Противопротозойный и противомикробный препарат, производное... Инструкция
Показания к применению
Заместительная гормональная терапия: атрофия слизистой оболочки нижних отделов урогенитального тракта, связанная с дефицитом эстрогенов. Пред- и послеоперационная терапия у женщин в постменопаузе, которым предстоит или проведена операция влагалищным доступом. С диагностической целью при неясных результатах мазка из влагалища на фоне атрофических изменений....
Установленный (в т.ч. в анамнезе) или подозреваемый рак молочной железы. Эстрогензависимые злокачественные новообразования или подозрение на них (в т.ч. рак эндометрия). Недиагностированное генитальное кровотечение. Нелеченная гиперплазия эндометрия. Тромбозы (венозные и артериальные) и тромбоэмболии в настоящее время или в анамнезе (в т.ч. тромбоз ...
Действующее вещество: ЭстриолКонцентрация действующего вещества (мкг): 500 мкг
Фармакологические свойства
Противопротозойный и противомикробный препарат, производное 5-нитроимидазола. Механизм действия заключается в биохимическом восстановлении 5-нитрогруппы метронидазола внутриклеточными транспортными протеинами анаэробных микроорганизмов и простейших. Восстановленная 5-нитрогруппа метронидазола взаимодействует с ДНК клетки микроорганизмов, ингибируя синтез нуклеиновых кислот, что ведет к гибели микроорганизмов. Активен в отношении Trichomonas vaginalis, Entamoeba hystolitica, Gardnerella vaginalis, Giardia intestinalis, а также облигатных анаэробов Bacteroides spp. (в т.ч. Bacteroides fragilis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides distasonis, Bacteroides vulgatus), Fusobacterium spp., Veillonella spp., Prevotella (Prevotella bivia, Prevotella buccae, Prevotella disiens) и некоторых грамположительных микроорганизмов (Eubacterium spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.). МПК для этих штаммов составляет 0.125-6.25 мкг/мл. В сочетании с амоксициллином проявляет активность в отношении Helicobacter pylori (амоксициллин подавляет развитие резистентности к метронидазолу). К метронидазолу нечувствительны аэробные микроорганизмы и факультативные анаэробы, но в присутствии смешанной флоры (аэробы и анаэробы) метронидазол действует синергично с антибиотиками, эффективными против обычных аэробов. Увеличивает чувствительность опухолей к облучению, вызывает дисульфирамоподобные реакции, стимулирует репаративные процессы.
Показания к применению
Заместительная гормональная терапия: атрофия слизистой оболочки нижних отделов урогенитального тракта, связанная с дефицитом эстрогенов. Пред- и послеоперационная терапия у женщин в постменопаузе, которым предстоит или проведена операция влагалищным доступом. С диагностической целью при неясных результатах мазка из влагалища на фоне атрофических изменений.
Противопоказания
Установленный (в т.ч. в анамнезе) или подозреваемый рак молочной железы. Эстрогензависимые злокачественные новообразования или подозрение на них (в т.ч. рак эндометрия). Недиагностированное генитальное кровотечение. Нелеченная гиперплазия эндометрия. Тромбозы (венозные и артериальные) и тромбоэмболии в настоящее время или в анамнезе (в т.ч. тромбоз глубоких вен, тромбоэмболия легочной артерии, инфаркт миокарда, инсульт), цереброваскулярные нарушения. Состояния, предшествующие тромбозу (в т.ч. стенокардия) в настоящее время или в анамнезе. Множественные или выраженные факторы риска венозного или артериального тромбоза (в т.ч. осложненные поражения клапанного аппарата сердца, фибрилляция предсердий, заболевания сосудов головного мозга или коронарных артерий; неконтролируемая артериальная гипертензия, серьезное хирургическое вмешательство с длительной иммобилизацией, курение в возрасте старше 35 лет). Подтвержденные тромбофилии, наследственные или приобретенные факторы, предрасполагающие к развитию венозных и артериальных тромбозов, такие как: резистентность к активированному протеину С, дефицит антитромбина III, дефицит протеина С, дефицит протеина S, наличие антител к фосфолипидам и другие. Тромбофлебит глубоких вен (в т.ч. в анамнезе). Выраженная гипертриглицеридемия. Холестатическая желтуха. Отосклероз (в т.ч. во время предшествующей беременности или при лечении половыми гормонами). Острые заболевания печени или наличие заболеваний печени в анамнезе до тех пор, пока показатели печеночной функции не вернуться в норму. Порфирия. Беременность. Период лактации. Повышенная чувствительность к компонентам препарата. С осторожностью: Лейомиома. Эндометриоз. Тромбоэмболия в анамнезе или факторы риска ее развития. Факторы риска эстрогензависимых опухолей, в т.ч. 1-я степень родства по раку молочной железы в семейном анамнезе. Артериальная гипертензия. Заболевания печени (в т.ч. аденома). Сахарный диабет с диабетической ангиопатией или без нее. Холелитиаз. Мигрень или тяжелая головная боль. Системная красная волчанка. Эпилепсия. Бронхиальная астма. Семейная гиперлипопротеинемия. Панкреатит. Рак или гиперплазия эндометрия в анамнезе. Сердечная недостаточность. Почечная недостаточность. Метаболические нарушения костной ткани. Герпес во время предшествующей беременности.
Применение при беременности и в период грудного вскармливания
Метронидазол противопоказан к применению в I триместре беременности. Назначение препарата в II и III триместрах беременности возможно только в том случае, если предполагаемая польза для матери превышает потенциальный риск для плода. Противопоказано применение препарата в период лактации (грудного вскармливания). Метронидазол выделяется с грудным молоком. При необходимости применения препарата следует прекратить грудное вскармливание.
Способ применения и дозы
Интравагинально, перед сном. При атрофии слизистой оболочки нижних отделов урогенитального трактаНазначают по 1 суппозиторию (0,5 мг) ежедневно в первые 2-3 недели, затем постепенно снижают дозу, основываясь на симптоматике, 1 суппозиторий (0,5 мг) 2 раза в неделю. Пред- и послеоперационная терапия у женщин в постменопаузеПо 1 суппозиторию (0,5 мг) в течение 2 недель до или после операции. В качестве диагностического средства1 суппозиторий через день в течение недели перед взятием следующего мазка. В случае если очередная доза препарата была пропущена, следует принять ее немедленно. Однако если это обнаружилось только в день приема следующей дозы, следует продолжить прием препарата по обычной схеме, не восполняя пропущенную дозу. Нельзя применять две дозы в один день.
Побочное действие
ВозможноЗуд и раздражение в месте введения, напряжение и болезненность молочных желез. В комбинации с гестагенамиДоброкачественные и злокачественные эстрогензависимые опухоли (в т.ч. рак молочной железы и эндометрия), венозная тромбоэмболия (в т.ч. глубоких вен голени и малого таза, легочных вен), инфаркт миокарда, инсульт, заболевания желчного пузыря, хлоазма, многоформная эритема, узловатая эритема, геморрагическая пурпура, деменция при начале ЗГТ в непрерывном приеме препарата после 65 лет, ациклические кровянистые выделения, кровотечения прорыва, повышение либидо.
Передозировка
Симптомы: тошнота, рвота, атаксия. Лечение: проведение симптоматической терапии. Специфического антидота нет. Метронидазол и его метаболиты хорошо элиминируются при гемодиализе.
Особые указания
В/в введение раствора Клиона показано больным, у которых пероральный прием препарата невозможен. При смешанных инфекциях раствор Клиона можно применять в комбинации с парентеральными антибиотиками, не смешивая препараты между собой. При в/в капельном введении нельзя смешивать Клион с другими препаратами. При длительности курса лечения более10 дней необходимо тщательное наблюдение за состоянием больного и регулярный контроль лабораторных показателей крови. Если необходим более длительный курс лечения из-за наличия хронических заболеваний, следует тщательно взвешивать соотношение между ожидаемой пользой и потенциальным риском возникновения осложнений. При применении Клиона возможно обострение кандидоза. Употребление спиртных напитков во время лечения Клионом строго запрещено. При применении Клиона может наблюдаться незначительная лейкопения, поэтому целесообразно контролировать показатели общего анализа крови (количество лейкоцитов) в начале и в конце терапии. Влияние на способность к вождению автотранспорта и управлению механизмамиПри появлении побочных эффектов со стороны ЦНС следует воздержаться от управления автотранспортом и работы с потенциально опасными механизмами.
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Механизм действия заключается в биохимическом восстановлении 5-нитрогруппы метронидазола внутриклеточными транспортными протеинами анаэробных микроорганизмов и простейших. Восстановленная 5-нитрогруппа метронидазола взаимодействует с ДНК клетки микроорганизмов, ингибируя синтез нуклеиновых кислот, что ведет к гибели микроорганизмов. Активен в отношении Trichomonas vaginalis, Entamoeba hystolitica, Gardnerella vaginalis, Giardia intestinalis, а также облигатных анаэробов Bacteroides spp. (в т.ч. Bacteroides fragilis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides distasonis, Bacteroides vulgatus), Fusobacterium spp., Veillonella spp., Prevotella (Prevotella bivia, Prevotella buccae, Prevotella disiens) и некоторых грамположительных микроорганизмов (Eubacterium spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.). МПК для этих штаммов составляет 0.125-6.25 мкг/мл. В сочетании с амоксициллином проявляет активность в отношении Helicobacter pylori (амоксициллин подавляет развитие резистентности к метронидазолу). К метронидазолу нечувствительны аэробные микроорганизмы и факультативные анаэробы, но в присутствии смешанной флоры (аэробы и анаэробы) метронидазол действует синергично с антибиотиками, эффективными против обычных аэробов. Увеличивает чувствительность опухолей к облучению, вызывает дисульфирамоподобные реакции, стимулирует репаративные процессы."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Заместительная гормональная терапия: атрофия слизистой оболочки нижних отделов урогенитального тракта, связанная с дефицитом эстрогенов. Пред- и послеоперационная терапия у женщин в постменопаузе, которым предстоит или проведена операция влагалищным доступом. С диагностической целью при неясных результатах мазка из влагалища на фоне атрофических изменений."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Установленный (в т.ч. в анамнезе) или подозреваемый рак молочной железы. Эстрогензависимые злокачественные новообразования или подозрение на них (в т.ч. рак эндометрия). Недиагностированное генитальное кровотечение. Нелеченная гиперплазия эндометрия. Тромбозы (венозные и артериальные) и тромбоэмболии в настоящее время или в анамнезе (в т.ч. тромбоз глубоких вен, тромбоэмболия легочной артерии, инфаркт миокарда, инсульт), цереброваскулярные нарушения. Состояния, предшествующие тромбозу (в т.ч. стенокардия) в настоящее время или в анамнезе. Множественные или выраженные факторы риска венозного или артериального тромбоза (в т.ч. осложненные поражения клапанного аппарата сердца, фибрилляция предсердий, заболевания сосудов головного мозга или коронарных артерий; неконтролируемая артериальная гипертензия, серьезное хирургическое вмешательство с длительной иммобилизацией, курение в возрасте старше 35 лет). Подтвержденные тромбофилии, наследственные или приобретенные факторы, предрасполагающие к развитию венозных и артериальных тромбозов, такие как: резистентность к активированному протеину С, дефицит антитромбина III, дефицит протеина С, дефицит протеина S, наличие антител к фосфолипидам и другие. Тромбофлебит глубоких вен (в т.ч. в анамнезе). Выраженная гипертриглицеридемия. Холестатическая желтуха. Отосклероз (в т.ч. во время предшествующей беременности или при лечении половыми гормонами). Острые заболевания печени или наличие заболеваний печени в анамнезе до тех пор, пока показатели печеночной функции не вернуться в норму. Порфирия. Беременность. Период лактации. Повышенная чувствительность к компонентам препарата. С осторожностью: Лейомиома. Эндометриоз. Тромбоэмболия в анамнезе или факторы риска ее развития. Факторы риска эстрогензависимых опухолей, в т.ч. 1-я степень родства по раку молочной железы в семейном анамнезе. Артериальная гипертензия. Заболевания печени (в т.ч. аденома). Сахарный диабет с диабетической ангиопатией или без нее. Холелитиаз. Мигрень или тяжелая головная боль. Системная красная волчанка. Эпилепсия. Бронхиальная астма. Семейная гиперлипопротеинемия. Панкреатит. Рак или гиперплазия эндометрия в анамнезе. Сердечная недостаточность. Почечная недостаточность. Метаболические нарушения костной ткани. Герпес во время предшествующей беременности."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Метронидазол противопоказан к применению в I триместре беременности. Назначение препарата в II и III триместрах беременности возможно только в том случае, если предполагаемая польза для матери превышает потенциальный риск для плода. Противопоказано применение препарата в период лактации (грудного вскармливания). Метронидазол выделяется с грудным молоком. При необходимости применения препарата следует прекратить грудное вскармливание."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Интравагинально, перед сном. При атрофии слизистой оболочки нижних отделов урогенитального трактаНазначают по 1 суппозиторию (0,5 мг) ежедневно в первые 2-3 недели, затем постепенно снижают дозу, основываясь на симптоматике, 1 суппозиторий (0,5 мг) 2 раза в неделю. Пред- и послеоперационная терапия у женщин в постменопаузеПо 1 суппозиторию (0,5 мг) в течение 2 недель до или после операции. В качестве диагностического средства1 суппозиторий через день в течение недели перед взятием следующего мазка. В случае если очередная доза препарата была пропущена, следует принять ее немедленно. Однако если это обнаружилось только в день приема следующей дозы, следует продолжить прием препарата по обычной схеме, не восполняя пропущенную дозу. Нельзя применять две дозы в один день."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"ВозможноЗуд и раздражение в месте введения, напряжение и болезненность молочных желез. В комбинации с гестагенамиДоброкачественные и злокачественные эстрогензависимые опухоли (в т.ч. рак молочной железы и эндометрия), венозная тромбоэмболия (в т.ч. глубоких вен голени и малого таза, легочных вен), инфаркт миокарда, инсульт, заболевания желчного пузыря, хлоазма, многоформная эритема, узловатая эритема, геморрагическая пурпура, деменция при начале ЗГТ в непрерывном приеме препарата после 65 лет, ациклические кровянистые выделения, кровотечения прорыва, повышение либидо."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: тошнота, рвота, атаксия. Лечение: проведение симптоматической терапии. Специфического антидота нет. Метронидазол и его метаболиты хорошо элиминируются при гемодиализе."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В/в введение раствора Клиона показано больным, у которых пероральный прием препарата невозможен. При смешанных инфекциях раствор Клиона можно применять в комбинации с парентеральными антибиотиками, не смешивая препараты между собой. При в/в капельном введении нельзя смешивать Клион с другими препаратами. При длительности курса лечения более10 дней необходимо тщательное наблюдение за состоянием больного и регулярный контроль лабораторных показателей крови. Если необходим более длительный курс лечения из-за наличия хронических заболеваний, следует тщательно взвешивать соотношение между ожидаемой пользой и потенциальным риском возникновения осложнений. При применении Клиона возможно обострение кандидоза. Употребление спиртных напитков во время лечения Клионом строго запрещено. При применении Клиона может наблюдаться незначительная лейкопения, поэтому целесообразно контролировать показатели общего анализа крови (количество лейкоцитов) в начале и в конце терапии. Влияние на способность к вождению автотранспорта и управлению механизмамиПри появлении побочных эффектов со стороны ЦНС следует воздержаться от управления автотранспортом и работы с потенциально опасными механизмами."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Противопротозойный и противомикробный препарат, производное 5-нитроимидазола. Механизм действия заключается в биохимическом восстановлении 5-нитрогруппы метронидазола внутриклеточными транспортными протеинами анаэробных микроорганизмов и простейших. Восстановленная 5-нитрогруппа метронидазола взаимодействует с ДНК клетки микроорганизмов, ингибируя синтез нуклеиновых кислот, что ведет к гибели микроорганизмов. 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