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Active ingredients
Clioquinol + Flumetazon
Release form
Ointment
Composition
Active ingredient: Flumetazon pivalate 0.20 mg, Clioquinol (Jodhloroxiquinoline) 30.0 mg Auxiliary substances: white wax, white petrolatum Concentration of active substance (mg): 30.20 mg
Pharmacological effect
A drug with antibacterial, antifungal, and anti-inflammatory effects for external use. Flumethasone is a synthetic two-fluorinated GCS for external use. It has anti-inflammatory, anti-allergic, antipruritic, anti-edema and vasoconstrictor action. When exposed to the skin, it prevents the regional accumulation of neutrophils, which leads to a decrease in inflammatory exudate and production of lymphokines, inhibition of macrophage migration, reduction of infiltration processes and granulation. Reduces the production of prostaglandins and leukotrienes by inhibiting the activity of phospholipase A2 and reducing the release of arachidic acid from the phospholipids of the cell membrane. It causes a reduction in the basic substance of connective tissue, weakens proliferative and exudative reactions in the skin. It is an inhibitor of cellular kinins with proteolytic activity. Clioquinol (iodochloroxyquinoline) is a derivative of 8-hydroxyquinolines. It is active against dermatophytes, yeast fungi (Microsporum spp., Trichophyton spp., Candida albicans) and gram-positive bacteria (Staphylococcus spp., Enterococcus spp.). Strengthens the anti-exudative effect of flumethasone. As a result of the combined action of flumethasone and clioquinol (iodhloroxiquinoline), the drug suppresses the development of inflammatory and allergic reactions from the skin, complicated by bacterial and fungal infections. exposure to external moisture. Due to the peculiarities of the ointment base, the drug can be used in patients with dry and thin skin.
Pharmacokinetics
Absorption and distribution When applying an ointment to the skin, the active ingredients easily penetrate through the stratum corneum. Flumethasone Pivalate is practically not absorbed into the bloodstream and has no systemic effect.Absorption increases with frequent use of the drug and / or applied to large areas of skin, when applied on the face, in the area of skin folds, on areas of skin with damaged epidermis, as well as when applying an occlusive dressing that increases moisture and local temperature (penetration into the deep layers of the skin approximately 100 times more under the occlusive dressing than with simple application on the affected areas). Absorption of flumethasone pivalate from the skin in children is more pronounced than in adults. Clioquinol when used as azi, may be slightly absorbed through the skin and bind to plasma proteins. Metabolism and elimination of Flumethasone pivalate is practically not metabolized in the skin. After absorption, the drug is mainly metabolized in the liver. It is excreted in the form of metabolites and a small amount in an unchanged form with urine and with bile. Clioquinol partially biotransformed in the liver and excreted with urine.
Indications
allergic dermatosis, complicated by the accession of a bacterial infection caused by sensitive to clioquinol flora: dermatitis (including allergic, contact, professional, seborrheic, solar), eczema; psoriasis (especially old cases), including scalp psoriasis; erythema multiforme; erythroderma; atopic dermatitis (common neurodermatitis); pruritus; fungal infections of the skin, complicated by the development of local allergic reactions: impetigo, infected diaper rash, ringworm, actinomycosis, blastomycosis, sporotrichosis.
Contraindications
Hypersensitivity to the drug. Viral skin diseases (herpes, chickenpox), skin tuberculosis, skin manifestations of syphilis, neoplasms and precancerous skin conditions (skin cancer, nevus, atheroma, epithelioma, melanoma, hemangioma, xanthoma, sarcoma). Acne and rosacea, perioral dermatitis, trophic leg ulcers associated with varicose veins, conditions after vaccination. Skin infections (for occlusive dressings). Do not use the drug in children under 10 years.
Precautionary measures
Do not exceed recommended doses.
Use during pregnancy and lactation
The drug is contraindicated in the first trimester of pregnancy. There were no controlled studies of possible teratogenic effects in the local application of flumetasone and jodhloroxiquinoline during pregnancy, so the drug can only be prescribed when the intended benefit to the mother outweighs the possible risk to the fetus. It is not known to what extent flumethasone and clioquinol excreted in breast milk when applied externally. Special care should be taken when prescribing the drug during lactation (breastfeeding). Application is possible only in exceptional cases, briefly and in limited areas of the skin (can not be applied on the skin of the mammary glands).
Dosage and administration
Outwardly. Ointment is applied with a thin layer on the affected areas. At the beginning of treatment, the drug is used no more than 2-3 times a day, with the appearance of positive dynamics -1-2 times a day. The drug can not be used for more than 2 weeks. If there is a need for a dressing, use an air-tight dressing. In case of excessive lichenisation and hyperkeratosis, the ointment is applied only under an occlusive dressing once every 24-48 hours. Do not use the drug for more than 1 week. If there is no need, do not apply more than 2 g of ointment during the day. In adolescents over 10 years of age, use only in exceptional cases on limited areas of the skin, avoid applying the drug to the skin of the face.
Side effects
Rarely: burning, itching, steroid acne, striae, dry skin, folliculitis. With prolonged use - atrophy of the skin, local hirsutism, telangiectasia, purpura, pigmentation disorders; when applied to large surfaces, systemic manifestations of the glucocorticosteroid are possible.
Overdose
Overdose cases are rarely observed. Symptoms: with improper, frequent or long-term use in large quantities in large areas, systemic side effects of GKS may occur. Treatment: gradual withdrawal of the drug; symptomatic therapy.
Interaction with other drugs
During therapy with Lorinden C, vaccination and immunization should not be carried out due to the immunosuppressive effect of the drug. The drug should not be administered in combination with other drugs for external use. When the drug is absorbed into the systemic circulation, flumetasone decreases the effectiveness of insulin, oral hypoglycemic agents,antihypertensive drugs, anticoagulants, reduces the concentration of salicylates and praziquantel in the serum. When used together, the risk of side effects of androgens, estrogens, oral contraceptives, anabolic steroids (hirsutism, acne) increases; antipsychotic drugs, bucarban, azathioprine (cataract); holinoblokatorov, antihistamine drugs, tricyclic antidepressants, nitrates (glaucoma); diuretics (hypokalemia), cardiac glycosides (digitalis intoxication).
special instructions
It is not recommended to apply the drug on the skin of the face; avoid getting ointment in the eyes. It is not recommended to increase the duration of the course of treatment or apply for a long time on large areas of skin. With prolonged use of the drug on a large surface area of the skin increases the risk of systemic side effects of GCS. When a secondary infection appears at the site of the ointment, use agents with a more pronounced antibacterial or antifungal effect. With caution, you should use the drug for atrophic skin changes, especially in elderly people age. With long-term use, the development of microflora resistance to clioquinol is possible. For fungal diseases with secondary allergies Skim reactions Lorinden C is used in exceptional cases, under medical kontrolem.Vliyanie the ability to drive and control mehanizmamiPreparat not limit psychophysical activity, the ability to drive vehicles and maintenance of moving mechanisms.