Before taking Tricolam
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking Tricolam it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you drink a lot of alcohol.
- If you have a rare inherited blood disorder called porphyria.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
Other Nitroim > Tricolam , secnidazole, and ornidazole are other members of the 5-nitroimidazole class. Trindiazole, which has been widely prescribed in Europe and developing countries, was approved for used in the United States in 2004. All agents in the class exhibit similar mechanism of action, spectrum activity, toxicity, and adverse effects. 131 However, the distinguishing feature among agents is the half-life and need for less frequent dosing compared with metronidazole. 131 The half-life for Tricolam, secnidazole, and ornidazole is 10 to 15 hours, 17 to 28.8 hours, and 11 to 14 hours, respectively, which allows for once-daily dose (see Table 28-1 ). 131 These agents offer a potential advantage over metronidazole, as a single-dose option for the treatment of intestinal amebiasis, giardiasis, and bacterial vaginosis. However, metronidazole should be considered the drug of choice for life-threatening anaerobic infections because there are limited data evaluating the efficacy and safety of other nitromidazole agents. 132,133
Although not specifically identified in studies with Tricolam, the following drug interactions were reported for metronidazole, a chemically-related nitroimidazole. Therefore, these drug interactions may occur with Tricolam.
Pregnancy Category C
The use of Tricolam in pregnant patients has not been studied. Since Tricolam crosses the placental barrier and enters fetal circulation it should not be administered to pregnant patients in the first trimester.
Embryo-fetal developmental toxicity studies in pregnant mice indicated no embryo-fetal toxicity or malformations at the highest dose level of 2,500 mg/kg (approximately 6.3-fold the highest human therapeutic dose based upon body surface area conversions). In a study with pregnant rats a slightly higher incidence of fetal mortality was observed at a maternal dose of 500 mg/kg (2.5-fold the highest human therapeutic dose based upon body surface area conversions). No biologically relevant neonatal developmental effects were observed in rat neonates following maternal doses as high as 600 mg/kg (3- fold the highest human therapeutic dose based upon body surface area conversions). Although there is some evidence of mutagenic potential and animal reproduction studies are not always predictive of human response, the use of Tricolam after the first trimester of pregnancy requires that the potential benefits of the drug be weighed against the possible risks to both the mother and the fetus.
There are several case reports suggesting that metronidazole has the potential to increase the levels of cyclosporine and tacrolimus. During Tricolam co-administration with either of these drugs, the patient should be monitored for signs of calcineurin-inhibitor associated toxicities.
Alcoholic beverages and preparations containing ethanol or propylene glycol should be avoided during Tricolam therapy and for 3 days afterward because abdominal cramps, nausea, vomiting, headaches, and flushing may occur. Psychotic reactions have been reported in alcoholic patients using metronidazole and disulfiram concurrently. Though no similar reactions have been reported with Tricolam, Tricolam should not be given to patients who have taken disulfiram within the last two weeks.
Acquired resistance is becoming more common. For example, in some countries a significant percentage of strains of H. pylori are resistant to metronidazole, as are some strains of C. difficile. Resistance results most commonly from reduced uptake of the drug and the development of altered ox >Tricolam is less common.
What do I need to tell my doctor BEFORE I take Tricolam?
- If you have an allergy to Tricolam, metronidazole, or any other part of Tricolam.
- If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
- If you are breast-feeding. Do not breast-feed while you take Tricolam and for at least 3 days after your last dose.
- If you have taken disulfiram within the past 2 weeks.
This is not a list of all drugs or health problems that interact with Tricolam.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Tricolam with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.
Metron > Metron >Tricolam are synthetic nitroimidazoles with selective activity against organisms that utilize anaerobic metabolism. Metronidazole has been shown to be efficacious for the following protozoan infections: Entamoeba histolytica, 5 E. polecki, 6 Giardia intestinalis, 7 Trichomonas vaginalis, 8 Blastocystis hominis, 9 and Balantidium coli. 10 The approval of Tricolam was based on studies done predominantly in the 1970s and 1980s prior to its use in European countries. Tricolam is approved for use against giardiasis and amebiasis in adults and children >3 years of age and for trichomoniasis in adults. 11 For amebiasis, these drugs are active against the trophozoite stage of the parasite life cycle and can be used to treat the luminal and tissue phases of the infection, including liver abscesses. Patients with invasive colonic disease or liver abscess also are treated with iodoquinol or other luminally active amebicides to eliminate residual cyst forms of the parasite. Metronidazole and Tricolam are the only effective therapy available in the U.S. for trichomoniasis, with cure rates approaching 95% with single-dose regimens of both drugs. 12 Tricolam has in vitro activity against metronidazole-resistant strains of T vaginalis. 13 Both drugs are effective against giardiasis. 14 Generally, Tricolam is as effective as metronidazole for most clinical indications and is modestly better tolerated. Tricolam is used as a single-dose regimen for giardiasis and trichomoniasis and the recommended course for amebiasis is shorter. Despite this, a course of Tricolam is considerably more expensive than generic metronidazole for all indications. 11 Tricolam is not available in suspension but can be formulated by crushing the tablets. Ornidazole is another nitroimidazole with a similar pharmacokinetic profile to Tricolam and also with extensive clinical experience in non-U.S. settings. 15
Both metronidazole and Tricolam generally are well tolerated, with Tricolam being modestly more favorable compared with metronidazole at the high single-dose regimens or at the higher doses used for amebiasis. Side effects of both drugs include nausea, vomiting, epigastric discomfort, anorexia, and a metallic or bitter taste. Seizures and peripheral neuropathy have been reported uncommonly with both drugs. Patients taking either drug should avoid alcohol (including that found commonly in suspensions of children's medicines) because of the disulfiram-like effects.
Rated Tricolam for Bacterial Vaginosis Report
Doctor prescribed me to take 4 medicines on day 1 and 4 medicines on day 2 for re-occuring BV. I took 4 meds on the same time on day 1 which resulted in immediate metalic taste in my mouth. Started feeling nauseated and dizzy. Went to sleep and had heart burn in the middle of the night. Woke up in the morning with swelling around my lips and chin and yellowish watery eyes. The whole day I had swelling on my face and felt tired and nauseated. I did not take the day 2 dosage because I felt sick to my stomach.
Tricolam , 1-2-(ethylsulfonyl)ethyl-2-methyl-5-nitroimidazole (37.2.12), is also made from 2-methyl-5-nitroimidazole (37.2.9), which upon being reacted with 2-ethoxysulfonyl- p-toluenesulfonate (37.2.11) transformed into the desired tin > The 2-ethoxysulfonyl-p-toluenesulfonate (37.2.11) necessary for this reaction is in turn made by tosylation of 2-ethylsulfonyl ethanol using p-toluenesulfonyl chloride .
Metron > Metron >Tricolam are synthetic nitroimidazoles with selective activity against organisms that use anaerobic metabolism. Metronidazole has been efficacious for the following protozoan infections: E. histolytica, E. polecki, G. intestinalis, T. vaginalis, B. hominis, and B. coli. 1–6 Tricolam is approved for use against giardiasis and amebiasis in adults and children older than 3 years of age and for trichomoniasis in adults. 7 For amebiasis, these drugs are active against the trophozoite stage of the parasite life cycle and can be used to treat the luminal and tissue phases of the infection, including liver abscesses. Patients with invasive colonic disease or liver abscess also are treated with paromomycin or iodoquinol or other luminally active amebicides to eliminate residual luminal forms of the parasite.
Metronidazole and Tricolam are the only effective therapies available in the United States for trichomoniasis. 8 Both drugs are effective against giardiasis. Tricolam is as effective as metronidazole for most clinical indications and is modestly better tolerated. Tricolam is used as a single-dose regimen for giardiasis and trichomoniasis, and the recommended course for amebiasis is shorter. Despite this, a course of Tricolam is considerably more expensive than generic metronidazole for all indications. 7 Tricolam is not available in suspension, but it can be formulated by crushing the tablets.
Metronidazole and Tricolam are well tolerated; Tricolam is modestly better tolerated compared with metronidazole at the high single-dose regimens or at the higher doses used for amebiasis. Side effects of both drugs include nausea, vomiting, epigastric discomfort, anorexia, and a metallic or bitter taste. Seizures and peripheral neuropathy have been reported uncommonly with both drugs. Patients taking either drug should avoid alcohol (including that found commonly in suspensions of children's medicines) because of the disulfiram-like effects.
Laboratory Test Interactions
Tricolam, like metronidazole, may interfere with certain types of determinations of serum chemistry values, such as aspartate aminotransferase (AST, SGOT), alanine aminotransferase (ALT, SGPT), lactate dehydrogenase (LDH), triglycerides, and hexokinase glucose. Values of zero may be observed. All of the assays in which interference has been reported involve enzymatic coupling of the assay to oxidation-reduction of nicotinamide adenine dinucleotide (NAD+↔ NADH). Potential interference is due to the similarity of absorbance peaks of NADH and Tricolam.
Tricolam, like metronidazole, may produce transient leukopenia and neutropenia; however, no persistent hematological abnormalities attributable to Tricolam have been observed in clinical studies. Total and differential leukocyte counts are recommended if re-treatment is necessary.
What should I discuss with my healthcare provider before taking Tricolam (Tindamax)?
You should not use this medication if you are allergic to Tricolam or metronidazole (Flagyl), or if you are in the first 3 months of pregnancy.
Tricolam can pass into breast milk and may harm a nursing baby. Do not breast-feed while you are taking Tricolam and for at least 3 days after your last dose.
You may begin nursing again 3 days after your last dose or Tricolam. If you use a breast pump during treatment, throw out any milk you collect while taking Tricolam. Do not feed it to your baby.
To make sure you can safely take Tricolam, tell your doctor if you have any of these other conditions:
- kidney disease (or if you are on dialysis);
- epilepsy or other seizure disorder;
- a blood cell disorder such as anemia or low platelets; or
- a weak immune system.
FDA pregnancy category C. Do not take Tricolam during the first 3 months of pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
A medicine similar to Tricolam has caused cancer in laboratory animals. It is not known if Tricolam would have the same effect in animals, or in humans. Talk with your doctor about your individual risk.
The recommended dose in non-pregnant females is a 2 g oral dose once daily for 2 days taken with food or a 1 g oral dose once daily for 5 days taken with food. The use of Tricolam in pregnant patients has not been studied for bacterial vaginosis.