Composition
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of 1 g of ointment for external use contains: Â
Active ingredients:
flumetasone pivalate 200 mcg,
salicylic acid 30 mg.
Auxiliary substances: Â
propylene glycol,
lanolin anhydrous,
white vaseline.
Pharmacological action
Lorinden A is a combination drug with anti-inflammatory and keratolytic effects for external use.
Flumetasone pivalate is a synthetic corticosteroid that has anti-inflammatory, anti-edematous, anti-allergic, and antipruritic effects. It inhibits the activity of phospholipase A2, which leads to suppression of the synthesis of prostaglandins and leukotrienes, and inhibits the release of inflammatory mediators.
Inhibits the migration of white blood cells and lymphocytes to the focus of inflammation. Prevents marginal accumulation of neutrophils, which leads to a decrease in inflammatory exudate, cytokine production and inhibition of macrophage migration, resulting in reduced infiltration and granulation processes. Inhibits the proteolytic activity of tissue kinins, delays the growth of fibroblasts, and prevents the development of connective tissue in the focus of inflammation. Reduces hyperemia, hypersensitivity reactions, proliferative and exudative processes occurring in the connective tissue in the focus of inflammation.
Salicylic acid is an NSAID, promotes the penetration of corticosteroids and gives the drug an additional antiparakeratous, moderate keratolytic and local hypothermic property, promotes the penetration of Flumetasone into the skin. In addition, it has an antibacterial and fungicidal effect, and also restores the protective function of the skin. Suppresses the secretion of sebaceous and sweat glands.
Pharmacokinetics
Suction
Absorption of flumetasone pivalate is higher in children than in adults and increases when used in the area of skin folds, on the face, on skin with damaged epidermis and skin affected by the inflammatory process, under occlusive dressings, when used on large areas of the skin (in this case, it can have a systemic effect).
Distribution
Due to the external route of application and keratolytic action of salicylic acid, flumetasone pivalate easily penetrates the stratum corneum of the skin, through the keratinized layers of the skin, where it accumulates.
Metabolism
Flumetasone pivalate is practically not metabolized in the skin. After insignificant absorption into the systemic circulation of flumetasone, pivalate is biotransformed in the liver.
Deduction
It is excreted in the urine and, to a lesser extent, with bile in the form of compounds with glucuronic acid, as well as in small amounts in unchanged form.
Indications
Lorinden A ointment is prescribed for:
- eczema-subacute or chronic;
- diffuse neurodermatitis;
- atopic dermatitis;
- hyperkeratosis;
- psoriasis
- ; chronic dyshidrosis;
- lichen planus;
- seborrhea;
- photodermatitis;
- pruritus with lichenization;
- cystic skin diseases;
- warty lichen red;
- discoid lupus erythematosus;
- exudative erythema;
- insect bites.
Contraindications
It is not recommended to use the drug in patients suffering from:
- bacterial, fungal and viral skin lesions;
- skin tuberculosis;
- exudative stages of skin diseases;
- syphilis with skin manifestations;
- precancerous conditions and skin neoplasms;
- acne.
In addition, the use of ointments should be avoided at the beginning of pregnancy, with trophic ulcers from varicose veins, with hypersensitivity and in childhood. Caution should be exercised in treating patients with a diagnosis of renal failure, as there is still a risk of nephrotoxic effects of significant doses of salicylates.
Side effects
Local reactions: possible-burning, itchy skin, dry skin; with prolonged use-skin atrophy, local hirsutism, telangiectasia, purpura, steroid acne, perioral dermatitis, pigmentation disorders.
Systemic reactions: with prolonged use, application to large areas of the skin and/or use of occlusive dressings, side effects characteristic of corticosteroids may occur.
When Lorinden A is applied externally on the skin of the eyelids, cataracts or glaucoma may sometimes develop in the future.
Interaction
During treatment with the drug, it is contraindicated to carry out vaccination and immunization due to the immunosuppressive effect of the drug.
Do not use in combination with other medications for external use.
With systemic absorption of the drug, corticosteroids reduce the effect of insulin, oral hypoglycemic agents, antihypertensive drugs, anticoagulants, and reduce the concentration of praziquantel in the blood serum.
The combination of Lorinden A with the following medications increases the risk of side effects: androgens, estrogens, oral contraceptives, anabolic steroids ( hirsutism, acne), antipsychotics, bucarban, azathioprine (cataract), anticholinergic blockers, antihistamines, tricyclic antidepressants, nitrates (glaucoma), diuretics (hypokalemia), cardiac glycosides (digitalis intoxication).
How to take, course of use and dosage
Externally.
The ointment is applied in a thin layer on the skin in the affected area 2-3 times a day. After removing acute inflammation, the drug is used 1-2 times / day. After the complete disappearance of painful manifestations, treatment is carried out for another 3-4 days. For chronic skin lesions, treatment should not be continued for more than 3 weeks.
The ointment can also be applied as an occlusive dressing, which should be changed every 24-48 hours. In the treatment of lesions on dry and non-greasy skin areas characterized by severe infiltration, lichenization, desquamation and hyperkeratosis, as well as homozolism, the degree of moisture can be adjusted using the thickness of the applied layer, in accordance with the therapeutic requirements specific to each individual case.
Overdose
Symptoms: extremely rare when used on very large areas of the skin, systemic manifestations of corticosteroids and/or symptoms of salicylate poisoning are possible.
Special instructions
Lorinden A is an adequate drug for the treatment of lesions on dry and fat-free areas of the skin, characterized by severe infiltration, lichenization, desquamation and hyperkeratosis, as well as omozolelost; it is easily applied, adheres well to dry skin, increases the fat content in it and helps to retain moisture. The degree of hydration can be adjusted by the thickness of the applied layer, in accordance with the therapeutic requirements specific to each individual case.
It is contraindicated to apply the drug on the face. It is necessary to ensure that the drug does not get on the mucous membranes and conjunctiva.
It is not recommended to exceed the course of treatment. With prolonged use of the ointment on large areas of the skin, the frequency of side effects increases.
If an infection occurs at the site of application of the ointment, you should use products with a more pronounced antibacterial or antifungal effect.
It should be used with caution in patients with atrophic skin changes, especially in elderly patients.
The ointment does not contaminate clothes and bed linen.
– Use in patients with impaired renal function, repeated application to large areas of the skin should be avoided in patients with severe renal insufficiency (possible systemic action of salicylic acid).
– Use in pediatrics In children, the drug is used only if absolutely necessary, in a short course, on small body surfaces.
– Influence on the ability to drive motor vehicles and manage mechanisms
The drug does not limit psychophysical activity, the ability to drive vehicles and maintain moving mechanisms.
Form of production
Ointment
Storage conditions
The drug should be stored at a temperature not exceeding 25°C.
Shelf
life is 3 years.
Active ingredient
Salicylic Acid, Flumetasone
Conditions of release from pharmacies
By prescription
Dosage form
ointment
Purpose
Children as prescribed by a doctor, Adults as prescribed by a doctor
Indications
Eczema, Seborrhea, Psoriasis, Dermatitis, Insect Bites
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Side effects of Lorinden A, ointment, 15g.
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