Ксилометазолин относится к группе местных сосудосуживающих средств (деконгестантов) с альфа- адреномиметической активностью, вызывает сужение кровеносных сосудов слизистой оболочки полости носа, восстанавливает проходимость носовых ходов, облегчает носовое дыхание. Действие препарата обычно наступает через несколько минут после его применения и продолжается до 10 часов.
Декспантенол - витамин группы В - производное пантотеновой кислоты. Декспантенол превращается в организме в пантотеновую кислоту, являющуюся составной частью коэнзима А и участвует в процессах ацетилирования, углеводном и жировом обмене, в синтезе ацетилхолина, кортикостероидов, порфиринов; стимулирует регенерацию кожи, слизистых оболочек, нормализует клеточный метаболизм, ускоряет митоз и увеличивает прочность коллагеновых волокон. Оказывает регенерирующее, метаболическое и слабое противовоспалительное действие.
Фармакокинетика
Ксилометазолин при местном применении практически не абсорбируется, концентрации в плазме настолько малы, что их невозможно определить современными аналитическими методами.
Декспантенол при местном применении быстро абсорбируется кожей и превращается в пантотеновую кислоту, связывается с белками плазмы (главным образом с бета-глобулином и альбумином). Концентрация ее в крови - 0,5-1 мг/л,
в сыворотке крови - 100 мкг/л. Пантотеновая кислота не подвергается в организме метаболизму (кроме включения в Ко-А), выводится в неизмененном виде.
Показания к применению
острые респираторные заболевания с явлениями ринита;
острый аллергический ринит;
вазомоторный ринит;
синусит;
средний отит (в составе комбинированной терапии для уменьшения отека слизистой носоглотки);
для облегчения проведения риноскопии;
для восстановления нарушенного носового дыхания после хирургических вмешательств в носовой полости.
Противопоказания
повышенная чувствительность к компонентам препарата;
артериальная гипертензия;
тахикардия;
выраженный атеросклероз;
атрофический ринит;
гипертиреоз;
порфирия;
гиперплазия предстательной железы;
глаукома;
хирургические вмешательства на мозговых оболочках (в анамнезе);
детский возраст до 6 лет;
одновременная терапия ингибиторами моноаминоксидазы (МАО) и трициклическими аитидепрессантами.
С осторожностью
сахарный диабет, феохромоцитома.
Применение при беременности и в период грудного вскармливания
Учитывая, что нет данных о репродуктивной токсичности препарата, в период беременности и лактации не рекомендуется его применение.
Способ применения и дозы
Интраназально. Для взрослых и детей старше 6 лет.
Извлечь помповое дозирующее устройство из упаковки. Откупорить флакон с препаратом, накрутить на горлышко флакона дозирующее устройство, снять защитный колпачок.
Перед первым применением спрея несколько раз нажать на помповое дозирующее устройство до появления равномерного распыления.
При применении назального спрея флакон необходимо держать в вертикальном положении. Во время впрыскивания нужно легко вдохнуть носом. Одно впрыскивание в каждый носовой ход 3-4 раза в день.
Продолжительность терапии 3-5 дней.
Побочное действие
При частом и/или длительном применении - раздражение и/или сухость слизистой оболочки носоглотки, жжение, покалывание, чихание, гиперсекреция, аллергические реакции, отек слизистой оболочки носа, рвота, головная боль, сухой ринит, ощущение сердцебиения, повышение артериального давления, бессонница, нарушение зрения, депрессия (при длительном применении высоких доз).
Передозировка
В случаях передозировки или случайного перорального применения могут возникнуть следующие симптомы: мидриаз,
тошнота, рвота, цианоз, лихорадка, судороги, тахикардия, нарушение ритма сердца, сосудистая недостаточность, остановка сердца, гипертензия, отек легких, нарушение функции дыхания, галлюцинации. У пациентов также могут появиться симптомы угнетения со стороны ЦНС, сопровождающиеся сонливостью, снижением температуры тела, брадикардией, шоком, остановкой дыхания и комой.
Лечение. Применение активированного угля, промывание желудка, кислородная вентиляция легких. Для снижения артериального давления назначают 5 мг фентоламина в 0,9% раствора натрия хлорида путем медленного внутривенного введения или 100 мг фентоламина перорально. Сосудосуживающие препараты противопоказаны. При необходимости применяют жаропонижающие и противосудорожные средства.
Взаимодействие с другими лекарственными средствами
При одновременном применении ингибиторов МАО и трициклических антидепрессантов возможно усиление системного действия.
Особые указания
Перед применением необходимо очистить носовые ходы.
Не следует применять более 5 дней.
Влияние на способность к управлению транспортными средствами и механизмами
В период применения препарата следует соблюдать меры предосторожности, либо избегать управления транспортными средствами и занятий другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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