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Active ingredients
Hydrocortisone 17-Butyrate
Release form
Ointment
Composition
Ointment for external use 0.1% 1 g - active substance: hydrocortisone 17-butyrate 1 mg, excipients: polyethylene ointment base (vaseline oil 95%, PE 5%)
Pharmacological effect
Pharmacological action - against edematous, antipruritic, local anti-inflammatory.
Pharmacokinetics
Absorption: After 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 17-butyrate is metabolized to hydrocortisone and other metabolites directly in the epidermis and subsequently in the liver. Excretion: Metabolites and a small portion of unchanged hydrocortisone 17-butyrate is excreted by the kidneys and through the intestines.
Indications
Surface uninfected, sensitive to local GCS, 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, chicken pox, shingles, etc.), fungal infections of the skin, tuberculosis and syphilitic skin lesions, parasitic skin infections, neoplastic skin changes (benign and malignant tumors), acne, rosacea, perioral dermatitis, post-vaccination period, violation of the integrity of the skin us, ulcers). With care: pregnancy, lactation.
Precautionary measures
The use of Lokoid requires monitoring by a doctor in the event that it is necessary to apply it to patients younger than 12 years. If the use of a drug causes the patient to begin to aggravate the symptoms of the disease or manifest side effects, then these phenomena require the discontinuation of the use of this drug. It is necessary to apply Lokoid only after consultation with the doctor.In the case when the patient requires long-term treatment with Lokoid, it is necessary to adjust the diet. So the patient should increase the intake of potassium and protein, but the amount of sodium that will be ingested with food should be limited. You should also be careful about the state of blood pressure, be sure to regularly monitor it. In addition, regular blood tests are necessary, special attention is paid to the amount of glucose and cortisol in the patient’s blood, and blood clotting is controlled. Be sure to control the patient's body weight.
Use during pregnancy and lactation
GCS penetrate through 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
Outwardly. Locoid in the form of an ointment is used for subacute and chronic processes, especially in the presence of lichenification, infiltration, dryness. The drug is applied to the affected skin with a thin layer 1-3 times a day. With the appearance of positive dynamics, the frequency of use of the drug can be reduced to 2-3 times a week. To improve the penetration of the drug is applied with massaging movements. In cases of resistant disease, for example, when localized psoriatic plaques are located on the elbow areas, knees, the drug can be used under occlusive dressings. The dose of the drug used during the week should not exceed 30-60 g.
Side effects
Local reactions: irritation of the skin, in rare cases, other local reactions characteristic of local steroid therapy. Systemic reactions: long-term use, application to large surfaces or the use of occlusive dressings may experience side effects characteristic of systemic corticosteroids. 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. Symptoms: with prolonged use of the drug in high doses may increase 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. When systematically hit the conjunctiva, there is a risk of an increase in intraocular pressure. It is undesirable to use any GCS for external use in the form of an ointment on the scalp, as well as in acute inflammation (especially exudative). For the treatment of steroid-sensitive skin lesions localized in the face, folds, genitalia, as well as on skin areas with abundant hair coat, it is preferable to use Lokoid, cream and Lokoid Krelo. The drug is undesirable to use in the presence of atrophic changes in the skin. The risk of local and systemic side effects increases when applied to large areas of damage, prolonged use, use of occlusive dressings and in childhood. If there is no effect for 2 weeks of continuous treatment, the diagnosis should be clarified. As with the use of any corticosteroids, it is desirable to limit the duration of use and the course dose minimum sufficient for the relief of the skin process. Pediatric use: May be used in children from 6 months of age. In cases of use of the drug in children, in the face or under occlusive dressings, the duration of treatment should be reduced. When used in children, the surface area of the skin to which the preparation is applied should not exceed 20% of the total. In childhood, the suppression of the function of the adrenal cortex can develop faster. In addition, there may be a decrease in growth hormone excretion. When using the drug for a long time, you need to monitor body weight, height, plasma cortisol level. In a study of children who received 30–60 g of Lokoid per week for 4 weeks, compared with the use of 1% hydrocortisone ointment, no one child showed any impaired function of the adrenal cortex, i.e. this indicator from normal hydrocortisone was not observed.Influence on the ability to drive vehicles and work with mechanismsData on the influence of Locoid on the ability to drive vehicles and work with mechanisms no