Hydrocortisone

General characteristics. Structure:

Active ingredient: 0,01 g (10 mg) of a hydrocortisone in 1 g of gel.

Vspomogatvspomogatelny substances: alcohol of 96%, glycerin, propylene glycol, isopropyl alcohol, carbomer, a dimethyl sulfoxide, diethanol amide, the water purified.

The glucocorticoid means for topical administration possessing antiinflammatory, antiallergic and anti-exudative action.

Pharmacological properties:

Pharmacodynamics. The hydrocortisone – a glucocorticoid – at topical administration renders the expressed antiinflammatory, antiallergic, anti-exudative, antipruritic action. Slows down hypersensitivity reactions, proliferative and exudative processes in connecting fabric, in the inflammation center. Reduces a local dermahemia. Action is mediated through specific intracellular receptors. Prevents activation of a phospholipase of A2, stimulating formation of its inhibitor – a lipomodulin and owing to direct impact on cellular membranes, breaks synthesis of PG and allocation of a macrophagic chemotactic factor, inhibits activation of fabric kinin. Reduces migration of macrophages and lymphocytes in the inflammation center.

Blocks Fc – receptors on a surface of macrophages for IgG and C3 of a component of a complement. Stabilizes membranes of lysosomes, preventing release of lizosomalny enzymes. Suppresses alteration, exudation and proliferation. Slows down development of adenoid and connecting tissue, activity of hyaluronidase oppresses, reduces permeability of capillaries. Brakes products of a collagenase and activates synthesis of inhibitors of proteases, reducing thereby development of connecting fabric, adjournment of collagen and rough scarring. Blocks synthesis and release from sensitized mast cells and basophiles of a histamine and other biologically active agents, suppresses various stages of an immunogenesis, without having mitostatichesky effect.

At appointment in the recommended doses does not cause suppression гипоталамо - pituitary and adrenal system.

Pharmacokinetics. Absorption. After drawing on skin there is an accumulation of active agent in epidermis, generally in a granular layer. System absorption is insignificant. A small amount of a hydrocortisone is soaked up in a system blood stream in not changed look.

Metabolism. The most part of a hydrocortisone is metabolized directly in epidermis and, in the subsequent, in a liver.

Removal. Metabolites and an insignificant part of not changed hydrocortisone are removed with urine and with bile.

Indications to use:

Inflammatory and allergic diseases of skin of not microbic etiology, including eczema;
• dermatitis (allergic, atopic, violent herpetiform, exfoliative, seborrheal, contact);
• pruritic dermatosis;
• photodermatoses;
• anogenitalny itch;
• stings of insects;
• pempigus;
• erythrosis;
• psoriasis;
• red flat deprive.

Route of administration and doses:

Gel is applied with a thin layer on affected areas of skin by 1-3 times a day, slightly rubbing. Duration of a course of treatment depends on the nature of a disease and efficiency of therapy, making usually 6-14 days. It is not necessary to use drug longer than 14 days. At purpose of drug to children 2 years are more senior it is necessary to limit the general duration of treatment up to 3-7 days and to exclude the measures leading to strengthening of absorption of corticosteroids (warming, fixing and occlusive bandages).

Features of use:

It is necessary to avoid hit of gel in eyes. It is not necessary to apply medicine on periorbital area in connection with risk of development of glaucoma.

Treatment should be carried out under control of the doctor. It is necessary to appoint drug in the smallest dosages and in minimum short terms, necessary for achievement of the necessary therapeutic effect. If after 7 days of use there does not occur improvement or the aggravation of symptoms, and also in case of resuming of symptoms later after medicine cancellation is observed several days, its use it is necessary to stop and consult with the doctor. Prolonged use of gel has to be limited at arterial hypertension, stomach ulcer and a 12-perstny gut, a diabetes mellitus, Itsenko-Cushing's disease, a renal failure, ulcer colitis, mental diseases, oral administration of NPVP. At prolonged treatment it is necessary to control the ABP, concentration of glucose and cortisol in blood, a diuresis, body weight.

With care it is necessary to apply at immunodeficiency (including AIDS or to the HIV-positive people).

At use of gel for children of 2 years is also more senior it is necessary to limit the general duration of treatment and to exclude the actions leading to strengthening of a resorption and assimilation of a steroid (warming, fixing and occlusive bandages). At children's age suppression of function of bark of adrenal glands can quicker develop. At drug use for a long time for children it is necessary to watch the body weight, growth, plasma cortisol level.

Pregnancy and lactation. Use during pregnancy is possible only in case the estimated advantage for mother exceeds potential risk for a fruit, especially in the I trimester. In the period of a lactation it is recommended to stop breastfeeding.

Corticosteroids get through a placenta. Impact on a fruit can be especially expressed when putting drug on big affected areas.

Influence on ability to drive the car or other mechanisms. This medicine does not influence ability to drive the car and to work with mechanisms.

Side effects:

Emergence of local irritation at hypersensitivity to medicine components is possible.

Excessively long and too frequent use of medicine, and also its use on big sites of defeat or with use of occlusive bandages, can create conditions for increase in absorption of a hydrocortisone from the place of application that can be shown by system side effects.

At prolonged treatment also development of secondary infectious damages of skin, atrophic changes, a hypertrichosis is possible.

Interaction with other medicines:

At topical administration of a hydrocortisone in the form of gel medicinal interaction is not described. During treatment it is not necessary to carry out vaccination against smallpox or other types of immunization through an immunodepressive effect of GKS, especially at prolonged use on the big surface area of skin.

Contraindications:

- hypersensitivity to a hydrocortisone and other components of medicine;
- postvaccinal period;
- bacterial, viral and fungus diseases of skin (pyoderma, herpes, mycosis), tuberculosis cutis;
- disturbance of integrity of integuments (ulcer, wound);
- syphilitic damages of skin;
- skin tumors;
- children's age (up to 2 years, at an itch in the field of an anus – up to 12 years);
- rozatsea, vulgar eels, perioral dermatitis.

Overdose:

At overdose strengthening of manifestations of side reactions is possible. At prolonged use of a hydrocortisone in large numbers emergence of symptoms of a hypercorticoidism is possible. Symptomatic treatment.

It is necessary to cancel use of drug and to see a doctor.

Storage conditions:

To store in the place protected from light at a temperature not above +25 °C. To store in the place, unavailable to children. Period of validity 2 years.

Issue conditions:

According to the recipe

Packaging:

On 7,0 g, 15,0 g, 30,0 g and 50,0 g in the tubas placed together with a leaf insert in a pack from a cardboard.