Pharmacological properties

Pharmacodynamics. properties of ointment lorindenm and are caused by the combined effect of Flumethasonum of the pivalat and salicylic acid.

Flumethasonum pivalat is synthetic GKS with moderate anti-inflammatory property. In case of application in the form of ointment has local effect of average intensity. Has lipophilic effect, 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 And ₂ and reduction of release of arachidonic acid from phospholipids of cellular membranes. Suppresses phagocytosis, release of the interleukins and other cytokines causing inflammatory processes. Suppresses 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.

Salicylic acid in the concentration which is available in medicament possesses weak keratolytic action.

Pharmacokinetics. Flumethasonum pivalat well 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 have systemic action. After penetration through skin medicine is metabolized mainly in a liver, removed with urine and in insignificant quantities with bile in the form of conjugates of glyukoronid and also in not changed look. Absorption of Flumethasonum of the pivalat increases at application 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 on extensive sites of skin. Dermal absorption at persons of young age more intensively, than at people of advanced age.

External use of salicylic acid facilitates pivalat Flumethasonum penetration through the keratosic epidermis.

Indication

Inflammation of skin (without exudation), uncomplicated consecutive bacterial infection, including the allergic nature, followed by a steady itch and a hyperkeratosis: seborrheal dermatitis, atopic dermatitis, nodular urticaria (papular urticaria), allergic contact dermatitis, a multiformny erythema, a tubercular lupus, psoriasis, red flat deprive.

Use

It is intended for topical administration. ointment is applied a thin layer on an affected area of skin in the beginning by 2–3 times a day, and after weakening of the sharp phenomena — 1–2 times a day. putting medicine under an occlusive bandage is allowed. at approach of clinical recovery the treatment is continued within 3–4 days. it is not necessary to carry out continuous therapy it is impossible to apply more than 2 weeks to face skin more than 1 week for a week it is recommended to spend no more than 1 tuba of cream.

At a considerable likhenization or an excessive hyperkeratosis in the field of skin changes allowed application of an occlusive bandage which should be changed each 24–48 h

Contraindication

Hypersensitivity to gks, to salicylic acid or other components of medicine. virus (for example herpetic damages of skin) and fungus diseases of skin, tuberculosis cutis, skin new growths, ordinary and pink eels, perioral and diaper dermatitis, anal itch, inflammation or ulcers of varicose nodes.

on extensive sites of skin, especially at violation of integrity of skin, for example at burns.

Side effects

from skin and hypodermic cellulose: rash, skin peeling, eels, post-steroid purple, oppression of growth of epidermis, atrophy of hypodermic cellulose, xeroderma, burning sensation, irritation, itch, overgrowth of hair on a body or alopecia, decolouration or hyperpegmentation of skin, atrophy and violations of integrity of skin, teleangiectasia, contact and 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.

from a cardiovascular system: AG.

from an endocrine system: a glucosuria, a hyperglycemia, dysfunction gipotalamo - a hypophysial and adrenal system, Cushing's syndrome, oppression of growth and development in children.

Others: use of ointment under an occlusive bandage, considering the increased absorption, can entail systemic action which is shown in the form of hypostases, AG, hypersensitivity to infections.

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Special instructions

should not use continuously medicament more than 2 weeks at long therapy on extensive sites of skin the frequency of development of side effects increases.

Use of medicine should be stopped immediately if its use leads to painful feelings or allergic reactions (an itch, burning or erubescence). During external use of Flumethasonum of the pivalat, discharge AKTG hypophysis owing to oppression of hypophysial and adrenal communication can decrease, raise the level of cortisol of blood and appear an iatrogenic syndrome of Cushing which passes after the treatment termination. During therapy carry out periodic control of function of adrenal glands by determination of level of cortisol in blood and urine after stimulation of adrenal glands of AKTG. In case of infectious process on the place of use of ointment it is necessary to appoint antibacterial or antifungal therapy. If infectious process does not regress, it is necessary to stop use of ointment before elimination of an infection.

Should avoid putting medicine 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 strengthening of symptoms of a disease. It is necessary to avoid contact of medicine 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 application is possible.

should limit Use of ointment under an occlusive bandage to exceptional cases in connection with a possibility of emergence of an atrophy and defects of epidermis, superinfection. It is necessary to 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 medicine sharply.

with care to 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.

Drug contains propylene glycol and lanolin which can cause irritation of skin and local skin reactions (for example contact dermatitis).

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

Ointment Lorindenm And can be applied at women during pregnancy only quickly, on small sites of skin and only if, according to the doctor, the advantage exceeds possible risk. Drug is not used in the I trimester of pregnancy.

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

Children. Drug is not appointed to children aged up to 12 years. At children 12 years ointment are aged more senior apply in some cases and on small sites of skin. It is not necessary to apply medicine to face skin.

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 to steer vehicles or other mechanisms.

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

Interaction

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

Only at prolonged use of ointment on extensive sites of skin in response to absorption of a significant amount of salicylic acid notes increase in action of a methotrexate and oral gipoglikemiziruyushchy medicines (sulphonylurea derivatives). Lorindenm And can strengthen action of immunosuppressive and suppress effect of the immunostimulating medicines.

At prolonged use of medicine on extensive sites of skin the development of symptoms of overdose which are shown by strengthening of side effects (hypostases, burning sensation, irritations, an itch, ag, a hyperglycemia, decrease in resistance to infections, dysfunction gipotalamo - a hypophysial and adrenal system, suppression of growth and development in children), 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 application gks weak action. there can seldom be symptoms of poisoning with salicylates: a headache, dizziness, a ring in ears, it is extremely rare — violation of indicators of box, decrease in visual acuity. symptomatic therapy.

Storage conditions

At a temperature not above 25 °C.