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Active ingredients
Hydrocortisone
Release form
Cream
Composition
1 g kremel contains: Active substance: hydrocortisone butyrate 1 mg. Auxiliary substances: cetostearyl alcohol 72 mg, macrogol 25 cetostearyl ether 18 mg, liquid paraffin 60 mg, soft white paraffin 150 mg, propyl parahydroxybenzoate 1 mg, butyl parahydroxybenzoate, 0.5 mg, propyl parahydroxybenzoate 0.5 mg, butyl parahydroxybenzoate 0.5 mg, 500 mg 4.2 mg, sodium citrate anhydrous 2.8 mg, purified water to 1 g.
Pharmacological effect
Locoid is a synthetic non-halogenated glucocorticosteroids for external use. Esterification of a hydrocortisone molecule with a residue of butyric acid (butyrate) allowed a radical increase in the activity of the drug compared to native hydrocortisone. Locoid has a rapidly advancing anti-inflammatory, anti-edema, antipruritic effect. The use of Locoid in recommended doses does not cause suppression of the hypothalamic-pituitary-adrenal system. Although the use of large doses of the drug for a long time, especially when using occlusive dressings, can lead to an increase in plasma cortisol, it is usually not accompanied by a decrease in the reactivity of the pituitary-adrenal system, and withdrawal of the drug leads to a rapid normalization of cortisol production.
Pharmacokinetics
AbsorptionAfter application, the active substance accumulates in the epidermis, mainly in the granular layer, systemic absorption is negligible. A small amount of hydrocortisone 17-butyrate is absorbed into the systemic circulation unchanged. Metabolism Most hydrocortisone of 17-butyrate is metabolized to hydrocortisone and other metabolites directly in the epidermis and subsequently in the liver.
Indications
Surface, uninfected, sensitive to local glucocorticosteroids skin diseases: dermatitis, including atopic, contact, seborrheic, eczema, psoriasis.
Contraindications
hypersensitivity to hydrocortisone or auxiliary components of the drug; bacterial infections of the skin (strepto-and staphyloderma, gram-negative folliculitis, etc.); viral infections of the skin (herpes simplex,chickenpox, herpes zoster, etc.); fungal infections of the skin; tuberculosis and syphilitic skin lesions; parasitic infections of the skin; neoplastic skin changes (benign and malignant tumors); acne, rosacea, perioral dermatitis; post-vaccination period, violation of the integrity of the skin (wounds, ulcers) .With caution: pregnancy, lactation.
Precautionary measures
Do not exceed recommended doses.
Use during pregnancy and lactation
Use with caution during pregnancy, during lactation. Glucocorticosteroids penetrate the placenta. Impact on the fetus can be particularly pronounced when applying the drug on large surfaces. No data on the amount of hydrocortisone excreted in breast milk; It is recommended to take special care when prescribing the drug during lactation.
Dosage and administration
External. Lokoid cream is preferably used for acute and sub-acute skin processes (without soak). The preparation is applied to the affected skin with a thin layer 1-3 times a day. To improve the penetration of the drug is applied with light massaging movements. With the appearance of positive dynamics, the frequency of use of the drug can be reduced to 2-3 times a week. The dose of the drug used during the week should not exceed 30-60 g.
Side effects
Local reactions: skin irritation, in rare cases - other local reactions characteristic of external steroid therapy. Systemic reactions: with prolonged use, application to large surfaces and / or the use of occlusion, side effects characteristic of systemic glucocorticosteroids can be observed. The risk of local and systemic side effects when using Locoid is lower than when using fluorinated steroids.
Overdose
There is no data on Lokoid overdose. With prolonged use of the drug in high doses, it is possible to enhance the side effects described above. When symptoms of hypercortisolism appear, the drug should be withdrawn.
Interaction with other drugs
Data on drug interactions Lokoid not.
special instructions
Lokoid should not be applied to the periorbital area due to the risk of developing glaucoma.With systematic contact with the conjunctiva, there is a risk of an increase in intraocular pressure. If the process is localized on the scalp and exudative inflammation, it is preferable to use Lokoid in the form of Krelo. , dryness is better to give preference to Lokida in the form of ointment or Lipokrem, if necessary - under occlusive dressings. The drug is not desirable and use when the presence of atrophic skin changes. The risk of local and systemic side effects increases when applied to large areas of damage, prolonged use, use of occlusion and in children. In the absence of an effect for 2 weeks of continuous treatment, the diagnosis should be clarified. As with any glucocorticosteroid drug, it is desirable limit the duration of application and the course dose is minimal enough for the relief of the skin process. The effect on the ability to drive and work with mechanisms Data on the influence of Lokoid on the ability to drive vehicles and work with mechanisms do not.