Composition
Composition per suppository: Active ingredient:  Bovhyaluronidase azoximer (Longidase®) – 3000 IU; Excipient:  cocoa butter – until receiving a suppository weighing 1.3 g
Pharmacological action
Prolongation of the enzyme action is achieved by covalent binding of the enzyme to a physiologically active polymer carrier (azoximer). Longidase® exhibits antifibrotic properties, weakens the course of the acute phase of inflammation, regulates (increases or decreases depending on the initial level) the synthesis of inflammatory mediators (interleukin-1 and tumor necrosis factor-alpha), increases the humoral immune response and the body’s resistance to infection.
Pronounced antifibrotic properties of Longidase are provided by conjugation of hyaluronidase with the carrier, which significantly increases the resistance of the enzyme to denaturing effects and the action of inhibitors: the enzymatic activity of Longidase is preserved when heated to 37 °C for 20 days, while native hyaluronidase under the same conditions loses its activity during the day.
Longidase® provides simultaneous local presence of the enzyme hyaluronidase and a carrier capable of binding enzyme inhibitors and stimulators of collagen synthesis released during hydrolysis of matrix components (iron, copper, heparin, etc. ). Due to these properties, Longidase® has not only the ability to depolymerize the connective tissue matrix in fibrogranulomatous formations, but also to suppress the reverse regulatory reaction aimed at the synthesis of connective tissue components.
The specific substrate of testicular hyaluronidase is glycosaminoglycans (hyaluronic acid, chondroitin, chondroitin-4-sulfate, chondroitin-6-sulfate), which form the basis of the connective tissue matrix.
As a result of depolymerization (breaking the bond between C1 of acetylglucosamine and C4 of glucuronic or induronic acids), glycosaminoglycans change their basic properties: the viscosity decreases, the ability to bind water and metal ions decreases, the permeability of tissue barriers temporarily increases, the movement of fluid in the intercellular space is facilitated, the elasticity of connective tissue increases, which is manifested in a decrease in tissue edema, flattening of scars, an increase in the volume of joint movement, a decrease in contractures and prevention of their formation, a decrease in the adhesive process.
Biochemical, immunological, histological and electron microscopic studies have shown that Longidase® does not damage normal connective tissue, but causes the destruction of connective tissue altered in composition and structure in the area of fibrosis.
Longidase® has no mutagenic, embryotoxic, teratogenic or carcinogenic effects.
The drug is well tolerated by patients, there are no local and general allergic reactions.
The use of Longidase in therapeutic doses during or after surgical treatment does not worsen the course of the postoperative period or the progression of the infectious process; it does not slow down the recovery of bone tissue.
Indications
Adults and adolescents over 12 years of age in the form of monotherapy and as part of the complex therapy of diseases accompanied by connective tissue hyperplasia, including against the background of the inflammatory process:
- in urology: chronic prostatitis, interstitial cystitis, urethral stricture and urethral, Peyronie’s disease, early onset benign prostatic hyperplasia, prevention of scarring and strictures after surgery on the urethra, bladder, ureters;
- in gynecology: adhesions (prevention and treatment) in the pelvis in chronic inflammatory diseases of internal genital organs, after gynecological manipulations, including induced abortions migrated surgical interventions on the organs of the small pelvis; sinehii intrauterine devices, tubal-peritoneal infertility, chronic endomyometritis;
- in dermatology: limited scleroderma, prevention of fibrotic complications of sexually transmitted infections;
- in surgery: prevention and treatment of adhesions after surgical interventions on the abdominal organs; impaired wound healing;
- in pulmonology and tuberculosis: pulmonary fibrosis, sideros, tuberculosis (cavernous fibrous, infiltrative, ‘s a tuberculoma), interstitial pneumonia, fibrosing alveolitis, pleuritis;
- to increase the bioavailability of antimicrobial therapy in urology, gynecology, dermatology, surgery, pulmonology, etc.
Contraindications
- increased individual sensitivity to drugs with hyaluronidase activity, Longidase®;
- malignant neoplasms;
- pregnancy (no clinical experience);
- children under 12 years of age (efficacy and safety have not been studied).
Use with caution (apply no more than once a week): renal failure; a history of pulmonary hemorrhage.
Side effects
Rarely-allergic reactions with increased individual sensitivity.
Interaction
When using Longidase® in patients receiving high doses of salicylates, cortisone, ACTH, estrogens or antihistamines, the effectiveness of the hyaluronidase enzyme may be reduced.
When prescribed in combination with other drugs, the possibility of increasing their absorption (bioavailability) and enhancing the systemic effect should be taken into account.
How to take, course of use and dosage
Rectally,1 supp. 1 time a day after bowel cleansing.
Vaginally,1 time a day (at night) 1 supp. is inserted into the vagina in the supine position.
Longidase ® suppositories 3000IU is recommended for a course of 10 to 20 injections.
The schedule of use is adjusted depending on the severity, stage and duration of the disease: Longidase® scheduled every other day or with 2-3 day breaks.
Recommended regimens and doses:
in urology: 1 supp. in a day 10 introductions, then 2-3 days — 10 introductions General course of 20 supp. ;
– in gynecology: vaginally or rectally 1 supp. after 2 days — 10 introductions, further, if necessary, assigned to supportive therapy;
in dermatology: 1 supp. in 1-2 days — 10-15 injections;
in surgery: 1 supp. 2-3 days — 10 introductions;
– in pneumology and Phthisiology: 1 supp. 2-4 days — 10-20 injections.
If necessary, a second course of Longidase®is recommended not earlier than after 3 months or long-term maintenance therapy — 1 supp. 1 time in 5-7 days for 3-4 months.
Special instructions
Discontinue Longidase®use with the development of an allergic reaction.
When used against the background of exacerbation of foci of infection, to prevent the spread of infection, prescribe under the cover of antimicrobial agents.
Form of production
Suppositories are torpedo-shaped, light yellow in color, with a weak specific smell of cocoa butter, marbling coloring is allowed.
Active ingredient
Bovhyaluronidase azoximer
Dosage form
rectal suppositories
Description
For children over 12 years of age, For adults as prescribed by a doctor, For Children as prescribed by a doctor
Indications
Scars, Wounds, Prostatic Hyperplasia, Adhesions, Prostatitis, Tuberculosis
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Side effects of Longidaza suppositories vaginal and rectal 3000IU, 20pcs.
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