Flogenzim

General characteristics. Structure:

Active ingredients: 450FIP of Piece of a bromelain, 1440 FIP Pieces (24|ikat) trypsin, 100 mg of Rutinum (rutoside).

Excipients: lactose monohydrate, corn starch, magnesium stearate, the stearic acid, water purified silicon dioxide colloid, talc.

Structure of a cover: methacrylic acid and methylmethacrylate copolymer (1:1), macrogoal 6000, talc, triethyl citrate, vanillin.

Pharmacological properties:

Pharmacodynamics. FLOGENZIM represents the medicine of new generation consisting of a combination of highly active proteolytic enzymes (enzymes) of plant and animal origin - a bromelain and trypsin in combination with Rutinum. In a combination enzymes have pleyotropny (multiple) effect, possessing various pharmacological actions on pathophysiological and biochemical processes. Enzymes of drug realize the medical effects through antiinflammatory, immunomodulatory, antiagregantny, fibrinolitic, thrombolytic, antiedematous and for the second time analgeziruyushchy actions. The drug tablets covered with a kishechnorastvorimy cover tranzitorno pass upper parts of digestive tract, without injuring a stomach, are soaked up in a small intestine by a resorption of intact molecules (endocytosis, a pinocytic). Drug proteases, contacting transport blood proteins (alpha 2 - macroglobulin and alpha 1 - antitrypsin), form a reversible complex protease-anti-protease in which antigenic determinants of exogenous proteases of drug are disguised that prevents allergic reactions. As a result of formation of a complex with enzymes anti-protease (alpha 2 - macroglobulin) passes into an active form which performs function of the extracellular regulator of pro-inflammatory cytokines and growth factors, carrying out their transfer, clearance and elimination.

Formation of an active complex protease-anti-protease allows to move safely proteolytic enzymes on a vascular bed to the center of an inflammation and to the place of an injury irrespective of the place of localization in an organism. The complex holds and slows down removal of proteolytic enzymes of drug from an organism, increases time of their circulation in a vascular bed and, respectively, therapeutic effect. Getting to the center of an inflammation and a wound, proteolytic enzymes split (hydrolyze) the damaged proteins, fabrics and eliminirut (remove) cellular fragments (detritis), promoting acceleration of clarification and a wound repair.

Drug positively influences the course of inflammatory process, modulates defense reactions of an organism that promotes a physiological current of an inflammation at different stages. Proteolytic enzymes of drug accelerate disintegration of mediators of an inflammation, split cell-bound immune complexes and membrane deposits, increase activity of phagocytes, natural killerny cells, stimulate интерфероногенез. Proteases of drug reduce the level of pro-inflammatory cytokines (IL-1R, IL-6, IL-8, INF-u FNO-a) and promote increase in products of antiinflammatory cytokines (IL-4, IL-10, etc.), regulate the level of immunoglobulins and antibodies of blood. Enzymes of drug limit pathological manifestations of autoimmune and immunocomplex processes, recover an immune responsiveness of an organism.

Proteases drug reduce the level of a transforming factor of growth-betta increase in which leads to excess scarring. Proteolytic enzymes make regulatory impact on synchronization of processes of formation of a basal membrane (laminin), modulation of a wound process and an expression of factors of an angiogenesis (a vaskuloendotelialny growth factor, a growth factor of fibroblasts and some other factors). Thus, enzymes of drug promote improvement of reparative processes, the prevention of education hypertrophic and keloid cicatrixes, to development of an adhesive desease after operative measures on an abdominal cavity.

Enzymes of drug split and delete the damaged fabrics, accelerate a rassasyvaniye of hematomas and hypostases due to normalization of permeability of walls of vessels, reduction of infiltration of an interstitium plasmatic proteins, increases in elimination of a proteinaceous detritis and deposits of fibrin, improvement of microcirculation and trophic processes in a damage zone. Optimization by proteolytic enzymes of inflammatory process for the account reduction of oncotic pressure and hypostasis of fabrics, pressure decrease by nerve terminations, elimination of ischemia and normalization of microcirculation, direct proteolysis of mediators of an inflammation gives the chance to proteases to have for the second time analgezirushchy effect. At the same time proteolytic enzymes provide stimulation of processes of healing and a reparation, reduce risk of tromboembolic episodes at a long immobilization, prevent development of trophic disturbances and purulent complications.

Drug enzymes positively influence microcirculation improvement, increase in delivery of oxygen and nutrients in a wound, reduction of an inflammation in the damage center, maintenance of physiological process of regeneration and acceleration of recovery of function of bodies and fabrics.

Drug improves rheological properties of blood (viscosity and flowability) due to positive impact on a functional condition of blood cells and a vascular wall, plasticity (deformabelnost) of erythrocytes, stabilization of permeability of an endothelium, increase in fibrinolitic activity of blood serum, reduction of density  of adhesive   molecules,   decrease  in aggregation  (adhesion)  in thrombocytes.
 
Proteolytic enzymes reduce quantity of the activated forms of thrombocytes (spheroechinocytes) and micro and macrounits, thus reducing risk of a thrombogenesis in vessels and at the same time participate in a lysis of the formed blood clots. Proteolytic enzymes reduce the level of atherogenous lipids, promoting increase in lipoproteins of high density, decrease in risk of development of atherosclerosis and vascular disorders.

Drug improves blood supply of bronchial tubes and pulmonary fabric at the chronic respiratory diseases including caused by smoking improves viscous properties of a bronchial secret, function of a ciliary epithelium, recovers drainage function of bronchial tubes, liquefies a phlegm that facilitates breath and reduces cough.

Proteolytic enzymes of drug increase efficiency of antibiotics, at the same time reducing undesirable effects of an antibioticotherapia (дисбиоз, a syndrome of the angry intestines). Proteases improve splitting of substrates, optimize balance of a microbiota, promote recovery of endoecology of intestines.

Indications to use:

Surgery: postoperative   recovery   and  rehabilitation   of patients (improvement of reparative processes and regeneration), postoperative pyoinflammatory complications, the prevention of development of an adhesive desease and formation of a keloid cicatrix, decrease in risk of tromboembolic episodes at a long immobilization.

Traumatology: fractures of bones, injuries of sinews and sheaves, bruises and hematomas of soft tissues, sports injuries, burns, improvement of integration of endoprostheses, osteosynthesis.

Angiology: acute deep vein thrombosis, thrombophlebitises of superficial veins, posttrombotichesky disease, obliterating atherosclerosis of arteries of the lower extremities and other chronic angiopatiya, microcirculation disturbances, lymphatic hypostases (limfedema).

Urology, gynecology: inflammations of an urinogenital path (cystitis, an urethritis, tsistopiyelit, prostatitis). Acute and chronic inflammatory diseases of bodies of a small pelvis   (adnexitis,   salpingo-oophoritis),   vascular   complications of a climacteric, decrease in frequency and expressiveness of complications of replacement hormonal therapy.

Cardiology: coronary heart disease, prevention of attacks of stenocardia, decrease in risk of vascular accidents and repeated heart attacks.

Gastroenterology: hepatitises.

Rheumatology: the pseudorheumatism ankylosing a spondylarthritis, reactive arthritis, rheumatic defeat of soft tissues.

Neurology: ischemic stroke, multiple sclerosis.

Pulmonology: pneumonia, chronic obstructive pulmonary disease.

Stomatology: the prevention of complications during the postoperative period   at extraction of teeth, pyoinflammatory diseases of maxillofacial   area,   rehabilitation   and   recovery       after surgical   interventions   on   maxillofacial   area, improvement of integration of implants, an osteosynthesis.

Route of administration and doses:

Pill of drug is taken inside, not less than in 30 min. prior to food, without getting to the core, washing down with water (200 ml). After operation drug is recommended to be accepted about 2-3 days.

Treatment. Drug rassasyvaniye of hematomas, improvements of a trophicity of fabrics and reparative processes, reduction of an inflammation and hypostasis, decrease in risk of complications - fibrinferment accept after injuries and operations or an acute inflammation for splitting and removal of the damaged fabrics, development of an adhesive desease, formation of a keloid cicatrix and suppuration of a wound, on 3 tablets 3 times a day within 2 weeks. In case of need, for improvement of recovery and healing the course of administration of drug can be prolonged up to 4 weeks and more on 2 tablets 3 times a day.

Prevention of complications. For the prevention of the remote effects after operation - tromboembolic episodes, development of an adhesive desease of an abdominal cavity, trophic disturbances at a long bed rest and the patient's immobilization, drug is recommended to accept a long course in a dosage on 2 tablets 3 times a day within 4 weeks and more or for all term of an immobilization.

Use with antibiotics. At prescription of antibiotics drug is used for increase in efficiency of an antibioticotherapia and reduction of undesirable effects of antibiotics. Drug is recommended to accept during all course of an antibioticotherapia on 2 tablets 3 times a day.

Use with hormones. At purpose of long rates of hormones drug is recommended to accept for decrease in risk of development of complications (thromboses) on 2 tablets 3 times a day during all course of reception of hormonal drugs. At purpose of the replacement hormonal therapy (RHT) for decrease in risk of a vein thrombosis of the lower extremities, drug is recommended to accept on 2 tablets 3 times a day repeated courses for 2 weeks with breaks on 3 weeks 3-4 times a year.

Prevention. For the prevention of a vein thrombosis of the lower extremities and decrease in risk of vascular accidents (heart attack) drug is recommended to accept on 2 tablets 3 times a day a course not less than 3-4 weeks, repeating courses of administration of drug 3-4 times a year.
Change of course and dosages of drug is recommended after consultation with the doctor.

Features of use:

In case of infectious processes of FLOGENZIM does not replace antibiotics.

In case of an aggravation of a basic disease at administration of drug the temporary dose decline of drug or temporary drug withdrawal after consultation with the doctor is recommended.

Drug is not dope, does not exert a negative impact on driving of the car and performance of work, the mental and physical reactions demanding high speed.

The patients suffering from a diabetes mellitus should consider that each tablet of drug contains 0,015 grain units.

Administration of drug in the conditions of pregnancy and breastfeeding. Administration of drug with care after consultation with the doctor.

Side effects:

Drug is well transferred by patients. In some cases increase of a chair, change of a consistence and smell of a chair which are quickly stopped at temporary decrease in a dosage of drug can be observed.

Occasionally there can be an allergic reaction (skin rash, an itch) which disappears after a dose decline or drug withdrawal.

At disturbance of conditions of use of drug developing of nausea, swelling and abdominal pains, a headache, dizziness, a dieback, the general weakness, feeling of overpopulation of intestines is possible. These states disappear after decrease in a dosage or temporary drug withdrawal.

Interaction with other medicines:

Cases of incompatibility with other medicines were not noted.

Use of drug together with antibiotics increases efficiency of an antibioticotherapia.

At use with hormones drug reduces risk of a thrombogenesis.

Contraindications:

Individual  intolerance  of components  of drug.  The inborn  or acquired disturbances of coagulability of blood. Children's age.

With care (after consultation with the doctor). Carrying out hemodialysis.

Overdose:

Cases of overdose of drug are unknown.

Storage conditions:

In the dry place at a temperature from 15 to 25 °C. To store in the place, unavailable to children. Period of validity 3 years.

Issue conditions:

Without recipe

Packaging:

On 20 tablets in PVH/A1 blisters. On 2, 5 or 10 blisters together with the application instruction in a pack cardboard. On 800 tablets in bottles from polyethylene of high density with the application instruction enclosed under a cover.