Действующее вещество: КлобетазолКонцентрация действующего вещества (г): 0,05г
Фармакологические свойства
ГКС для наружного применения. Предупреждает краевое скопление нейтрофилов, уменьшает воспалительную экссудацию и продукцию лимфокинов, тормозит миграцию макрофагов, снижает интенсивность процессов инфильтрации и грануляции, оказывает местный противовоспалительный, противозудный, противоаллергический и антиэкссудативный эффекты.
Показания к применению
Комплексное лечение острых и хронических воспалительных заболеванийполости носа, околоносовых пазух и носоглотки:
Острые и хронические риниты
Острые и хронические синуситы
Острые и хронические аденоидиты
Аллергические риниты
Атрофические риниты.- Комплексное лечение ОРВИ и гриппа- Профилактика ОРВИ и гриппа в период эпидемии.- Уход за полостью носа:
После хирургических вмешательств
Очищение от бактерий, вирусов, пыли, пыльцы, дыма
Для подготовки слизистой к применению лекарственных средств
Длительная терапия топическими кортикостероидами
Противопоказания
Розовые угриВульгарные угриРак кожиУзловая почесуха ГайдаПериоральный дерматитПерианальный и генитальный зудБактериальные, вирусные и грибковые заболевания кожи (простой герпес, ветряная оспа, туберкулез кожи, актиномикоз и др.)Распространенный бляшечный и пустулезный псориазГиперчувствительность к активному и вспомогательным веществам препаратаВозраст до 1 годаПериод лактации
Применение при беременности и в период грудного вскармливания
Препарат Дермовейт следует применять с осторожностью у пациентов с наличием в анамнезе местной повышенной чувствительности к ГКС или к любому вспомогательному веществу, входящему в состав препарата. Местные реакции повышенной чувствительности могут иметь сходство с симптомами протекающего заболевания. У некоторых лиц в результате повышенной системной абсорбции ГКС для наружного применения могут возникать проявления гиперкортицизма (синдрома Иценко-Кушинга) и обратимое угнетение гипоталамо-гипофизарно-надпочечниковой системы, ведущее к развитию глюкокортикоидной недостаточности. Если наблюдается любое из вышеуказанного, следует отменить препарат, постепенно уменьшая частоту его нанесения, или заменить его менее активным ГКС. Внезапное прекращение лечения может привести к развитию глюкокортикостероидной недостаточности. К факторам риска усиления системных эффектов относятся: активность ГКС и состав лекарственного препарата для наружного применения, продолжительность применения, нанесение препарата на обширные участки кожи, применение в закрытых областях кожи (т.е. в интертригинозных зонах или под окклюзионные повязки (пеленки и подгузники у младенцев могут играть роль окклюзионной повязки)), повышенная гидратация рогового слоя кожи, использование на областях с тонкой кожей, таких как лицо, нанесение на поврежденную кожу или при других состояниях, которые могут сопровождаться нарушением целостности кожного барьера. По сравнению со взрослыми у детей и младенцев может отмечаться больший процент абсорбции ГКС для наружного применения, в связи с чем данная категория пациентов более подвержена риску развития системных побочных эффектов. Это обусловлено тем, что дети имеют незрелый кожный барьер и большее значение отношения площади поверхности тела к массе тела по сравнению с взрослыми. Применение у детейПо возможности следует избегать назлечения ГКС для наружного применения в течение продолжительного времени у детей младше 12 лет, т.к. длительное применение ГКС для наружного применения может вызывать угнетение функции надпочечников. У детей чаще, чем у взрослых возникают атрофические изменения кожи при наружном применении ГКС. В случае назначения клобетазола детям курс лечения должен ограничиваться несколькими днями, требуется наблюдение у врача не реже 1 раза в неделю. Применение при псориазеВ некоторых случаях лечение псориаза ГКС для наружного применения может сопровождаться возобновлением симптомов заболевания, устойчивостью к препарату, развитием генерализованной пустулезной формы псориаза и местной или системной токсичностью из-за нарушения барьерной функции кожи, поэтому особенно важно внимательное наблюдение за пациентом. Сопутствующая инфекцияПри присоединении вторичной инфекции следует проводить соответствующую антибактериальную терапию. При любых признаках генерализации инфекции необходимо прекратить наружное применение ГКС и провести соответствующее лечение антибактериальными препаратами. Риск развития инфекции при окклюзииТеплые влажные условия, создаваемые при наложении окклюзионной повязки, способствуют возникновению бактериальной инфекции, поэтому следует обязательно тщательно очищать кожу перед наложением новой повязки. Хронические язвы голенейГКС для наружного применения иногда используются для лечения дерматита вокруг хронических язв голеней. Однако такое применение может сопровождаться повышенной частотой возникновения местных реакций гиперчувствительности и повышенным риском развития местных инфекций. Нанесение на кожу лицаНанесение на кожу лица нежелательно, т.к. данная область более подвержена развитию атрофических изменений. В случае нанесения на кожу лица лечение следует ограничить несколькими днями. Нанесение на векиПри нанесении крема на веки необходимо следить за тем, чтобы препарат не попал в глаза, потому что неоднократное воздействие крема может вызвать катаракту и глаукому. Влияние на способность к вождению автотранспорта и управлению механизмамиИсследований по изучению влияния клобетазола на способность к управлению транспортными средствами или работе с механизмами не проводилось. Исходя из профиля побочных реакций клобетазола для наружного применения, какого-либо неблагоприятного влияния на такие виды деятельности не ожидается.
Способ применения и дозы
Крем и мазь наносится тонким слоем на пораженную кожу один-два раза в день до получения эффекта. Лечение нельзя проводить более 4 недель без оценки необходимости его продолжения. Для лечения обострений кожных заболеваний можно проводить повторные короткие курсы Дермовейтом. Если необходимо продолжение терапии глюкокортикостероидами, следует использовать менее активные препараты. В особо резистентных случаях, особенно при наличии гиперкератоза, противовоспалительный эффект крема и мази Дермовейт может быть усилен с помощью наложения на ночь на область применения препарата повязки из полиэтиленовой пленки, что обычно сопровождается положительным эффектом. В дальнейшем достигнутый эффект удается поддерживать без применения окклюзионной повязки.
Побочное действие
Было показано, что одновременное применение препаратов, способных ингибировать изофермент CYP3A4 (например, ритонавира и итраконазола), угнетает метаболизм ГКС, приводя к повышению их системной экспозиции. Степень клинической значимости данного взаимодействия зависит от дозы и способа применения ГКС и активности ингибитора изофермента CYP3A4.
Передозировка
Длительное назначение глюкокортикостероидов для местного применения в больших дозах или нанесение их на обширные участки кожи может сопровождаться системной абсорбцией с последующим развитием симптомов гиперкортицизма. Риск развития данного осложнения повышен у детей, особенно при применении окклюзионной повязки, при этом пеленка может выполнять роль такой повязки. При условии назначения мази Дермовейт взрослым пациентам в дозировке не более 50 г в неделю, подавление функции гипофиза и надпочечников имеет транзиторный характер с быстрым их восстановлением сразу после окончания курса лечения. Длительное лечение высокоактивными глюкокортикостероидами для местногоПрименения в больших дозах может вызвать атрофические изменения кожи, в частности, ее истончение, появление атрофических полос (стрий), дилятацию поверхностных кровеносных сосудов, особенно при наложении окклюзионных повязок и при нанесении препарата на участки кожи со складками. Могут развиться пигментация кожи и гипертрихоз. В редких случаях лечение псориаза глюкокортикостероидами для местного применения (или их отмена) провоцирует развитие пустулезного псориаза. Иногда Дермовейт может вызвать обострение симптомов заболевания.
Особые указания
Симптомы: препарат Дермовейт при наружном применении может абсорбироваться в количествах, достаточных для того, чтобы вызвать развитие системных эффектов. Развитие острой передозировки маловероятно. Однако в случае хронической передозировки или неправильного применения препарата Дермовейт могут развиться симптомы гиперкортицизма. Лечение: в случае передозировки препарата Дермовейт следует постепенно отменять препарат, снижая частоту нанесения или заменяя менее активным ГКС, под наблюдением врача ввиду риска возникновения надпочечниковой недостаточности. Дальнейшее лечение следует проводить с учетом клинической ситуации или в соответствии с рекомендациями токсикологических центров при их наличии.
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Местные реакции повышенной чувствительности могут иметь сходство с симптомами протекающего заболевания. У некоторых лиц в результате повышенной системной абсорбции ГКС для наружного применения могут возникать проявления гиперкортицизма (синдрома Иценко-Кушинга) и обратимое угнетение гипоталамо-гипофизарно-надпочечниковой системы, ведущее к развитию глюкокортикоидной недостаточности. Если наблюдается любое из вышеуказанного, следует отменить препарат, постепенно уменьшая частоту его нанесения, или заменить его менее активным ГКС. Внезапное прекращение лечения может привести к развитию глюкокортикостероидной недостаточности. К факторам риска усиления системных эффектов относятся: активность ГКС и состав лекарственного препарата для наружного применения, продолжительность применения, нанесение препарата на обширные участки кожи, применение в закрытых областях кожи (т.е. в интертригинозных зонах или под окклюзионные повязки (пеленки и подгузники у младенцев могут играть роль окклюзионной повязки)), повышенная гидратация рогового слоя кожи, использование на областях с тонкой кожей, таких как лицо, нанесение на поврежденную кожу или при других состояниях, которые могут сопровождаться нарушением целостности кожного барьера. По сравнению со взрослыми у детей и младенцев может отмечаться больший процент абсорбции ГКС для наружного применения, в связи с чем данная категория пациентов более подвержена риску развития системных побочных эффектов. Это обусловлено тем, что дети имеют незрелый кожный барьер и большее значение отношения площади поверхности тела к массе тела по сравнению с взрослыми. Применение у детейПо возможности следует избегать назлечения ГКС для наружного применения в течение продолжительного времени у детей младше 12 лет, т.к. длительное применение ГКС для наружного применения может вызывать угнетение функции надпочечников. У детей чаще, чем у взрослых возникают атрофические изменения кожи при наружном применении ГКС. В случае назначения клобетазола детям курс лечения должен ограничиваться несколькими днями, требуется наблюдение у врача не реже 1 раза в неделю. Применение при псориазеВ некоторых случаях лечение псориаза ГКС для наружного применения может сопровождаться возобновлением симптомов заболевания, устойчивостью к препарату, развитием генерализованной пустулезной формы псориаза и местной или системной токсичностью из-за нарушения барьерной функции кожи, поэтому особенно важно внимательное наблюдение за пациентом. Сопутствующая инфекцияПри присоединении вторичной инфекции следует проводить соответствующую антибактериальную терапию. При любых признаках генерализации инфекции необходимо прекратить наружное применение ГКС и провести соответствующее лечение антибактериальными препаратами. Риск развития инфекции при окклюзииТеплые влажные условия, создаваемые при наложении окклюзионной повязки, способствуют возникновению бактериальной инфекции, поэтому следует обязательно тщательно очищать кожу перед наложением новой повязки. Хронические язвы голенейГКС для наружного применения иногда используются для лечения дерматита вокруг хронических язв голеней. Однако такое применение может сопровождаться повышенной частотой возникновения местных реакций гиперчувствительности и повышенным риском развития местных инфекций. Нанесение на кожу лицаНанесение на кожу лица нежелательно, т.к. данная область более подвержена развитию атрофических изменений. В случае нанесения на кожу лица лечение следует ограничить несколькими днями. Нанесение на векиПри нанесении крема на веки необходимо следить за тем, чтобы препарат не попал в глаза, потому что неоднократное воздействие крема может вызвать катаракту и глаукому. Влияние на способность к вождению автотранспорта и управлению механизмамиИсследований по изучению влияния клобетазола на способность к управлению транспортными средствами или работе с механизмами не проводилось. Исходя из профиля побочных реакций клобетазола для наружного применения, какого-либо неблагоприятного влияния на такие виды деятельности не ожидается."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Крем и мазь наносится тонким слоем на пораженную кожу один-два раза в день до получения эффекта. Лечение нельзя проводить более 4 недель без оценки необходимости его продолжения. Для лечения обострений кожных заболеваний можно проводить повторные короткие курсы Дермовейтом. Если необходимо продолжение терапии глюкокортикостероидами, следует использовать менее активные препараты. В особо резистентных случаях, особенно при наличии гиперкератоза, противовоспалительный эффект крема и мази Дермовейт может быть усилен с помощью наложения на ночь на область применения препарата повязки из полиэтиленовой пленки, что обычно сопровождается положительным эффектом. В дальнейшем достигнутый эффект удается поддерживать без применения окклюзионной повязки."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Было показано, что одновременное применение препаратов, способных ингибировать изофермент CYP3A4 (например, ритонавира и итраконазола), угнетает метаболизм ГКС, приводя к повышению их системной экспозиции. Степень клинической значимости данного взаимодействия зависит от дозы и способа применения ГКС и активности ингибитора изофермента CYP3A4."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Длительное назначение глюкокортикостероидов для местного применения в больших дозах или нанесение их на обширные участки кожи может сопровождаться системной абсорбцией с последующим развитием симптомов гиперкортицизма. Риск развития данного осложнения повышен у детей, особенно при применении окклюзионной повязки, при этом пеленка может выполнять роль такой повязки. При условии назначения мази Дермовейт взрослым пациентам в дозировке не более 50 г в неделю, подавление функции гипофиза и надпочечников имеет транзиторный характер с быстрым их восстановлением сразу после окончания курса лечения. Длительное лечение высокоактивными глюкокортикостероидами для местногоПрименения в больших дозах может вызвать атрофические изменения кожи, в частности, ее истончение, появление атрофических полос (стрий), дилятацию поверхностных кровеносных сосудов, особенно при наложении окклюзионных повязок и при нанесении препарата на участки кожи со складками. Могут развиться пигментация кожи и гипертрихоз. В редких случаях лечение псориаза глюкокортикостероидами для местного применения (или их отмена) провоцирует развитие пустулезного псориаза. Иногда Дермовейт может вызвать обострение симптомов заболевания."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: препарат Дермовейт при наружном применении может абсорбироваться в количествах, достаточных для того, чтобы вызвать развитие системных эффектов. Развитие острой передозировки маловероятно. Однако в случае хронической передозировки или неправильного применения препарата Дермовейт могут развиться симптомы гиперкортицизма. Лечение: в случае передозировки препарата Дермовейт следует постепенно отменять препарат, снижая частоту нанесения или заменяя менее активным ГКС, под наблюдением врача ввиду риска возникновения надпочечниковой недостаточности. Дальнейшее лечение следует проводить с учетом клинической ситуации или в соответствии с рекомендациями токсикологических центров при их наличии."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"ГКС для наружного применения. 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