Trombless Plus, gel 30 g

Pharmgroup:

Preparation with antithrombotic, angioprotective, venotonic, local anesthetic and improves tissue regeneration action for external use

Pharmic action:

Trombless Plus Gel is a combination drug.

Heparin sodium is a direct-acting anticoagulant, has anti-inflammatory, anti-proliferative, anti-edema and analgesic effect. Reduces platelet aggregation, binds antithrombin III, preventing the transition of prothrombin to thrombin. Inhibits the activity of thrombin. Reduces the activity of hyaluronidase, increases the fibrinolytic properties of blood. It improves microcirculation and activates tissue exchange, due to this it accelerates the process of resorption of hematomas and thromboses, and finally it restores venous patency, clinically it is accompanied by pronounced analgesic and anti-inflammatory effect.

Dexpanthenol – provitamin B5 – in the skin is converted into pantothenic acid, a member of coenzyme A, which is involved in acetylation processes, carbohydrate and fat metabolism, stimulates skin regeneration, normalizes cell metabolism, increases the strength of collagen fibers. It has a regenerating, vitamin, metabolic and anti-inflammatory effect.

Troxerutin – a flavonoid (derived from rutin), has P-vitamin activity, has venotonic, angioprotective, anti-inflammatory, anti-inflammatory, antioxidant effect. It participates in redox processes, blocks hyaluronidase, stabilizes hyaluronic acid in cell membranes and reduces capillary permeability and fragility, increases their tone. Increases the density of the vascular wall, reduces the exudation of the liquid part of the plasma and diapedesis of blood cells. It reduces inflammation in the vascular wall by limiting platelet adhesion to its surface.

Benzocaine is a local anesthetic for surface anesthesia. It reduces the permeability of the cell membrane for sodium ions, displaces calcium ions from the receptors located on the inner surface of the membrane, blocks the conduction of nerve impulses. Prevents the occurrence of pain impulses in the endings of sensitive nerves and their conduction along the nerve fibers. Benzocaine dilates surface vessels, promoting absorption of heparin.

Pharmacokinetics:

A small amount of heparin is absorbed from the skin surface into the systemic bloodstream. Cmax of the drug in the blood is noted 8 hours after application. Excretion of heparin mainly occurs through the kidneys, T1/2 12 hours.

Troxerutin is well absorbed from the surface of the skin when used externally. Dexpanthenol when applied topically is quickly absorbed by the skin and converted to pantothenic acid. Its concentration in blood is 0.5-1 mg/l, in serum 100 µg/l. Pantothenic acid is not metabolized in the body (except for its incorporation into coenzyme A) and is excreted unchanged.
Benzocaine is practically not absorbed by skin application.

Indications

Sprains and strains, Stiffness and pain in the legs, Inflamed tendons, Thrombophlebitis, Swelling after injuries and operations, Swelling, Hematomas, Bruises, Varicose

• varicose veins of the lower extremities.
• Migrating phlebitis, thrombophlebitis.
• Subcutaneous hematomas, localized edemas and aseptic infiltrates, including those on the face.
• Traumas and bruises of joints, tendons, muscle tissue.
• Complications arising after surgical operations on the veins.

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Composition

1 g:
– heparin sodium 1000 IU (0.00833 g)
– troxerutin 0.02 g
– dexpanthenol 0.1 g
– benzocaine 0.001 g

Supplementary substances:

ethanol 0.1 g,

methylparahydroxybenzoate 0.0015 g,

trolamine 0.007 g,

carbomer up to 0.01 g,

glycerol 0.05 g,

purified water up to 1 g.

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How to take, the dosage

Externally, Trombless Plus is applied in a thin layer to the skin over and around the affected area, spreading evenly over the skin surface in a gentle circular motion 2-3 times a day. The course of treatment is 2-3 weeks, with repetition if there is a recurrence of the disease.

In case of trophic ulcers with poor exudation the wound surface is cleaned of exudate and necrotic tissues before application, if necessary the solution of hydrogen peroxide 3%, nitrofural 1:5000 or chlorhexidine 0.05% is washed and dried. Trombless Plus gel is applied in an even thin layer to the entire affected surface and a sterile gauze dressing is applied. The dressing is changed once a day. During open treatment the drug is applied 1-2 times a day. The duration of treatment is determined by the dynamics of epithelialization.

In case of subcutaneous hematomas, localized edemas, aseptic infiltrates, injuries, contusions and similar conditions the drug is applied to the affected area 2-3 times a day until complete restoration of the normal condition of the damaged tissues.

Interaction

Co-use of the gel with oral anticoagulants may cause prolongation of the prothrombin time.

Nonarcotic analgesics and anticholinesterase drugs increase the effect of benzocaine contained in the drug.

Benzocaine reduces the antibacterial activity of sulfonamides.

Special Instructions

A reduction in the severity of clinical manifestations is usually noted in the first days of treatment. If treatment is irregular or discontinued prematurely, there is a risk of recurrence of the infection. If there are no signs of improvement after 1-2 weeks of therapy, the diagnosis must be verified.

The cream is for external use only.

Avoid contact with the mucous membranes of the eyes, nose and mouth. If the drug comes into contact with the mucosa, rinse with water and consult a doctor if necessary.

Synopsis

Transparent or semi-transparent gel of light yellow to yellow color, greenish tint is possible. It has a faint characteristic odor.

Features

When the cream is applied topically less than 5% of the dose is absorbed, so the systemic effect of the drug is minimal.

Contraindications

– open infected wounds or wounds with abundant exudation in the area of the intended application;
– children under 18 years of age (no data on the efficacy and safety of the drug);
– pregnancy and lactation.
With caution
Increased susceptibility to bleeding, thrombocytopenia.

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Side effects

In rare cases, redness, itching or burning sensations have been reported where the cream was applied, but these phenomena have rarely made it necessary to stop treatment.

The above symptoms should be differentiated from allergic reactions, such as urticaria, which are rare, but if they do occur, treatment should be discontinued.

Overdose

Trombless Plus Gel overdose cases have not been reported.