Triderm

General characteristics. Structure:

Active agents: 0,643 mg of betamethasone of Dipropionas (0,5 mg of betamethasone are equivalent), 10 mg of Clotrimazolum, Gentamycini sulfas - in an equivalent of 1 mg (1 000 ME) of basis gentamycin.

Excipients: liquid paraffin and vaseline.

Pharmacological properties:

The combined drug for external use.
Ointment Triderm combines antiinflammatory, antipruritic, antiallergic and anti-exudative effect of a glucocorticosteroid (GKS) of betamethasone of Dipropionas with antifungal activity of Clotrimazolum and broad antibacterial action of Gentamycini sulfas.
Clotrimazolum has antifungal effect due to disturbance of synthesis of the ergosterol which is a component of a cellular membrane of mushrooms.
Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, Candida albicans, Malassezia furtur (Pityrosporum obiculare) is active concerning Trichophyton rubrum.
Gentamycin is an antibiotic of a broad spectrum of activity from group of aminoglycosides. Works bakteritsidno and provides highly effective topical treatment of primary and consecutive bacterial infections of skin. It is active concerning gram-negative bacteria: Pseudomonas aeruginosa, Aerobacter aerogenes, Escherichia coli, Proteus vulgaris and Klebsiella pneumoniae; gram-positive bacteria: Streptococcus spp. (sensitive strains of a beta and alpha and hemolitic streptococcus of group A), Staphylococcus aureus (a coagualase - positive, a coagualase - the negative and some strains producing a penicillinase).

Indications to use:

The dermatosis complicated by the infections caused by activators, sensitive to drug, or at suspicion of such infections including - simple and allergic dermatitis, atopic dermatitis (including diffusion neurodermatitis), limited neurodermatitis, eczema, dermatomycoses (dermatofitiya, candidiasis, multi-colored deprive), especially at localization in inguinal area and large folds of skin; chronic deprive idle time (limited neurodermatitis).

Route of administration and doses:

Ointment Triderm should be applied a thin layer on all struck surface of skin and surrounding fabric twice a day - in the morning and for the night. Ointment Triderm needs to be applied to ensuring efficiency of treatment regularly.
Duration of therapy depends on the size and localization of defeat, and also, reactions of the patient.
If clinical improvement does not occur after 3-4 weeks of treatment, it can be the cause for specification of the diagnosis.

Features of use:

Ointment Triderm is not intended for use in ophthalmology.
Long local use of antibiotics can sometimes lead to growth of resistant microflora. In this case, and also at development of irritation, a sensitization or superinfection against the background of treatment ointment Triderm, treatment it is necessary to stop and appoint the corresponding therapy. Cross allergic reactions with aminoglikozidny antibiotics were observed.
Any side effects which are found at use of system GKS including oppression of function of bark of adrenal glands, can be noted also at topical administration of GKS, in particular at children.

System absorption of GKS or gentamycin at topical administration will be higher if treatment is carried out on big sites of skin or when using occlusive bandages, especially at prolonged treatment or at disturbance of integrity of integuments. It is necessary to avoid putting gentamycin on open wounds and the injured skin. Otherwise emergence of the side effects characteristic of gentamycin at its system use is possible. It is necessary to observe the appropriate measures of precaution in such cases, especially at treatment of children.

At long use of drug its cancellation is recommended to be carried out gradually.
Use in pediatrics
To children drug is appointed only according to strict indications and under medical control since development of the system side effects connected with betamethasone is possible. At Triderm's use, as well as many other drugs for topical administration on the basis of GKS, on extensive surfaces and / or with an occlusive bandage function suppression gipotalamo-gipofizo-adrenal system is possible, decrease in excretion of a growth hormone, and also increase in intracranial pressure can be observed.

Side effects:

- Very seldom at Triderm's use are noted: burning sensation, erythema, exudation, disturbance of pigmentation and itch.
- The side reactions which are found at use of local GKS (especially at use of occlusive bandages): burning sensation, itch, xeroderma, folliculitis, hypertrichosis, eels, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of skin, development of consecutive infection, atrophy of skin, striya, heat rash.
- The side reactions caused by Clotrimazolum: erythema, feeling of a pricking, emergence of blisters, peeling, local hypostasis, itch, small tortoiseshell, irritation of skin.
- The side reactions caused by gentamycin: the passing irritation of skin (an erythema, an itch) which is usually not demanding the treatment termination.

Interaction with other medicines:

Data on medicinal interaction of drug Triderm are not provided.

Contraindications:

Hypersensitivity to any of drug components, a tuberculosis cutis, skin displays of syphilis, chicken pox, a herpes simplex, skin postvaccinal reactions, open wounds, children's age (up to 2 years).

With care. Pregnancy (especially in the I trimester), children's age (> 2 years), prolonged treatment, use on big sites of skin or at disturbance of integrity of integuments, use of occlusive bandages (especially at children).

Use during pregnancy and a lactation. Triderm's use during pregnancy is possible only in that case when the estimated advantage for mother surpasses potential risk for a fruit.
It is not known whether drug components with breast milk are allocated. Therefore at Triderm's appointment in the period of a lactation it is necessary to resolve an issue of the termination of chest feeding.

Overdose:

Symptoms: At prolonged use of local GKS in high doses suppression of function of adrenal glands with development of secondary adrenal insufficiency and symptoms of a hypercorticoidism, including Cushing's syndrome is possible.
The overdose of Clotrimazolum at its topical administration does not lead to emergence of any symptoms.
At single overdose of gentamycin of emergence of any symptoms it is also not expected.
Prolonged treatment by gentamycin in the raised doses can lead to growth of insensitive flora.
Treatment: symptomatic. Acute symptoms of a hypercorticoidism are usually reversible. If necessary carry out correction of an electrolytic imbalance. In case of chronic GKS of toxicity gradual cancellation of GKS is recommended.

Storage conditions:

To store in the place, unavailable to children, at a temperature up to 30 °C.

Issue conditions:

Without recipe

Packaging:

Ointment on 15 g or 30 g in the aluminum tubas processed by an epoxy varnish and closed by a membrane. The tuba is in addition closed by the screw-on polyethylene cap with the perforator for a membrane. On one tuba together with the application instruction in a cardboard pack.