Triderm – composition, action, indications, dosage, side effects

Proven content

Triderm is an antibiotic that is applied to the skin. It is characterized by anti-inflammatory, antipruritic and decongestant properties. It can only be obtained with a prescription and comes in the form of an ointment or cream. This preparation is a combined drug consisting of three active substances: betamethasone, clotrimazole and gentamicin. What is Triderm? What does it consist of and what does it do? What are the indications and contraindications for its use? How to dose it and what side effects can its use cause?

Triderm – general characteristics of the drug

Triderm is a prescription-only medicine. It is mainly used in dermatology. Its international name is Betamethasoni dipropionas + Clotrimazolum + Gentamicinum.

Triderm comes in the form of a cream or ointment and is available in packages of 15 g or 30 g for about PLN 20.

This preparation contains three active substances such as: betamethasone dipropionate, clotrimazole and gentamicin.

It is mainly used in the symptomatic treatment of inflammatory skin lesions caused by microorganisms.

The drug should be stored at a temperature below 25 degrees Celsius, out of the sight or reach of children.

The entity responsible for the production of Triderm is the Belgian pharmaceutical company Schering-Plow Labo NV, which produces pharmaceutical products sold all over the world. In Poland, the entity responsible for drug distribution is MSD Polska Sp. z o. o., which has been operating in the world for over 125 years, and has been present in Poland since 1991.

Triderm – composition and action

The medicinal preparation Triderm, both in the form of ointments and cream, consists of three active substances, i.e .: betamethasone dipropionate with anti-inflammatory effect, Clotrymazole with antifungal activity and gentamicin with antibacterial activity.

The mechanism of action of Triderm is related to the properties and mode of action of the above substances.

Clotrimazole is a drug that belongs to the group of imidazoles. It works by inhibiting the growth of fungi that cause skin diseases by acting on the fungal cell wall. It is effective in the treatment of fungal lesions located mainly in the groin, perineum, feet and on the hairless skin. Clotrimazole is minimally absorbed after topical application to the skin.

Gentamicin is an antibiotic belonging to the group of aminoglycosides and has an antibacterial effect by inhibiting the synthesis of bacterial proteins.

The last active substance in Triderm is betamethasone dipropionate, which belongs to the group of corticosteroids that are very potent. When applied topically, the drug has a rapid and long-lasting anti-inflammatory, anti-itching and vasoconstrictor effect.

Both in the case of gentamicin and betamethasone, although they penetrate into the circulation to a small extent, their systemic effects cannot be completely excluded, especially after long-term use, on large and damaged skin areas and in children.

Typically one gram of Triderm ointment / cream contains 0,64 mg betamethasone dipropionate (equivalent to 0,5 mg betamethasone), 10 mg clotrimazole and 1 mg gentamicin (as gentamicin sulphate). The difference in composition between the ointment and the cream concerns the auxiliary ingredients.

Triderm in the form of a cream in addition to active substances, it contains auxiliary substances such as:

1. liquid paraffin;
2. white petroleum jelly;
3. cetostearyl alcohol;
4. propylene glycol;
5. macrogol cetostearyl ether;
6. benzyl alcohol;
7. sodium dihydrogen phosphate dihydrate;
8. phosphoric acid;
9. sodium hydroxide;
10. Purified Water.

While Triderm in the form of an ointment apart from the active substances, it contains only two auxiliary substances, i.e. liquid paraffin and white petroleum jelly.

What are antibiotics and how do they work? Read on: Antibiotics – types, action, use and side effects [EXPLAIN]

Triderm – dosage and method of application

Triderm, which is an ointment or cream, is intended for topical application to the skin. The preparation should be used according to the doctor’s recommendations or according to the package leaflet.

The preparation should be used regularly by applying a thin layer to the affected area and the surrounding skin. This operation should be repeated twice a day, in the morning and in the evening without the use of an occlusive dressing. After each use of the preparation, wash your hands with water and soap and avoid getting the drug into your eyes and mouth.

The duration of treatment depends on the size and location of the lesions and the patient’s response to treatment. If there is no improvement after 3 to 4 weeks of using Triderm, a doctor should be consulted to verify the diagnosis.

The preparation should not be used in children under 2 years of age, while in children over 2 years of age it can be used for no longer than 5 days.

Triderm used for a long time and in excessive amounts may cause:

1. suppression of the hypothalamic-pituitary-adrenal axis;
2. secondary adrenal insufficiency;
3. development of side effects characteristic of corticosteroids, including Cushing’s syndrome;
4. development of bacterial strains insensitive to gentamicin;
5. damage to the organ of hearing and kidneys.

Therefore, if you have used more Triderm than recommended or if no improvement occurs after the recommended period of use, you should immediately contact your doctor or pharmacist.

If you forget to use Triderm, do not take a double dose to make up for the forgotten dose. If you have any doubts about the dosage and method of using Triderm, consult your doctor or pharmacist.

How to take medication correctly? Check: How to take medications effectively?

Triderm – indications for use

The Triderm medicinal preparation is used in the symptomatic treatment of inflammatory skin lesions complicated by secondary infections caused by microorganisms, such as bacteria and fungi.

Triderm is indicated for the topical treatment of mycosis of the groin, perineum, feet and hairless skin. Thanks to the substances contained in the Triderm preparation, such as clotrimazole, the preparation has an antifungal effect on:

1. Trichophyton rubrum;
2. Trichophyton mentagrophytes;
3. Epidermophyton floccosus;
4. Microsporum dog;
5. candidiasis caused by Candida albicans;
6. and Pityriasis versicolor caused by Malassezia furfur (Pityrosporum obiculare).

In addition, thanks to gentamicin, Triderm is indicated in the treatment of bacterial infections caused by:

1. streptococcal strains (groups A: β-hemolytic, α-hemolytic);
2. golden staphylococcus (coagulase-positive strains, coagulase-negative strains and some penicillinase producing strains);
3. Gram-negative bacteria such as: Pseudomonas aeruginosa, Aerobacter aerogenes, Escherichia coli, Proteus vulgaris and Klebsiella pneumoniae.

In what situations does the risk of ringworm infection increase significantly? Check: Factors that increase the likelihood of “catching” ringworm

Triderm – contraindications and precautions

The medicinal preparation Triderm, despite the indications for its use, cannot always be included in the treatment. The doctor individually assesses the risk of treatment with this preparation in the patient.

Particular caution should be exercised in patients with certain diseases or other circumstances that may constitute a contraindication to use or an indication for a change in the dosage of Triderm.

There are also situations in which, before using this preparation, it is necessary to conduct a thorough medical history, and even carry out certain control tests.

Main contraindication to the use of the drug Triderm is hypersensitive to the active substances betamethasone dipropionate, clotrimazole or gentamicin, or other drugs belonging to the group of corticosteroids, imidazole derivatives, aminoglycoside antibiotics or any of the excipients of the product.

Other contraindications to the use of Triderm are:

1. rosacea;
2. common acne;
3. viral skin infection, e.g. chicken pox, cold sores;
4. open wounds, skin damage;
5. primary bacterial and fungal skin infection;
6. location of skin lesions – contraindication applies to the anus and genitals;
7. changes in the skin of the face;
8. inflammation of the skin around the mouth.

Moreover, Triderm cannot be used on children under 2 years of age, on large areas of the skin and for a long time. If in doubt about the possibility of using the drug, consult your doctor or pharmacist.

How to recognize athlete’s foot? Check: Detect athlete’s foot at an early stage, or how to recognize its symptoms

Triderm – side effects

Triderm, like all medicines, may cause side effects that do not have to occur in every person using the preparation. Most often, the benefits of using the drug are greater than the damage that may result from the appearance of side effects. Very rarely (occurring in less than 1 patient in 10), the following side effects may occur after taking Triderm:

1. skin discoloration;
2. anemia;
3. burning sensation;
4. erythema;
5. exudation;
6. itchy skin.

Side effects from the use of Triderm may also occur with the topical use of corticosteroids, clotrimazole and gentamicin. The presence of clotrimazole in Triderm may cause side effects such as:

1. erythema;
2. burning sensation;
3. bubble formation;
4. exfoliation of the epidermis;
5. swelling, itching, hives;
6. general skin irritation.

The drug gentamicin may cause skin irritation (erythema, itching) which may require immediate discontinuation of treatment. In extreme cases, it can cause blurred vision.

The last active ingredient of Triderm, betamethasone dipropionate, can cause the following side effects:

1. burning sensation, itching, irritation, dry skin;
2. inflammation of follicle;
3. hirsutism;
4. acne;
5. skin discoloration;
6. inflammation of the skin around the mouth;
7. allergic contact dermatitis;
8. swelling or softening of the skin;
9. secondary infections;
10. skin atrophy, stretch marks;
11. heat rash.

Long-term use of Triderm on a large area of ​​the skin and in children may cause systemic side effects of corticosteroids (including adrenal suppression). Growth and development disorders may occur in children and infants, and the gentamicin contained in the drug may cause allergic reactions as well as ototoxic (hearing damage) and nephrotoxic (kidney damage) effects.

The side effect of long-term use of the antibiotic, which is Triderm, may be the development of resistant bacteria and fungi, therefore, during treatment, continuous observation of the affected skin is recommended.

As a result of excessive absorption of active substances in connection with the use of a dressing, side effects that are characteristic of corticosteroids may occur, such as:

1. inhibition of the natural production of steroid hormones by the cortex of the adrenal glands;
2. the appearance of symptoms of Cushing’s syndrome.

People suffering from psoriasis must be especially careful when using Triderm, as this drug may pose a risk of developing tolerance and recurrence of psoriasis, development of pustular psoriasis and general toxic effects.

If the above side effects or other effects occur, immediately inform your doctor or pharmacist about them, or report them directly to the Department for Monitoring Undesirable Effects of Medicinal Products of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products.

How to proceed to permanently get rid of mycosis problems? Check: Healed athlete’s foot and what next? How to prevent reinfection with mycosis

Triderm – interactions with other drugs

Before starting treatment with Triderm, please inform your doctor or pharmacist about all the medicines you are taking or have taken recently. You should also inform what medications the patient plans to take in the near future.

The active substances of Triderm may interact with other drugs or substances contained in medicinal products. It is worth paying attention to the following combinations of drugs:

1. Triderm in Hepsera — Ir, Hepsera – the preparations contain interacting compounds, i.e. gentamicin and adefovir. The simultaneous use of both drugs significantly increases the risk of renal dysfunction as well as other side effects of adefovir. In case of nausea, vomiting, changes in the amount or color of urine, edema, high blood pressure, arrhythmias or other disturbing symptoms, the patient should consult a doctor;
2. Triderm i Zyban, Mysimba, Oribion – the preparations contain interacting compounds, i.e. betamethasone and bupropion. These drugs can cause seizures. The administration of betamethasone by injection with bupropion increases the risk, especially in patients who have or have had epilepsy;
3. Triderm i Exjade – the preparations contain interacting compounds, i.e. gentamicin and deferasirox. The use of both drugs at the same time significantly increases the risk of kidney disorders. In case of nausea, vomiting, changes in the amount or color of urine, edema, high blood pressure, arrhythmias or other disturbing symptoms, consult a doctor;
4. Triderm i Votubia, Everolimus Teva, Everolimus Stada – the preparations contain interacting compounds, i.e. gentamicin and everolimus. The use of both drugs at the same time significantly increases the risk of kidney disorders. If you experience nausea, vomiting, changes in the amount or color of urine, swelling, high blood pressure, arrhythmias or other disturbing symptoms, consult your doctor;
5. Triderm i Torisel – the preparations contain interacting compounds, i.e. gentamicin and temsirolimus. Using both drugs at the same time significantly increases the risk of kidney disorders;
6. Triderm i Xeljanz – the preparations contain interacting compounds, i.e. betamethasone and tofacitinib. These drugs reduce the body’s ability to fight bacterial, viral and fungal infections. Therefore, the risk of infections and inflammation of various organs increases, which can be very difficult and even life-threatening.
7. Triderm i Minirin, Desmoperil, Adiuretin, Adin, Noqturina, Minirin Rhinyle, Minirin Melt – the preparations contain interacting compounds, i.e. betamethasone and desmopressin. The combined use of both drugs can cause serious side effects: vomiting, headache, convulsions, disorientation, breathing problems, and even cardiac arrest;
8. Triderm i Protopic – the preparations contain interacting compounds, i.e. gentamicin and tacrolimus. The use of both drugs at the same time increases the risk of kidney disorders.

Which drugs should never be combined with each other? Check: Dangerous interactions

Triderm during pregnancy and breastfeeding

The use of drugs without consulting a doctor during pregnancy is strictly prohibited. The use of any drug or medicinal preparation during pregnancy or breastfeeding requires prior consultation with a doctor and explaining beyond any doubt the potential risks and benefits associated with the use of the drug.

In the case of Triderm, a patient who is pregnant, suspects that she may be in her pregnancy, or plans to become pregnant, should consult her doctor or pharmacist before taking this medicine, or inform her doctor about her condition when prescribing a prescription for this medicine.

There are no data on the safety of the drug in pregnant women. Nevertheless, the active substances of Triderm, i.e. corticosteroids and gentamicin, can be absorbed through the skin and its use during pregnancy is only allowed if, in the doctor’s opinion, the benefit to the mother outweighs the risk to her, the fetus or the newborn.

If the doctor recommends the use of Triderm in the treatment, the lowest possible dose should be used, on the smallest possible area of ​​the skin and only for a short time.

However, if you are breastfeeding, you should avoid using Triderm, unless your doctor tells you otherwise. Most often, when introducing this drug to treatment, the doctor, taking into account the benefits of treatment for the mother and the risk for the child, decides to stop breastfeeding due to the risk of active substances being excreted into breast milk.

What is worth knowing about proper supplementation during pregnancy? Check: Conscious choices. Diet and supplementation in pregnancy