Hydrocortisone + Lidocaine - instructions for use, dose, side effects, contraindications

Clinical and pharmacological group: & nbsp

Glucocorticosteroids

Included in the formulation

Hydrocortisone Richter

suspension in / Sust.

GEDEON RICHTER, OJSC Hungary

АТХ:

H.02.A.B.09 Hydrocortisone

Pharmacodynamics:

Combined drug. Glucocorticosteroid for injection (depot form).

Hydrocortisone

By inhibition of phospholipase A activity₂ and reducing the release of arachidonic acid from the phospholipids of cell membranes reduces the production of leukotrienes and prostaglandins. Due to this suppresses the development of inflammatory manifestations: pain, swelling, fever and redness in the area of inflammation. It inhibits the expression of the cyclooxygenase-2 gene, which also leads to inhibition of prostaglandin synthesis.

Reduces the main substance of the connective tissue, weakening the exudative and proliferative processes in the skin. Inhibits cellular kinins, which have proteolytic activity. Prevents the access of macrophages and T-sensitized lymphocytes to the foci of inflammation.

It has anti-inflammatory, anti-edematous and anti-allergic effect.

Lidocaine

It blocks the voltage-dependent sodium channels of peripheral nerve endings of sensory nerves. It has analgesic effect.

Pharmacokinetics:

After intraarticular administration the maximum concentration in the blood plasma is reached after 6 hours.When intramuscular injection is absorbed slowly, providing a prolonged action. The connection with plasma proteins is 90%.

Therapeutic effect develops in 6-24 hours. Penetrates through the blood-brain and placental barrier. Metabolism in the liver.

The half-life is 6-7 days. Elimination by the kidneys.

Indications:

It is used to treat osteoarthritis, monoarthrosis, rheumatoid arthritis, bronchial asthma, bursitis, epicondylitis, tendovaginitis. Used for contractures, before surgical treatment of ankylosed joints, as well as in the tuberculostatic therapy.

ICD-10

XIII.M05-M14.M05 Seropositive rheumatoid arthritis

XIII.M15-M19.M15 Polyarthrosis

XIII.M65-M68.M65 Synovitis and tenosynovitis

XIII.M65-M68.M67 Other disorders of synovial membranes and tendons

XIII.M70-M79.M71 Other bursopathies

XIII.M70-M79.M75.0 Adhesive shoulder capsulitis

Contraindications:

Syndrome Itenko-Cushing, thrombophilia, Achilles tendon lesions, systemic infection, individual intolerance.

With intraarticular administration: intraarticular fracture of bones, infectious arthritis, infectious osteoporosis, severe deformation and destruction of the joint, aseptic necrosis of the epiphyses of bones.

Children up to 12 months.

Carefully:

Chronic heart failure, osteoporosis, gastric and duodenal ulcer, diabetes mellitus, arterial hypertension, herpetic infection, glaucoma, measles, epilepsy, steroid myelopathy, hypersensitivity.

Pregnancy and lactation:

Recommendations for FDA - Category C. Contraindicated in pregnancy and lactation.

Dosing and Administration:

Use in children

Periarticular, single dose:

2-6 years: 25-50 mg;

7-14 years: 50-75 mg.

Adults

Periarticular, single dose is from 5 to 25 mg.

Intramuscularly deep, 125-250 mg per day. In diseases of the respiratory system no more than 3 days. In rheumatology - no more than 6 days.

The highest daily dose: 250 mg.

The highest single dose: 250 mg.

Side effects:

Central and peripheral nervous system: agitation, headache, dizziness, anxiety, insomnia, irritability, depression, paranoia, hallucinations, pseudotumor of the cerebellum, edema of the nipple of the optic nerve due to increased intracranial pressure.

Hemopoietic system: leukocytosis, leukocyturia.

The cardiovascular system: arterial hypertension, arrhythmia, peripheral vasodilation, cardiac insufficiency, thromboembolism.

Digestive system: nausea, vomiting, peptic ulcer, pancreatitis, esophagitis, increased appetite, hiccups, flatulence.

Musculoskeletal system: osteoporosis, rarely - pathological bone fractures, aseptic necrosis of the head of the femoral and humerus, steroid myopathy, arthralgia, decrease in muscle mass, rupture of the tendons of muscles.

Dermatological reactions: hyperhidrosis, folliculitis, telangiectasia, striae, steroid acne, petechiae, ecchymosis, hypopigmentation.

Sense organs: glaucoma, exophthalmos, optic nerve damage, posterior capsular cataract, secondary eye infections, trophic corneal changes.

Endocrine system: a decrease in glucose tolerance, diabetes mellitus, Itenko-Cushing syndrome, suppression of adrenal cortex function, growth retardation in children and adolescents.

The immune system: exacerbation of chronic infections, exacerbation of tuberculosis, pyoderma and candidiasis.

Allergic reactions.

Overdose:

Arterial hypertension, arthralgia, hypokalemia.

Treatment is symptomatic.

Interaction:

Enhances the effect of anticoagulants.

Increases the toxicity of cardiac glycosides, barbiturates.

Enhances the hepatotoxic effect of paracetamol.

Reduces the effect of somatotropin, oral hypoglycemic drugs, praziquantel.

Mifepristone, thyroid hormones, estrogens, inhibitors of the adrenal cortex reduce the effect of hydrocortisone.

When used simultaneously with loop diuretics, carbonic anhydrase inhibitors, amphotericin B, theophylline, the risk of hypokalemia is increased.

With simultaneous application with salicylates, the risk of developing gastric and duodenal ulcers increases, as well as hemorrhage.

When used simultaneously with carbonic anhydrase inhibitors, the risk of developing osteoporosis increases.

The use of tricyclic antidepressants for the treatment of hydrocortisone-induced depression exacerbates mental disorder.

Special instructions:

Control of blood pressure, coagulation and the composition of peripheral blood, the concentration of glucose in the blood plasma.

It is recommended to postpone vaccination for the duration of treatment.

When treating joints, it is not recommended to administer the drug more than 3 times a year.

In the treatment it is not recommended to drive vehicles and work with moving mechanisms.

Instructions

Hydrocortisone + Lidocaine (Hydrocortisonum + Lidocainum)