Dalteparin sodium

International name:
Dalteparin sodium (Dalteparin sodium)

Group Affiliation:
Direct anticoagulant

Description of the active substance (INN):
Dalteparin sodium

Dosage form:
injection

Mode of action:
Direct-acting anticoagulant, is associated with plasma antithrombin III, inhibits certain coagulation factors, especially factor Xa and thrombin, but suppresses the formation of thrombin is somewhat less conventional heparin. Virtually no effect on clotting time. Little effect on the adhesion of platelets (compared with heparin) and, thus has less effect on primary hemostasis. also has fibrinolytic, koronarodilatiruyuschee, hypolipidemic and immunosuppressive effects, suppresses trombokinazu. Effect develops rapidly and lasts 4-6 hours

Indications:
Acute deep vein thrombosis, pulmonary embolism, unstable angina, acute myocardial infarction (without Q wave on ECG). Prevention of clotting in the extracorporeal circulation during long-term hemodialysis, prevention of thrombosis during surgical operations.

Contraindications:
Hypersensitivity, hypocoagulation (various origins), hemophilia, erosive and ulcerative lesions GIT (exacerbation) with a tendency to bleeding, pulmonary tuberculosis, liver cirrhosis, nefrourolitiaz, renal and hepatic failure, bacterial endocarditis, trauma central nervous system, organs of vision, surgical intervention these organs, spinal and epidural punktsii.C caution. Thrombocytopenia, BPD.

Side effects:
Bleeding (when used in high doses), thrombocytopenia, allergic reactions (rash, itching, rare - anaphylactic shock), osteoporosis, spontaneous fractures, increased activity of "liver" transaminases, alopecia, skin necrosis, hematoma in the field vvedeniya.Peredozirovka. Symptoms: Hemorrhagic syndrome. Treatment: Introduction protamine (1 mg protamine inhibits dalteparina 100 IU).

Dosage and administration:
Prevention of clotting in the extracorporeal circulation during hemodialysis or hemofiltration in patients with chronic renal failure with or without the risk of bleeding - in / jet at a dose of 30-40 IU / kg followed by infusion at a rate of 10-15 IU / kg / h (duration hemodialysis at least 4 h is also possible once in / jet introduction to the doses of 5 thousand m). The activity of factor Xa in plasma should be 0.5-1 IU / ml. In acute renal failure in patients at high risk of bleeding - in / on 5-10 IU / kg in the jet, then drip at a rate of 4-5 IU / kg / h, the activity of factor Xa in plasma should be 0.2-0.4 IU / ml. In acute deep vein thrombosis and / or pulmonary embolism (usually with indirect anticoagulants - vitamin K antagonists) - n / a dose of 200 IU / kg once , or 100 IU / kg every 12 hours (at an increased risk of bleeding). The maximum single dose - 18 tys.ME. The activity of factor Xa in plasma should not exceed 0.5-1 IU / ml. Duration of treatment - 5 days (up to normalization of prothrombin index). Prevention of thrombosis in surgical interventions (factor Xa activity should be 0.1-0.4 IU / ml). Patients at risk for thromboembolic complications - n / a 2.5 thousand m for 2 h before surgery and then every morning with the same dose throughout the period of bed rest, usually - 5-7 days. If there are additional risk factors for thromboembolism (in m . h. malignant tumors) and during orthopedic surgery (including the endoprosthetics) in the case of initiation of therapy up to 1 day before surgery - S / by 5 thousand m night before the operation, then - to 5 thousand m night after the operation, with the start of therapy on the day of operation - n / a 2,500 IU for 2 h before operation and after 8-12 h (but not earlier than 4 h) after surgery at the same dose, then daily in the morning five thousand m . After 4-8 hours (no earlier than 4 h) after orthopedic surgery sc injected 2.5 thousand m, then - to 5 thousand m daily. The course of treatment in the presence of additional risk factors for thromboembolism - the duration of bed rest (usually 5-7 days), and orthopedic operations - for 5 weeks. At a myocardial infarction (without Q-wave on ECG) and unstable angina (usually in combination with ASA in doses of 75-325 mg / d) - n / a, 120 IU / kg every 12 hours for women weighing less than 80 kg and men weighing less than 70 kg - 5 thousand m s / c every 12 h, women with body weight over 80 kg or more and men with a body weight of 70 kg or more - by 7.5 thousand m every 12 h. The maximum dose - 10 thousand m every 12 hours therapy is carried out to stabilize the clinical condition (usually not less than 6 days but not more than 45 days). Factor Xa activity should be within 0.5-1 IU / ml. In elderly patients the dose is reduced.

Cautions:
The application is only possible under the supervision of active suppression of factor Xa by anti-Xa analysis using the chromogenic protein substrate. Clotting time varies slightly. At the level of activity suppression factor Xa more than 1.5 IU / ml dramatically increased risk of bleeding. Health and Safety during pregnancy and lactation not established.

Interaction:
ASA, indomethacin and other NSAIDs, indirect anticoagulants, inhibitors of platelet aggregation (including ticlopidine), thrombolytics (alteplase, streptokinase, urokinase) vitamin K antagonists, dipyridamole, dextran, fenilbutazon, sulfinpirazon, blockers tubular secretion, ethacrynic acid , cytostatics (with in / in the introduction) increase anticoagulant effect (risk of bleeding), antihistamine drugs, cardiac glycosides, tetracyclines, ascorbic acid - decrease.

Calcium folinate

International name:
Folinat Calcium (Calcium folinate)

Group Affiliation:
Vitamin

Description of the active substance (INN):
Calcium folinat

Dosage form:
capsule lyophilisates for solution for intravenous and intramuscular injection, solution for intravenous and intramuscular injection, tablets

Mode of action:
Folinievaya acid, which is a reduced form of folic acid is easily converted into other derivatives recovered folic acid (dihydro-and then to tetrahydrofolic) required for the synthesis of thymine and purines and, hence, DNA, RNA and proteins. Contributes to the shortfall in the body of folic acid. Has hematopoietic effect, stimulates the growth of tissues quickly updated (including gastrointestinal mucosa). As antidote to folic acid antagonist, prevents damage to bone marrow hematopoiesis provides safety and allows the use of cytostatics, including methotrexate and 5-fluorouracil required for tumor chemotherapy with high doses. The initial effect develops in 20-30 minutes after ingestion, after 10-20 minutes - after i / m administration, less than 5 minutes - after i / v administration and lasts for 3 - 6 h regardless of route of administration.

Indications:
Oral and parenteral administration - intoxication folic acid antagonists (methotrexate, trimethoprim and pyrimethamine). Parenteral - megaloblastic anemia against a background of folic acid deficiency when oral therapy is ineffective (including against the background of malabsorption syndrome, malnutrition, pregnancy, sprue, in early childhood with congenital dihydrofolate reductase deficiency). Cancer of the large intestine, including the rectum (as adjuvant). Local - ulcer-necrotic stomatitis on a background of metotreksatae

Contraindications:
Hypersensitivity, megaloblastic anemia caused by vitamin A deficiency B12.C caution. Predisposition to the development of epileptic seizures in children with chronic renal failure.

Side effects:
Allergic reactions: skin rash, hives, itching and anaphylactic shock.

Dosage and administration:
V / m, in / in, inside (hereinafter all doses of calcium folinata given in terms of base). After i / v infusion of methotrexate in high doses (12-15 g / sq m) and multiple dose administration of calcium folinata determined by the state renal excretory function in a systematic (at least 1 time per day) control the concentration of creatinine and methotrexate in plasma. In the normal breeding (the concentration of methotrexate in plasma - approximately 10 mmol 24 h after injection, 1 mmol - 48 hours and less than 0.2 mmol - 72 hrs), calcium folinat prescribe a dose of 15 mg (approximately 10 mg / m) inside , in / or / m every 6 h for 60 h (starting 24 hours after methotrexate). In the case of reducing "late" removal (methotrexate concentration above 0.2 mmol - 72 hrs and 0.05 micromol - after 96 hours after introduction) - inside, in / m or i / c, 15 mg every 6 h up to as long as the concentration of methotrexate does not become lower than 0.05 mmol. In "early" decline excretion (concentration of methotrexate - 50 uM and above 24 h , 5 uM and above - 48 hours or increase the content of creatinine in plasma by 100% or more within 24 hours after methotrexate) - a / c, a dose of 150 mg every 3 h up to as long as the concentration of methotrexate to be below 1 uM, and then - I / O and 15 mg every 3 hours until the methotrexate concentration in plasma becomes lower than 0.05 mmol. At the same time to prevent the development of CRF spend hydration (3 l / day) and injected sodium bicarbonate to maintain pH urine at a level 7 or higher. With the development of toxic reactions expressed by the introduction of methotrexate should be extended for an additional 24 h in subsequent courses (total number - 24 doses within 84 h). In case of accidental overdose of methotrexate calcium folinat injected immediately after an overdose (or slow breeding methotrexate - within 24 hours) in / in / m or oral (expressed in gastrointestinal events apply only to parenteral administration) to 10 mg / m every 6 hours until methotrexate level becomes less than 0.01 uM. Determination of the concentration of creatinine and methotrexate should be carried out every 24 h. When 24 h creatinine content in plasma increased by 50% or the concentration of methotrexate than 5 uM, or the concentration of methotrexate after 48 h more than 0.9 uM, calcium folinat injected into / in a dose of 100 -150 mg / m every 3 h up to as long as the concentration of methotrexate in plasma becomes lower than 0.01 mmol. When ulcer-necrotic stomatitis during treatment with methotrexate - locally, at the ulcerated surface of the oral mucosa (avoid swallowing the solution for injection). In megaloblastic anemia, deficiency of folic acid - inside the / m or i / v, 1 mg / day. In cancer, colon and rectum - in / slowly, for not less than 3 min, 200 mg / m, followed by a / in the introduction of fluorouracil at a dose of 370 mg / m or i / v, 20 mg / m, followed by a / in the injection of fluorouracil at a dose of 425 mg / sqm. The course of treatment - 1 times a day for 5 days. Repeated courses are held at intervals of 4 weeks for 2 courses, then - at intervals of 4-5 weeks, depending on the toxic effect of the previous year. When the manifestation of hematological or gastrointestinal toxicity of fluorouracil to reduce the dose (at a moderate toxicity in 20%, with severe - 30%). When tolerance to fluorouracil in the previous course of its dose should be increased. In the absence of toxicity from the previous year dose increased by 10%. The dose of calcium folinata depending on the toxicity did not change.

Cautions:
When using large doses dissolved with sterile water for injection (a solution not be stored). The prepared solution must be used within 12 hours Do not use the medication in pernicious and other megaloblastic anemia due to deficiency of cyanocobalamin, because during treatment, along with improvements in haematological parameters, neurological phenomena continue to progress. It may increase the frequency of epileptic seizures in children prone to them due to reduce the effect of antiepileptic drugs (phenytoin and primidona). Doses above 25 mg should be given by injection, as ingestion doses are not absorbed.

Interaction:
Reduces the effect of folic acid antagonists. Reduces toxic effect of methotrexate, anticonvulsant activity of phenobarbital, phenytoin and primidona. Strengthens the toxicity of fluorouracil.

DALERON® C JUNIOR

Pharmacological properties: The product contains paracetamol and ascorbic acid (vitamin C). Paracetamol inhibits the synthesis of prostaglandins in the CNS, leading to lower fever and reduce pain. Since paracetamol does not irritate the stomach lining, it can be used in children with diseases of the stomach, including peptic ulcer of the stomach and duodenum. Daleron With junior also contains vitamin C, which enhances the nonspecific resistance of the body, promotes more rapid recovery and improves the taste of the drug. The drug is in the form of hot drink is easy to use in patients with inflammatory diseases of the oropharynx, as it is difficult to swallow drugs in solid dosage forms.

Paracetamol is rapidly absorbed in the digestive tract, binds to plasma proteins. The half - 1-4 pm Metabolised in the liver to form glucuronide and sulfate of paracetamol. Provided by the kidneys mainly as conjugates, less than 5% excreted in an unaltered state.

INDICATIONS: to reduce elevated body temperature during fever caused by bacterial and viral infections, to reduce myalgia and arthralgia with influenza and other acute respiratory viral infections, for reduction of mild to moderate pain of various origin (headache, toothache, after injuries and medical interventions) especially in children with concomitant diseases of the stomach.

APPLICATION: prigovleniya drink the contents of a bag pour into a glass, add hot water or tea and stir well. Drink a warm drink. For children aged 2-3 years prescribe the contents of 1 sachet dissolved in 50 ml of liquid, 4-6 years - 2 bags of 100 ml, 7-10 years - 2-3 bags of 100-150 ml, 10-12 years - 3 -4 bags at 150 ml. The interval between doses must be at least 4 h, the frequency of intake - no more than 4 times per day.

CONTRAINDICATIONS: Hypersensitivity to paracetamol, aksorbinovoy acid or other components of the drug, acute renal failure or liver.

SIDE EFFECTS: Sometimes - nausea, skin hypersensitivity reactions (skin rash, itching, rash).

Cautions: Children under 2 years, as well as in children with moderate renal or hepatic insufficiency drug is used only under medical supervision.

Do not exceed recommended dose.

You can not take Daleron With Junior simultaneously with other medications containing paracetamol.

You should not assign Daleron with Junior for more than 3 days without a re-examination of the patient.

The product contains sugar, so it is not recommended to assign patients with diabetes mellitus. The contents of a bag corresponds to 4,6 g of sugar.

INTERACTION: caution is used in combination with metoclopramide, domperidone, kolestiraminom and warfarin.

There should be appointed concurrently with barbiturates, antiepileptic drugs, rifampicin and chloramphenicol, as well as with preparations containing paracetamol.

OVERDOSE: Symptoms of overdose may occur only a few days. Paracetamol in toxic doses can cause nausea, vomiting, provide Hepatotoxic effects, especially in children with kidney or liver disease.

DALERON® COLD 3

Pharmacological properties: a combined preparation containing analgesic and antipyretic - paracetamol, anti-(dekongestivnoe) means - pseudoephedrine hydrochloride, and antitussive - dextromethorphan hydrobromide. These components at the same time reduce the severity of the major symptoms characteristic of colds.

The mechanism of action of paracetamol is not fully understood. Its analgesic effect is likely due to inhibition of COX enzyme activity and related prostaglandin synthesis in the CNS. Paracetamol has virtually no effect on the synthesis of prostaglandins in the foci of inflammation, so he has only weakly anti-inflammatory effect. Compared with other NSAIDs, paracetamol is much less likely causes the development of side effects from the digestive tract, because it has little effect on the synthesis of prostaglandins in peripheral tissues. Antipyretic effect of paracetamol is associated with its direct influence on the thermoregulation center in the hypothalamus. Paracetamol increases the heat transfer through the expansion of peripheral blood vessels and increasing blood flow in the skin, and increased sweating.

Pseudoephedrine is a sympathomimetic amine, the effect of which is connected with the influence on adrenergic receptors. It acts as an agonist β-adrenergic receptors in heart and smooth muscles of the bronchi, as well as an agonist of peripheral α-adrenergic receptors, has an indirect effect on the release of neurotransmitters (norepinephrine) from adrenergic neurons. Reduction of edema of the mucous membrane of the upper respiratory tract as a result of the use of pseudoephedrine is linked to its action as an agonist of α-adrenergic receptors of bronchial smooth muscle and mucosa of the respiratory tract. Because of the restriction extended arterioles reduces congestion and edema of the nasal mucosa, thus reducing stagnation, exudation and Restoration of free nasal breathing.

Compared with ephedrine pseudoephedrine significantly less stimulating β-adrenergic receptors. When you receive the recommended doses, practically does not increase blood pressure. Pseudoephedrine has a weak stimulating effect on the CNS.

Dextromethorphan is a D-stereoisomer opioid levorfanola. Effective on cough center in the central nervous system, raising the threshold of the cough reflex, suppresses dry nonproductive cough associated with irritation of the mucous membrane of the upper airways in patients with colds. Antitussive effect of the active component is similar to that of codeine, but unlike the latter dextromethorphan does not have a pronounced analgesic effect, does not suppress the respiratory center and does not lead to the development of dependence.

Indication: Used for symptomatic treatment of colds and influenza to reduce the severity of pain (headache, myalgia, arthralgia, sore throat), lower body temperature during fever, reduction of nasal congestion and rinorei, suppression of dry unproductive cough.

USE: Adults and children over the age of 12 years prescribed by mouth 2 tablets not more than 4 times a day. The interval between doses must be at least 4 h, duration of treatment is chosen individually.

CONTRAINDICATIONS: Hypersensitivity to paracetamol, pseudoephedrine, dextromethorphan, or other components of the drug, dysfunction of liver or kidney disease, severe hypertension or coronary heart disease, the age of 12 years.

SIDE EFFECTS: when taking the recommended doses, side effects are rare and usually moderately expressed. Possible nausea, dry mouth, increased irritability and excitability; rarely - increased BP.

SPECIAL PRECAUTIONS: Not recommended primenenyat drug over 5 days, without re-medical examination. With caution used in patients with liver and kidney, cardiovascular system, thyroid, diabetes mellitus, benign prostatic hyperplasia, after suffering a severe disease and in patients with alcoholism.

In the period of the drug is contraindicated alcohol consumption.

Safety of the drug during pregnancy and lactation is not installed, so assign it is not recommended.

The drug may have a negative impact on psychomotor reaction, so we recommend caution when driving and working with potentially dangerous machinery.

INTERACTION: the simultaneous use of the drug is contraindicated with MAO inhibitors or a reception for 2 weeks after completing therapy MAO inhibitors (hypertensive crisis may develop a headache, hyperthermia, as well as dangerous cardiac arrhythmias).

The drug should not be prescribed concomitantly with other medicines containing paracetamol, antidepressants (fluoxetine), antipsychotic (haloperidol), antiparkinsonian and antiepileptic drugs, barbiturates, rifampicin, chloramphenicol, dihydroergotamine, methyldopa.

Precautions should be prescribed the drug in conjunction with metoclopramide, domperidone, kolestiraminom and warfarin.

OVERDOSE: particularly hard manifested in patients with impaired renal function and liver. Overdose of paracetamol is accompanied by nausea, vomiting and severe liver damage.

An overdose of pseudoephedrine may cause severe psychomotor agitation, increased blood pressure and arrhythmia.

An overdose of dextromethorphan can cause nausea, vomiting, dizziness, drowsiness, sopor, impaired vision, coordination of movements and breathing.

Storage: Store in a dry place protected from light at temperatures below 30 ° C.

(DALERON® C

Pharmacological properties: The product contains paracetamol and ascorbic acid (vitamin C). Paracetamol inhibits the synthesis of prostaglandins in the CNS, leading to lower fever and reduce pain. Since paracetamol does not irritate the stomach lining, it can be used in patients with diseases of the stomach, including peptic ulcer of the stomach and duodenum. Daleron C contains Vitamin C which enhances the nonspecific resistance of the body, promotes more rapid recovery and improves the taste of the drug. The drug in the form of warm drink is easy to use in patients with inflammatory diseases of the oropharynx.

Paracetamol is rapidly absorbed in the digestive tract, binds to plasma proteins. The half - 1-4 pm Metabolised in the liver to form glucuronide and sulfate of paracetamol. Provided by the kidneys mainly as conjugates, less than 5% excreted in an unaltered state.

INDICATIONS: to reduce elevated body temperature during fever caused by bacterial and viral infections, to reduce myalgia and arthralgia with influenza and other acute respiratory viral infections, for reduction of mild to moderate pain of various origin (headache, toothache, after injuries and medical interventions) especially in patients with concomitant diseases of the stomach.

USE: Adults and children over the age of 12 years shall designate the contents of 1 sachet 4-6 times a day. The interval between doses must be at least 4 hours The maximum daily dose - the contents of eight bags.

To prepare the drink spilled contents of one packet into a glass, add 150 ml of warm water or tea and stir well. Drink a warm drink.

CONTRAINDICATIONS: Hypersensitivity to paracetamol, ascorbic acid or other components of the drug, acute renal failure or liver.

SIDE EFFECTS: Sometimes - nausea, skin hypersensitivity reactions (skin rash, itching, rash).

SPECIAL INSTRUCTIONS: for moderate renal or hepatic insufficiency Daleron with applicable only under medical supervision.

Do not exceed recommended dose.

You should not assign Daleron C for more than 3 days without re-examination of the patient.

The drug should be used with caution in debilitated patients and patients with chronic alcoholism.

The product contains sugar, so it is not recommended to assign patients with diabetes mellitus. The contents of a bag corresponds to 3,9 g of sugar.

Security reception Dalerona C during pregnancy and lactation have not been established, and the drug can be used only on doctor's advice, for a short period of time, preferably once.

INTERACTION: caution is used in combination with metoclopramide, domperidone, kolestiraminom and warfarin.

You should not assign Daleron C simultaneously with barbiturates, antiepileptic drugs, rifampicin and chloramphenicol, as well as with preparations containing paracetamol.

OVERDOSE: Symptoms of overdose may occur only a few days. Paracetamol in toxic doses can cause nausea, vomiting, provide Hepatotoxic effects, especially in patients with kidney or liver disease.

Storage: Store in a dry place at temperatures below 30 ° C.

Clindamycin

International name:
Clindamycin (Clindamycin)

Group Affiliation:
Antibiotic Lincosamides

Description of the active substance (INN):
Clindamycin

Dosage form:
granules for syrup, capsule, solution for intravenous and intramuscular

Mode of action:
Antibiotic group Lincosamides. It has a wide spectrum of activity, bakteriostatik, binds to the 50S ribosomal subunit of the membrane and inhibits protein synthesis in the microbial cell. In a number of gram-positive cocci may bactericidal action. It is active against Staphylococcus spp. (Including Staphylococcus epidermidis, penicillinase-producing), Streptococcus spp. (Except Enterococcus spp), Streptococcus pneumoniae, Corynebacterium diphtheriae, spore and asporogenous anaerobes and microaerophilic gram positive cocci (including Peptococcus spp. And Peptostreptococcus spp.), Clostridium perfringens, Clostridium tetani, Mycoplasma spp., Bacteroides spp. (Including Bacteroides fragilis and Prevotella melaninogenica), Fusobacterium spp., Propionibacterium spp., Eubacter spp., Actinomyces spp. Most strains of Clostridium perfringens susceptible to clindamycin, however, since other types of clostridia (Clostridium sporogenes, Clostridium tertium) resistant to clindamycin , then with infections caused by Clostridium spp., recommended definition antibiotikogrammy. Clinically ineffective against Mycoplasma pneumoniae, Haemophilus influenzae, Helibacter pylori, Neisseria meningitidis, Neisseria gonorrhoeae, Ureaplasma urealyticum. between clindamycin and lincomycin there cross-resistance. It is effective for the treatment of asymptomatic carriers of diphtheria (one-week course of therapy, oral).

Indications:
Bacterial infections caused by susceptible organisms: infections of the ENT organs (including tonsillitis, pharyngitis, sinusitis, otitis media), infections of the respiratory system (bronchitis, pneumonia, lung abscess, empyema, fibrosing alveolitis), infections of bones and joints ( osteomyelitis, septic arthritis), abscesses of skin and soft tissue (including acne, boils, abscess, impetigo, whitlow, infected wounds, abscesses, erysipelas), sepsis (especially anaerobic) infections of the pelvic organs, and intraabdominal infection ( including peritonitis, abscesses of the abdominal cavity with the simultaneous use of drugs, active against gram-negative aerobic microbes), gynecological diseases (endometritis, adnexitis, colpitis, abscesses of the fallopian tubes and ovaries, salpingitis, pelvioperitonit) infection of oral cavity (in including periodontal abscess), Toxoplasma encephalitis, malaria (caused by Plasmodium falciparum), pneumonia (caused by Pneumocystis carinii), sepsis, endocarditis, chlamydia, scarlet fever, diphtheria.

Contraindications:
Hypersensitivity, children's age (up to 1 month). C care. Myasthenia gravis, asthma, ulcerative colitis (in history), severe renal and / or hepatic insufficiency, pregnancy, lactation.

Side effects:
Of the nervous system: rarely - a violation of neuromuscular conduction. On the part of the digestive system: stomach pain, nausea, diarrhea, vomiting, esophagitis, pseudomembranous enterocolitis, hepatotoxicity, hyperbilirubinemia, jaundice, dysbacteriosis. From the side of hematopoiesis: leukopenia, neutropenia, agranulocytosis, thrombocytopenia. On the part of the SSA: the rapid i / v administration - lowering blood pressure, until the collapse. Allergic reactions: seldom - maculopapular rash, urticaria, pruritus, and in some cases - and exfoliative dermatitis vezikulobullezny, eosinophilia, anaphylactoid reactions. Local reaction : pain (in place of i / m injection), thrombophlebitis (where i / v injection). Other: the development of superinfection.

Dosage and administration:
Inside, adults: 150 mg every 6 hours, in severe infections single dose may be increased to 300-450 mg. Children: 8-25 mg / kg / day (depending on the severity of infection), divided into 3-4 reception. When treating obesity, caused by Chlamydia trachomatis, appoint 450 mg 4 times daily for 10-14 days. / m or / v: adults - 300 mg 2 times a day. In moderate infections - 150-300 mg 2-4 times a day, in severe infections - 1.2-2.7 g / day for 2-4 introduction. In life-threatening infections in / dose may be increased to 4.8 g / day. Children appoint 10-40 mg / kg / day, divided into 3-4 reception. For iv administration to throw until the concentration no higher than 6 mg / ml diluted solution is introduced in / infusion over 10-60 min. dilution scheme and the duration of infusion: dose, volume of solvent and the duration of infusion (respectively): 300 mg - 50 ml - 10 min, 600 mg - 100 ml - 20 min , 900 mg - 150 ml - 30 min, 1200 mg - 200 ml - 45 min. We do not recommend the introduction of more than 1.2 g for 1 h infusion. The solution is used within 24 hours after cooking. In the treatment of colitis caused by Clostridium difficile, once appropriate to combine assignment with vancomycin for 10 days at 500 mg - 2 g per day, divided into 3 or 4 equal doses. Patients with severe renal / hepatic failure require dosage adjustment.

Cautions:
Pseudomembranous colitis may occur against the background of receiving clindamycin, and 2-3 weeks after cessation of treatment (3-15% of cases) manifested by diarrhea, leukocytosis, fever, abdominal pain (sometimes accompanied with the release of faecal mass of blood and mucus). If you experience these effects in mild cases rather discontinuation of treatment and application of ion exchange resins (kolestiramin, colestipol), in severe cases showed recovery of loss of fluid, electrolytes and protein, the appointment of vancomycin at a dose of 125-500 mg 4 times per day, or bacitracin in a dose of 25 tys.ED 4 times / day for 7-10 days, or metronidazole 500 mg 3 times / day. Do not use drugs which inhibit intestinal motility. Safety of the drug in neonates is not established. Solution contains benzyl alcohol, which can lead to asphyxiation syndrome in preterm infants. In "real life" testimony newborn appoint a dose of 15-20 mg / kg / day in 3-4 receiving, in some cases it may be efficient and smaller dose. During prolonged therapy of children requires periodic monitoring of the blood and liver functional state. In the appointment of the drug in high doses is necessary to monitor the concentration of clindamycin in plasma. There should be appointed for the treatment of meningitis. Quick to / in the introduction may lead to the development of acute left ventricular failure and lower blood pressure.

Interaction:
Incompatible with solutions containing a complex of vitamins B, aminoglycosides, ampicillin, phenytoin, barbiturates, aminophylline, calcium gluconate and magnesium sulfate. Shows antagonism with erythromycin and chloramphenicol. Enhances the action of competitive muscle relaxants. With simultaneous use of opioid (narcotic) analgesics may be caused by increased of respiratory depression (up to apnea). Simultaneous with the appointment of antidiarrhoeal drugs that reduce gastrointestinal motility, increases the risk of pseudomembranous colitis. Aminoglycosides broaden the spectrum of antimicrobial action; increases (relatively) the effect of rifampicin.

DALACIN C PHOSPHATE

Pharmacological properties: clindamycin - a semisynthetic antibiotic that is produced from lincomycin by replacing 7 - (R)-hydroxyl group of 7 - (S)-chloro. In vitro active against the following microorganisms:

- Aerobic Gram-positive cocci, including Staphylococcus aureus, Staphylococcus epidermidis (including strains producing and not producing penicillinase; in vitro saw a rapid development of resistance to the drug in some strains that are resistant to erythromycin); Streptococcus spp. (Except Streptococcus faecalis), Streptococcus pneumoniae;

- Anaerobic Gram-negative bacteria, including Bacteroides spp. (Including B. fragilis, B. melaninogenicus), Fusobacterium spp.;

- Anaerobic Gram-positive asporogenous bacteria, including Propionibacterium, Eubacterium, Actinomyces spp.;

- Anaerobic and microaerophilic Gram-positive cocci, including Peptococcus spp., Peptostreptococcus spp., Microaerophilic streptococci.

In in vitro studies found that the clindamycin susceptible strains of microorganisms such as Bacteroides melaninogenicus, B. disiens, B. bivius, Peptostreptococcus spp., Gardnerella vaginalis, Mobiluncus mulieris, M. curtisii, Mycoplasma hominis. Clostridium have greater resistance to clindamycin than most other anaerobes. Most Clostridium perfringens are susceptible to clindamycin, but some species (eg C. sporogenes and C. tertium) is often resistant to clindamycin. In this connection, to conduct test for sensitivity to antibiotics.

Between lincomycin and clindamycin there cross-resistance. There is antagonism between clindamycin and erythromycin.

Offer the drug in serum after prolonged use of clindamycin hydrochloride (up to 14 days) did not find the data that could indicate a cumulation of the drug or change in its metabolism. The half-life of clindamycin from the serum slightly increased in patients with significant deterioration of renal function. Hemodialysis and peritoneal dialysis is not effective in removing clindamycin from the serum. The concentration of clindamycin in the serum increased linearly with increasing doses and exceed the minimum bacteriostatic concentration for the most common microorganisms for at least 6 hours after taking the usual recommended dose. Clindamycin is widely distributed in liquids and body tissues (including bone). The average half-life of the drug is 2.4 hours Approximately 10% of the biologically active drug is excreted in the urine and 3,6% - with the feces; the remainder of the drug appears in the form of inactive metabolites. Doses up to 2 grams of clindamycin per day for 14 days were well tolerated healthy volunteers, but with increasing doses increased the percentage of adverse reactions from the digestive tract. In the CSF concentration of clindamycin does not reach a significant level even with meningitis. Pharmacokinetic parameters (clearance, half-life, volume of distribution and AUC) in different age groups (adults and elderly) after i / v administration is different, and because there is no need to change the dosage of the drug in the treatment of elderly patients with preserved function of age, respectively, liver and kidneys.

INDICATIONS: infectious-inflammatory diseases caused by microorganisms sensitive to clindamycin:

- Infection of ENT organs, including tonsillitis, pharyngitis, sinusitis, otitis media, scarlet fever;

- Respiratory infections, including bronchitis, pneumonia, lung abscess, empyema;

- Infections of skin and soft tissues, including acne, furunculosis, abscess, impetigo, abscesses, infected wounds, specific infectious processes of the skin and soft tissues (erysipelas, and paronychia / felon);

- Infections of bones and joints, including osteomyelitis and suppurative arthritis;

- Gynecological infection, including endometritis, pelviotsellyulit, infection, vaginal cuff, ovarial abscesses, salpingitis and pelvic inflammatory disease if the drug is given with an antibiotic with activity against gram-negative pathogens, infection of the cervix, caused by Chlamydia trachomatis, clindamycin monotherapy leads to eradication of the causative agent;

- Infectious processes in the abdominal cavity, including peritonitis, abscesses of the abdominal cavity (in combination with antibiotics, acting on Gram-negative aerobes);

- Septicemia and endocarditis;

- Infection of oral cavity (including periodontitis and periodontal abscess);

- Toxoplasma encephalitis in AIDS patients (in combination with pyrimethamine in patients with intolerance to standard therapy);

- Pneumocystis pneumonia in AIDS patients (in combination with primaquine);

- Malaria, including cases of multidrug-resistant Plasmodium falciparum, as monotherapy or in combination with quinine or chloroquine;

- Prevention of endocarditis in patients with allergy to penicillin (s);

- Prevention of wound infection in surgical interventions in head and neck;

- Prevention of peritonitis and intraabdominal abscesses after perforation and trauma contamination in combination with aminoglycosides (gentamicin or tobramitsinom).

APPLICATION: in / or / m In the case of pelvic infection in women, abdominal and other complications or severe infections in adults Dalatsin C Phosphate is usually prescribed at a daily dose of 2400-2700 mg divided by 2, 3 or 4 equal doses. To treat more lung infections caused by highly sensitive to clindamycin microorganisms can be assigned a lower daily dose - 1200-1800 mg divided into 3 or 4 of the introduction.

In severe cases, the daily dose can be increased to 4800 mg.

In most cases (except for some evidence) with the / m more than the introduction of a single dose over 600 mg is not recommended. No need for dose adjustment in the treatment of elderly patients, patients with renal or hepatic insufficiency.

Use in children older than 1 month. Daily dose Dalatsina C Phosphate is 20-40 mg / kg, divided into 3 or 4 of the introduction.

Application of newborns (children below the age of 1 month). Dose of Daqing C Phosphate is 15-20 mg / kg, divided into 3 or 4 of the introduction. In premature infants the dose may be reduced body weight, respectively.

Dosage for individual testimony

In the treatment of infections caused by β-hemolytic streptococcus, apply the above dose. Duration of treatment - not less than 10 days.

In the treatment of inflammatory diseases of the pelvic organs. Assign to 900 mg C Dalatsina phosphate / in every 8 h with a / in the introduction of an antibiotic active against gram-negative aerobes (eg gentamicin at a dose of 2.0 mg / kg with a further reduction to 1.5 mg / kg every 8 h in patients with preserved kidney function). In / in the introduction should continue for at least 4 days, and at least within 48 hours after onset of clinical effect. After parenteral administration of the drug for 6 days should continue receiving clindamycin hydrochloride inside of 450-600 mg every 6 h until the completion of 10-14-day cycle of therapy.

In the treatment of Toxoplasma encephalitis in AIDS patients. Enter in / at a dose of 600-1200 mg every 6 h for 2 weeks, followed by 300-600 mg orally every 6 hours Usually therapy is 8-10 weeks. The dose of pyrimethamine 25-75 mg orally every day for 8-10 weeks. Folinievaya acid at a dose of 10-20 mg per day should be appointed in the application of higher doses of pyrimethamine.

In the treatment of pneumonia caused by Pneumocystis carinii, in patients with AIDS. Dalatsin C Phosphate is introduced into / in to 600-900 mg every 6 hours or 900 mg every 8 hours for 21 days in combination with primaquine - by 15-30 mg orally 1 time a day.

For the prevention of surgical infection during operations in the head and neck. For intraoperative irrigation of contaminated surgical wounds in the head and neck before suturing the wounds are used 900 mg Dalatsina C phosphate, diluted in 1000 ml of isotonic p-ra sodium chloride.

Dalatsin C Phosphate should not be used in / with no dilution in the form of bolus injection. The drug should be administered by infusion over 10-60 min. Dalatsin C phosphate can be diluted in 50-100 ml of p-ra injection of dextrose 5% or sodium chloride 0.9%. The concentration of drug in the p re-infusion should not exceed 18 mg / ml, the rate of introduction - 30 mg / min . When preparing p-ra for infusion should be remembered that clindamycin phosphate is physically compatible with the p-ramie-containing sodium chloride, glucose, potassium and B vitamins in normal doses, and such antibiotics as cefalotin, kanamycin, gentamicin, penicillin or Carbenicillin. Rr Dalatsina C Phosphate is not compatible with ampicillin sodium, phenytoin sodium, barbiturates, aminophylline, calcium gluconate, magnesium sulfate, ceftriaxone sodium and ciprofloxacin.

Commonly used are the rate of introduction:
Dose, mg

Volume p-ra, ml

Time of administration, min


300

50

10


600

50

20


900

50-100

30


1200

100

40




For once in / infusion does not exceed recommended dose of 1200 mg.

CONTRAINDICATIONS: Hypersensitivity to clindamycin, lincomycin or to any component of the drug.

SIDE EFFECTS: Co side of the blood system - Cases of leukopenia, neutropenia, eosinophilia, agranulocytosis and thrombocytopenia, but the true causal relationship between these changes and the drug intake was found;

by the immune system - isolated instances of anaphylactoid reactions;

from cardiovascular and respiratory systems - at too fast a / in the introduction of the drug are rare cases of cessation of breathing and heart, as well as the development of arterial hypotension;

from the digestive tract - may be abdominal pain, nausea, vomiting, diarrhea, pseudomembranous colitis, and candidiasis, esophagitis and esophageal ulcer;

of the hepatobiliary system - jaundice, changes in indicators of liver function tests;

from the skin - in some cases there were maculopapular rash, urticaria, mild to moderate generalized korepodobnaya rash, isolated cases of polymorphous erythema, pruritus, vaginitis, exfoliative, and vesicle-bullous dermatitis, toxic epidermal necrolysis, local reactions - if i / m administration the drug may experience local irritation, tenderness and abscess formation in the introduction, with a / in the conduct of - the phenomenon of thrombosis (the frequency decreases with decrease in the use of permanent in / catheters).

Cautions: Dalatsin C Phosphate Injection contains benzyl alcohol, which can cause fatal flow Gasping syndrome in infants. Treatment of clindamycin, as well as treatment of almost all other antibiotics, may be accompanied by the development of severe pseudomembranous colitis with fatal consequences. It is important to promptly suspect this diagnosis in patients who have diarrhea occurred after the application of antibacterial drugs. Antibacterial drugs suppressed vital functions of normal microflora of the colon that can cause rapid multiplication of clostridia. Our studies indicate that the toxins produced by Clostridium, especially Clostridium difficile, are a crucial and immediate cause of colitis caused by antibiotics. In establishing the diagnosis of pseudomembranous colitis should designate an appropriate treatment. In the case of mild forms of pseudomembranous colitis may be sufficient to cease treatment clindamycin. With the development of moderate and severe forms of pseudomembranous colitis should be appropriate therapy with the appointment of fluids, electrolytes, proteins and drugs effective against Clostridium difficile. Clindamycin should not be appointed for the treatment of meningitis because the drug penetrates poorly through the BBB.

If the treatment is done for a long time, it is necessary to control the function of the liver and kidneys.

Because clindamycin therapy may be enhanced by the microflora are not sensitive to this drug, especially yeast.

Clindamycin is able to penetrate through the placenta. With prolonged use of clindamycin levels in amniotic fluid is approximately 30% of the level of drug concentration in maternal blood. Clindamycin may be appointed to pregnant only if absolutely necessary.

It has been reported about the penetration of clindamycin into breast milk in concentrations from 0,7 to 3,8 mg / ml. It is recommended to stop breast-feeding during the period of Dalatsina C phosphate.

Effect of clindamycin on the ability to drive and work with potentially dangerous machinery has not been studied sufficiently.

Interactions: There is in vitro antagonism between clindamycin and erythromycin. Because such interaction may have clinical significance, these drugs should not be given simultaneously.

Clindamycin is partly a blocker of the neuromuscular conduction and may exacerbate the effects of other muscle relaxants.

OVERDOSE: under recommended doses was not observed. Hemodialysis and peritoneal dialysis are not effective.

STORAGE: at room temperature (15-25 ° C).

Clindamycin

International name:
Clindamycin (Clindamycin)

Group Affiliation:
Antibiotic Lincosamides

Description of the active substance (INN):
Clindamycin

Dosage form:
gel for external use, vaginal cream, vaginal suppositories

Mode of action:
Bacteriostatic antibiotic group Lincosamides, has a broad spectrum of activity, binds to the 50S ribosomal subunit of the membrane and inhibits protein synthesis in the microbial cell. In a number of gram-positive cocci may bactericidal action. It is active against Staphylococcus spp. (Including Staphylococcus epidermidis, producing and neprodutsiruyuschih penicillinase), Streptococcus spp. (Except Enterococcus faecalis), Streptococcus pneumoniae, Corynebacterium diphtheriae, Mycoplasma spp., Anaerobic and microaerophilic gram positive cocci (including Peptococcus spp. And Peptostreptococcus spp.), Clostridium perfringens, Clostridium tetani, Bacteroides spp. (Including Bacteroides fragilis and Prevotella melaninogenica), Fusobacterium spp., Propionibacterium spp., Eubakterium and Actinomyces israelii. Most strains of Clostridium perfringens susceptible to clindamycin, but other types of Clostridium spp. (Including Clostridium sporogenes, Clostridium tertium) are resistant to its action in this connection with infections caused by Clostridium spp., Recommended definition antibiotikogrammy. Between clindamycin and lincomycin there is cross-resistance.

Indications:
Vaginal Cream - vaginitis, caused by microorganisms sensitive to drugs. Gel - acne.

Contraindications:
Hypersensitivity, pregnancy trimester I (for vaginal cream).

Side effects:
Allergic reactions. Vaginal Cream - irritation at the site of application, cervicitis, vaginitis, the development of superinfection (fungal vaginitis). Gel - irritation (in place of application), contact dermatitis. When resorption is likely to develop systemic side effects, including in rare cases - pseudomembranous enterocolitis.

Dosage and administration:
Vaginal: vaginal cream administered in a single dose - 100 mg clindamycin (1 applicator) for the night, a course of treatment - 3-7 days. Outwardly: gel for external use is applied to the affected area 2-3 times a day.

Cautions:
Vaginal Cream is not recommended for use in conjunction with other intravaginal drugs.

Interaction:
Incompatible with solutions containing a complex of vitamins B, aminoglycosides, ampicillin, calcium gluconate and magnesium sulfate. Shows antagonism with erythromycin.


Description Dalatsin product is not intended for purposes of treatment without the participation of a physician.

DALACIN VAGINAL CREAM

Pharmacological properties: clindamycin - antimicrobial means effective in infections caused by susceptible strains of anaerobic to him, as well as gram-positive aerobic bacteria. In vitro active against microorganisms that cause bacterial vaginosis, - Gardnerella vaginalis; Mobiluncus spp; Bacteroides spp; Mycoplasma hominis; Peptostreptococcus spp.

It operates on Trichomonas vaginalis and Candida albicans.

Was noted cross-resistance of microorganisms to clindamycin and lincomycin.

In healthy volunteers after intravaginal application of clindamycin phosphate 100 mg 1 time a day at a concentration equivalent to 20 mg clindamycin in 1 g of cream, the peak concentration of clindamycin in serum reached an average of 20 ng / ml (range - 3-93 ng / ml). Approximately 3% (0,1-7,0%) of the administered dose is absorbed systemically. In women with bacterial vaginosis after vaginal insertion of 5 g of cream clindamycin phosphate (clindamycin 20 mg / d) intake of clindamycin was 4% (0,8-8,0%), approximately in line with those in healthy volunteers.

INDICATIONS: bacterial vaginosis, caused by microorganisms sensitive to the drug.

APPLICATION: The recommended dose is 1 full applicator 2% clindamycin phosphate cream intravaginally preferably at bedtime for 3-7 days.

CONTRAINDICATIONS: Hypersensitivity to clindamycin or lincomycin, I trimester of pregnancy, lactation.

SIDE EFFECTS: The safety of the drug has been studied in clinical trials as in nonpregnant and pregnant patients in II and III trimester of pregnancy. Were identified such side effects associated with use of the drug (observed in less than 10% of patients) - vaginal candidiasis; irritation of the vulva and vagina; vulvovaginitis, vaginitis caused by Trichomonas vaginalis; menstrual disorders, pain in the vagina, metrorrhagia, dysuria, discharge from vagina, urinary tract infections, abnormal childbirth; endometriosis; Glycosuria and proteinuria. Also noted dizziness, headache, heartburn, nausea, vomiting, diarrhea, constipation, abdominal pain, allergic reaction (rash, urticaria), candidiasis, fungal infections, generalized or localized abdominal pain, bacterial infections, pelvic pain, an unpleasant breath, upper respiratory tract infection, pain throughout the body, back pain, abnormalities in microbiological tests.

Cautions: Before starting treatment is necessary laboratory exclude the presence of pathogenic organisms, insensitive to the drug, - Trichomonas vaginalis, Chlamydia trachomatis, N. Gonorrhoeae, Candida albicans, and Herpes simplex virus.

The use of clindamycin may result in excessive growth of microorganisms insensitive to it, especially yeast. In the application of virtually all antibiotics mentioned diarrhea and cases of pseudomembranous colitis. In the event of a pronounced or prolonged diarrhea medicine should be repealed (even though the minimum quantity, absorbing after intravaginal application) and if necessary, to conduct appropriate diagnostic and therapeutic measures.

According to clinical trials Vaginal application of clindamycin phosphate cream in pregnant women in the II trimester, as well as systemic application of clindamycin in the II and III trimester does not lead to the appearance of any pathological effects.

In the I trimester of pregnancy adequate and well-controlled studies had been conducted, so this period the drug should be used only for compelling testimony.

Whether clindamycin is excreted in breast milk after intravaginal application of clindamycin phosphate is unknown. Reported, however, the penetration of clindamycin into breast milk after oral or parenteral administration, which should take into account when considering the appointment of the drug during lactation.

Interactions: There is cross-resistance between clindamycin and lincomycin. In vitro demonstrated antagonism between clindamycin and erythromycin. There were no interactions in pharmacodynamic, pharmacokinetic or clinical studies were not observed. Information on the use of other drugs in conjunction with the cream clindamycin phosphate is absent. Vaginal Cream contains mineral oil, which can reduce the strength of products made from latex or rubber: condoms or vaginal contraceptive diaphragms. Therefore, use of these products during drug treatment is not recommended.

OVERDOSE: If intravaginal application impossible. If you accidentally taking the drug inside may cause effects that arise when therapeutic concentrations of clindamycin in the blood.

STORAGE: at room temperature (20-25 ° C). Do not freeze!

DALACIN

Pharmacological properties: clindamycin phosphate - a semisynthetic antibiotic, clindamycin ester or 7 - (S)-hlorolinkomitsina. Clindamycin inhibits bacterial protein synthesis by binding to the 50S subunit of bacterial ribosomes.

In the body of clindamycin phosphate is rapidly hydrolyzed with the formation of clindamycin, which has antibacterial activity.

Clindamycin is active against many gram-positive aerobes and gram-positive and Gram-negative anaerobes. He is active in vitro against microorganisms causing bacterial vaginosis, - Gardnerella vaginalis, Mobiluncus mulieris, Mobiluncus curtisii, Mycoplasma hominis and anaerobes (Peptostreptococcus spr., Bacteroides spr.)

With the introduction of intravaginal suppository (100 mg), 1 time per day exposed to systemic absorption averaged 30% (6,5-70%) of the drug. Systemic effects of clindamycin vaginal application are less pronounced than ingestion or / in the introduction.

INDICATIONS: bacterial vaginosis.

APPLICATION: The recommended dose - 1 suppository intravaginally, preferably at bedtime, for 3 consecutive days.

Suppositories extracted from the packaging before using.

With the introduction of the applicator without the patient in supine position with knees bent and feet pressed against his chest introduces suppository deep into the vagina.

When you enter using the flat end of the suppository applicator is placed in a hole applicator, hold the applicator over the end of the ribbed shell, gently introduce him as deeply as possible into the vagina, slowly pressing the plunger, introduce the suppository and removes the applicator from the vagina. After each use, the applicator should wash with warm soapy water and let it dry completely.

CONTRAINDICATIONS: Hypersensitivity to clindamycin, lincomycin, or other components of the drug.

SIDE EFFECTS: there are less than 10% of cases.

Subject to these side effects: pain in the vagina, vaginal candidiasis, menstrual disorders, vaginal discharge, dysuria, pyelonephritis, vaginitis / vaginal infections, fungal infections, abdominal pain, headache, fever, pain in the side, generalized pain throughout the body localized swelling, candidiasis, nausea, vomiting, diarrhea, itching, rash.

Cautions: Vaginal clindamycin can lead to increased growth insensitive to the antibiotic microorganisms, especially yeasts.

Oral and parenteral use of clindamycin, as well as other antibiotics, may cause the development of diarrhea, and in some cases - colitis. If clindamycin for intravaginal administration develops pronounced or prolonged diarrhea, the drug should be removed and if necessary, assign the appropriate treatment.

Patients should be alert that during treatment should refrain from vaginal intercourse, and not to use the products or funds intended for intravaginal administration (eg tampons, means for the soul).

The product contains components that can reduce the strength of products made of latex or rubber (condoms, diaphragm), so the use of such products during treatment with clindamycin in the form of vaginal suppositories is not recommended.

According to clinical trials Vaginal suppositories with clindamycin phosphate in the II trimester of pregnancy, as well as systemic application of clindamycin in the II-III trimester did not cause any adverse effects.

In the I trimester of pregnancy drug can be used only in the presence of undeniable evidence.

It is not known whether clindamycin is allocated in the breast milk after intravaginal application, so when deciding on the appointment of clindamycin in the form of vaginal suppositories breast-feeding woman is necessary to estimate the ratio of the potential risks and benefits.

INTERACTION: not recommended during treatment with use latex condoms.

When systemic clindamycin phosphate can potentiate the action of blocking the neuromuscular transmission.

OVERDOSE: not described. If you accidentally taking the drug may develop inside the side effects typical of therapeutic concentrations of clindamycin in the blood.

Storage conditions: at 25 ° C, the reach of children.
DALATSIN (DALACIN)


CLINDAMYCINUM G01A A10
Pfizer Inc.

COMPOSITION AND FORM:

TIS. vaginal. 100 mg, № 3 94.17 grn.

Clindamycin 100 mg

Other ingredients: hard fat base Witepsol H-32 (European Pharmacopoeia).

The drug contains clindamycin phosphate in the form.

№ R.03.01/02933 from 23.01.2006 to 23.01.2011

Pharmacological properties: clindamycin phosphate - a semisynthetic antibiotic, clindamycin ester or 7 - (S)-hlorolinkomitsina. Clindamycin inhibits bacterial protein synthesis by binding to the 50S subunit of bacterial ribosomes.

In the body of clindamycin phosphate is rapidly hydrolyzed with the formation of clindamycin, which has antibacterial activity.

Clindamycin is active against many gram-positive aerobes and gram-positive and Gram-negative anaerobes. He is active in vitro against microorganisms causing bacterial vaginosis, - Gardnerella vaginalis, Mobiluncus mulieris, Mobiluncus curtisii, Mycoplasma hominis and anaerobes (Peptostreptococcus spr., Bacteroides spr.)

With the introduction of intravaginal suppository (100 mg), 1 time per day exposed to systemic absorption averaged 30% (6,5-70%) of the drug. Systemic effects of clindamycin vaginal application are less pronounced than ingestion or / in the introduction.

INDICATIONS: bacterial vaginosis.

APPLICATION: The recommended dose - 1 suppository intravaginally, preferably at bedtime, for 3 consecutive days.

Suppositories extracted from the packaging before using.

With the introduction of the applicator without the patient in supine position with knees bent and feet pressed against his chest introduces suppository deep into the vagina.

When you enter using the flat end of the suppository applicator is placed in a hole applicator, hold the applicator over the end of the ribbed shell, gently introduce him as deeply as possible into the vagina, slowly pressing the plunger, introduce the suppository and removes the applicator from the vagina. After each use, the applicator should wash with warm soapy water and let it dry completely.

CONTRAINDICATIONS: Hypersensitivity to clindamycin, lincomycin, or other components of the drug.

SIDE EFFECTS: there are less than 10% of cases.

Subject to these side effects: pain in the vagina, vaginal candidiasis, menstrual disorders, vaginal discharge, dysuria, pyelonephritis, vaginitis / vaginal infections, fungal infections, abdominal pain, headache, fever, pain in the side, generalized pain throughout the body localized swelling, candidiasis, nausea, vomiting, diarrhea, itching, rash.

Cautions: Vaginal clindamycin can lead to increased growth insensitive to the antibiotic microorganisms, especially yeasts.

Oral and parenteral use of clindamycin, as well as other antibiotics, may cause the development of diarrhea, and in some cases - colitis. If clindamycin for intravaginal administration develops pronounced or prolonged diarrhea, the drug should be removed and if necessary, assign the appropriate treatment.

Patients should be alert that during treatment should refrain from vaginal intercourse, and not to use the products or funds intended for intravaginal administration (eg tampons, means for the soul).

The product contains components that can reduce the strength of products made of latex or rubber (condoms, diaphragm), so the use of such products during treatment with clindamycin in the form of vaginal suppositories is not recommended.

According to clinical trials Vaginal suppositories with clindamycin phosphate in the II trimester of pregnancy, as well as systemic application of clindamycin in the II-III trimester did not cause any adverse effects.

In the I trimester of pregnancy drug can be used only in the presence of undeniable evidence.

It is not known whether clindamycin is allocated in the breast milk after intravaginal application, so when deciding on the appointment of clindamycin in the form of vaginal suppositories breast-feeding woman is necessary to estimate the ratio of the potential risks and benefits.

INTERACTION: not recommended during treatment with use latex condoms.

When systemic clindamycin phosphate can potentiate the action of blocking the neuromuscular transmission.

OVERDOSE: not described. If you accidentally taking the drug may develop inside the side effects typical of therapeutic concentrations of clindamycin in the blood.

Storage conditions: at 25 ° C, the reach of children.

DACTINOMYCIN

Pharmacological action

Antitumor agents from the group aktinomitsinovyh antibiotics. Inhibits cell proliferation through the formation of a stable complex with DNA and DNA-dependent violations of RNA synthesis. Provides an immunosuppressive effect.


Pharmacokinetics

To a large extent associated with the proteins of tissues. Metabolised weak. Do not cross the BBB. T 1 / 2 of 36 hours is excreted in the bile - 50% as unchanged by the kidneys - 10% unchanged.


Statement

Wilms' tumor, rhabdomyosarcoma, choriocarcinoma (including metastatic), metastatic carcinoma neseminomatoznaya testicles, Kaposi's sarcoma, Ewing's tumor, melanoma, racemose sarcoma, ovarian cancer, endometrial cancer (in a combination and / or adjuvant therapy).


Dosage regimen

Set individually, depending on the testimony and stage of disease, the state of the hemopoietic system, the scheme of anticancer therapy.


Side effect

On the part of the digestive system: nausea, vomiting, cheilitis, esophagitis, ulcerative stomatitis, pharyngitis, anorexia, dysphagia, abdominal pain, diarrhea, erosive and ulcerative lesions gastrointestinal tract, proctitis.

On the part of the hemopoietic system: anemia (up to aplastic anemia), agranulocytosis, leukopenia, thrombocytopenia, pancytopenia, reticulopenia.

On the part of the reproductive system: azoospermia, amenorrhea.

Dermatological reactions: alopecia, skin rashes, acne.

Local reactions: tissue necrosis (with extravasation).

Other: malaise, fatigue, lethargy, fever, muscle pain, hypocalcemia, hyperuricemia, and nephropathy.


Contraindications

Chickenpox, herpes zoster, marked disturbances of liver function, pregnancy, sensitivity to dactinomycin. Do not use in newborns and infants.


Application of pregnancy and breastfeeding

Dactinomycin contraindicated in pregnancy. If necessary, use during lactation should stop breastfeeding.

Women of childbearing age should use reliable methods of contraception in the period of receiving dactinomycin.

In experimental studies revealed teratogenic, mutagenic and embryotoxic action of dactinomycin.


Cautions

The treatment is conducted under the strict supervision of a doctor who has experience working with antitumor agents.

With careful application dactinomycin in patients with gout or nephrolithiasis (including history).

During the period of treatment necessary to control the degree mielodepressii, as well as liver and kidney function, the concentration of uric acid in blood plasma.

It has been reported that dactinomycin may distort the results of biological samples used to determine the concentration of antibacterial drugs in blood plasma.

The therapy is not recommended to vaccinate the patient and his family.

In the application of dactinomycin in conjunction with radiation therapy may be more frequent toxic reactions of the gastrointestinal tract and bone marrow. Special caution is required when appointing dactinomycin during two months of radiation therapy of right-sided Wilms tumor, as it marked hepatomegaly and elevated activity of AST.

Dactinomycin is also used by the method of isolated perfusion and injected alone or in combination with other antitumor drugs or as a palliative treatment or as an adjunct to surgical treatment. When you enter through perfusion in some cases dactinomycin is more effective temporary improvement than its systemic use.


Drug Interactions

With simultaneous application of dactinomycin chemotherapy, providing myelotoxic effect, possibly strengthening the toxic effect.

When combined therapy with doxorubicin may gain cardiotoxic action.

At simultaneous application with urikozuricheskimi means increased risk of nephropathy.

Daclizumab

International name:
Daklizumab (Daclizumab)

Group Affiliation:
Immunosuppressant

Description of the active substance (INN):
Daklizumab

Dosage form:
Concentrate for solution for infusion

Mode of action:
Selective immunosuppressant, is a recombinant antibody IgG1 (anti-Tas), acting as receptor blockers to interleykinu2. It is specific binds to the alpha-subunit receptor complex vysokoaffinnogo interleykina2 (which is expressed on activated T-cells) and inhibits the binding and its biological activity. Inhibits interleykinom2 mediated activation of lymphocytes (link the pathogenesis of immune response that underlies the rejection of the transplant). In the recommended doses saturates the receptor subunit vysokoaffinnogo receptor complex interleykina2 within 90 days. There is no marked changes in the number of circulating lymphocytes, or cell phenotypes, except for transient decrease in Tas- positive cells. Reduces the frequency of histologically confirmed acute renal allograft rejection within 6 months after transplantation and significantly prolongs the time before the first episode of rejection. Increasing the frequency of rejection after the cancellation is not marked.

Indications:
Prevention of acute graft rejection reaction kidneys (consisting of combined immunosuppressive therapy with cyclosporine and GCS).

Contraindications:
Hypersensitivity.

Side effects:
On the part of the digestive system: nausea, vomiting, diarrhea or constipation, abdominal pain, stomachalgia, flatulence, gastritis, hemorrhoids. On the part of the SSA: the reduction and / or raising blood pressure, tachycardia, thrombosis. The nervous system: weakness, dizziness, headache pain, insomnia, depression, anxiety, epileptic syndrome, tremor. On the part of the urinary system: oliguria, dysuria, nefronekroz, nephrotoxicity, hydronephrosis, bleeding from the urinary tract, renal failure, peripheral edema, urinary retention. the respiratory system: dyspnea, pulmonary edema, cough, pulmonary atelectasis, chronic pneumonia, pharyngitis, rhinitis, hypoxia, pleural effusion. From a musculoskeletal: myalgia, ossalgiya, arthralgia, pain in the lumbar spine. Allergic reactions: chills, fever, itching, skin rash, anaphylactoid reaction. Local reaction: flushing, pain at the injection site, lymphocele. Other: poor wound healing, acne, hirsutism, increased sweating, hyperglycemia, phlegmon, visual disturbances.

Dosage and administration:
B / c, for 15 minutes in the peripheral or central vein. Adults and children first injection is carried out for 24 hours before transplantation at a dose of 1 mg / kg. Concentrate is diluted 0.9% NaCl solution to 50 ml. Mixing solutions can not shake the vial to avoid foaming, and should take measures to ensure the sterility of prepared diluted solution. Infusion solution should be used within 4 h after preparation, if the solution should be kept longer (up to 24 h), it should be kept in a refrigerator at 2-8 grad.S. The second and each subsequent doses given at intervals of 14 days in total - 5 doses.

Cautions:
The introduction of the drug should be performed only in a qualified medical facility. Dose adjustment in severe chronic renal failure is not required. Patients receiving immunosuppressants after organ transplantation have an increased risk of lymphoproliferative disease and opportunistic infections. Women of reproductive age should use effective methods of contraception for 4 months after last injection.

Interaction:
Pharmaceutical incompatible with other solutions. Compatible with cyclosporine, mycophenolate mycophenolate, ganciclovir, acyclovir, azathioprine, antithymocyte Ig, muromonabom-CD3 (OKT3), SCS.


Description Zenapaks product is not intended for purposes of treatment without the participation of a physician.

Dacarbazine

Trade name:
Dacarbazine Medak

International name:
Dacarbazine (Dacarbazine)

Group Affiliation:
Antitumor agents, alkylating

Description of the active substance (INN):
Dacarbazine

Dosage form:
lyophilisates for solution for intravenous

Mode of action:
Antitumor agents, alkylating agents, becomes active after metabolism in the liver releases diazomethane, covalently bind to SH-groups of biomolecules. As an analog of purine bases, also has the properties of antimetabolites. It blocks the synthesis of RNA and DNA (due to the formation of complexes with carbonium ions) leads to the cessation of mitosis of cells. Fazonespetsifichen.

Indications:
Melanoma, venereal disease, soft tissue sarcoma (excluding Kaposi's sarcoma). In the composition of multicomponent chemotherapy: osteogenic sarcoma, uterine sarcoma, lymphosarcoma, embryonal rhabdomyosarcoma, mesothelioma of the pleura and peritoneum, carcinoid tumor (including bronchogenic carcinoma, small cell lung cancer, thyroid cancer), pheochromocytoma, insulinoma, neuroblastoma, CNS tumors (gliomas).

Contraindications:
Hypersensitivity, severe suppression of bone marrow hematopoiesis, severe hepatic and / or renal failure, pregnancy, laktatsii.C caution. Mielodepressiya (including on a background of concomitant radiotherapy and chemotherapy), acute infectious viral disease (including chickenpox, herpes zoster), fungal or bacterial origin (the risk of severe complications and the generalization of the process), concomitant radiotherapy

Side effects:
On the part of the digestive tract: decreased appetite, stomatitis, nausea, vomiting rarely - increased activity of "liver" enzymes, diarrhea, and in rare cases - gepatonekroz caused by occlusion of the intrahepatic veins, possibly with fatal consequences (usually the syndrome arose during the 2 treatment) - fever, eosinophilia, abdominal pain, liver enlargement and shock, the severity of which increases rapidly for several hours or days. From the side of blood: anemia, granulocytopenia, thrombocytopenia, leukopenia. the nervous system: headache, blurred vision, confusion, marked drowsiness, seizures, asthenia, paresthesia, hypoesthesia skin. On the part of the endocrine system: alopecia, amenorrhea, azoospermia. Allergic reactions: skin rash, flushing skin, a feverish syndrome, anaphylactic reaction. Local reactions: pain in the injection site and along the veins when the product enters the skin - a sharp pain at the injection site and necrosis of surrounding tissues. Other: increased bleeding, hemorrhage, superinfection, thrombosis of hepatic veins, myalgia, flu-like syndrome. With long-term use increases the risk of novoobrazovaniy.Peredozirovka. Symptoms: increased suppression of bone marrow hematopoiesis and severity of dyspeptic disorders. Treatment: symptomatic, specific antidote known.

Dosage and administration:
When choosing the dose and the drug treatment in each individual case should use the data of literature. The drug is introduced strictly in / in. Doses up to 200 mg / m entered the jet slowly over 1-2 minutes. Higher doses should be administered in the form of intravenous infusion over 15-30 min. Usually used as monotherapy dacarbazine at a dose of 200-250 mg / m daily for 5 days. Repeated courses are held at intervals of 3 weeks. In combination with other cytostatic agents dacarbazine is introduced at a dose of 100-150 mg / m 4-5 consecutive days with an interval of 4 weeks or 375 mg / m² every 15 days. Before the introduction of product diluted with water for injection to achieve a concentration of 10 mg / ml. For freshly prepared solution for infusion solution is diluted in 200-300 ml 0.9% NaCl solution or 5% dextrose solution (a solution of dacarbazine should be protected from light).

Cautions:
The drug should be administered under the supervision of a physician who has considerable experience in conducting anti-tumor therapy. During and after treatment is necessary to monitor patterns of peripheral blood, liver function and its size. In the event of violations by the liver or kidneys, symptoms of hypersensitivity to the drug or thrombosis hepatic veins dacarbazine treatment should be stopped immediately. When the first signs of extravasation dacarbazine (burning or pain at the injection site), the introduction should be stopped immediately. The remaining dose should be introduced in other vein. At the period of treatment should be abandoned immunization (including all family members residing with the patient), oral polio vaccine, as well as to avoid contact with people who receive it, or wear a protective mask, Cover your mouth and nose. If you suspect depression blood should avoid contact with patients with bacterial infections. During the treatment sessions to avoid contact sports and other situations which are likely to hemorrhage and trauma. Given that the different sensitivity of dacarbazine, the solutions of the drug should be stored protected from light. Women and men during treatment and for 6 months after should use reliable methods of contraception.

Interaction:
Compatible with bleomycin, cisplatin, 5-fluorouracil, vincristine, prednisone. Strengthens effect (including toxicity), phenobarbital, azathioprine, 6-mercaptopurine. Inductors microsomal liver enzymes (barbiturates, rifampicin, phenytoin) increase the toxic effect of dacarbazine. Intensifies effects arthrifuge drugs, as well as bone marrow depression on the background of myelotoxicity of drugs. dacarbazine may increase the photosensitizing action metoksipsoralena. dacarbazine solution are chemically incompatible with heparin, hydrocortisone, L-cysteine and sodium bicarbonate.

Daclizumab

Trade name:
Zenapaks

International name:
Daklizumab (Daclizumab)

Group Affiliation:
Immunosuppressant

Description of the active substance (INN):
Daklizumab

Dosage Form:
Concentrate for solution for infusion

Mode of action:
Selective immunosuppressant, is a recombinant antibody IgG1 (anti-Tas) acting as receptor blockers to interleykinu2. It is specific binds to the alpha-subunit receptor complex vysokoaffinnogo interleykina2 (which is expressed on activated T-cells) and inhibits the binding and its biological activity. Inhibits interleykinom2 mediated activation of lymphocytes (link in the pathogenesis of immune response that underlies the rejection of the transplant). In the recommended doses saturates the receptor subunit vysokoaffinnogo receptor complex interleykina2 within 90 days. There is no marked changes in the number of circulating lymphocytes, or cell phenotypes, except for transient decrease in Tas- positive cells. Reduces the frequency of histologically confirmed acute renal allograft rejection within 6 months after transplantation and significantly prolongs the time before the first episode of rejection. Increasing the frequency of rejection after the cancellation is not marked.

Indications:
Prevention of acute graft rejection reaction kidneys (consisting of combined immunosuppressive therapy with cyclosporine and GCS).

Contraindications:
Hypersensitivity.

Side effects:
On the part of the digestive system: nausea, vomiting, diarrhea or constipation, abdominal pain, stomachalgia, flatulence, gastritis, hemorrhoids. On the part of the SSA: the reduction and / or raising blood pressure, tachycardia, thrombosis. The nervous system: weakness, dizziness, headache pain, insomnia, depression and anxiety, epileptic syndrome, tremor. On the part of the urinary system: oliguria, dysuria, nefronekroz, nephrotoxicity, hydronephrosis, bleeding from urinary tract, renal failure, peripheral edema, urinary retention. the respiratory system: dyspnea, pulmonary edema, cough, pulmonary atelectasis, chronic pneumonia, pharyngitis, rhinitis, hypoxia, pleural effusion. From a musculoskeletal: myalgia, ossalgiya, arthralgia, pain in the lumbar spine. Allergic reactions: chills, fever, itching, skin rash, anaphylactoid reaction. Local reaction: flushing, pain at the injection site, lymphocele. Other: poor wound healing, acne, hirsutism, increased sweating, hyperglycemia, phlegmon, visual disturbances.

Dosage and administration:
B / c, for 15 minutes in the peripheral or central vein. Adults and children first injection is carried out for 24 hours before transplantation at a dose of 1 mg / kg. Concentrate is diluted 0.9% NaCl solution to 50 ml. Mixing solutions can not shake the vial to avoid foaming, and should take measures to ensure the sterility of prepared diluted solution. Infusion solution should be used within 4 h after preparation, if the solution should be kept longer (up to 24 h), it should be kept in a refrigerator at 2-8 grad.S. The second and each subsequent doses given at intervals of 14 days in total - 5 doses.

Cautions:
The introduction of the drug should be performed only in a qualified medical facility. Dose adjustment in severe chronic renal failure is not required. Patients receiving immunosuppressants after organ transplantation have an increased risk of lymphoproliferative disease and opportunistic infections. Women of reproductive age should use effective methods of contraception for 4 months after last injection.

Interactions:
Pharmaceutical incompatible with other solutions. Compatible with cyclosporine, mycophenolate mycophenolate, ganciclovir, acyclovir, azathioprine, antithymocyte Ig, muromonabom-CD3 (OKT3), SCS.


Description Zenapaks product is not intended for purposes of treatment without the participation of a physician.

Dacarbazine

Trade name:
Dacarbazine

International name:
Dacarbazine (Dacarbazine)

Group Affiliation:
Antitumor agents, alkylating

Description of the active substance (INN):
Dacarbazine

Dosage Form:
lyophilisates for solution for intravenous

Mode of action:
Antitumor agents, alkylating agents, becomes active after metabolism in the liver releases diazomethane, covalently bind to SH-groups of biomolecules. As an analog of purine bases, also has the properties of antimetabolites. It blocks the synthesis of RNA and DNA (due to the formation of complexes with carbonium ions) leads to the cessation of mitosis of cells. Fazonespetsifichen.

Indications:
Melanoma, venereal disease, soft tissue sarcoma (excluding Kaposi's sarcoma). In the composition of multicomponent chemotherapy: osteogenic sarcoma, uterine sarcoma, lymphosarcoma, embryonal rhabdomyosarcoma, mesothelioma of the pleura and peritoneum, carcinoid tumor (including bronchogenic carcinoma, small cell lung cancer, thyroid cancer), pheochromocytoma, insulinoma, neuroblastoma, CNS tumors (gliomas).

Contraindications:
Hypersensitivity, severe depression of medullary hematopoiesis, severe hepatic and / or renal failure, pregnancy, laktatsii.C caution. Mielodepressiya (including on a background of concomitant radio-and chemotherapy), acute infectious viral disease (including chickenpox, herpes zoster), fungal or bacterial origin (the risk of severe complications and the generalization of the process), concomitant radiotherapy

Side effects:
On the part of the digestive tract: decreased appetite, stomatitis, nausea, vomiting rarely - increased activity of "liver" enzymes, diarrhea, and in rare cases - gepatonekroz caused by occlusion of the intrahepatic veins, possibly with fatal consequences (usually the syndrome arose during the 2 treatment) - fever, eosinophilia, abdominal pain, liver enlargement and shock, the severity of which increases rapidly for several hours or days. From the side of blood: anemia, granulocytopenia, thrombocytopenia, leukopenia. the nervous system: headache, blurred vision, confusion, marked drowsiness, seizures, asthenia, paresthesia, hypoesthesia skin. On the part of the endocrine system: alopecia, amenorrhea, azoospermia. Allergic reactions: skin rash, flushing skin, a feverish syndrome, anaphylactic reaction. Local reactions: pain in the injection site and along the veins when the product enters the skin - a sharp pain at the injection site and necrosis of surrounding tissues. Other: increased bleeding, hemorrhage, superinfection, thrombosis of hepatic veins, myalgia, flu-like syndrome. With long-term use increases the risk of novoobrazovaniy.Peredozirovka. Symptoms: increased suppression of bone marrow hematopoiesis and severity of diarrheal disorders. Treatment: symptomatic, specific antidote known.

Dosage and administration:
When choosing the dose and the drug treatment in each individual case should use the data of literature. The drug is introduced strictly in / in. Doses up to 200 mg / m entered the jet slowly over 1-2 minutes. Higher doses should be administered in the form of intravenous infusion over 15-30 min. Usually used as monotherapy dacarbazine at a dose of 200-250 mg / m daily for 5 days. Repeated courses are held at intervals of 3 weeks. In combination with other cytostatic agents dacarbazine is introduced at a dose of 100-150 mg / m 4-5 consecutive days at intervals of 4 weeks or 375 mg / m² every 15 days. Before the introduction of product diluted with water for injection to achieve a concentration of 10 mg / ml. For freshly prepared solution for infusion solution is diluted in 200-300 ml 0.9% NaCl solution or 5% dextrose solution (solution of dacarbazine should be protected from light).

Cautions:
The drug should be administered under the supervision of a physician who has considerable experience in conducting anti-tumor therapy. During and after treatment is necessary to monitor patterns of peripheral blood, liver function and its size. In the event of violations by the liver or kidneys, symptoms of hypersensitivity to the drug or thrombosis hepatic veins dacarbazine treatment should be stopped immediately. When the first signs of extravasation dacarbazine (burning or pain at the injection site), the introduction should be stopped immediately. The remaining dose should be introduced in other vein. At the period of treatment should be abandoned immunization (including all family members residing with the patient), oral polio vaccine, as well as to avoid contact with people who receive it, or wear a protective mask, Cover your mouth and nose. If you suspect depression blood should avoid contact with patients with bacterial infections. During the treatment sessions to avoid contact sports and other situations which are likely to hemorrhage and trauma. Given that the different sensitivity of dacarbazine, the solutions of the drug should be stored protected from light. Women and men during treatment and for 6 months after should use reliable methods of contraception.

Interactions:
Compatible with bleomycin, cisplatin, 5-fluorouracil, vincristine, prednisone. Strengthens effect (including toxicity), phenobarbital, azathioprine, 6-mercaptopurine. Inductors microsomal liver enzymes (barbiturates, rifampicin, phenytoin) increase the toxic effect of dacarbazine. Intensifies effects arthrifuge drugs, as well as bone marrow depression on the background of myelotoxicity of drugs. dacarbazine may increase the photosensitizing action metoksipsoralena. dacarbazine solution are chemically incompatible with heparin, hydrocortisone, L-cysteine and sodium bicarbonate.


Description of the drug dacarbazine is not intended for purposes of treatment without the participation of a physician.

Paracetamol

Trade name:
Daynafed EX

International name:
Paracetamol (Paracetamol)

Group Affiliation:
Analgetic non-narcotic means

Description of the active substance (INN):
Paracetamol

Dosage Form:
capsule, effervescent powder for solution for oral use [for children], solution for infusion, Solution for oral use [for children], syrup, rectal suppositories, rectal suppositories [children], a suspension for oral, suspension

Mode of action:
Non-opioid analgesics, blocks and TSOG1 TSOG2 predominantly in the CNS, acting on pain centers and thermoregulation. In inflamed tissue the cellular peroxidase neutralize the influence of paracetamol on COX, which explains the almost complete absence of anti-inflammatory effect. The absence of a blocking effect on the synthesis of Pg in peripheral tissues determines that it has no negative effect on water-salt metabolism (delay of Na + and water) and gastrointestinal mucosa.

Indications:
Feverish syndrome on a background of infectious diseases, pain (mild to moderate severity): arthralgia, myalgia, neuralgia, migraine, toothache and headache, algomenorrhea.

Contraindications:
Hypersensitivity, the neonatal period (up to 1 month). C care. Renal and hepatic failure, benign hyperbilirubinemia (including Gilbert's syndrome), viral hepatitis, alcoholic liver disease, alcoholism, pregnancy, lactation, old age, early infancy (up to 3 months), lack of glucose-6-phosphate dehydrogenase; diabetes mellitus (for syrup).

Side effects:
On the part of the skin: itching, skin rash and mucous membranes (usually erythematous, rash), angioedema, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome). On the part of the CNS (usually develops when taking high doses): dizziness, psychomotor agitation, and disorientation. On the part of the digestive system: nausea, epigastric pain, increased activity of "liver" enzymes, usually without the development of jaundice, gepatonekroz (dose-dependent effect). From the Endocrine: hypoglycemia, up to hypoglycemic coma. From the side of blood: anemia, sulfgemoglobinemiya and methemoglobinemia (cyanosis, shortness of breath, pain in the heart), hemolytic anemia (especially for patients with deficiency of glucose-6-phosphate dehydrogenase). With prolonged use at high doses - aplastic anemia, pancytopenia, agranulocytosis, neutropenia, leukopenia, thrombocytopenia. On the part of the urinary system: (in large doses) - nephrotoxicity (renal colic, interstitial nephritis, papillary necrosis). Overdosage. Symptoms (acute overdose develops within 6-14 h after administration of paracetamol, chronic - within 2-4 days after exceeding the dose) acute overdose: dysfunction of the gastrointestinal tract (diarrhea, decreased appetite, nausea and vomiting, abdominal discomfort and / or pain in the abdominal), increased sweating. Symptoms of chronic overdose: development hepatotoxic effect, characterized by common symptoms (pain, fatigue, weakness, increased sweating), and specific, characterizing liver lesions. As a result, may develop gepatonekroz. Hepatotoxic effect of paracetamol may be complicated by the development of hepatic encephalopathy (disturbances of thinking, CNS depression, stupor), convulsions, respiratory depression, coma, cerebral edema, hypocoagulation, the development of DIC-syndrome, hypoglycemia, metabolic acidosis, arrhythmia, collapse. Rarely abnormal liver function developed at lightning speed and can be complicated by kidney failure (renal tubular necrosis). Treatment: An Introduction donators of SH-groups and precursors of glutathione synthesis - through methionine 8-9 h after the overdose, and N-acetylcysteine - 12 pm The need for additional therapeutic interventions (further introduction of methionine, in / in the introduction of N-acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as the time elapsed after the reception.

Dosage and administration:
Inside, with plenty of fluid after 1-2 hours after meals (reception immediately after a meal leads to delay the onset of action). Adults and adolescents older than 12 years (body weight 40 kg) single dose - 500 mg and the maximum one-time dose - 1 of Multiplicity purpose - to 4 times a day. The maximum daily dose - 4 g and the maximum duration of treatment - 5-7 days. In patients with disorders of the liver or kidneys, with Gilbert syndrome, in elderly patients with daily dose should be reduced and increase the interval between doses. Children: The maximum daily dose for children up to 6 months (up to 7 kg) - 350 mg, up to 1 year ( to 10 kg) - 500 mg, up to 3 years (15 kg) - 750 mg, up to 6 years (up to 22 kg) - 1 g, up to 9 years (30 kg) - 1.5 g, up to 12 years (up to 40 kg) - 2 years in the form of a suspension: Children 6-12 years - 10-20 ml (5 ml - 120 mg), 1-6 years - 5-10 mL, 3-12 months - 2.5-5 ml. The dose for children aged 1 to 3 months is determined individually. Multiplicity pattern - 4 times a day interval between each reception - at least 4 h. The maximum duration of treatment without consulting a doctor - 3 days (for admission as an antipyretic drug) and 5 days (as an analgesic). Rectally. Adults - 500 mg 1-4 times a day and a maximum single dose - 1 g, the maximum daily dose - 4 PM Children 12-15 years - 250-300 mg 3-4 times a day, and 8-12 years - 250 -300 mg 3 times daily, 6-8 years - 250-300 mg 2-3 times a day, 4-6 years - 150 mg 3-4 times a day, 2-4 years - 150 mg 2 - 3 times a day, 1-2 years - 80 mg 3-4 times a day, from 6 months to 1 year - 80 mg 2-3 times a day from 3 months to 6 months - 80 mg 2 times day.

Cautions:
With the continued feverish syndrome during treatment with paracetamol for more than 3 days, and pain for more than 5 days is required doctor's consultation. The risk of liver damage increases in patients with alcoholic hepatosis. Distorts the performance of laboratory research in quantitative determination of glucose and uric acid in plasma. During the long treatment is necessary to monitor patterns of peripheral blood and functional state of the liver. syrup contains 0.06 XE sucrose 5 ml, which should be considered when treating patients with diabetes mellitus.

Interactions:
Urikozuricheskih reduces the effectiveness of drugs. Concomitant use of paracetamol at high doses increases the effect of anticoagulant drugs (reduced synthesis prokoagulyantnyh factors in the liver). Inductors microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, fenilbutazon, tricyclic antidepressants), ethanol, and hepatotoxic drugs increase the production hydroxylated active metabolites, leading to the possibility of severe intoxication, even with a small overdose. Prolonged use barbiturates reduce the effectiveness of paracetamol. Ethanol contributes to the development of acute pancreatitis. microsomal oxidation inhibitors (including cimetidine) can reduce the risk of hepatotoxic action. Long-term joint use of paracetamol, etc . NSAIDs increases the risk of "analgesic" nephropathy and renal papillary necrosis, onset of end-stage renal failure. Simultaneous long-term assignment in high doses of paracetamol and salicylates increases the risk of kidney cancer or bladder. Diflunisal increases the plasma concentration of paracetamol by 50% - the risk of hepatotoxicity . myelotoxic drugs increase the expression gematotoksichnosti drug.


Description of the drug Daynafed EX is not intended for purposes of treatment without the participation of a physician.

DAIVONEX

Pharmacological action

The drug for the treatment of psoriasis. Calcipotriol is an analog of vitamin D. It stimulates the morphological differentiation and inhibits proliferation of keratinocytes that lies at the basis of its therapeutic effect in psoriasis.

Calcipotriol is a potent inhibitor of activation of T-lymphocytes induced by interleukin I.

Effect of calcipotriol on calcium metabolism in 100 times weaker than vitamin D 3.


Pharmacokinetics

Transdermal absorption of calcipotriol, depending on the dose, from 1% to 5%. Calcipotriol undergoes rapid biotransformation in the liver with the formation of pharmacologically inactive metabolites.

T 1 / 2 is very short.


Statement

- Vulgar psoriasis (including chronic psoriasis of the scalp).


Dosage regimen

Ointment

For the adult maximum daily dose is 15 g, the maximum dose per week - less than 100 g ointment applied thinly to the affected skin 2 times a day. Therapeutic effect is usually observed after 1-2 weeks of starting treatment. Duration of treatment - no more than 6-8 weeks.

For children under the age of 12 years, the maximum dose per week is 1975 The ointment is applied a thin layer to affected skin 2 times a day.

For children aged 6 to 12 years maximum dose per week - no more than 1950 ointment applied thinly to the affected skin 2 times a day.

Cream

For the adult maximum daily dose is 15 g, the maximum dose per week - less than 100 g. The cream is applied thinly on the affected skin 2 times a day. The therapeutic effect is observed after 1-2 weeks of starting treatment. Duration of treatment - no more than 6-8 weeks.

Solution

For adults the maximum total dose per week is 60 ml. A small amount of solution is applied to the affected areas of the scalp 2 times per day (morning and evening).


Side effect

Dermatological reactions: possible local irritation, erythema and itching of the skin, seldom - dermatitis (including dermatitis and perioral skin when applying the solution), exacerbation of psoriasis, and in some cases - hyperpigmentation, photosensitivity.

On the part of metabolism: in some cases - hypercalciuria, hypercalcemia.

Allergic reactions: in some cases - angioedema in the face (when using the drug in solution).


Contraindications

- Diseases which are accompanied by violations of calcium metabolism;

- Hypersensitivity to the drug's components.

With care use in patients with hypercalcemia, hypercalciuria, hypervitaminosis D, nephrolithiasis in children in the appointment of the cream and the solution (under 6 years old - in the appointment of the ointment) in the absence of experience in the application; in patients over 65 years.


Application of pregnancy and breastfeeding

Do not use Dayvoneks during pregnancy and lactation. Safety of the drug during pregnancy and lactation not established. It is not known whether calcipotriol is allocated through breast milk.


Application for violations of liver function

No data


Application for violations of renal function

No data


Cautions

Patients should be informed of that before applying Dayvoneksa should consult with your doctor.

Do not apply ointment, lotion and solution of the drug on the skin.

To avoid skin contact person hands should be thoroughly cleaned after each use, ointments, creams or solution.

Hypercalcemia develops in excess of the maximum dose of calcipotriol per week. If you remove the drug concentration of calcium in the blood rapidly returning to normal.

In the case of solution with ointment or cream should be borne in mind that the total dose of calcipotriol should not exceed 5 mg per week, which corresponds to 60 ml and 40 g of cream or ointment or 40 mL and 60 g of ointment or cream (1 ml corresponds to 1 g 1 g ointment or cream).

Treatment Dayvoneksom can be combined with PUVA-therapy.

Effects on ability to drive vehicles and management mechanisms

Dayvoneks not affect the ability to drive motor vehicles and management mechanisms.


Overdose

Symptoms: when using the drug in doses exceeding the recommended may increase the concentration of calcium in the blood.

Treatment: removal of the drug.


Drug interaction

Dayvoneks should not be used in conjunction with drugs for topical use containing salicylic acid.


To the top

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


Terms and Conditions of storage

The drug should be stored at temperatures not above 25 ° C in the reach of children. Shelf-life creams and ointments for external application - 2 years, solution for outdoor applications - 3 years.

DAIVOBET

Pharmacological action

Combined preparation for topical treatment of psoriasis. Calcipotriol is a synthetic analogue of the active metabolite of vitamin D, inhibits proliferation of keratinocytes and accelerates their morphological differentiation.

Betamethasone - GCS, when used externally has a local anti-inflammatory, antipruritic, vasoconstrictor and immunosuppressive effects. The use of occlusive dressings increases the effect of SCS for external use, because it increases their penetration into the skin itself.


Pharmacokinetics

Absorption and distribution

When applied topically suction calcipotriol and betamethasone through intact skin is less than 1%. When applying the product to psoriatic plaques and under occlusive dressings absorption increases.

Because the skin is created depot medication, his elimination from the skin occurs within a few days.

Metabolism and excretion

Betamethasone biotransformiruetsya in the liver and kidneys with the formation of two drugs and sulfoefirov. Is derived from the feces and urine.


Statement

- Chronic patchy vulgar psoriasis.


Dosage regimen

Dayvobet designated adult. Ointment applied thinly to the affected skin 1 time / day.

The maximum daily dose is no more than 15 g, the maximum weekly dose is 100 g.

Duration of treatment - 4 weeks. Perhaps a re-treatment courses.

The area of application should not exceed 30% of body surface.


Side effect

Adverse effects are classified according to frequency of occurrence: the most common> 1 / 10, parts> 1 / 100 and <1> 1 / 1000 and <1> 1 / 10 000 and <1 / 1000, very rare <1 / 10 000.

Dermatological reactions: frequent - itching, rash, burning sensation, sometimes - pain, skin irritation, dermatitis, erythema, exacerbation of psoriasis, pigmentation disorders on-site application of ointment, folliculitis, rare - pustular psoriasis.

Calcipotriol may cause local skin irritation, itching, burning, sharp pain, dry skin, erythema, rash, dermatitis, eczema and exacerbation of psoriasis.

With prolonged use of topical betamethasone (dipropionate) link development Skin atrophy, telangiectasia, striae formation, folliculitis, hypertrichosis, perioral dermatitis, allergic contact dermatitis, hyperpigmentation, colloid degeneration of the skin, as well as the increased risk of generalized pustulous psoriasis, hyper-reaction and the photosensitivity, including the extremely rare cases of angioedema and edema of the face.

Systemic reactions:

In the application of calcipotriol very rare side effect is hypercalcemia and hypercalciuria.

With topical application of betamethasone link (rare but sometimes severe, especially for prolonged use, the vast surfaces and the use of occlusive dressings) - suppression of adrenocortical function, cataracts, infection, increased intraocular pressure.


Contraindications

- Diseases which are accompanied by violations of calcium metabolism;

- Expressed in renal and hepatic failure;

- Viral (including herpes or varicella), fungal, bacterial and parasitic skin infections, rosacea, acne rosacea, acne vulgaris, perioral dermatitis, cutaneous manifestations of tuberculosis and syphilis, skin atrophy, skin ulcers, increased fragility of vessels of skin, ichthyosis, and periproctic genital itching;

- Psoriatic erythroderma, teardrop-shaped, exfoliative, pustular psoriasis;

- Hypersensitivity to the drug's components.


Application of pregnancy and breastfeeding

Health & Safety Dayvobeta during pregnancy and lactation is not installed, so the drug may only when in the opinion of the doctor therapy with its use is required.


Application for violations of liver function

Contraindicated appointment in marked hepatic insufficiency


Application for violations of renal function

Contraindicated appointment in marked renal insufficiency


Cautions

Do not apply ointment on the skin, mucous membranes and the scalp. After using the product, wash your hands.

In applying Dayvobeta in doses exceeding recommended, may develop hypercalcemia, quickly passing at lower doses or withdrawal of the drug.

Not recommended during the application Dayvobeta conduct concomitant treatment with other SCS.

Do not use the drug to large areas of skin, make up more than 30% body surface, and the folds of the skin, as well as under occlusive dressing, as This increases the likelihood of systemic absorption of GCS and the development of systemic adverse reactions.

For very long-term use of GCS for outdoor use (including Dayvobet) may develop suppression of the hypothalamic-pituitary-adrenal system with the development of reversible secondary adrenal insufficiency, or exacerbation of diabetes mellitus.

Complication of psoriasis secondary infection should be antibiotic therapy, while exacerbating the disease repeal the drug.

During treatment Dayvobetom should limit or avoid excessive exposure to natural or artificial sunlight. Application Dayvobeta with UV radiation is possible only if the potential benefit outweighs the potential risk.

Use in Pediatrics

Clinical experience with Dayvobeta in children and adolescents under the age of 18 years is missing.

Effects on ability to drive vehicles and management mechanisms

Dayvobet not affect the ability to drive motor vehicles and management mechanisms.


Overdose

Symptoms: increased content of calcium in the blood, suppressing the function of the hypothalamic-pituitary-adrenal system to the development of reversible secondary adrenal insufficiency.

Treatment: removal of preparation, if necessary, carry symptomatically. In cases of chronic toxicity GCS should be lifted gradually.


Drug interaction

To date, drug interactions drug Dayvobet not described.


To the top

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


Terms and Conditions of storage

The product should be stored out of reach of children at or above 25 ° C. Shelf life - 2 years.

After first opening of the tube shelf life - 3 months.