Usage
Tricholine citrate is primarily used as a hepatoprotective and lipotropic agent. It is often prescribed in combination with other medications, such as cyproheptadine, for conditions like anorexia nervosa and other causes of poor appetite and weight loss. It aids in liver detoxification and helps prevent fatty liver disease. It also assists in the breakdown and metabolism of lipids, which can be beneficial for cholesterol management. Some sources also mention its use in promoting digestive health and relieving diarrhea.
Pharmacological Classification: Lipotropic, Hepatoprotective agent.
Mechanism of Action: Tricholine is a precursor to phosphatidylcholine, a key component of cell membranes and lipoproteins. It facilitates the transport and metabolism of fats in the liver, preventing their accumulation. It also acts as a source of methyl groups for various metabolic processes.
Alternate Names
No widely used alternate names exist for tricholine citrate specifically, although it’s a salt formed from choline and citric acid. There may be variations due to differences in salt combinations (e.g. tricholine chloride). Different brand names exist depending on the manufacturer and the combined drugs it is sold with.
How It Works
Pharmacodynamics: Tricholine enhances liver function by promoting the synthesis and secretion of very-low-density lipoproteins (VLDL), preventing fat accumulation in the liver. It facilitates the transport of lipids from the liver to peripheral tissues for utilization.
Pharmacokinetics: Absorption of tricholine citrate is relatively rapid after oral administration. It’s metabolized in the liver and subsequently eliminated primarily via renal excretion. More detailed pharmacokinetic data specific to tricholine citrate is limited in the provided sources.
Mode of Action: The primary mode of action is facilitating the biosynthesis of phosphatidylcholine and other phospholipids, which are essential for lipid transport and metabolism.
Receptor binding, enzyme inhibition, or neurotransmitter modulation: No direct receptor binding, enzyme inhibition, or neurotransmitter modulation activity has been documented for tricholine citrate.
Elimination pathways: Primarily renal excretion.
Dosage
Standard Dosage
Adults:
Dosage recommendations vary, with some sources indicating 5-10 ml two to three times daily of a syrup containing tricholine citrate. Other sources mention cyproheptadine 4 mg three times a day in combination with tricholine citrate. Maximum daily doses for cyproheptadine are advised at 0.5mg/kg. However, it is essential to consult the specific product information as formulations and concentrations vary.
Children:
Dosages are generally lower and should be determined by a pediatrician. Syrup containing 2 mg Cyproheptadine and 275 mg Tricholine Citrate in 5 ml are recommended at 0.5ml twice daily for infants up to six months, and 1ml twice daily for infants between six months and one year. For children over 7 years, up to 5ml doses of syrup with the above concentration may be administered, according to some sources.
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary based on renal and hepatic function.
- Patients with Renal Impairment: Dose modifications considering creatinine clearance are advisable.
- Patients with Hepatic Dysfunction: Adjustments for impaired metabolism may be necessary.
- Patients with Comorbid Conditions: Individualized dosing is required considering the interplay with other medications.
Clinical Use Cases
The use of tricholine citrate in specific clinical settings like intubation, surgical procedures, mechanical ventilation, ICU, or emergency situations, isn’t explicitly described. However, the general recommendations for adults and children apply.
Dosage Adjustments
Dose modifications are often required based on the patient’s age, weight, renal and hepatic function, and other medical conditions. Polypharmacy requires careful consideration of potential drug interactions and their impact on dosing.
Side Effects
Common Side Effects
Drowsiness, constipation, dry mouth, nausea are common side effects when tricholine citrate is used in combination with cyproheptadine.
Rare but Serious Side Effects
Allergic reactions.
Long-Term Effects
Limited data exists on the long-term effects of tricholine citrate use, particularly in isolated form. More research is required.
Adverse Drug Reactions (ADR)
Allergic reactions requiring immediate medical attention.
Contraindications
Hypersensitivity to tricholine citrate or any component of the formulation is a contraindication. Use with caution in patients with severe hepatic or renal impairment.
Drug Interactions
Limited specific information is available for isolated tricholine citrate. However, combined formulations, especially with cyproheptadine, may interact with other medications metabolized by the liver, potentially affecting their efficacy or toxicity. It is recommended to avoid combination with other medications that are primarily hepatically eliminated. Alcohol and other CNS depressants should be avoided due to the risk of additive sedative effects when used with cyproheptadine.
Pregnancy and Breastfeeding
The safety of tricholine citrate during pregnancy and breastfeeding has not been definitively established. Pregnant and breastfeeding women should consult their doctor before using tricholine citrate.
Drug Profile Summary
- Mechanism of Action: Lipotropic and hepatoprotective agent, promoting fat metabolism and preventing liver steatosis.
- Side Effects: Drowsiness, dry mouth, constipation, and rarely, allergic reactions.
- Contraindications: Hypersensitivity.
- Drug Interactions: Limited data available for isolated tricholine citrate, however combined formulations may interact with other medications.
- Pregnancy & Breastfeeding: Consult a physician before use.
- Dosage: Varies depending on formulation, age, and health conditions. Usually a combination drug.
- Monitoring Parameters: Liver function tests, lipid profile.
Popular Combinations
Cyproheptadine and Tricholine Citrate Syrup is a widely used combination.
Precautions
Assess liver and renal function before starting tricholine citrate. Monitor for any signs of allergic reactions or gastrointestinal disturbances. Avoid concurrent use of alcohol and CNS depressants due to the risk of potentiating drowsiness if used with cyproheptadine.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Tricholine Citrate?
A: Dosage varies depending on the formulation, age, and clinical condition. Consult the specific product information and consider patient factors.
Q2: What are the primary uses of Tricholine Citrate?
A: Primarily used as a hepatoprotective and lipotropic agent. It is often prescribed in combination with other medications.
Q3: How does Tricholine Citrate work in the body?
A: It acts as a precursor for phosphatidylcholine, facilitating the transport and metabolism of fats in the liver, preventing their accumulation, and acting as a source of methyl groups.
Q4: What are the common side effects of Tricholine Citrate?
A: Commonly reported side effects, particularly when used in combination with cyproheptadine, include drowsiness, constipation, and dry mouth.
Q5: Are there any contraindications for Tricholine Citrate use?
A: Hypersensitivity to any of the components in the formulation is a contraindication.
Q6: Does Tricholine Citrate interact with other medications?
A: Limited specific information is available for tricholine citrate. However, it is always recommended to be cautious when using it with other medications and look at interactions of all medications in the product.
Q7: Can Tricholine Citrate be used during pregnancy or breastfeeding?
A: Safety during pregnancy and breastfeeding is not clearly established. Consult with a physician before use.
Q8: How is Tricholine Citrate eliminated from the body?
A: Primarily eliminated via renal excretion.
Q9: What should patients be monitored for when taking Tricholine Citrate?
A: Patients should be monitored for allergic reactions, gastrointestinal discomfort, and improvement in liver function tests and lipid profile.
Q10: Is Tricholine citrate ever prescribed as a standalone medication?
A: It is less frequently prescribed on its own and more commonly found combined with medications like cyproheptadine to address undernutrition and poor appetite.
