Flogenzyme, 100 pcs.

FLOGENSIM is a new generation drug, consisting of a combination of highly active proteolytic enzymes (enzymes) of plant and animal origin – bromelain and trypsin in combination with rutin. In combination the enzymes have pleiotropic (multiple) effects with a variety of pharmacological actions on pathophysiological and biochemical processes.

The enzymes of the drug realize their therapeutic effects through anti-inflammatory, immunomodulatory, anti-aggregant, fibrinolytic, thrombolytic, anti-edema and secondary analgesic actions. Tablets of the drug, coated with an enteric coating, transiently pass the upper gastrointestinal tract without damaging the stomach, are absorbed in the small intestine by resorption of intact molecules (endocytosis, pinocytosis).

The proteases of the drug, binding with blood transport proteins (α-2-macroglobulin and α-1-antitrypsin), form reversible protease-antiprotease complex, in which the antigenic determinants of exogenous proteases of the drug are masked, preventing allergic reactions. As a result of formation of the complex with enzymes, antiprotease (α-2-macroglobulin) changes into the active form which functions as an extracellular regulator of proinflammatory cytokines and growth factors, performing their transport, clearance and elimination.

The formation of an active protease-antiprotease complex allows proteolytic enzymes to move safely through the vascular bed to the focus of inflammation and to the site of injury, regardless of where they are localized in the body.

The complex retains and slows down excretion of proteolytic enzymes from the body, increases time of their circulation in the vascular bed and accordingly the therapeutic effect. Getting into the center of inflammation and wounds, proteolytic enzymes break down (hydrolyze) the damaged proteins, tissues and eliminate (remove) cellular debris (detritus), helping to accelerate wound cleansing and healing.

The drug has a positive effect on the course of the inflammatory process, modulates the body’s defense reactions, which contributes to the physiological course of inflammation at different stages. Proteolytic enzymes of the product accelerate decomposition of inflammatory mediators, break immune complexes and membrane deposits, increase activity of phagocytes and natural killer cells and stimulate interferonogenesis.

Proteases of the preparation decrease levels of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, INF-γ, TNF-α) and increase production of anti-inflammatory cytokines (including IL-4, IL-10), regulate levels of Ig and blood antibodies. Enzymes of the preparation limit pathological manifestations of autoimmune and immunocomplex processes and restore immunological reactivity of the body.

The proteases of the drug decrease the level of transforming growth factor β, the increase of which leads to excessive scarring. Proteolytic enzymes have a regulatory effect on the synchronization of basal membrane formation (laminin), modulation of the wound process and expression of angiogenesis factors (vasculoendothelial growth factor, fibroblast growth factor and several other factors). Thus the enzymes of the drug contribute to improvement of reparative processes, prevention of formation of hypertrophic and keloid scars, development of adhesions after surgical interventions on abdominal cavity.

The enzymes of the preparation decompose and remove damaged tissues, accelerate resolution of hematomas and edemas due to the normalization of vascular wall permeability, decrease of interstitial infiltration by plasma proteins, increase of elimination of protein detritus and fibrin deposits, improvement of microcirculation and trophic processes in the damaged area.

The optimization by proteolytic enzymes of the inflammatory process due to the decrease of oncotic pressure and tissue edema, reduction of the pressure on nerve endings, elimination of ischemia and normalization of microcirculation, direct proteolysis of inflammatory mediators enables proteases to produce secondary analgesic effect. At the same time proteolytic enzymes provide stimulation of healing and reparation processes, decrease the risk of thromboembolic complications during long-term immobilization, prevent development of trophic disorders and purulent complications.

The enzymes of the drug have a positive effect on improvement of microcirculation, increasing delivery of oxygen and nutrients to the wound, reduction of inflammation in the lesion, maintaining the physiological process of regeneration and acceleration of organ and tissue function recovery.

The drug improves rheological properties of blood (viscosity and fluidity) due to positive effect on the functional state of blood cells and vascular wall, plasticity (deformability) of red blood cells, stabilization of endothelial permeability, increase of fibrinolytic activity of blood serum, decrease of density of adhesive molecules, decrease of platelet aggregation (sticking).

Proteolytic enzymes reduce the number of activated forms of platelets (spheroequinocytes) and micro- and macroaggregates, thus reducing the risk of thrombosis in blood vessels, and at the same time participate in the lysis of formed clots. Proteolytic enzymes reduce the level of atherogenic lipids, helping to increase HDL, reducing the risk of atherosclerosis and vascular disorders.

The preparation improves blood supply to bronchi and lung tissue of chronic respiratory diseases including those caused by smoking, improves viscosity of bronchial secretion, function of intermittent epithelium, restores drainage function of bronchi, thins sputum which facilitates breathing and reduces cough.

The product’s proteolytic enzymes increase the effectiveness of antibiotics while reducing the undesirable effects of antibiotic therapy (dysbiosis, irritable bowel syndrome). Proteases improve breakdown of substrates, optimize microbiota balance and contribute to restoration of endoecology of the intestine.

Indications

In complex therapy and prevention of the following diseases and conditions:

Active ingredient

Composition

1 enteric-coated tablet contains:

The active ingredients:

bromelain 450 units (FIP),

trypsin 1440 units (FIP) (24 μkat),

rutin (rutoside) 100 mg;

Excipients:

Lactose monohydrate, 148.58 mg;

Corn starch, 24 mg;

How to take, the dosage

Ingestion.

Take at least 30 minutes before a meal, without chewing, with water (200 ml). After surgery, it is recommended to take the drug from the 2nd or 3rd day.

The treatment. The preparation is taken after trauma and surgery or acute inflammation for splitting and removal of damaged tissues, resorption of hematoma, improvement of tissue trophism and reparative processes, decrease of inflammation and edema, decrease of risk of complications – thrombosis, adhesions development, keloid scar formation and wound festering: 3 tablets 3 times a day for 2 weeks. If necessary to improve recovery and healing the course of the drug can be prolonged up to 4 weeks or more: 2 pills 3 times a day.

Prevention of complications. To prevent long-term sequelae after the operation – thromboembolic complications, development of abdominal adhesions, trophic disorders in case of prolonged bed rest and immobilization of the patient: it is recommended to take the long-term course of the drug in dosage of 2 tablets 3 times a day for 4 weeks or more or for the whole period of immobilization.

Application with antibiotics. When prescribing antibiotics the drug is used to increase the effectiveness of antibiotic therapy and reduce the undesirable effects of antibiotics. It is recommended to take the drug during the whole course of antibiotic therapy 2 tablets 3 times a day.

The use with hormones. It is recommended to take 2 tablets 3 times a day during the whole course of taking hormones with the purpose of reducing the risk of complications (thrombosis). It is recommended to take 2 tablets 3 times a day in repeated courses of 2 weeks with 3 to 4 breaks during the whole course of taking hormonal replacement therapy to decrease the risk of development of thrombosis in lower limbs.

Prevention. In order to prevent lower limb venous thrombosis and to decrease the risk of vascular accidents (heart attack) it is recommended to take the preparation 2 tablets 3 times a day with courses of at least 3-4 weeks repeated 3-4 times a year.

Changing the course and dosage of the drug is recommended after consulting a physician.

Interaction

Incompatibilities with other drugs have not been reported.

The use of the drug together with antibiotics increases the effectiveness of antibiotic therapy.

When used with hormones the drug reduces the risk of thrombosis.

Special Instructions

In case of infectious processes, FLOGENSIM is not a substitute for antibiotics.

In case of exacerbation of the underlying disease while taking the drug, a temporary reduction in the dose of the drug or temporary withdrawal of the drug after consultation with the physician is recommended.

Patients with diabetes should be aware that each tablet of the drug contains 0.015 IU.

The effect on the ability to drive or perform work requiring increased speed of physical and mental reactions. The drug is not a doping agent and has no adverse effect on driving and performance of work requiring high-speed mental and physical reactions.

Contraindications

With caution: performing hemodialysis (after consulting with a physician).

Side effects

The drug is well tolerated by patients. In some cases, increased frequency of stools, changes in the consistency and odor of stools may be observed, which are quickly stopped by temporarily reducing the dosage of the drug.

In rare cases an allergic reaction may occur (skin rash, itching), which disappears after reducing the dose or discontinuing the drug. Nausea, abdominal bloating and pain, headache, dizziness, exanthema, general weakness, and a feeling of fullness of the bowels may occur if the drug is used improperly.

These conditions disappear after dosage reduction or temporary withdrawal of the drug.