API

Azithromycin dihydrate, Fluconazole, Secnidazole

Drug classification

Antimicrobial agents; subclasses: macrolide antibiotic, triazole antifungal, nitroimidazole antiprotozoal.

Dosage form

Tablet

API strength per dosage

Azithromycin Dihydrate 1G +Fluconazole 150MG +…

Dose

TRIOKIT standard adult dose: Azithromycin 1 g orally single dose, Fluconazole 150 mg orally single dose, Secnidazole 2 g orally single dose. Not recommended for children; safety and efficacy in pediatrics and special populations (pregnancy, renal/hepatic impairment) not established.

Mechanism of action

Azithromycin inhibits bacterial protein synthesis by binding the 50S ribosomal subunit. Fluconazole inhibits fungal cytochrome P450 enzyme 14α-demethylase, blocking ergosterol synthesis. Secnidazole disrupts DNA structure and function in anaerobic bacteria and protozoa by generating reactive intermediates. The result is inhibition of microbial growth or cell death.

Indications

Treatment of syndromic vaginal discharge, mixed vaginal infections including bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis, and sexually transmitted infections causing vaginal discharge in women.

Side effects

Gastrointestinal upset (nausea, vomiting, diarrhea, abdominal pain), headache, dizziness, rash, taste disturbance, hepatotoxicity, QT prolongation, allergic reactions, vaginal irritation, pruritus, and rarely, severe skin reactions.

Pregnancy category

Safety in pregnancy is not established; use only if potential benefits justify potential risks to the fetus. Consult current guidelines before prescribing in pregnancy.

Precautions

Assess for hypersensitivity, hepatic or renal impairment, QT prolongation risk, drug interactions (especially with CYP3A4 substrates), pregnancy and lactation status, gastrointestinal disturbances, liver function tests, complete blood count, ECG if cardiac risk, monitor for superinfections, counsel on adherence and potential side effects.

Contraindications

Hypersensitivity to azithromycin, fluconazole, secnidazole, other macrolides, azole antifungals, nitroimidazoles; concomitant use with drugs that prolong QT interval (for azithromycin, fluconazole); severe hepatic impairment; pregnancy (for secnidazole).