на 1 г: Активные вещества: клиндамицин (в форме фосфата) - 10 мг. Вспомогательные вещества: аллантоин - 2 мг, метилпарабен - 3 мг, пропиленгликоль - 50 мг, полиэтиленгликоль - 100 мг, карбомер 934Р - 7.5 мг, натрия гидроксида раствор 40% - q.s., вода очищенная - q.s. до 1 г.
Фармакологические свойства
Антибиотик группы линкозамидов для местного применения. Клиндамицина фосфат не активен in vitro, но после нанесения на кожу быстро гидролизуется фосфатазами в протоках сальных желез с образованием клиндамицина, обладающего антибактериальной активностью. Показана чувствительность всех исследованных штаммов Propionibacterium acnes к клиндамицину in vitro (МПК 0.4 мкг/мл). После нанесения клиндамицина на кожу количество свободных жирных кислот на поверхности кожи уменьшается примерно с 14% до 2%.
Показания к применению
— вульгарные угри.
Противопоказания
Антибиотик-ассоциированный колит в анамнезе
Возраст до 12 лет (данные по безопасности и эффективности отсутствуют)
Повышенная чувствительность к клиндамицину или линкомицину в анамнезе
Применение при беременности и в период грудного вскармливания
В исследованиях на животных при введении клиндамицина п/к или внутрь ухудшения фертильности, а также каких-либо отрицательных влияний на плод не обнаружено, за исключением случаев применения препарата в дозах, токсичных для матери. Результаты исследований на животных не всегда можно экстраполировать на человека. В клинических исследованиях при системном введении препарата женщинам во II и III триместрах беременности не отмечали увеличения частоты врожденных аномалий плода. Исследований применения препарата у женщин в I триместре беременности не проводилось. Препарат следует назначать при беременности только в том случае, если ожидаемая польза для матери превосходит потенциальный риск для плода. Неизвестно, выделяется ли клиндамицин с грудным молоком после наружного применения. Клиндамицин обнаруживается в грудном молоке после перорального или парентерального введения, поэтому в период лактации следует либо отменить препарат, либо прекратить грудное вскармливание, учитывая степень важности применения препарата для матери.
Способ применения и дозы
Наружно. Тонкий слой геля наносят на пораженную область чистой сухой кожи 2 раза/сут. Для получения удовлетворительных результатов лечение следует продолжать в течение 6-8 недель, а при необходимости можно продолжить до 6 мес. Если после применения препарата в течение нескольких месяцев эффективность терапии снижается, следует сделать перерыв в лечении на 4 недели.
Побочное действие
Классификация частоты нежелательных реакций: очень часто (≥1/10), часто (≥1/100 и <1/10), нечасто (≥1/1000 и <1/100), редко (≥1/10 000 и <1/1000), очень редко (<1/10 000), частота неизвестна (невозможно определить на основании имеющихся данных). Инфекционные и паразитарные заболевания: частота неизвестна - фолликулит. Со стороны органа зрения: частота неизвестна - боль в глазах. Со стороны пищеварительной системы: часто - нарушение пищеварения; частота неизвестна - боль в животе, псевдомембранозный колит. Со стороны кожных покровов: очень часто - сухость кожи, раздражение кожи, крапивница; часто - себорея; частота неизвестна - контактный дерматит. Если любые из указанных в инструкции побочных эффектов усугубляются или отмечаются любые другие побочные эффекты, не указанные в инструкции, пациенту следует немедленно сообщить об этом врачу.
Передозировка
Симптомы: при местном применении клиндамицин может всасываться в количествах, вызывающих системные эффекты; к возможным системным побочным эффектам можно отнести диарею, геморрагическую диарею, включая псевдомембранозный колит. Лечение: проведение симптоматической и поддерживающей терапии.
Особые указания
Следует избегать попадания препарата на слизистую оболочку глаз и полости рта. После нанесения геля следует тщательно вымыть руки. При случайном контакте с чувствительными поверхностями (глаза, ссадины на коже, слизистые оболочки) следует обильно промыть данную область прохладной водой. Применение клиндамицина (как и других антибиотиков) внутрь или парентерально в ряде случаев связано с развитием тяжелой диареи и псевдомембранозного колита. При наружном применении клиндамицина случаи возникновения диареи и колита редки, тем не менее, следует проявлять осторожность, и при развитии выраженной или продолжительной диареи препарат следует отменить и при необходимости провести соответствующие диагностические и лечебные мероприятия. Обычно начало диареи, колита и псевдомембранозного колита отмечается в течение нескольких недель после завершения пероральной и парентеральной терапии клиндамицином. В случае тяжелой диареи следует решить вопрос о целесообразности проведения колоноскопии. Назначение препаратов, снижающих моторику ЖКТ, таких как опиоидные анальгетики и дифеноксилат с атропином, может продлить и/или ухудшить течение данного осложнения. Было установлено, что ванкомицин эффективен в отношении антибиотик-ассоциированного псевдомембранозного колита, вызванного Clostridium difficile. Обычная доза, разделенная на 3-4 введения для взрослых, составляет от 500 мг до 2 г ванкомицина/сут внутрь в течение 7-10 дней. Влияние на способность к вождению автомобиля и управлению механизмамиНет оснований полагать, что применение препарата Далацин; может оказывать влияние на способность к вождению автомобиля и управлению механизмами.
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