Tricomax

Uses

Calcium Pantothenate is used as a calcium supplement, dietary supplements, burning feet syndrome, greying hair, peripheral neuritis, muscular cramps.

Copper is a transition metal found in a variety of supplements and vitamins, including intravenous solutions for total parenteral nutrition (TPN).

For use in the supplementation of total parenteral nutrition and in contraception with intrauterine devices .

Zinc Sulphate is used for Recurrent Respiratory Tract Infections; Diarrhoea; Loss of appetite; Severe growth retardation; Deformed bone formation; Impaired immunological response; Acrodermatitis enteropathica; Parakeratatic skin lesions; Defective and delayed wound healing; Anaemia; Night blindness; Mental disturbances

Tricomax is also used to associated treatment for these conditions: Emergency Contraception, IUD, Trace Element Deficiency, Dietary supplementation

How Tricomax works

Copper is absorbed from the gut via high affinity copper uptake protein and likely through low affinity copper uptake protein and natural resistance-associated macrophage protein-2 . It is believed that copper is reduced to the Cu1+ form prior to transport. Once inside the enterocyte, it is bound to copper transport protein ATOX1 which shuttles the ion to copper transporting ATPase-1 on the golgi membrane which take up copper into the golgi apparatus. Once copper has been secreted by enterocytes into the systemic circulation it remain largely bound by ceruloplasmin (65-90%), albumin (18%), and alpha 2-macroglobulin (12%).

Copper is an essential element in the body and is incorporated into many oxidase enzymes as a cofactor . It is also a component of zinc/copper super oxide dismutase, giving it an anti-oxidant role. Copper defiency occurs in Occipital Horn Syndrome and Menke's disease both of which are associated with impaired development of connective tissue due to the lack of copper to act as a cofactor in protein-lysine-6-oxidase. Menke's disease is also associated with progressive neurological impairment leading to death in infancy. The precise mechanisms of the effects of copper deficiency are vague due to the wide range of enzymes which use the ion as a cofactor.

Copper appears to reduce the viabilty and motility of spermatozoa . This reduces the likelihood of fertilization with a copper IUD, producing copper's contraceptive effect . The exact mechanism of copper's effect on sperm are unknown.

Dosage

Tricomax dosage

Slow intravenous or deep intramuscularas required or as directed by physician.

Syrup-

• Children under 10 kg: One teaspoonful 2 times daily.
• Children within 10 to 30 kg: Two teaspoonful 1-3 times daily.
• Adults and children over 30 kg body weight: Four teaspoonful 1-3 times daily.

Tablet-In the treatment of Diarrhoea Zinc should be given as soon as diarrhoea starts:

• For infants between 2 to 6 months of age: 10 mg Zinc once daily for 10-14 days.
• For children between 6 months to 5 years of age: 20 mg Zinc once daily for 10-14 days.

For other indications:

• The recommended dose for children: 2 to 2.5 mg/kg/day.
• Children under 10 kg: 10 mg Zinc 2 times daily.
• Children within 10 to 30 kg: 20 mg Zinc 1-3 times daily.
• Adults and children over 30 kg body weight: 40 mg Zinc 1-3 times daily.

Dispersible Tablet-

• Place the tablet in a teaspoon
• Add adequate amount of water
• Let the tablet dissolve completely
• Give the entire spoonful solution

Side Effects

Mild gastrointestinal disturbances, bradicardia, arrythmia and irritation after IV injection

In case of zinc mild side effects such as gastric ulcer, nausea, vomiting, metallic taste, headache, drowsiness have been observed.

Toxicity

Copper toxicity is belevied to be due to fenton-type redox reactions occuring with high copper concentrations which produce damaging reactive oxygen species .

Precaution

Renal impairment, sarcoidosis, concurrent administration of thiazide diuretics may increase the risk of hypercalcaemia.

Concurrent administration of Zinc salt with penicillamine might diminish the effect of Penicillamine. The absorption of Zinc, although poor, may be decreased by various compounds including some foods. Chelation may occur with tetracyclines.

Interaction

There are no known drug interactions and none well documented.

Zinc may inhibit the absorption of concurrently administered tetracyclines, when both are being given an interval of at least 3 hours.

Elimination Route

Copper absorption varies inversely with intake. Absorption range is 12-65%.

Elimination Route

Copper appears to be eliminated primarily through bile .

Pregnancy & Breastfeeding use

Pregnancy Category-C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks

Pregnant women and nursing mothers should avoid zinc doses higher than RDA amounts.

Contraindication

Contraindicated in patients with hypercalcaemia, hypercalciuria.

It is contraindicated in patients with hypersensitivity to Zinc.

Acute Overdose

Zinc sulphate is corrosive in overdose. Symptoms are corrosion and inflammation of the mucous membrane of the mouth and stomach; ulceration of the stomach followed by perforation may occur. Gastric lavage and emesis should be avoided. Demulcents such as milk should be given. Chelating agents such as sodium edetate may be useful.

Storage Condition

Store in a cool place. The syrup should be protected from light.

Innovators Monograph

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