Liver Enzyme Elevations
In clinical studies, up to one third of patients had liver enzyme elevations at baseline, which generally improved post-treatment. Of those with normal liver enzyme values at baseline, 6.8%, 4.5%, 4.2% and 3% of patients had post-treatment elevations in bilirubin, aspartate aminotransferase (AST), alkaline phosphatase (ALP) and alanine aminotransferase (ALT), respectively. Transient increases in liver enzymes and total bilirubin in fascioliasis patients receiving Tribex are reported in the literature.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Clinical Trials Experience
The safety profile of Tribex 20 mg/kg in divided doses in a non-hepatic parasitic infection (N = 104) was generally similar to the safety profile in fascioliasis, except for a lower incidence of post-treatment abdominal pain.
Tribex™ is indicated for the treatment of fascioliasis in patients 6 years of age and older.
The recommended dose of Tribex is 2 doses of 10 mg/kg given 12 hours apart in patients 6 years of age and older. The 250 mg tablets are functionally scored and divisible into two equal halves of 125 mg. If the dosage cannot be adjusted exactly, round the dose upwards.
Resistance to Tribex has been reported outside the United States.
Wilkins AL, et al. Photosensitivity in South Africa. IX. Structure elucidation of a beta-glucosidase-treated saponin from Tribulus terrestis, and the identification of saponin chemotypes of South African T. terrestis. Onderstepoort Journal Veterinary Res 1996; 63:327-34. View abstract.
Bedir, E. and Khan, I. A. New steroidal glycosides from the fruits of Tribulus terrestris. J Nat Prod 2000;63(12):1699-1701. View abstract.
These difficulties may be aggravated in some markets by lack of clarity and transparency on, for example, timings and price points of tenders, as well as tacit or overt preference for local manufacturers.
Santos CA Jr, Reis LO, Destro-Saade R, et al. Tribulus terrestris versus placebo in the treatment of erectile dysfunction: a prospective randomized, double blind study. Actas Urol Esp 2014;38(4):244-8. View abstract.
Just ask yourself: are you really managing your tenders as effectively and seamlessly as you could do? Is everyone involved in tender management working together as fruitfully as they should be, and towards the same goals? Do you have full visibility of tender management across workstreams and countries worldwide?
Taking up the slack in emerging markets is by no means a given, though. In its recent report 2018 and Beyond: Outlook and Turning Points, the IQVIA Institute for Human Data Science noted that net spending on branded medicines in developed markets rose by 21%, from $326 billion to $395 billion ,over the last five years.
Baery N, Ghasemi Nejad A, Amin M, et al. Effect of vaginal suppository on bacterial vaginitis based on Persian medicine (Iranian traditional medicine): a randomised double blind clinical study. J Obstet Gynaecol. 2018 Nov;38(8):1110-1114. View abstract.
Tribulus might have an effect like a water pill or “diuretic.” Taking tribulus might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.
Gauthaman K, Adaikan PG, Prasad RN. Aphrodisiac properties of Tribulus Terrestris extract (Protodioscin) in normal and castrated rats. Life Sci 2002;71:1385-96. View abstract.
Uses & Effectiveness ?
Seth, S. D. and Jagadeesh, G. Cardiac action of Tribulus terrestris. Indian J Med Res 1976;64(12):1821-1825. View abstract.
People use tribulus for sexual disorders, infertility, chest pain, enlarged prostate, and many other conditions, but there is no good scientific evidence to support most of these uses.
Conrad, J., Dinchev, D., Klaiber, I., Mika, S., Kostova, I., and Kraus, W. A novel furostanol saponin from Tribulus terrestris of Bulgarian origin. Fitoterapia 2004;75(2):117-122. View abstract.