Prednikarb-Darnitsa ointment of a tube of 15 g

Pharmacological properties

Pharmacodynamics. a prednikarb-darnitsa — the combined medicine for topical administration rendering anti-inflammatory, anti-exudative, antiallergic, keratolytic, keratoplastichesky, antimicrobic and antipruritic action.

Prednisolonum — the dehydrogenated hydrocortisone analog. At external use renders anti-inflammatory, antiallergic, antipruritic and anti-exudative action. Reduces education, release and activity of mediators of inflammation (a histamine, a kinin, prostaglandins, lizosomalny enzymes). Oppresses migration of cages to the place of inflammation; reduces a vazodilatation and hyperpermeability of vessels in the inflammation center. Reduces exudation thanks to vasopressor effect. Has immunosuppressive effect on type III-IV of reaction of hypersensitivity, inhibiting effect of complexes antigen — an antibody, the blood vessels collecting on walls and causing an allergic vasculitis. Reduces expressiveness of action of macrophages, target cells, the cytokines participating in development of reaction in the form of allergic contact dermatitis. Prevents access of sensibilized T lymphocytes and macrophages to target cells.

Mochevin's (carbamide)

is regulated by water balance of skin and provides its turgor. Interacting with a keratin in skin cells, strengthens its hydration and desquamation of the keratosic layer, has keratoplastichesky (softens the keratosic epithelium) and keratolytic effects. Urea in concentration of 10% at topical administration renders bacteriostatic and fungistasis. Has insignificant superficial mestnoanesteziruyushchy effect at the expense of what has antipruritic effect, it is additive amplifying similar effect of Prednisolonum.

Pharmacokinetics. At topical administration there is Prednisolonum absorption.

Prednisolonum gets through a placental barrier and in small amounts into breast milk. The excipients which are a part of ointment hold urea in the site of application, interfere with its absorption in a system blood-groove.

Indication

Psoriasis, atopic dermatitis, various forms of eczema (including with a likhenization), the dyshydrosis, seborrheal dermatitis, an ichthyosis, an ikhtiozoformny dermatosis which are followed by dryness and a hyperkeratosis.

Use

to Adults and children is aged more senior than 1 year. to apply outwardly. to apply ointment a thin layer on affected areas of skin 1–3 times a day. on limited sites for strengthening of effect use of occlusive bandages is possible. duration of a course of treatment is determined by the doctor depending on the nature of a disease and efficiency of therapy, usually the course of treatment makes 6–14 days.

to children should limit to

When assigning the general duration of treatment up to 5–7 days and to exclude the measures leading to strengthening of absorption of GKS (warming, fixing and occlusive bandages).

Contraindication

Individual hypersensitivity to medicine components; Cushing's syndrome; chicken pox; vaccination period; herpes simplex, wounds and ulcers; bacterial, viral, fungal infections of skin, tuberculosis cutis; skin manifestations of syphilis; skin tumors; ordinary eels, pink eels; the dermatosis which is followed by the expressed exudation.

Side effects

from the immune system: development of allergic reactions is possible.

from skin and hypodermic cellulose: at use of medicine can arise: an itch, hyperaemia, hypostasis, rash on skin, dermatitis, urticaria, xeroderma, burning sensation, prickings, irritation of skin, steroid eels, purple, a teleangiectasia.

At prolonged use or application on extensive sites of skin the manifestation of system side reactions, in particular development of secondary infectious damages of skin, atrophic changes, a hypertrichosis, a hypercorticoidism is possible

.

General violations and reactions in the site of application: skin cracks in the site of application are possible, such side effects (frequency is not determined) as skin thinning (skin atrophy), emergence of striya, inflammation of hair follicles can be observed (folliculitis), skin discoloration, bacterial cellulitis.

Special instructions

needs to Appoint by

medicine in the minimum dose and to minimum short terms necessary for achievement of necessary therapeutic effect.

it is desirable for

in order to avoid impact on healthy fabrics that the site of skin on which apply ointment did not exceed the size of the struck zone.

Treatment should be carried out by

under control of the doctor. In the course of treatment the control of the oculist, control of the ABP is necessary.

for the purpose of reduction of expressiveness of side effect should alternate corticosteroids and nonsteroid medicines.

Maksimalno dopustimaya Square of the integument processed by medicine should not exceed 20% of a body surface.

needs to Use GKS short courses and only for aggravation treatment, but not for prevention.

When prescribing medicine should consider a day-night secretory rhythm of GKS: appoint high doses, in the afternoon in the morning — averages, in the evening — minimum.

Sudden medicament withdrawal is dangerous by

as exacerbation of a disease and deterioration in the general condition of the patient is possible. It is necessary to cancel medicine gradually.

during treatment should not carry out vaccination against smallpox or other types of immunization owing to immunodepressive effect of GKS. To avoid hit of medicine in eyes, on mucous membranes and a hairy part of the head. In the presence in the anamnesis of the instruction to psychosis the high doses are appointed under stringent control of the doctor.

to apply

With care at immunodeficiency (including AIDS or HIV infection).

At emergence of irritation of skin or emergence of signs of hypersensitivity in connection with use of ointment treatment the patient should stop and pick up adequate therapy.

in case of prolonged use of medicine at application on a big body surface, especially at children, system side effects from an endocrine system are possible

. These side reactions develop exclusively seldom, have reversible character and disappear right after medicine phase-out. Regular control of function gipotalamo - a hypophysial and adrenal system is necessary for such patients during use of medicine. At emergence of symptoms of oppression of function gipotalamo - a hypophysial and adrenal system it is necessary to cancel medicine or to increase intervals between ointment appliques. Use of local steroids for treatment of psoriasis can lead in certain cases to a disease recurrence, development of tolerance, to increase risk of generalized pustulous psoriasis and development local or system (reversible oppression gipotalamo - a hypophysial and adrenal system) toxicity in connection with reduced barrier function of skin. Therefore at treatment of psoriasis medicine constant observation of a condition of the patient is important.

to

in case of development of fungal or bacterial superinfection of skin needs additional use of antifungal or antibacterial agent.

Use during pregnancy and feeding by a breast. Contraindicated.

Children. At children 1 years are aged more senior use medicament on limited sites of skin a short course (5–7 days). Use of medicine for children at the age of 1–3 years is possible if the expected effect of therapy exceeds potential risk for the child. In such cases it is necessary to limit the general duration of treatment and to exclude the actions causing the strengthenings of a resorption and absorption of steroid (warming, fixing and occlusive bandages). Diapers can render occlusal effect. It is necessary to avoid prolonged use at children irrespective of age. At prolonged use for prevention of local infectious complications the application in combination with antimicrobial medicines is possible. It is not recommended to apply on big surfaces. It is necessary to remember that the more the area of putting medicine, the is higher a likelihood of development of side reactions. At use of medicine for children it is necessary to consider possibility of signs of oppression gipotalamo - a hypophysial and adrenal system which arise at children more often than at adult patients that is connected with bigger absorption of medicine at children owing to bigger value of a ratio of the area of integuments to body weight.

At the children receiving corticosteroids for topical administration noted oppression of function of adrenal glands, Cushing's syndrome, a growth inhibition, insufficient gain of body weight, increase in intracranial pressure.

Ability to influence speed of response at control of vehicles or work with other mechanisms. Does not influence.

Interaction

Glucocorticosteroid medicines of systemic and local action enhance effects of medicine.

Combined application with antimicrobic and antifungal medicines promotes prevention of consecutive infection at prolonged use of medicine.

Overdose

Depending on quantity of the corticosteroid which came to an organism the development of both local, and system side reactions is possible

. at overdose of medicine it is impossible to stop sharply treatment — it is done, gradually reducing a medicine dose. at development of symptoms of insufficiency of bark of adrenal glands the introduction of a hydrocortisone can be required.

Storage conditions

In original packing at a temperature not above 25 °C. not to freeze.