Pharmacological properties: a combined systemic effects of decongestants, applied in the pathology of the nasal cavity. Triprolidin is an antagonist of H 1-receptor is used as a means of reducing symptomatic symptoms caused by the release of histamine. Pseudoephedrine - systemically acting decongestants, sympathomimetic, a stimulant α-and β-adrenergic receptors.

The components of the drug rapidly and almost completely absorbed in the digestive tract. The output in the form of metabolites with feces. The half - from 4 to 6 hours

INDICATIONS: Symptomatic treatment of upper respiratory tract, rhinitis, including allergic and vasomotor rhinitis, rhinitis with colds.

USE: Adults and children over the age of 12 years - 10 ml of syrup or 1 tablet 3 times a day, from 6 months to 2 years - on 1.25 ml of syrup 3 times daily, 2-5 years - 2, 5 ml syrup 3 times a day, 6-12 years - 5 ml syrup 3 times a day. Tablets are not recommended to be used in children under the age of 12 years.

CONTRAINDICATIONS: Hypersensitivity to any component of the drug, severe hypertension and coronary artery disease, the application for the last 2 weeks of MAO inhibitors, pregnancy and lactation, age up to 6 months.

SIDE EFFECTS: drowsiness, sometimes - itching, tachycardia, dry mouth, nose, throat.

Cautions: efficacy and safety of drugs during pregnancy and lactation are not well understood.

Precautions should be considered in patients with diabetes, cardio-vascular diseases, hyperthyroidism, increased intraocular pressure, prostatic hypertrophy, as well as with severe disorders of the liver and kidneys.

INTERACTION: with caution appointed concurrently with antihypertensive drugs, MAO inhibitors, tricyclic antidepressants, sympathomimetic.

OVERDOSE: can manifest mydriasis, tachycardia, AH, cardiac arrhythmia, agitation, hallucinations (usually in children), nausea and vomiting, hypertensive crisis, insomnia, muscle tremors, change in mental status. In case of overdose should support respiration and the cardiovascular system. After the departure should wash out the stomach, activated charcoal to appoint, with the development of seizures - anticonvulsants. Accelerate the elimination of pseudoephedrine can be accelerated by diuresis or dialysis.

Storage: Store in dark place at a temperature of 15-25 ° C


Pharmacological action

Incoming in the drug paracetamol has analgesic, antipyretic and anti-inflammatory effects negligible. The mechanism of action is associated with a moderate inhibition of cyclooxygenase-1 and to a lesser extent COX-2 in peripheral tissues and central nervous system, resulting in the inhibition of prostaglandin biosynthesis modulators of pain sensitivity, thermoregulation and inflammation.

The second component ditsikloverina tertiary amine hydrochloride, which has a relatively weak non-selective M-anticholinergic and direct miotropnym antispasmodic effect on smooth muscles of internal organs. At therapeutic doses, is effective relaxation of smooth muscles, which is not accompanied by side effects typical of atropine.

The combined effect of two components Trigano-D provides a relaxation spasm of smooth muscles of internal organs and reducing pain.


The drug is well absorbed in the gastrointestinal tract. C max plasma levels achieved after 60-90 min. V d - 3.65 L / kg. Paracetamol is metabolized in the liver with the formation of several metabolites, one of which is N-acetyl-benzohinomin under certain conditions (an overdose of medication, lack of glutathione in the liver) could have a damaging effect on the liver and kidneys. About 80% of the drug excreted in the urine and in small numbers in the faeces.

Indications for use of the drug Trigano-D

- Spasm of smooth muscles of internal organs;

L - intestinal, hepatic and renal colic;

- Algomenorrhea;

- Headache, toothache, migraine headache;

- Neuralgia;

- Myalgia;

- Infectious and inflammatory diseases accompanied by fever.

Dosage regimen

Used inside adults and children over 15 years: 1 tablet 2-3 The maximum single dose for adults is 2 tablets, 4 tablets daily. The duration of intake without consulting a physician not more than 5 days when administered as an analgesic and 3 days - as a febrifuge. Prolonged use of the drug is necessary to monitor patterns of peripheral blood and functional state of the liver.

Do not exceed the daily dose, increasing it or more prolonged treatment is possible only under medical supervision, because overdose of the drug can cause liver failure.

Side effect

On the part of the gastrointestinal tract: dry mouth, loss of taste, loss of appetite, epigastric pain, constipation, increased liver enzymes, usually without the development of jaundice, gepatonekroz (dose-dependent effect).

Allergic reactions: skin rash, itching, urticaria, Quincke's edema, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

Quired for central nervous system (usually develops when taking high doses): drowsiness, dizziness, psychomotor agitation, and disorientation.

From the Endocrine: hypoglycemia, up to hypoglycemic coma.

From the side of blood: anemia, methemoglobinemia (cyanosis, shortness of breath, pain in the heart), hemolytic anemia (especially for patients with deficiency of gluco-6-phosphate dehydrogenase).

On the part of the genitourinary system: Piura, urinary retention, interstitial nephritis, papillary necrosis.

From the side of view: mydriasis, blurred vision, cycloplegia, increased vnetriglaznogo Dahlen.

- Reduction of potency.

Contraindications to the use of the drug Trigano-D

- Hypersensitivity to paracetamol and ditsikloverinu;

- Obstructive bowel disease;

- Peptic ulcer and 12 duodenal ulcer (acute phase);

- Reflux esophagitis;

- Hypovolemic shock;

- Myasthenia gravis;

- Pregnancy

- Lactation;

- Children age (up to 15 years).

Precautions should be used in patients with severe disorders of the liver or kidneys, if the genetic absence of glucose-6-phosphate dehydrogenase, blood diseases, glaucoma, benign hyperbilirubinemia (including Gilbert's syndrome), viral hepatitis, alcoholic liver damage, alcoholism, old age .

Use of the drug Trigano-D during pregnancy and breastfeeding

The drug is contraindicated during pregnancy and lactation.

Application for violations of liver function

Precautions should be used in patients with severe disturbances of liver function.

An overdose of the drug can cause liver failure.

Application for violations of renal function

Precautions should be used in patients with severe impaired renal function.


With caution and under medical supervision should priment drug in patients with impaired liver function or kidney disease, in conjunction with other anti-inflammatory and painkiller, as well as anticoagulants and drugs affecting the central nervous system. When you receive metoclopramide, domperidone, or kolestiramina also need to consult with your doctor.

Paracetamol distorts performance laboratory for the quantitative determination of the content of uric acid and glucose in plasma.

To prevent toxic liver damage paracetamol should not be combined with the reception of alcoholic beverages, and to take individuals who are prone to chronic alcohol consumption. The risk of liver damage increases in patients with alcoholic hepatosis.

Effects on ability to drive vehicles and management mechanisms:

In applying the drug should avoid potentially hazardous activities, tebuyuschih increased concentration and speed of psychomotor reactions (management of vehicles, etc.)

During prolonged treatment is necessary to monitor patterns of peripheral blood and liver functional state.


Symptoms: tachycardia, tachypnea, fever, agitation, convulsions, epigastric pain, decreased appetite, anemia, thrombocytopenia, hemolytic anemia, aplastic anemia, methemoglobinemia, pancytopenia, nephrotoxicity (papillary necrosis), gepatonekroz.

Treatment: stop taking the drug, do gastric lavage, appoint adsorbents introduce tools that increase the formation of glutathione (acetylcysteine intravenously) and strengthening the conjugation reaction (methionine inside).

Drug Interactions

The action intensifies ditsikloverina amantadine, antiarrhythmic drugs I-Class, antipsychotic means, benzodiazepines, MAO inhibitors, narcotic analgesics, nitrates and nitrites, sympathomimetic drugs, tricyclic antidepressants.

Ditsikloverin increases the concentration of dioxin in the blood (due to slow gastric emptying).

Stimulants microsomal oxidation in the liver (fenitoin. ethanol, barbiturates, rifampicin, fenilbutazon, tricyclic antidepressants) increase the production of hydroxylated active metabolites, which leads to the possibility of severe intoxication with small overdoses of paracetamol. Adrenostimulyatorov, as well as other preparatys anticholinergic effect of increasing the risk of side effects. Mikerosomalnogo oxidation inhibitors (cimetidine) decrease the risk of hepatotoxic action.

Reduces the effectiveness of urikoziricheskih drugs.

Paracetamol increases the effectiveness of indirect anticoagulants.

To the top

The drug is approved for use as a non-prescription medicines.

Terms and Conditions of storage

List B. In dry place, protected from light and away from children at or above 25 ° C.

Shelf life 3 years. Do not use after the time specified on the package.


Pharmacological action

Antiparkinsonian agent. Has a strong central anticholinergic effects of n-and m-peripheral anticholinergic effect. The central action helps to reduce or eliminate the motor disorders associated with extrapyramidal disorders.

In Parkinson's disease reduces the tremor, to a lesser extent, affects the rigidity and bradykinesia.

Has antispasmodic effect, which is associated with anticholinergic activity and direct miotropnym action.


Parkinsonism (idiopathic, postentsefalitny, atherosclerotic, due to side effects of drugs, as monotherapy and in combination with levodopa), Parkinson's disease, Little, spastic paralysis, associated with lesions of the extrapyramidal system.

Dosage regimen

Set individually. The initial dose is 0.5-1 mg / day. Then, if necessary, every 3-5 days, gradually increase the dose of 1-2 mg to achieve an optimal therapeutic effect, the multiplicity of reception - 3-5 times / day.

When hyperptyalism before treatment Trihexyphenidyl should be taken after meals. With the development in the treatment of dryness of the oral mucosa Trihexyphenidyl appointed before eating (if no nausea).

Maximum dose: when administered a single dose - 10 mg daily - 20 mg.

Side effect

From the CNS: headache, irritability, delirium, hallucinations, mental disorientation (especially in patients with atherosclerosis).

Effects due to the anticholinergic activity: dryness of the oral mucosa, blurred vision, increased intraocular pressure, constipation, difficulty urinating, tachycardia.

Allergic reactions: skin rash.

Other: purulent parotitis (due to xerostomia).


Urinary retention, prostate adenoma, glaucoma, atrial fibrillation, obstructive diseases of the digestive tract, pregnancy.

Application of pregnancy and breastfeeding

Trihexyphenidyl is contraindicated in pregnancy.


Precautions are used for diseases of the heart, kidney or liver disease, arterial hypertension. Patients aged 60 years dosage Trihexyphenidyl exercise extreme caution because of the high likelihood of hypersensitivity reactions.

During treatment should regularly monitor the intraocular pressure.

Prolonged treatment of the intensity of adverse reactions caused by anticholinergic activity Trihexyphenidyl, usually decreases, possibly the development of drug dependence.

With simultaneous use of Trihexyphenidyl with levodopa dosing regimen required correction.

Effects on ability to drive vehicles and management mechanisms

During the period of Trihexyphenidyl is not recommended to engage in activities that require a high concentration of attention and quickness of psychomotor reactions.

Drug Interactions

With simultaneous use of agents possessing anticholinergic effects, may enhance their anticholinergic effect.

When applied simultaneously with levodopa decreases absorption and C max of levodopa in blood plasma.

When applied simultaneously with reserpine antiparkinsonian action Trihexyphenidyl reduced because drained reserves of catecholamines in the CNS. As a result, cholinergic neurons are activated, and the syndrome of parkinsonism increases.

With the simultaneous use may decrease the concentration of chlorpromazine in plasma, related, apparently, in violation of absorption from the gastrointestinal tract.


International name:
Triamtsinolon (Triamcinolone)

Group Affiliation:
Glucocorticosteroids for local use

Description of the active substance (INN):

Dosage form:
cream for external use, ointment for external use

Mode of action:
Fluorinated GCS has a marked anti-inflammatory, antiallergic and antiexudative action. Interacting with a specific protein receptor in target-tissues, regulates the expression of genes kortikoidzavisimyh and thus the effect protein synthesis. Reduces the formation, release and activity of inflammatory mediators (histamine, kinins, Pg, lysosomal enzymes). Suppresses migration of cells to the site of inflammation, reduces vasodilation and increased vascular permeability in inflammation. Stabilizes lysosomal enzymes membranes of leukocytes, inhibits the synthesis of antibodies and violates the recognition of antigen. Hinders release interleykina1, interleykina2, interferon gamma from lymphocytes and macrophages. Induces the formation of lipokortina, inhibits the release of inflammatory mediators and eosinophils stabilizes the membrane of mast cells. All these effects are involved in suppressing the inflammatory response in tissues in response to mechanical, chemical, or immune injury.

Simple and allergic dermatitis, eczema, atopic dermatitis, diffuse neurodermatitis, psoriasis, granuloma annulare, lichen planus, simple chronic lichen (restricted neurodermatitis), toksidermiya, keloid scars, alopecia areata, a complete alopecia, insect bites.

Hypersensitivity, bacterial, viral and fungal skin diseases, pregnancy.

Side effects:
Itching, skin irritation, contact eczema, steroid acne, purpura. Prolonged use - the development of secondary infectious lesions and atrophic changes of the skin.

Dosage and administration:
Skin of: treated with 0.1% cream or ointment, after achieving the therapeutic effect of switching to 0.025% ointment to the gradual lifting 2-3 times a day gently rubbing a small amount of cream or ointment. Ointments with occlusive dressing for lihenifitsirovannyh manifestations. Cream - with weeping and acute inflammatory skin lesions, as well as in places of its transition to the mucosa and in natural folds. The course of treatment - usually 5-10 days, with persistent flow - up to 25 days is not recommended to use more than 4 weeks.

Do not use on large surfaces, avoid prolonged use in children regardless of age. For the prevention of local infectious complications may be used in combination with antimicrobial drugs.


International name:
Triamtsinolon (Triamcinolone)

Group Affiliation:

Description of the active substance (INN):

Dosage form:

Mode of action:
GCS, inhibits the release of interleykina1, interleykina2, interferon gamma from lymphocytes and macrophages. Has anti-inflammatory, antiallergic, desensitizing, antishock, anti-toxic and immunosuppressive effect. Absorbs release of pituitary ACTH and beta-lipotropina, but does not reduce the concentration of circulating beta-endorphin. Inhibits the secretion of TSH and FSH. Increase the excitability of the CNS, reduces the number of lymphocytes and eosinophils, increases - erythrocytes (stimulates the production of erythropoietin). Interaction with specific cytoplasmic receptors, forming a complex that penetrates the cell nucleus, and stimulates the synthesis of mRNA, the latter induces the formation of proteins, Including lipokortina, mediating cellular effects. Lipokortin inhibits phospholipase A2, inhibits arachidonic acid and inhibits the synthesis of endoperekisey, Pg, leukotrienes that contribute to inflammation, allergies and other protein metabolism: it reduces the amount of protein in the plasma (due to globulin) with an increase in the coefficient of albumin / globulin, albumin synthesis increases in liver and kidneys, increases catabolism of protein in muscle tissue. Lipid metabolism: increased synthesis of fatty acids and triglycerides, redistributes fat (fat accumulation mainly in the shoulder girdle, face, abdomen), leads to the development of hypercholesterolemia. Carbohydrate metabolism: increases the absorption of carbohydrates from GIT; increases the activity of glucose-6-phosphatase, which leads to an increase of glucose from the liver to blood increases the activity of fosfoenolpiruvatkarboksilazy and synthesis of aminotransferases, resulting in the activation of gluconeogenesis. Water-electrolyte metabolism: retards Na + and water in the body, stimulates the excretion of K + (ISS activity ), reduces the absorption of Ca2 + from the gastrointestinal tract, "washes out" Ca2 + from the bones, increases the excretion of Ca2 + by the kidneys. Antiinflammatory effect associated with inhibition of the release of eosinophils inflammatory mediators, induction, education lipokortina and reduce the number of mast cells that produce hyaluronic acid, a decrease in capillary permeability, stabilization of cell membranes and membrane organelles (especially the lysosomal). antiallergic effect is due to suppression of synthesis and secretion of mediators of allergy, inhibition of release from sensitized mast cells and basophils of histamine and other biologically active substances, reducing the number of circulating basophils, suppress the development of lymphoid and connective tissue, reducing the number of T-and B-lymphocytes, mast cells, reducing the sensitivity of effector cells to the mediators of allergy, inhibition of antibody production, changes in immune response. With COPD action is mainly based on inhibition of inflammatory processes, inhibition of growth or prevention of swelling of mucous membranes, inhibition of eosinophilic infiltration of the submucous layer of bronchial epithelium, deposition in the bronchial mucosa of circulating immune complexes, as well as braking erozirovaniya and desquamation of the mucous membrane. Increases the sensitivity of beta-adrenergic bronchial small-and medium-sized to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of mucus due to suppression or reduction of its products. Antishock and anti-toxic effect associated with elevated blood pressure (by increasing the concentration of circulating catecholamines and recovery of sensitivity to them adrenoceptor, and vasoconstriction), decrease the permeability of the vascular wall, membrano properties, activation of liver enzymes involved in the metabolism of endo-and xenobiotics. immunosuppressive effect is caused by inhibition of the release of cytokines (interleykina1, interleykina2, interferon gamma) from lymphocytes and macrophages. suppresses the synthesis and secretion of ACTH and secondary - the synthesis of endogenous GCS. Hinders connective tissue reaction in the inflammatory process and reduces the possibility of formation of scar tissue. The anti-inflammatory activity triamtsinolon similar to hydrocortisone, triamtsinolona acetonide in 6 times more active. ISS activity is virtually absent. Maximum effect is observed after 1-2 hours, duration - 2.5 days.

Systemic connective tissue disorders (SLE, scleroderma, periarteritis nodosa, dermatomyositis, rheumatoid arthritis). Acute and chronic inflammatory joint diseases: gout and psoriatic arthritis, osteoarthritis (including post-traumatic), polyarthritis, humeroscapular periarthritis, ankylosing spondylitis (Bechterew's disease ), juvenile arthritis, Still syndrome in adults, bursitis, nonspecific peritendinitis, synovitis, and epicondylitis. Rheumatic fever, acute rheumatic heart disease. Bronchial asthma, asthmatic status. Acute and chronic allergic diseases: allergic reactions to drugs and foods, serum sickness, urticaria, Allergic rhinitis, angioedema, drug exanthema, pollinosis. Skin diseases: pemphigus, psoriasis, eczema, atopic dermatitis, diffuse neurodermatitis, contact dermatitis (with the defeat of the large surface of the skin), toksidermiya, seborrheic dermatitis, exfoliative dermatitis, toxic epidermal necrolysis (Lyell's syndrome ), bullous Dermatitis herpetiformis, a malignant exudative erythema multiforme (Stevens-Johnson syndrome). Cerebral edema (also on the background of a brain tumor or associated with surgery, radiotherapy, or head trauma) after a preliminary parenteral use. ocular allergy: allergic corneal ulcer, and allergic forms of conjunctivitis. Inflammatory eye diseases: sympathetic ophthalmia, severe lingering front and rear uveitis, optic neuritis. primary or secondary adrenal insufficiency (including the state after the removal of the adrenal glands). Congenital adrenal hyperplasia. Kidney disease of autoimmune origin (including acute glomerulonephritis), nephrotic syndrome. Subacute thyroiditis. Diseases of blood - agranulocytosis, panmielopatiya, autoimmune hemolytic anemia, acute lymphocytic and myeloid leukemia, venereal disease, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythroblastopenia (erythrocytic anemia) , congenital (erythroid) anemotrophy. Lung diseases: acute alveolitis, pulmonary fibrosis, sarcoidosis II-III century. Tuberculous meningitis, pulmonary tuberculosis, pneumonia, aspiration (in conjunction with specific chemotherapy). Berylliosis syndrome Leffler (not amenable to other therapies) . Lung cancer (in combination with cytotoxic drugs). Multiple sclerosis. gastrointestinal diseases: ulcerative colitis, Crohn's disease, a local enteritis. Hepatitis. Prevention of graft rejection reactions. hypercalcemia on the background of cancer, nausea and vomiting during the cytostatic therapy. Multiple myeloma.

For short-term use according to the life only contraindication is giperchuvstvitelnost.C caution. Parasitic and infectious diseases of viral, fungal or bacterial origin (currently or recently transferred, including the recent contact with a patient) - Herpes simplex, herpes zoster (viremicheskaya phase), chicken pox, measles, amoebiasis, strongyloidiasis (or suspected); system mycosis; active and latent tuberculosis. Application for serious infectious diseases is permissible only against the background of specific therapy. Postvaccination period (the period of duration 8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccination. Immunodeficiency states (including AIDS or HIV infection). Diseases of the digestive tract - stomach ulcer and 12 duodenal ulcer, esophagitis, gastritis, acute or latent peptic ulcer, the newly created anastomosis of the intestine, ulcerative colitis, with the threat of perforation or abscess formation , diverticulitis. Diseases of the SSA, including recent myocardial infarction (in patients with acute and subacute myocardial necrosis may spread the fire, slowing the formation of scar tissue and therefore rupture of the heart muscle), decompensated chronic heart failure, hypertension, hyperlipidemia). Endocrine disease - diabetes mellitus (including breach of tolerance to carbohydrates), hyperthyroidism, hypothyroidism, pituitary Cushing's. Severe chronic renal and / or liver failure, nefrourolitiaz. Hypoalbuminaemia and conditions that predispose to its occurrence. Systemic osteoporosis, myasthenia gravis, acute psychosis, obesity (III-IV century .), polio (except bulbar form of encephalitis), open-and-closure glaucoma, pregnancy, lactation.

Side effects:
The frequency and severity of side effects depend on the duration of application, size of the dosage used and the possibility of preserving the circadian rhythm of destination. On the part of the endocrine system: reduction of glucose tolerance, "steroid" diabetes or a manifestation of latent diabetes mellitus, adrenal suppression, Cushing's syndrome Itsenko- (moon face, obesity, pituitary type, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis, striae), delay sexual development in children. On the part of the digestive system: nausea, vomiting, pancreatitis, "steroid" stomach ulcers and 12 duodenal ulcer, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. In rare cases - increased activity of "liver" transaminase and alkaline phosphatase. On the part of the SSA: arrhythmia, bradycardia (down to heart failure), development (in predisposed patients) or increased severity of CHF, ECG changes typical of hypokalemia, increased blood pressure, hypercoagulation , thrombosis. In patients with acute and subacute myocardial infarction - the spread foci of necrosis, slowing the formation of scar tissue that can lead to rupture of the heart muscle. The nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor cerebellum, headache, convulsions. On the part of the sense organs: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, the propensity to develop secondary bacterial, fungal or viral eye infection trophic changes of the cornea, exophthalmos. On the part of metabolism: increased excretion of Ca2 +, hypocalcemia, increased body weight, negative nitrogen balance (an increased breakdown of proteins), increased sweating. The resulting ISS activity - fluid retention, and Na + (peripheral edema), hypernatremia, gipokaliemichesky syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness, and fatigue). From the musculoskeletal system: slowing growth and ossification in children (premature closure of epiphyseal growth zones), osteoporosis (very rare - pathological fractures, aseptic necrosis of the head humerus and femur), muscle tendon rupture, "steroid" myopathy, reduced muscle mass (atrophy). On the part of the skin and mucous membranes: delayed wound healing, petechiae, ecchymosis, skin thinning, hyper-or hypopigmentation, steroid acne, striae , the propensity to develop pyoderma and candidiasis. Allergic reactions: generalized (skin rash, itching, anaphylactic shock), local allergic reactions. Other: development or exacerbation of infection (the appearance of this side effect contribute jointly used immunosuppressants, and vaccination), Pyuria, syndrome cancel . Overdosage. Symptoms: Cushing's syndrome Itsenko-, hyperglycemia, Glycosuria. Treatment: symptomatic on the background of gradual abolition.

Dosage and administration:
Inside, after eating: initial dose - 4-40 mg / day for 2-3 reception, after the improvement of the daily dose is gradually reduced by 1-2 mg every 2-3 days to reach a minimum maintenance dose (1 mg) or completely abolished. Adults and teenagers (aged 12 years) with adrenal insufficiency - 4-12 mg once (morning) or in 2 divided doses (morning and lunch). In Hodgkin's disease, lymphosarcoma, chronic leukemia initial dose - 30-60-75 mg / day. Children from 6 to 12 years in case of insufficiency of the adrenal cortex - 0.117 mg / kg in the morning or in 2 divided doses, and in other cases - 0.416-1.7 mg / kg. Children weighing up to 25 kg - 0.1-0.5 mg / kg / day in 1 or more receptions. The maximum daily dose - 12-14 mg.

Oral use of doses exceeding 4 mg / day, suppression of the hypothalamic-pituitary system may develop in 6-12 weeks. Gradually remove the drug spend. Do not apply within 8 weeks prior to vaccination, and within 2 weeks after their implementation. In order to prevent failure of the adrenal cortex after treatment with corticotropin appointed within a few days. During the period of treatment is recommended to take vitamin D supplements and eat foods rich in Ca2 +. The children in the period of growth GCS should be used only if absolutely indicated and under very close supervision of a doctor.

Triamtsinolon pharmaceutical incompatible with other drugs (can form insoluble compounds). Triamtsinolon increases the toxicity of cardiac glycosides (because of the emerging hypokalemia increases the risk of arrhythmias). Accelerates Launch ACK, reduces its concentration in the blood (if you cancel triamtsinolona concentration of salicylates in the blood increases increases the risk of side effects). If applied simultaneously with live vaccines and antiviral against a background of other types of immunization increases the risk of virus activation and development of infections. Increases the metabolism of isoniazid, meksiletina (especially in "fast atsetilyatorov"), which leads to a decrease in their plasma concentrations . increases the risk of hepatotoxic reactions of paracetamol (induction of "liver" enzymes and formation of a toxic metabolite of paracetamol). Increases (with prolonged therapy) the concentration of folic acid. Hypokalemia caused by SCS, may increase the severity and duration of muscle blockade against the background of muscle relaxants. In high doses reduces the effect somatropina. Antacids reduce the absorption of the SCS. Triamtsinolon reduces hypoglycemic effect of drugs; enhances anticoagulant effect of coumarin derivatives. weakens the influence of vitamin D on the absorption of Ca2 + in the lumen of the intestine. Ergocalciferol and parathyroid hormone hinder the development of osteopathy caused by SCS. Reduces the concentration of praziquantel in blood. Ciclosporin (inhibits metabolism) and ketoconazole (lowers the ride height) increases the toxicity. Thiazide diuretics, inhibitors of carbonic anhydrase, etc. SCS and amphotericin B increase the risk of hypokalemia, Na +-containing HP - swelling and increase blood pressure. NSAIDS and ethanol increases the risk of gastrointestinal ulcerations and bleeding, in combination with NSAIDs to treat arthritis may reduce the dose of GCS due to summation of the therapeutic effect. indomethacin, displacing triamtsinolon from its association with albumin, increases the risk of its side effects. Amphotericin B and carbonic anhydrase inhibitors increase the risk of osteoporosis. The therapeutic effect of SCS is reduced under the influence of phenytoin, barbiturates, ephedrine, theophylline, rifampicin and other inducers, hepatic, microsomal enzymes (increased metabolic rate). Mitotan inhibitors and other functions adrenal cortex may necessitate increasing the dose of GCS. Clearence GCS rises against a background of drugs - thyroid hormones. Immunodepresanty increase the risk of infection and lymphoma or other lymphoproliferative disorders associated with Epstein-Barr virus. estrogens (including oral contraceptives estrogensoderzhaschie) reduce the clearance of GCS , extend T1 / 2 and their therapeutic and toxic effects. The appearance of hirsutism and acne promotes the simultaneous use of other steroid hormone drugs - androgens, estrogens, anabolic steroids, oral contraceptives. Tricyclic antidepressants may increase the severity of depression caused by GCS (not shown for the treatment of data side effects). The risk of developing cataracts increases with the application in the background, etc. SCS, antipsychotic drugs (neuroleptics), karbutamida and azathioprine. Simultaneous with the appointment of m-holinoblokatorami (including antihistamine drugs, tricyclic antidepressants), nitrates contribute to the development of increased intraocular pressure.


Pharmacological properties: anti-inflammatory and antiallergic, antibacterial, antifungal.

Betamethasone has anti-inflammatory and antiallergic and antipruritic effect. Hinders the accumulation of leukocytes, release of lysosomal enzymes and proinflammatory mediators in inflammation, inhibits phagocytosis, reduces vascular tissue permeability, prevents the formation of inflammatory edema.

Clotrimazole has antifungal action as a result of violations of synthesis of ergosterol, an integral part of the cell membrane of fungi. Active against: Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, Candida albicans, Malassezia furfur (Pityrosporum orbiculare).

Gentamicin - broad spectrum antibiotic of aminoglycoside, has a bactericidal action against Gram-negative bacteria: Pseudomonas aeruginosa, Aerobacter aerogenes, Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae; gram-positive bacteria: Streptococcus spp., Staphylococcus aureus.

For cutaneous use of the drug in dosage transdermal absorption of active substances in the blood is very low. The use of occlusive dressings increases the transdermal absorption of betamethasone and gentamicin, which can lead to increased risk of systemic side effects.

INDICATIONS: dermatitis, complicated by secondary bacterial and / or fungal infection, epidermofitiya stop, dermatomycoses caused by sensitive to clotrimazole mushrooms.

APPLICATION: cream applied topically. Dose was set individually, because it depends on the area of the affected area. The cream should be applied to the affected skin with a thin layer 2 times a day (morning and evening), gently rubbing the skin, after reaching a clinical improvement rate of the drug can be reduced to 1 times per day. To increase the effectiveness of treatment can be applied occlusive dressings. Duration Treatment is determined by the abolishment of the inflammatory process and negative data of bacterial and / or mycological analysis, end-of itching, peeling skin, duration of treatment depends on the type and severity of the disease, the effectiveness and sensitivity to therapy, determined by a physician and is usually less than 2-4 weeks ; between repeated courses must wait at least 20 days. The course of treatment in children and patients with damage to a person shall not exceed 5 days.

Children aged 7-16 years, a drug prescribed only strictly according to strict indications and under the supervision of a doctor. Children are not encouraged to use the drug in large areas of the body, as well as the use of occlusive dressings.

CONTRAINDICATIONS: primary viral skin infections, tuberculosis, skin, cutaneous manifestations of syphilis, skin reactions after vaccination, acne, increased sensitivity to the drug's components, the age of 7 years, during pregnancy and lactation.

SIDE EFFECTS: The drug is generally well tolerated, with proper application of the side effects are rare, but may be burning sensation, irritation, hyperemia, erythema, itching, dryness, peeling, pigmentation disorders, maceration, skin atrophy, striae, hypertrichosis, folliculitis, miliaria, urticaria , acne, perioral dermatitis. In the application of occlusive dressings is most likely the appearance of maceration of the skin, striae and miliaria. Prolonged use of possible systemic side effects (depression of function of the adrenal cortex).

Cautions: should not be allowed contact with the drug in the eyes, on broken skin and open wound sites. Do not put the cream on the skin around the eyes. In order to improve the effectiveness of therapy may use occlusive dressings, but please keep in mind that there is increased transdermal absorption of betamethasone and gentamicin, leading to an increased risk of systemic side effects. Systemic absorption of betamethasone increases when applying the cream for a long time, when applied to large body surface, as well as children.

When a resistant bacterial or fungal microflora should stop using the product and assign the appropriate therapy. Perhaps the development of cross-resistance to aminoglycoside antibiotics.

INTERACTION: data on drug interactions with other drugs in its local application are not available.

OVERDOSE: Excessive and prolonged use of the drug over a large surface of the skin may lead to the manifestation of systemic effects inherent in the SCS, in particular the oppression of the hypothalamic-pituitary-adrenal system to the development of secondary adrenal insufficiency and Cushing's symptoms (weight gain, edema formation, AH Glycosuria, hypokalaemia), including Itsenko syndrome - Cushing's (especially children). Children in overdose than it is possible to decrease the creation of growth hormone, increased intracranial pressure.

Treatment: symptomatic therapy, if necessary, carry out correction of electrolyte balance. It is recommended that the phasing out of the drug.

Storage conditions: at a temperature of 15-25 ° C. Do not freeze.


Pharmacological action

The combined three-phase preparation for hormone replacement therapy in peri-and postmenopausal women. Estradiol eliminates symptoms caused by lack of endogenous estrogen. Norethisterone prevents over-stimulation of the endometrium due to the action of estrogen.

Estradiol is identical to the endogenous estradiol, produced ovaries. It reduces or eliminates the early symptoms of estrogen deficiency causes a moderate proliferation of the endometrium and enhances trophism urinary organs. Plays an important role in the development of the bone tissue, prevents or reduces the decrease of bone mineral component, prevents the development of osteoporosis. Influencing the hypothalamic-pituitary system, eliminates the vegetative-vascular and psycho-emotional disorders.

The synthetic progestin - norethisterone, like progesterone serves to reduce the increased stimulation and proliferation of the endometrium, arising under the influence of estrogen.

While receiving a pink tablets or the end of the reception of white tablets of the drug occurs menstrualnopodobnoe bleeding due to cancellation of gestagen component.

The drug is not Triaklim contraceptives.



Absorption and distribution

Once inside quickly and completely absorbed. Estradiol is almost entirely associated with plasma proteins, mainly binding globulin sex hormone, and to a lesser extent to albumin.

Metabolism and excretion

Under the "first passage" through the liver biotransformiruetsya to less active metabolites: estrone and estriol. Estrone and estriol are allocated bile in the lumen of the small intestine, where the re-absorbed. Total loss of activity occurs as a result of oxidation in the liver.

Write mainly in the urine in the form of biotransformation products (sulfate and glucuronide) and partly in an unchanged form.


Absorption and distribution

Rapidly and almost completely absorbed from the gastrointestinal tract. C max in plasma is achieved in the range 1-3 h.

Metabolism and excretion

Biotransformiruetsya in the liver. T 1 / 2 varies between 5-12 h, on average 7.6 h. Approximately 60% of the dose released in the form of metabolites in the urine and a small amount - with the feces.


-Hormone replacement therapy in menopause to reduce symptoms associated with estrogen deficiency (vasomotor lability, atrophy of urogenital organs);

Prophylaxis postmenopauznogo osteoporosis at an increased risk of its development.

Dosage regimen

Assign 1 pi. / day every day.

In the final cessation of menses or rare and sporadic menses (2-4 monthly intervals) treatment can be started any day.

When a saved menstrual cycles of the first pills start with 5 days of menstrual cycle.

Acceptance of the drug should start with light gray tablets, then go to the reception of white tablets, then - to receive the pink tablets. Therapy is carried out without interruption. Typically, during the reception pink tablets containing a low dose of estrogen, cyclic come menstrualnopodobnye bleeding. Occasionally they may appear earlier in the last days of submission of white tablets.

For the prevention of osteoporosis treatment should be started after the onset of menopause as early as possible in the first 2-3 years.

Tablets should be taken by mouth, without chewing and drinking a small amount of liquid.

The drug is not prescribed for children and men.

Side effect

On the part of the urogenital system: in the first months of treatment - mazhuschie or intermenstrual breakthrough bleeding, change in the nature of menstruation, dysmenorrhea, symptoms such as premenstrual syndrome, enlargement of uterine fibroids, the change of cervical erosion and the degree of cervical secretion after 3 months of treatment - amenorrhea, changes in libido.

On the part of the endocrine system: in the first months of treatment - the voltage and / or an increase in mammary glands release secretions from the mammary glands.

On the part of the digestive system: in the first months of treatment - nausea, vomiting, abdominal cramping, bloating, cholestatic jaundice.

Dermatological reactions: chloasma or melazma, erythema multiforme, nodular erythema, hemorrhagic rash, hirsutism, and after 3 months of treatment - alopecia, skin rash, itching.

From the central nervous system: in the first months of treatment - headaches, migraines, dizziness, depression, chorea.

On the part of the organ of vision: after 3 months of treatment - in vision.

Since the cardiovascular system: in the first months of treatment - swelling, after 3 months of treatment - thrombosis, thromboembolism, increased blood pressure.

Miscellaneous: Increase or decrease in body weight, decrease glucose tolerance, worsening trends porphyria, cramping calf muscles.


, Pregnancy (including estimated);

-Lactation (breastfeeding);

-Acute and chronic liver disease, liver disease, or transferred, after which the indices of liver function is not normalized, hepatic impairment;

-Hepatic tumors (hemangioma, liver cancer);

-Thromboembolic disease (including history);

Disturbances of cerebral blood flow (ischemic or hemorrhagic stroke);

-Retinopathy, angiopathy;

-Malignant tumor of the breast or endometrium (including the assumed or history);

-Estrogenozavisimaya swelling (including swelling of the genitals), or suspicion thereof;

, Fibroadenoma of the breast;


-Idiopathic jaundice or itching during a previous pregnancy;

-Genital herpes (including history);

-Bleeding from the genital tract of unknown origin;

-Severe disease (CHD, atherosclerosis, heart disease, myocarditis);

-Severe kidney disease;

-Hypersensitivity to any component of the drug.

Application of pregnancy and breastfeeding

Use of the drug is contraindicated in pregnancy or suspected it, and during lactation.

Application for violations of liver function

Contraindicated in acute and chronic liver disease or illness the liver, after which the indicators of liver function is not normalized, as well as in liver failure.

Application for violations of renal function

With extreme caution should be prescribed the drug for kidney.


With extreme caution should be prescribed the drug for asthma, diabetes, migraine, heart failure, liver and gall bladder, epilepsy, hypertension, depression, ulcerative colitis, uterine cancer, fibrocystic mastopathy, varicose veins, kidney disease, tuberculosis , porphyria.

Before using the product should have a general medical examination (blood pressure, the state of the mammary glands, abdominal and pelvic), and gynecological examination to exclude endometrial hyperplasia. With long-term treatment should be carried out gynecological examination every 6 months (analysis of Pap smear of the cervix and the study of mammary glands), in addition, patients should be trained in self-breast examination. If necessary, conduct regular mammograms.

Requires regular monitoring of liver function, blood pressure, urine tests, blood lipid levels.

Acceptance of the drug should be stopped immediately if symptoms phlebitis, deep vein thrombosis, thromboembolic disease, with a significant increase in blood pressure, with the appearance of jaundice, when detecting liver tumors, with the appearance migrenepodobnyh headaches for the first time, the sudden visual impairment, with prolonged immobilization, with the increase of attacks epilepsy in pregnancy.

Prolonged monotherapy with oestrogens (over 1 year) increases the risk of hyperplasia and endometrial cancer. The combination of estrogen with gestagens reduces this risk. When during the reception Triaklima irregular bleeding from the genital tract should be carried out histological examination of endometrial smear. If intermenstrual bleeding lasts longer than 3 months or appeared for the first time after several months of drug treatment, should be diagnostic curettage to exclude malignant tumors of the uterus.

Long-term estrogen therapy is associated with some increased risk of breast cancer to women in menopause. If the duration of treatment of about 5 years or more should consider carefully the risk to the expected beneficial effect. Precautions should be prescribed the drug to women with knotted or fibrocystic mastopathy, including history. The state of the mammary glands in this case is subject to strict controls, including regular mammograms.

In the course of hormone replacement therapy for some diseases may deteriorate. Therefore, patients with otosclerosis, multiple sclerosis, systemic lupus erythematosus, porphyria, melanoma, epilepsy, migraine or asthma should regularly and thoroughly examination. In addition, under the influence of estrogen therapy may increase in the size of the available uterine fibroids with a subsequent worsening of symptoms of endometriosis.

Should closely monitor the status of patients with cardiovascular disease or renal dysfunction, because the drug contributes to water retention and sodium in the body. Patients with hypertension should routinely monitor blood pressure.

In the initial period of taking the medication a patient with diabetes requires careful monitoring because of possible reduction in glucose tolerance.

When you receive Triaklima increases the risk of gallbladder disease.

During the course of Triaklima may be distorted by the results of some laboratory parameters: the function of the liver, kidney, adrenal gland, thyroid gland.

Acceptance of the drug should be discontinued for 6 weeks before the planned surgery to prevent thrombosis.


Symptoms: nausea, vomiting, breast tenderness or excessive formation of cervical mucus.

Treatment: No specific antidote, if necessary, carry symptomatically.

Drug Interactions

Effectiveness Triaklima decreases with simultaneous application with inducers of microsomal liver enzymes (hydantoin, fenilbutazon), with barbiturates, antiepileptic drugs (phenytoin, carbamazepine) due to increased metabolism of components of the product, with antibiotics (ampicillin, rifampin), with drugs for general anesthesia, opioid analgesics, anxiolytics, ethanol, some antihypertensive drugs.

With simultaneous application of Triaklima with hypoglycemic agents may require adjustment of doses of the latter.

Mineral oil may decrease the absorption Triaklima from the intestine.


Pharmacological properties: The drug has α-adrenomimetics action narrows the peripheral vessels. When applied to the mucous membrane due to the vasoconstrictive effect reduces swelling of mucous membranes, congestion, exudation, facilitates nasal breathing. Thanks to its constituent of eucalyptus oil product removes dry nasal mucosa and has anti-inflammatory and antibacterial effect.

It acts mainly locally, when used in therapeutic doses absorbed through the mucous membranes in small quantities. The action begins in a few minutes after application, lasts for 8-10 hours

INDICATIONS: acute rhinitis and rhinosinusitis, pollinosis, otitis media (to reduce swelling of the mucous membrane nasopharynx); preparing the patient for diagnostic and therapeutic procedures in the nasal passages.

APPLICATION: Evkazolin drops

Adults and children over 12 years - 1-2 drops 2-3 times a day in each nasal passage.

Children aged 7 to 12 years - 1 drop in each nasal passage 2-3 times a day. The drug is used within 5-7 days.

Evkazolin Aqua Spray

Adults and children over the age of 12 years, appoint 1 injection of 2-3 times per day in each nasal passage. The duration of the drug - 5-7 days.

Contraindications: angle-closure glaucoma, atrophic rhinitis, hypersensitivity to the drug's components, hypertension, hyperthyroidism, the age of 7 years.

SIDE EFFECTS: irritation, dryness of the nasal mucosa, burning, stinging, sneezing, hypersecretion. In rare cases, possible swelling of the nasal mucosa and a violation of smell, mucosal atrophy (often with prolonged use), tachycardia, arrhythmia, increased blood pressure, headache, vomiting, sleep disturbances, and vision, allergic reactions.

SPECIAL PRECAUTIONS: Prolonged use of the drug develops tolerance to it (reducing the effectiveness or lack of effect).

Use during pregnancy and lactation: therapeutic doses of the drug acts locally and does not have a systemic impact, so the use of the drug in therapeutic doses in this group does not contraindicated.

In patients with hypertension, hyperthyroidism, disorders of the cardiovascular system, diabetes medication should be used with caution given the possibility of hypertension, tachycardia, and arrhythmias.

INTERACTION: Evkazolin interacts with other drugs only if the resorptive effect. Sympathomimetics other groups reinforce the effect Evkazolina. Adrenolitiki and sympatholytic, antagonists of calcium ions reduce its effect. Evkazolin weakens the action and psychoactive effects of tricyclic antidepressants, MAO effect on the cardiovascular system. Sympathomimetics should not be used in conjunction with sedation (reduction efficiency).

OVERDOSE: If you use the drug may show symptoms of an overdose in the form of headache, dryness in the nose, nausea, depression, improve blood pressure, short-term impairment, may increase the intraocular pressure. Must stop using the product and to appoint agents antagonists: blockers and sympatholytic α-adrenergic receptors (fentolamin, thropaphen), symptomatic therapy. If the drug is accidentally taken by mouth, wash the stomach, to appoint enterosorbents and laxatives, α-adrenoceptor blockers and symptomatic therapy. Frequent peredozrovka can lead to atrophy of the nasal mucosa.

Storage: Store in dark place at a temperature of 15-25 ° C.


Pharmacological properties: Dolar - combination drug, which has expressed anti-inflammatory, analgesic and antipyretic effect. Pharmacological activity of the drug due to the properties of diclofenac and paracetamol, comprising Dolar. Diclofenac sodium has a marked anti-inflammatory and analgesic, and mild antipyretic effect. Paracetamol has a pronounced analgesic, antipyretic and anti-negligible effect. The mechanism of action is associated with inhibition of prostaglandin synthesis.

When you receive diclofenac sodium inside the active substance is rapidly absorbed into the blood, the maximum plasma concentration is achieved in 1-2 hours a meal slows absorption, but does not affect its level. The drug is 99% associated with blood plasma proteins, well into the tissue and synovial fluid, where its concentration may exceed those in blood plasma. Half life of plasma is 1-2 h of synovial fluid - 3-6 pm Diclofenac sodium is metabolized in the liver, about 35% of drugs excreted in the urine as metabolites and approximately 1% - unchanged, about 35% - with feces. When administered paracetamol is well absorbed. The maximum concentration in blood is achieved within 30 min after administration and lasted approximately 1 h. About 25% of the drug binds to plasma proteins of blood, half-life - 1,5-2 pm By hepatic metabolism and is transformed into glucuronide sulfates. The concentration of the drug in the urine than in blood plasma.

INDICATIONS: headache, toothache, neuralgia, lumbago, sciatica, lumbago, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, diseases of the joints and spine, soft tissue, febrile conditions, acute musculo-skeletal pain, tendinitis, bursitis, post-operative pain, dysmenorrhea.

APPLICATION: depend on the nature and course of disease, tolerability and efficacy of the drug.

Adults and children over 6 years - 1 tablet 2-3 times daily after meals. The course of treatment is 5-7 days, depending on the dynamics of symptoms. Maximum daily dose for adults is 3 tablets a day.

In appointing Dolar children aged 6-12 years should take into account that the daily dose of diclofenac should not exceed 0,5-2 mg / kg body weight; dose divided by 2-3 reception. The maximum daily dose for children is calculated by diclofenac at 3 mg / kg body weight.


-Peptic ulcers of the stomach or duodenum exacerbation;

- Diseases of the liver or kidneys;

- Increased sensitivity to the drug's components;

- AD;

- Urticaria;

- Acute ritnit and other allergic reactions associated with NSAID intake;

- Hemodyscrasia of unknown origin;

- During pregnancy and lactation;

- The age of 6 years.


On the part of the digestive tract: nausea, anorexia, pain in the epigastric region, flatulence, constipation, diarrhea. In some cases, especially with frequent and prolonged use of the drug, possibly erosive-ulcerative lesion of digestive organs with signs of gastrointestinal bleeding (black feces).

From the side of the central nervous system: rarely - headache, depression, drowsiness.

From the urinary system: rarely - hematuria, proteinuria, nephrotic syndrome, acute renal failure.

On the part of the hemopoietic system: very rarely - thrombocytopenia, anemia (due to hidden bleeding from the gastrointestinal tract).

Allergic reactions (especially in asthmatic patients): skin rash, bronchospasm, pruritus, erythema.

Cautions: during application Dolar should be closely monitored and regular medical examination of patients with diseases of the digestive tract in history (especially with ulcers of the stomach or intestine); patients with ulcerative colitis or Crohn's disease, patients with impaired liver and kidney function. At the time of dollars, like other NSAIDs, may increase the activity of liver enzymes, and therefore should regularly conduct a study of liver function. If you have symptoms, gastrointestinal tract, liver, or in case of any other side effects (eosinophilia, rash, etc.), the medication should be abolished.

In connection with the role of prostaglandins in maintaining renal blood flow should be very careful when appointing the drug to patients with renal insufficiency.

With the emergence of changes in the urinary system (hematuria, proteinuria, nephrotic syndrome) discontinuing treatment usually leads to recovery of renal function. Prolonged use of dollars, like other NSAIDs, shows a picture of systematic monitoring of peripheral blood. Dolar may temporarily inhibit platelet aggregation. Therefore, patients with disorders of hemostasis requires careful monitoring of laboratory parameters.

Effects on ability to drive vehicles and working with potentially dangerous machinery. Patients who feel during the reception Dolar dizziness or blurred vision, drive vehicles and operate potentially dangerous machinery is not recommended.

INTERACTION: while receiving Dolar reduces the effect of furosemide and antihypertensive drugs, increases the concentration of digoxin in the blood plasma.

Combine techniques with potassium-sparing diuretics may lead to the development of hyperkalemia. With simultaneous use of other NSAIDs, or SCS increased risk of gastrointestinal bleeding. Undesirable to the combined use of Dolar with methotrexate and cyclosporine.


Symptoms: hypotension, respiratory depression, convulsions, kidney failure, violations of the gastrointestinal tract.

Treatment: symptomatic therapy, forced diuresis, dialysis or blood transfusions are ineffective because the active ingredient is largely associated with plasma proteins.

Storage: Store in a dry place protected from light at 25 ° C.