{"id":60960,"date":"2024-02-28T07:18:14","date_gmt":"2024-02-28T07:18:14","guid":{"rendered":"https:\/\/medsname.com\/trinicalm-plus\/"},"modified":"2026-05-01T10:49:16","modified_gmt":"2026-05-01T10:49:16","slug":"trinicalm-plus","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/trinicalm-plus\/","title":{"rendered":"Objednejte si Glynase XL (5 mg nebo 10 mg (XL)) od spole\u010dnosti MedsBase v balen\u00edch po 30, 60, 90 nebo 180 tablet\u00e1ch. Dod\u00e1v\u00e1me po cel\u00e9m sv\u011bt\u011b, s diskr\u00e9tn\u00edm balen\u00edm a certifikovan\u00fdm v\u00fdrobcem WHO-GMP."},"content":{"rendered":"

<\/p>\n

\n

\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Trinicalm Plus?<\/h3>\n
\n

Objednejte si Glynase XL (5 mg nebo 10 mg (XL)) od spole\u010dnosti MedsBase v balen\u00edch po 30, 60, 90 nebo 180 tablet\u00e1ch. Dod\u00e1v\u00e1me po cel\u00e9m sv\u011bt\u011b, s diskr\u00e9tn\u00edm balen\u00edm a certifikovan\u00fdm v\u00fdrobcem WHO-GMP.<\/strong> obsahuje fixn\u00ed kombinaci trifluoperazinu 5 mg + trihexifenidilu 2 mg<\/strong> od v\u00fdrobce certifikovan\u00e9ho WHO-GMP (Tripada Healthcare) \u2014 antipsychotikum prvn\u00ed generace<\/strong> (D2<\/sub> antagonista) kombinovan\u00e9 s anticholinergn\u00edm anti-Parkinsonov\u00fdm \u010dinidlem<\/strong> k prevenci extrapyramidov\u00fdch ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f (EPS \u2014 parkinsonismus, dystonie, akatizie), kter\u00e9 \u010dasto vyvol\u00e1vaj\u00ed vysoce potentn\u00ed typick\u00e1 antipsychotika. Pou\u017e\u00edv\u00e1 se p\u0159edev\u0161\u00edm v zem\u00edch, kde se typick\u00e1 antipsychotika st\u00e1le b\u011b\u017en\u011b pou\u017e\u00edvaj\u00ed k l\u00e9\u010db\u011b schizofrenie a t\u011b\u017ek\u00e9 \u00fazkosti\/agitace. D\u016fle\u017eit\u00e1 varov\u00e1n\u00ed<\/strong>: trifluoperazin nese varov\u00e1n\u00ed FDA \u010dern\u00e9 varov\u00e1n\u00ed pro mortalitu u star\u0161\u00edch pacient\u016f s demenc\u00ed<\/strong>, d\u00e1le vysok\u00e9 riziko tardivn\u00ed dyskineze a neuroleptick\u00e9ho malign\u00edho syndromu; trihexifenidyl m\u00e1 anticholinergn\u00ed vedlej\u0161\u00ed \u00fa\u010dinky (kognitivn\u00ed poruchy, retence mo\u010di, p\u00e1dy u star\u0161\u00edch pacient\u016f) a zn\u00e1m\u00fd potenci\u00e1l zneu\u017eit\u00ed<\/strong> (vyhled\u00e1van\u00fd pro euforick\u00fd\/stimula\u010dn\u00ed \u00fa\u010dinek v supraterapeutick\u00fdch d\u00e1vk\u00e1ch).<\/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<\/div>\n

D\u016fle\u017eit\u00e9 \u2014 nejedn\u00e1 se o l\u00e9k na situa\u010dn\u00ed \u00fazkost.<\/strong> Trinicalm Plus je antipsychotikum prvn\u00ed generace v kombinaci s anticholinergn\u00edm anti-Parkinsonov\u00fdm \u010dinidlem<\/strong>, p\u0159edepisov\u00e1n a titrov\u00e1n po t\u00fddny pro schizofrenie a dal\u0161\u00ed psychotick\u00e9 poruchy, t\u011b\u017ek\u00e1 \u00fazkost\/agitace v n\u011bkter\u00fdch star\u0161\u00edch re\u017eimech, s profylaktick\u00fdm pokryt\u00edm extrapyramidov\u00fdch p\u0159\u00edznak\u016f (EPS) vyvolan\u00fdch antipsychotiky<\/strong>. Nen\u00ed ne<\/strong> spr\u00e1vn\u00fdm l\u00e9kem pro akutn\u00ed, v\u00fdkonov\u011b souvisej\u00edc\u00ed \u00fazkost (l\u00e9t\u00e1n\u00ed, ve\u0159ejn\u00e9 vystupov\u00e1n\u00ed, zkou\u0161ky) \u2014 pro tyto p\u0159\u00edpady jsou klinicky vhodn\u011bj\u0161\u00ed betablok\u00e1tory (propranolol), benzodiazepiny nebo hydroxyzin. Pokud nem\u00e1te diagnostikovanou poruchu n\u00e1lady, \u00fazkostnou nebo psychiatrickou poruchu, neza\u010d\u00ednejte s u\u017e\u00edv\u00e1n\u00edm tohoto l\u00e9ku.<\/div>\n
FDA \u010dern\u00e9 varov\u00e1n\u00ed \u2014 mortalita u star\u0161\u00edch pacient\u016f s demenc\u00ed.<\/strong> V\u0161echna antipsychotika (atypick\u00e1 i konven\u010dn\u00ed) nesou FDA \u010dern\u00e9 varov\u00e1n\u00ed pro zv\u00fd\u0161enou mortalitu p\u0159i l\u00e9\u010db\u011b psych\u00f3zy nebo behavior\u00e1ln\u00edch poruch souvisej\u00edc\u00edch s demenc\u00ed u star\u0161\u00edch pacient\u016f. Tento l\u00e9k je FDA, EMA, MHRA ani \u017e\u00e1dn\u00fdm jin\u00fdm v\u00fdznamn\u00fdm regul\u00e1torem pro terapeutick\u00e9 pou\u017eit\u00ed u lid\u00ed. V\u00fdzkumn\u00fd DSIP prod\u00e1van\u00fd zde je dod\u00e1v\u00e1n<\/strong> pro p\u0159\u00edznaky spojen\u00e9 s demenc\u00ed.<\/div>\n

Co je Trinicalm Plus?<\/h2>\n

Trinicalm Plus je peror\u00e1ln\u00ed tableta trifluoperazinu 5 mg + trihexifenidilu 2 mg<\/strong> v fixn\u00ed kombinaci, vyr\u00e1b\u011bn\u00e1 spole\u010dnost\u00ed Tripada Healthcare. Tato kombinace \u0159e\u0161\u00ed dlouhodob\u00fd probl\u00e9m s antipsychotiky prvn\u00ed generace: vysoce \u00fa\u010dinn\u00e9 D2<\/sub> Antagonist\u00e9 jako trifluoperazin b\u011b\u017en\u011b zp\u016fsobuj\u00ed extrapyramidov\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky (l\u00e9kov\u011b indukovan\u00fd parkinsonismus, akatizie, akutn\u00ed dystonie), kter\u00e9 omezuj\u00ed toleranci a adherenci. Sou\u010dasn\u00e9 p\u0159edepisov\u00e1n\u00ed anticholinergn\u00edho antiparkinsonika, jako je trihexyfenidyl, tyto motorick\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky zm\u00edr\u0148uje.<\/p>\n

druholiniov\u00fd p\u0159\u00edstup v modern\u00ed psychiatrii druholiniov\u00fd p\u0159\u00edstup v modern\u00ed psychiatrii<\/strong> \u2014 prvn\u00ed volbou je atypick\u00e9 antipsychotikum (kter\u00e9 m\u00e1 ni\u017e\u0161\u00ed riziko EPS a nevy\u017eaduje rutinn\u00ed anticholinergn\u00ed kryt\u00ed). Kombinace z\u016fst\u00e1v\u00e1 b\u011b\u017en\u00e1 v zem\u00edch, kde jsou typick\u00e1 antipsychotika prvn\u00ed volbou z d\u016fvodu ceny nebo dostupnosti.<\/p>\n

Component Drugs<\/h2>\n

Funkce ka\u017ed\u00e9 slo\u017eky<\/h2>\n\n\n\n\n\n\n
Slo\u017eka<\/th>\nT\u0159\u00edda<\/th>\nMechanismus \u00fa\u010dinku<\/th>\nRole v t\u00e9to kombinaci<\/th>\n<\/tr>\n<\/thead>\n
Trifluoperazin 5 mg<\/td>\nAntipsychotikum prvn\u00ed generace ze skupiny fenothiazin\u016f (vysok\u00e1 \u00fa\u010dinnost)<\/td>\nTight D2<\/sub> antagonismus v mezolimbick\u00fdch, mezokortik\u00e1ln\u00edch, nigrostriat\u00e1ln\u00edch a tuberoinfundibul\u00e1rn\u00edch drah\u00e1ch<\/td>\nPrim\u00e1rn\u00ed antipsychotick\u00fd \u00fa\u010dinek; schv\u00e1leno tak\u00e9 pro kr\u00e1tkodobou l\u00e9\u010dbu t\u011b\u017ek\u00e9 nepsychotick\u00e9 \u00fazkosti nereaguj\u00edc\u00ed na obvykl\u00e1 opat\u0159en\u00ed (zastaral\u00e1 indikace)<\/td>\n<\/tr>\n
Trihexyphenidyl 2 mg<\/td>\nCentr\u00e1ln\u011b p\u016fsob\u00edc\u00ed anticholinergikum s anti-Parkinsonov\u00fdm \u00fa\u010dinkem<\/td>\nAntagonismus M1 muskarinov\u00fdch receptor\u016f v baz\u00e1ln\u00edch gangli\u00edch, obnovuj\u00edc\u00ed rovnov\u00e1hu acetylcholinu\/dopaminu<\/td>\nP\u0159edch\u00e1z\u00ed a l\u00e9\u010d\u00ed trifluoperazinem indukovan\u00fd parkinsonismus, dystonii a akatizii<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Schv\u00e1len\u00e9 indikace<\/h2>\n
    \n
  • Schizofrenie a dal\u0161\u00ed psychotick\u00e9 poruchy<\/strong> vy\u017eaduj\u00edc\u00ed l\u00e9\u010dbu trifluoperazinem s profylaktick\u00fdm pokryt\u00edm EPS<\/li>\n
  • T\u011b\u017ek\u00e1 \u00fazkost\/agitace<\/strong> nereaguj\u00edc\u00ed na standardn\u00ed l\u00e9\u010dbu (zastaral\u00e1 indikace trifluoperazinu; modern\u00edmi l\u00e9ky prvn\u00ed volby jsou SSRI a atypick\u00e1 antipsychotika)<\/li>\n<\/ul>\n

    D\u00e1vkov\u00e1n\u00ed<\/h2>\n\n\n\n\n\n\n\n
    Indikace<\/th>\nTypick\u00e1 d\u00e1vka<\/th>\nMaxim\u00e1ln\u011b<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
    Schizofrenie \/ psych\u00f3za<\/td>\n1 tableta (5\/2) 2\u20133\u00d7 denn\u011b<\/td>\n3 tablety (15 mg trifluoperazinu + 6 mg trihexyfenidylu) denn\u011b<\/td>\nCelkov\u00e1 d\u00e1vka trifluoperazinu 5\u201315 mg\/den v pevn\u00e9 kombinaci; vy\u0161\u0161\u00ed d\u00e1vky trifluoperazinu vy\u017eaduj\u00ed odd\u011blen\u00e9 d\u00e1vkov\u00e1n\u00ed<\/td>\n<\/tr>\n
    T\u011b\u017ek\u00e1 \u00fazkost<\/td>\n1 tableta 2\u00d7 denn\u011b<\/td>\n2 tablety\/den<\/td>\nPouze kr\u00e1tkodob\u011b \u2013 t\u00fddny sp\u00ed\u0161e ne\u017e m\u011bs\u00edce; p\u0159ehodnotit p\u0159echod na SSRI\/SNRI<\/td>\n<\/tr>\n
    Star\u0161\u00ed pacienti<\/td>\n\u00bd tablety 2\u00d7 denn\u011b, pokud je kombinace nevyhnuteln\u00e1<\/td>\n\u2014<\/td>\nVysok\u00e9 riziko EPS, anticholinergn\u00edch \u00fa\u010dink\u016f a p\u00e1d\u016f; varov\u00e1n\u00ed v \u010dern\u00e9m r\u00e1me\u010dku pro demenci<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Vedlej\u0161\u00ed \u00fa\u010dinky (podle slo\u017eky)<\/h2>\n

    Vedlej\u0161\u00ed \u00fa\u010dinky trifluoperazinu<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n
    Mechanismus \u00fa\u010dinku<\/th>\n\u00da\u010dinky<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
    D2<\/sub> blok\u00e1da (nigrostriat\u00e1ln\u00ed)<\/td>\nAkutn\u00ed dystonie (z\u00e1\u0161kuby o\u010d\u00ed, tortikolis, sev\u0159en\u00ed \u010delisti), parkinsonismus (t\u0159es, ztuhlost, bradykineze), akatizie (vnit\u0159n\u00ed neklid), tardivn\u00ed dyskineze (dlouhodob\u00e9 mimovoln\u00ed pohyby)<\/td>\nVysok\u00e9 riziko \u2013 d\u016fvod, pro\u010d je trihexyfenidyl p\u0159edepisov\u00e1n spolu; tardivn\u00ed dyskineze m\u016f\u017ee b\u00fdt nevratn\u00e1 a rozv\u00edj\u00ed se p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed<\/td>\n<\/tr>\n
    D2<\/sub> blok\u00e1da (tuberoinfundibul\u00e1rn\u00ed)<\/td>\nHyperprolaktin\u00e9mie (galaktorhea, gynekomastie, amenorea, sexu\u00e1ln\u00ed dysfunkce)<\/td>\n\u010cast\u00e9 u vysoce potentn\u00edch typick\u00fdch neuroleptik<\/td>\n<\/tr>\n
    H1<\/sub> blok\u00e1da<\/td>\nSedace<\/td>\nM\u00e9n\u011b ne\u017e chlorpromazin<\/td>\n<\/tr>\n
    Blok\u00e1da alfa-1<\/td>\nOrtostatick\u00e1 hypotenze<\/td>\nM\u00e9n\u011b ne\u017e chlorpromazin<\/td>\n<\/tr>\n
    Prodlou\u017een\u00ed QT intervalu<\/td>\nRiziko srde\u010dn\u00edch arytmi\u00ed<\/td>\nV\u00fdchoz\u00ed EKG; opatrnost s dal\u0161\u00edmi l\u00e9ky prodlu\u017euj\u00edc\u00edmi QT interval<\/td>\n<\/tr>\n
    Jin\u00e9<\/td>\nFotosenzitivita, o\u010dn\u00ed zm\u011bny, \u017eloutenka<\/td>\nDlouhodob\u00e9 obavy<\/td>\n<\/tr>\n
    Vz\u00e1cn\u00e9, ale z\u00e1va\u017en\u00e9<\/td>\nNeuroleptick\u00fd malign\u00ed syndrom (hypertermie, rigidita, autonomn\u00ed dysfunkce, zm\u011bn\u011bn\u00fd ment\u00e1ln\u00ed stav)<\/td>\nL\u00e9ka\u0159sk\u00e1 pohotovost<\/td>\n<\/tr>\n
    Vz\u00e1cn\u00e9<\/td>\nSn\u00ed\u017een\u00fd pr\u00e1h pro z\u00e1chvaty<\/td>\nOpatrnost u epilepsie<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Vedlej\u0161\u00ed \u00fa\u010dinky trihexifenidilu<\/h2>\n\n\n\n\n\n\n\n\n
    Mechanismus \u00fa\u010dinku<\/th>\n\u00da\u010dinky<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
    Perifern\u00ed anticholinergn\u00ed \u00fa\u010dinky<\/td>\nSucho v \u00fastech, rozmazan\u00e9 vid\u011bn\u00ed, z\u00e1cpa, retence mo\u010di<\/td>\nB\u011b\u017en\u00e9; zvl\u00e1\u0161t\u011b problematick\u00e9 u BPH<\/td>\n<\/tr>\n
    Centr\u00e1ln\u00ed anticholinergn\u00ed \u00fa\u010dinky<\/td>\nZmatenost, poruchy pam\u011bti, zpomalen\u00e9 my\u0161len\u00ed, agitovanost<\/td>\nNejvy\u0161\u0161\u00ed riziko u star\u0161\u00edch dosp\u011bl\u00fdch \u2014 spojeno s dlouhodob\u00fdm kognitivn\u00edm \u00fabytkem<\/td>\n<\/tr>\n
    Jin\u00e9<\/td>\nTachykardie, z\u00e1vrat\u011b, p\u00e1dy<\/td>\nRiziko p\u00e1d\u016f u star\u0161\u00edch osob<\/td>\n<\/tr>\n
    D\u016fle\u017eit\u00e9<\/td>\nPotenci\u00e1l zneu\u017eit\u00ed<\/strong><\/td>\nTrihexifenidyl je vyhled\u00e1v\u00e1n v nadterapeutick\u00fdch d\u00e1vk\u00e1ch pro euforick\u00e9\/stimula\u010dn\u00ed\/halucinogenn\u00ed \u00fa\u010dinky; n\u011bkter\u00e9 jurisdikce zavedly kontroln\u00ed opat\u0159en\u00ed. Pacienti s anamn\u00e9zou u\u017e\u00edv\u00e1n\u00ed n\u00e1vykov\u00fdch l\u00e1tek vy\u017eaduj\u00ed monitorov\u00e1n\u00ed.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

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

    Prodlou\u017een\u00ed QT intervalu<\/strong>: vyvarujte se kombinace s dal\u0161\u00edmi l\u00e9ky prodlu\u017euj\u00edc\u00edmi QT interval \u2014 ziprasidon, citalopram (vysok\u00e1 d\u00e1vka), metadon, ondansetron, fluorochinolony.<\/p>\n

    Kumulace anticholinergn\u00edch \u00fa\u010dink\u016f<\/strong>: trihexifenidyl ji\u017e zvy\u0161uje anticholinergn\u00ed z\u00e1t\u011b\u017e \u2014 kombinujte opatrn\u011b s TCA, paroxetinem, antihistaminiky, oxybutyninem, hyoscyaminem; u star\u0161\u00edch dosp\u011bl\u00fdch to m\u016f\u017ee vyvolat zmatenost, p\u00e1dy a retenci mo\u010di.<\/p>\n

    \u00datlum CNS<\/strong>: alkohol, benzodiazepiny, opioidy \u2014 aditivn\u00ed sedace.<\/p>\n

    Antihypertenziva<\/strong>: aditivn\u00ed ortostatick\u00e1 hypotenze.<\/p>\n

    Antagonismus levodopy<\/strong>: trifluoperazin D2<\/sub> blok\u00e1da sni\u017euje \u00fa\u010dinek levodopy \u2014 problematick\u00e9 u Parkinsonovy choroby.<\/p>\n

    Pro\u010d modern\u00ed praxe tuto kombinaci \u010dasto vylu\u010duje<\/h2>\n

    Tam, kde jsou atypick\u00e1 antipsychotika dostupn\u00e1 a cenov\u011b dostupn\u00e1, modern\u00ed praxe obecn\u011b vyh\u00fdb\u00e1 se antipsychotik\u016fm prvn\u00ed generace + rutinn\u00ed anticholinergn\u00ed ochran\u011b<\/strong> proto\u017ee:<\/p>\n