Pharmacological properties

Pharmacodynamics. properties of ointment lorindenm with are caused by the combined effect of Flumethasonum of the pivalat and a kliokhinol. Flumethasonum pivalat is synthetic gks with moderate anti-inflammatory action. in case of use in the form of ointment has local effect of average intensity. has lipophilic properties, easily gets into a corneal layer of skin and shows long anti-inflammatory, antipruritic and antiallergic action. at external use of Flumethasonum pivalat suppresses formation of prostaglandins and leukotrienes in skin owing to oppression of activity of a phospholipase a2 and reduction of release of arachidonic acid from phospholipids of cellular membranes. suppresses phagocytosis, release of interleukins and other cytokines, release of a histamine and manifestation of local allergic reactions, reduces proliferative processes. due to local vasoconstrictive action reduces expressiveness of exudative reaction. reduces synthesis of protein and adjournment of collagen.

Kliokhinol has antibacterial effect of rather gram-positive and gram-negative bacteria and also weak antifungal action.

Pharmacokinetics. Flumethasonum pivalat easily gets into a rogovy layer of skin where collects. In skin it is not metabolized. At external use in a small amount can get into an organism and in that case has systemic action. After penetration through skin medicament is metabolized mainly in a liver, removed with urine and in insignificant quantities with bile in the form of conjugates of glucuronides and also in not changed look. Absorption of Flumethasonum of the pivalat increases at use on sites with gentle skin — in the field of folds or the person, on skin with the injured epidermis or vospalitelno to the changed skin. Use of the occlusive bandage promoting temperature increase and humidity of skin also increases pivalat Flumethasonum absorption. Besides, absorption increases at frequent use of medicine or at use on extensive sites of skin. Dermal absorption at persons of young age more intensively, than at senior citizens.

Kliokhinol has local effect and is practically not soaked up in blood.

Indication

Topical treatment of the damages of skin without exudation complicated by a bacterial infection which are followed by an itching and a hyperkeratosis: seborrheal dermatitis, atopic dermatitis, allergic contact dermatitis, a multiformny erythema, a system lupus erythematosus, psoriasis, red flat deprive.

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for topical administration. ointment is applied a thin layer on an affected area of skin by 1–2 times a day. treatment it is not necessary to spend continuously more than 2 weeks it is impossible to apply on face skin within a week no more than 1 tuba are recommended to apply more than 1 week.

At the raised likhenization or an excessive hyperkeratosis is allowed to apply an occlusive bandage which should be changed each 24 h

Contraindication

Hypersensitivity to Flumethasonum to a pivalat, other corticosteroids, a kliokhinol or other components of ointment. virus (for example chicken pox, a herpes simplex), fungal or bacterial (for example tuberculosis) infections of skin, a skin new growth, ordinary and pink eels, a perioral and diaper dermatitis, an anal itching, an itching in a vulva, inflammation or ulcers of varicose nodes.

on big sites of skin, especially at disturbance of integrity of skin, for example, in burns.

Side effects

from skin and hypodermic cellulose: eels, post-steroid purpura, oppression of growth of epidermis, atrophy of hypodermic cellulose, xeroderma, burning sensation, irritation, itching, overgrowth of hair on a body or alopecia, decolouration or hyperpegmentation of skin, atrophy and disturbances of integrity of skin, teleangiectasia, perioral dermatitis, inflammation of hair follicles, consecutive infections. in some cases can appear: urticaria, spotty and papular rash or aggravation of the existing changes.

from an organ of sight: at external use on an eyelid skin the cataract or glaucoma can sometimes develop.

Others: absorption of active ingredient in blood can cause the system side effects inherent of Flumethasonum to a pivalat. Arise, mainly, in case of long use of drug, at use on extensive sites of skin, under an occlusive bandage or at use for children.

show the system side effects of Flumethasonum of the pivalat typical for corticosteroids, including dysfunction gipotalamo - a hypophysial and adrenal system, Cushing's syndrome, oppression of growth and development in children, a hyperglycemia, a glucosuria, hypostases, AG, hypersensitivity to infections, decrease in immunity; perhaps neurotoxic action at topical administration of a kliokhinol, especially in cases of prolonged use or use under an occlusive bandage.

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Special instructions

not to apply without interruption more than 2 weeks at long use on extensive sites of skin the frequency of development of side effects increases. use of medicament should be stopped immediately if its use leads to an itching, dryness or allergic reactions of skin.

during external use of Flumethasonum of the pivalat the secretion by AKTG hypophysis owing to oppression of hypophysial and adrenal communication can decrease, decrease cortisol level in blood and develop an iatrogenic syndrome of Cushing which passes after the treatment termination. In case of increase in severity of an infection in the place of use of drug, additional use of antibacterial, antifungal medicines is necessary. If symptoms of an infection do not disappear, use of medicament needs to be stopped.

Should avoid putting medicament on eyelids or skin around eyes at patients with a closed-angle and open angle glaucoma and also with a cataract, considering a possibility of increase in expressiveness of symptoms of a disease.

Should avoid contact of medicament with eyes and mucous membranes.

On face skin, inguinal and an underarm to apply only in case of special need as increase in absorption and high risk of development of side effects (teleangiectasias, perioral dermatitis), even after short use is possible.

should limit Use of ointment under an occlusive bandage to exclusive situations in connection with a possibility of emergence of an atrophy and defects of epidermis, superinfection.

Should use with care medicament in the presence of an atrophy of hypodermic cellulose, mainly at elderly people.

during treatment of chronicities, for example psoriasis or chronic eczema, it is not necessary to cancel medicament sharply. It is necessary to apply with care at patients with psoriasis as topical administration of GKS in this case can lead to the disease recurrence caused by development of tolerance, risk of spread of pustulous psoriasis and system toxicity owing to skin dysfunction.

Use during pregnancy and feeding by a breast. In the researches conducted on animals it is confirmed that GKS have teratogenic effect even at use inside in low doses. Teratogenic action is confirmed also at external use of GKS. Did not conduct controlled researches of reliability of teratogenic action at external use of Flumethasonum of the pivalat during pregnancy.

Ointment Lorindenm With can be applied during pregnancy only quickly, on small sites of skin and only if, according to the doctor, the advantage exceeds risk of use. Use of medicament in the I trimester of pregnancy is contraindicated.

. At use of GKS in a significant amount of hormone which could influence the newborn's organism in breast milk it is not revealed. However Lorindenm With during feeding by a breast is recommended to apply with care ointment. In some cases it is possible to use medicament quickly on small sites of skin. Not to apply ointment Lorindenm With on skin of mammary glands.

Children. Drug is not used at children aged up to 12 years. To children 12 years medicament are aged more senior appoint with care. It is allowed to apply ointment in some cases on small sites of skin. It is not necessary to apply medicament to face skin.

At children the bigger quantity of a topical corticosteroid can be absorbed in proportion therefore they are more susceptible to system side effects. It is connected with the fact that children have an underdeveloped skin barrier and the big surface of skin concerning body weight in comparison with adults.

Ability to influence speed of response at control of vehicles or work with other mechanisms. Medicine does not limit mental and motive ability and also ability of control of vehicles or other mechanisms.

At external use gks interactions with other medicines are not revealed by

Interaction

during treatment is not recommended to carry out vaccination against smallpox and also other types of immunization, especially at long use on extensive sites of skin, considering a possibility of the insufficient immune response.

Ointment Lorindenm With can strengthen action of immunosuppressive and oppress effect of the immunostimulating medicines.

At prolonged use of medicament on extensive sites of skin the emergence of symptoms of overdose which are shown by increase in severity of side effects, including hypostases, burning sensation, irritation, an itching, ag, a hyperglycemia, decrease in resistance to infections), and in hard cases — development of a syndrome of Cushing is possible

. it is necessary to stop in due time gradually use of medicine or to pass to use gks weak action. symptomatic therapy.

Storage conditions

At a temperature not above 25 °C.