Trinomia: The Polypill With Three Active Ingredients

Trinomia is used as a replacement treatment in adult patients who are at cardiovascular risk due to a heart attack, among other conditions. It's the first pill to combine three active ingredients in one pill.
Trinomia: The Polypill With Three Active Ingredients
María Vijande

Reviewed and approved by the pharmacist María Vijande.

Written by María Vijande

Last update: 27 May, 2022

Trinomia is the first polypill medication that consists of three active ingredients. Doctors prescribe this drug to prevent cardiovascular accidents.

The three active ingredients present in Trinomia are:

  • Acetylsalicylic acid
  • Atorvastatin
  • Ramipril

Doctors prescribe this drug to replace the established treatment in patients who are taking the three components at the same time. The doses normally used are those needed to reduce the risk of experiencing a cardiovascular accident. This is especially true in cases where a previous cardiovascular accident has occurred.

Three active ingredients: The composition of Trinomia

Trinomia capsules contain three different active ingredients, each of which affects cardiovascular risk factors.

  • Acetylsalicylic acid: This belongs to the group of antiplatelet drugs. It acts by preventing platelets from aggregating together and forming a clot.
  • Atorvastatin: This is an active ingredient that belongs to the group of statins. These are drugs that help regulate cholesterol and triglyceride levels in the blood.
  • Ramipril: Ramipril belongs to the group of ACE (angiotensin-converting enzyme) inhibitor drugs. This active ingredient exerts its effect on the blood vessels by controlling blood pressure. Its mechanism of action produces a relaxation of the blood vessels leading to an increase in their diameter. Thanks to this effect, the heart pumps blood to the rest of the body more easily.

How to take Trinomia

Your doctor will tell you how to start treatment with Trinomia. In general, the usual dosage is one capsule a day after dinner. It’s important to be aware that you should never open, crush, or chew Trinomia capsules.

Treatment shouldn’t be stopped abruptly without first talking to your doctor, as this is a drug prescribed for at-risk patients who’ve previously experienced a cardiovascular accident.

A man suffering from a heart attack, clutching his chest.
This drug’s prescribed for patients who’ve already suffered a cardiovascular event before and are at risk.

You may also be interested in: Work Stress Associated with Risk of Heart Attack

Possible side effects

Trinomia, like all medications, can produce side effects. However, treatment should stop if you experience serious effects including the following:

  • Vomiting blood: This symptom is important as it is a sign of stomach bleeding.
  • Allergic reactions: Skin, respiratory tract, especially in asthmatic patients.
  • Severe hemorrhages: Including cerebral hemorrhage, especially if your blood pressure is high and uncontrolled and also in case you’re under treatment with anticoagulants.
  • Muscle pain or cramps.
  • Hypersensitivity reactions: If you are hypersensitive to any of the components of Trinomia, you may suffer symptoms such as swelling of the face, tongue, and throat, difficulty breathing, or swallowing.
  • Skin rash: In these cases, reddish spots may appear, especially on the palms of the hands or soles of the feet, which may develop into blisters.

Some interactions with these three active ingredients

Trinomia with food, beverages, and alcohol

While you’re undergoing treatment with this medicine, you shouldn’t drink alcohol. Alcohol increases the risk of bleeding and ulcers of the stomach and intestine. In addition, alcohol consumption may increase the effect of some medicines used in the treatment of high blood pressure.

A person mixing pills with alcohol.
Trinomia can interact with alcohol, so it is not recommended to take them together.

Read also: Possible Symptoms of a Stomach Ulcer

Can I take Trinomia if I’m pregnant or breastfeeding?

You shouldn’t take Trinomia if you’re pregnant or if you think you might be pregnant. However, if you become pregnant while taking this drug, you should stop the treatment and contact your doctor.

However, in case that you’re planning to get pregnant, you’ll have to change to an alternative treatment that’s suitable for your condition. It’s also not advisable to take Trinomia if you’re breastfeeding and, in general, women of childbearing age should use an effective method of contraception for the duration of the treatment.

What’s so novel about Trinomia and its three active ingredients

Trinomia makes it easier for patients who need secondary prevention to follow their treatment correctly when they leave the hospital. However, it shouldn’t be used in cases where the use of aspirin, ACE inhibitors, or statins at medium or high doses is contraindicated.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Wiley B, Fuster V. The concept of the polypill in the prevention of cardiovascular disease. Ann Glob Health. 2014 Jan-Feb;80(1):24-34.
  • Barrios V, Escobar C. Improving cardiovascular protection: focus on a cardiovascular polypill. Future Cardiol. 2016 Mar;12(2):181-96.
  • Borroto J. Impact of the polypill approach in the efficacy and safety of Trinomia: Post-marketing pharmacovigilance data after three-years. J Pharmacovigil. 2017;05(03).
  • Ibañez B, Castellano JM, Fuster V. Polypill strategy at the heart of cardiovascular secondary prevention. Heart. 2019 Jan;105(1):9-10.
  • Tamargo J, Castellano JM, Fuster V. The Fuster-CNIC-Ferrer Cardiovascular Polypill: a polypill for secondary cardiovascular prevention. Int J Cardiol. 2015 Dec;201 Suppl 1:S15-22.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.