u0161lo k naru\u0161en\u00ed matrice s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm a pln\u00e1 biologick\u00e1 dostupnost by se uvolnila najednou, co\u017e by zv\u00fd\u0161ilo nevolnost a dal\u0161\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky. V\u017edy u\u017e\u00edvejte s j\u00eddlem \u2014 piribedil je jedn\u00edm z dopaminov\u00fdch agonist\u016f, kter\u00e9 nejv\u00edce vyvol\u00e1vaj\u00ed nevolnost p\u0159i u\u017e\u00edv\u00e1n\u00ed nala\u010dno.<\/p>\n

\u26a0 Poruchy impulzivn\u00ed kontroly \u2014 varov\u00e1n\u00ed, kter\u00e9 by m\u011bl sly\u0161et ka\u017ed\u00fd pacient (i partner)<\/strong> A\u017e 14\u201317 %<\/strong> pacient\u016f u\u017e\u00edvaj\u00edc\u00edch dopaminov\u00e9 agonisty vyvine jeden nebo v\u00edce poruch impulzivn\u00ed kontroly<\/em>: patologick\u00e9 hr\u00e1\u010dstv\u00ed, nutkav\u00e9 nakupov\u00e1n\u00ed, hypersexualita, z\u00e1chvatov\u00e9 p\u0159ej\u00edd\u00e1n\u00ed nebo punding (opakovan\u00e9 bez\u00fa\u010deln\u00e9 chov\u00e1n\u00ed). Riziko je z\u00e1visl\u00e9 na d\u00e1vce a nejvy\u0161\u0161\u00ed je u neergotn\u00edch agonist\u016f. Pacienti si zm\u011bny \u010dasto neuv\u011bdomuj\u00ed \u2014 jako prvn\u00ed ji mohou zaznamenat partne\u0159i nebo rodinn\u00ed p\u0159\u00edslu\u0161n\u00edci. Pokud vy nebo n\u011bkdo z va\u0161eho okol\u00ed pozoruje jak\u00e9koli nov\u00e9 nutkav\u00e9 chov\u00e1n\u00ed, neprodlen\u011b kontaktujte sv\u00e9ho neurologa.<\/strong> Sn\u00ed\u017een\u00ed d\u00e1vky nebo vysazen\u00ed obvykle chov\u00e1n\u00ed normalizuje b\u011bhem n\u011bkolika t\u00fddn\u016f.<\/div>\n
\u26a0 N\u00e1hl\u00e9 usnut\u00ed (\u201csp\u00e1nkov\u00e9 ataky\u201d)<\/strong> V\u0161echny neergotn\u00ed dopaminov\u00e9 agonisty mohou zp\u016fsobit n\u00e1hl\u00e9, neovladateln\u00e9 epizody sp\u00e1nku bez varov\u00e1n\u00ed \u2014 v\u010detn\u011b b\u011bhem \u0159\u00edzen\u00ed, j\u00eddla nebo rozhovoru. Tento jev je \u010dast\u011bj\u0161\u00ed v prvn\u00edch m\u011bs\u00edc\u00edch l\u00e9\u010dby, p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch a v kombinaci s levodopou. Dokud nebudete alespo\u0148 2 t\u00fddny na stabiln\u00ed d\u00e1vce a nebudete v\u011bd\u011bt, jak na l\u00e9k reagujete, ne\u0159i\u010fte, neobsluhujte stroje ani se nev\u011bnujte \u010dinnostem, p\u0159i nich\u017e by usnut\u00ed mohlo b\u00fdt nebezpe\u010dn\u00e9.<\/strong><\/div>\n

B\u011b\u017en\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky<\/h2>\n

\u010cast\u00e9 (>10%):<\/strong> nevolnost, z\u00e1vrat\u011b, ospalost, ortostatick\u00e1 hypotenze, perifern\u00ed ed\u00e9my (otoky kotn\u00edk\u016f), z\u00e1cpa, halucinace (\u010dast\u011bji vizu\u00e1ln\u00ed ne\u017e sluchov\u00e9), dyskineze (v kombinaci s levodopou).<\/p>\n

M\u00e9n\u011b \u010dast\u00e9, ale z\u00e1va\u017en\u00e9:<\/strong> n\u00e1hl\u00e9 usnut\u00ed, poruchy impulzivn\u00ed kontroly, livedo reticularis (mramorovan\u00e1 k\u016f\u017ee), \u017eiv\u00e9 sny, otoky nohou, synkopa, dyskineze, halucinace, paranoia.<\/p>\n

Vz\u00e1cn\u00e9:<\/strong> syndrom z vysazen\u00ed dopaminov\u00fdch agonist\u016f (DAWS) p\u0159i rychl\u00e9m sni\u017eov\u00e1n\u00ed d\u00e1vek \u2014 deprese, \u00fazkost, panika, \u00fanava, ba\u017een\u00ed po l\u00e9ku, autonomn\u00ed nestabilita. Z tohoto d\u016fvodu je nutn\u00e9 agonisty vysazovat postupn\u011b.<\/p>\n

Interakce s l\u00e9\u010divy<\/h2>\n