Lorinden A, ointment 15 g

Lorinden A is a combined drug with anti-inflammatory and keratolytic action for external use.

Flumetasone pyvalate is a synthetic GKS, it has anti-inflammatory, anti-edema, anti-allergic, antipruritic effects. It inhibits the activity of phospholipase A2, which leads to suppression of the synthesis of prostaglandins and leukotrienes, inhibits the release of inflammatory mediators.

Inhibits migration of leukocytes and lymphocytes to the center of inflammation. It prevents marginal accumulation of neutrophils, which leads to decrease of inflammatory exudate, cytokines production and inhibition of macrophages migration, as a result the infiltration and granulation processes are reduced. It inhibits proteolytic activity of tissue kinins, inhibits the growth of fibroblasts, prevents the development of connective tissue in the inflammation focus. It reduces hyperemia, manifestations of hypersensitivity reactions, proliferative and exudative processes in the connective tissue in the focus of inflammation.

Salicylic acid, an NSAID, promotes penetration of GCS and gives the drug additional antiparokeratotic, moderate keratolytic and local hypothermic properties, promotes penetration of flumetasone into the skin. In addition, it has antibacterial and fungicidal action and restores the protective function of the skin. It suppresses the secretion of sebaceous and sweat glands.

Pharmacokinetics

Absorption

Absorption of flumetasone pivalate is higher in children than in adults and is increased when applied to the skin folds, face, skin with damaged epidermis and inflammatory skin, under occlusive dressings, when applied to large areas of skin (in which case it may have systemic action).

Distribution

Because of the external route of administration and the keratolytic action of salicylic acid, flumethasone pyvalate easily penetrates the stratum corneum of the skin, through the keratinized layers of the skin, where it cumulates.

Metabolism

Flumetasone pyvalate is virtually unmetabolized in the skin. After minor absorption into the systemic bloodstream, flumetasone pivalate is biotransformed in the liver.

Elimination

Extracted in the urine and, to a lesser extent, in the bile in the form of compounds with glucuronic acid, as well as in small quantities unchanged.

Indications

Lorinden A ointment is prescribed for:

Active ingredient

Composition

1 g of ointment for external use contains:

Active ingredients:

flumetasone pivalate 200 mcg,

salicylic acid 30 mg.

Associates:

Propylene glycol,

Lanolin anhydrous,

Vaseline white.

How to take, the dosage

Externally.

The ointment is applied in a thin layer on the skin in the affected area 2-3 times a day. After acute inflammation is relieved, the drug is used 1-2 times a day. After complete disappearance of painful manifestations the treatment shall be carried out for another 3-4 days. In case of chronic skin lesions the treatment should not be continued for more than 3 weeks.

The ointment can also be used in the form of an occlusive dressing that should be changed every 24-48 hours. In the treatment of lesions on dry and de-greased skin areas characterized by severe infiltration, lichenization, desquamation and hyperkeratosis as well as omosols, the degree of moisturization may be adjusted by the thickness of the layer applied according to the therapeutic requirements specific to each individual case.

Interaction

Vaccinations and immunizations are contraindicated during treatment with the drug due to the immunosuppressive effect of the drug.

Do not use in combination with other drugs for external use.

In systemic absorption of the drug, GCS decreases the effects of insulin, oral hypoglycemic agents, hypotensive drugs, anticoagulants, decreases the serum concentration of praziquantel.

The combination of Lorinden A with the following drugs increases the risk of side effects: androgens, estrogens, oral contraceptives, anabolic steroids ( hirsutism , acne), antipsychotics, bucarban, azathioprine (cataracts), choline blockers, antihistamines, tricyclic antidepressants, nitrates (glaucoma), diuretics (hypokalemia), cardiac glycosides (digitalis intoxication).

Special Instructions

Lorinden A is an adequate drug for the treatment of lesions on dry and degreased skin areas characterized by marked infiltration, lichenization, desquamation and hyperkeratosis, as well as omozolelosis; it is easy to apply, adheres well to dry skin, increases its fat content and helps in moisture retention. The degree of hydration can be adjusted with the thickness of the layer applied, according to the therapeutic requirements specific to each individual case.

The product should not be applied to the skin of the face. Care should be taken to avoid contact with mucous membranes and the conjunctiva.

It is not recommended to exceed the course of treatment. Prolonged use of the ointment on large areas of skin increases the incidence of side effects.

If infection occurs where the ointment is used, products with stronger antibacterial or antifungal properties should be used.

Persons with atrophic skin changes, especially elderly patients, should use with caution.

The ointment does not contaminate clothing and bedding.

– Use in renal impairment Multiple applications to large areas of skin in patients with severe renal impairment should be avoided (systemic effects of salicylic acid are possible).

– Pediatric use In children, the drug is used only if absolutely necessary, in short courses, on small body surfaces.

– Effect on ability to drive and operate machinery

The drug does not limit psychophysical activity, ability to drive vehicles and operate moving machinery.

Contraindications

The drug is not recommended for patients suffering from:

In addition, the ointment should be refrained from use at the beginning of pregnancy, with trophic ulcers from varicose veins, with hypersensitivity and in children. Caution should be exercised when treating patients diagnosed with renal insufficiency, as there remains a risk of nephrotoxic effects of significant doses of salicylates.

Side effects

Local reactions: burning, itching, dry skin are possible; with long-term use – skin atrophy, local hirsutism, telangiectasia, purpura, steroid acne, perioral dermatitis, pigmentation disorders.

Systemic reactions: with long-term use, application to large areas of skin and/or use of occlusive dressings the side effects typical for GKS are possible.

When Lorinden A is used externally on the skin of the eyelids later, sometimes cataracts or glaucoma may develop.

Overdose

Symptoms: very rarely, systemic GCS and/or symptoms of salicylate poisoning are possible when used on very large areas of skin.