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Triphedinon Dosage |
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Dosage should be individualized. The initial dose should be low and then increased gradually, especially in patients over 60 years of age. Whether Triphedinon® (Triphedinon HCl) may best be given before or after meals should be determined by the way the patient reacts. Postencephalitic patients, who are usually more prone to excessive salivation, may prefer to take it after meals and may, in addition, require small amounts of atropine which, under such circumstances, is sometimes an effective adjuvant. If Triphedinon (Triphedinon) tends to dry the mouth excessively, it may be better to take it before meals, unless it causes nausea. If taken after meals, the thirst sometimes induced can be allayed by mint candies, chewing gum or water.
Abrupt withdrawal of treatment for parkinsonism may result in acute exacerbation of parkinsonism symptoms; therefore, abrupt withdrawal should be avoided.
Abrupt withdrawal of treatment may result in neuroleptic malignant syndrome (NMS)
As initial therapy for parkinsonism, 1 mg of Triphedinon (Triphedinon) in tablet or elixir form may be administered the first day. The dose may then be increased by 2 mg increments at intervals of three to five days, until a total of 6 to 10 mg is given daily. The total daily dose will depend upon what is found to be the optimal level. Many patients derive maximum benefit from this daily total of 6 to 10 mg, but some patients, chiefly those in the postencephalitic group, may require a total daily dose of 12 to 15 mg.
The size and frequency of the Triphedinon (Triphedinon) dose needed to control extrapyramidal reactions to commonly employed tranquilizers, notably the phenothiazines, thioxanthenes, and butyrophenones, must be determined empirically. The total daily dosage usually ranges between 5 and 15 mg although, in some cases, these reactions have been satisfactorily controlled with as little as 1 mg daily. It may be advisable to commence therapy with a single 1 mg dose. If the extrapyramidal manifestations are not controlled in a few hours, the subsequent doses may be progressively increased until satisfactory control is achieved. Satisfactory control may sometimes be more rapidly achieved by temporarily reducing the dosage of the tranquilizer when instituting Triphedinon (Triphedinon) therapy and then adjusting the dosage of both drugs until the desired ataractic effect is retained without onset of extrapyramidal reactions.
It is sometimes possible to maintain the patient on a reduced Triphedinon (Triphedinon) dosage after the reactions have remained under control for several days. Instances have been reported in which these reactions have remained in remission for long periods after Triphedinon (Triphedinon) therapy was discontinued.
When Triphedinon (Triphedinon) is used concomitantly with levodopa, the usual dose of each may need to be reduced. Careful adjustment is necessary, depending on side effects and degree of symptom control. An Triphedinon (Triphedinon) dosage of 3 to 6 mg daily, in divided doses, is usually adequate.
Triphedinon (Triphedinon) may be substituted, in whole or in part, for other parasympathetic inhibitors. The usual technique is partial substitution initially, with progressive reduction in the other medication as the dose of Triphedinon HCl is increased.
Triphedinon (Triphedinon) TABLETS and ELIXIR - The total daily intake of Triphedinon (Triphedinon) tablets or elixir is tolerated best if divided into 3 doses and taken at mealtimes. High doses ( > 10 mg daily) may be divided into 4 parts, with 3 doses administered at mealtimes and the fourth at bedtime.
Triphedinon® (Triphedinon HCl) Tablets are available as follows:
2 mg - round, flat, scored, white tablets; engraved “Triphedinon (Triphedinon) ” above “2” on one side and “LL” above “A11” below the score on the other side, supplied as follows:
NDC 0005-4434-23 - Bottle of 100
NDC 0005-4434-34 - Bottle of 1000
5 mg - round, flat, scored, white tablets; engraved “Triphedinon (Triphedinon) ” above “5” on one side and “LL” above “A12” below the score on the other side, supplied as follows:
NDC 0005-4436-23 - Bottle of 100
NDC 0005-4436-34 - Bottle of 1000
Store at controlled room temperature 20° to 25°C (68° to 77°F).
Dispense in tight containers as defined in the USP.
ALSO AVAILABLE
Triphedinon (Triphedinon) is available in Elixir as follows:
2 mg/5 mL - NDC 0005-4440-65 - Bottle of 16 fl oz
Store at controlled room temperature 20° to 25°C (68° to 77°F).
DO NOT FREEZE.
Dispense in tight containers as defined in the USP.
Lederle Pharmaceutical Division of American Cyanamid Company, Pearl River, NY 10965. Rev 03/03.
Before taking this medication, tell your doctor if you are taking any of the following medicines:
a tricyclic antidepressant (used to treat depression, pain, or obsessive-compulsive disorder) such as amitriptyline (Elavil, Endep), doxepin (Sinequan), clomipramine (Anafranil), amoxapine (Asendin), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), or protriptyline (Vivactil);
a phenothiazine (used to treat mania, schizophrenia, other psychiatric conditions, and nausea and vomiting) such as chlorpromazine (Thorazine), fluphenazine (Prolixin), perphenazine (Trilafon), mesoridazine (Serentil), thioridazine (Mellaril), promazine (Sparine), trifluoperazine (Stelazine), and others;
thiothixene (Navane) or chlorprothixene (Taractan);
an antihistamine such as diphenhydramine (Benadryl, others), chlorpheniramine (Chlor-Trimeton, others), triprolidine (Actifed, others), brompheniramine (Dimetapp, others), clemastine (Tavist), and others (antihistamines are often found in prescription and over-the-counter cold, allergy, and sleep medicines);
quinidine (Quinora, Quinaglute, Quinidex, Cardioquin);
amantadine (Symmetrel);
digoxin (Lanoxin, Lanoxicaps); or
haloperidol (Haldol).
You may not be able to take Triphedinon or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with Triphedinon. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
Cannabinoids, barbiturates, opiates, and alcohol may have additive effects with PMS Triphedinon, and thus, an abuse potential exists.
Concurrent use of alcohol or other CNS depressants with PMS Triphedinon may cause increased sedative effects.
Monoamine oxidase inhibitors and tricyclic antidepressants possessing significant anticholinergic activity may intensify the anticholinergic effects of antidyskinetic agents because of the secondary anticholinergic activities of these medications
Prophylactic administration of anticholinergic agents, such as Triphedinon, as a prevention of drug-induced parkinsonism during neuroleptic therapy is not recommended. There may be an increased risk for the development of tardive dyskinesia during concomitant administration of anticholinergics and neuroleptics.
The usual dose of either Triphedinon or levodopa may need to be reduced during concomitant therapy, since concomitant administration may increase drug-induced involuntary movements
Nursing Mothers It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when PMS Triphedinon is administered to a nursing woman. As with other anticholinergics, Triphedinon may cause suppression of lactation. Therefore, Triphedinon should only be used if the expected benefit to the mother outweighs the potential risk to the infant
Pediatric Use Safety and effectiveness in pediatric patients have not been established.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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