Salicylic acid + Flumethasone (Acidum salicylicum + Flumetasonum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Glucocorticosteroids

Non-narcotic analgesics, including non-steroidal and other anti-inflammatory drugs

Included in the formulation
  • Lorinden® A
    ointment externally 
    VALEANT, LLC     Russia
    • АТХ:

    D.07.X.B.01   Flumethasone in combination with other drugs

    Pharmacodynamics:

    Anti-inflammatory action salicylic acid is due to inhibition of COX-2 activity, which leads to a decrease in the production of inflammatory mediators - Pg D2, E2 and I2.

    The analgesic effect is associated with a decrease in the synthesis of PgE2, which prevents sensitization of pain receptors to bradykinin, histamine and other chemicals synthesized or released in the inflammatory focus.

    The antipyretic effect is caused by the disruption of the production of eicosanoide PgE2, which, when inflamed, stimulates the thermoregulatory center in the anterior parts of the hypothalamus. This reduces only febrile body temperature due to increased heat transfer as a result of increased sweating and widening of peripheral vessels, while normal body temperature does not decrease.

    Anti-inflammatory action flumethasone is caused by interaction with intracellular glucocorticoid receptors - the formation of dimers of the glucocorticoid-glucocorticoid receptor complex (release of the receptor from the bonds with heat shock proteins 70 and 90 and immunophyllin);penetration of the activated receptor into the nucleus, binding to glucocorticoid-sensitive regulatory elements of DNA - a specific effect on gene expression (activation and inhibition). Interaction with other protein transcription factors, including NFκB and AP-1, which regulate the expression of many proteins of the immune system leads to suppression of the expression of genes encoding some cytokines, collagenase and stromelysins, which also provides an anti-inflammatory effect.
    Pharmacokinetics:

    Absorption from the skin surface is insignificant; association with plasma proteins; biotransformation in the liver (after entering the systemic circulation) to inactive metabolites (CYP3A4); excretion mainly by the kidneys in the form of inactive metabolites.

    Indications:

    Atopic dermatitis, diffuse neurodermatitis, chronic eczema, chronic horny eczema, hyperkeratosis, ichthyosis; chronic dyshidrosis, psoriasis; red flat lichen, discoid lupus erythematosus.

    ICD-10

    XII.L20-L30.L20.9   Atopic dermatitis, unspecified

    XII.L20-L30.L20.8   Other atopic dermatitis

    XII.L20-L30.L20   Atopic dermatitis

    XII.L20-L30.L30.0   Coin-like eczema

    XII.L20-L30   Dermatitis and eczema

    XIII.M30-M36.M32.1   Systemic lupus erythematosus with lesions of other organs or systems

    XIII.M30-M36.M32   Systemic lupus erythematosus

    XII.L80-L99.L93.2   Other limited lupus erythematosus

    XII.L80-L99.L93.1   Subacute cutaneous lupus erythematosus

    XII.L60-L75.L74.0   Red sweets

    XII.L40-L45.L43.9   Lisha red flat, unspecified

    XII.L40-L45.L43.8   Another red flat lichen

    XII.L40-L45.L43.3   Lishay red flat subacute (active)

    XII.L40-L45.L43.1   Lishay red flat bullous

    XII.L40-L45.L43.0   Lishy hypertrophic red flat

    XII.L40-L45.L43   Lichen red flat

    XII.L55-L59.L58.0   Acute radiation dermatitis

    XII.L20-L30.L25.2   Unspecified contact dermatitis due to dyes

    XII.L20-L30.L25.0   Unspecified contact dermatitis due to cosmetics

    XII.L20-L30.L25   Contact dermatitis, unspecified

    XII.L20-L30.L24.9   Simple irritant contact dermatitis, cause not specified

    XII.L20-L30.L24.2   Simple irritant contact dermatitis due to solvents

    XII.L20-L30.L24.1   Simple irritant contact dermatitis due to oils and lubricants

    XII.L20-L30.L24.0   Simple irritant contact dermatitis due to cleansers

    XII.L20-L30.L24   Simple irritant contact dermatitis

    XII.L20-L30.L23.9   Allergic contact dermatitis, cause not specified

    Contraindications:Hypersensitivity; skin tuberculosis, syphilis, rash after vaccination, fresh viral, bacterial, fungal skin infections (pyoderma, chicken pox, herpes, actinomycosis, blastomycosis, sporotrichosis); trophic ulcers of the leg, associated with varicose veins, skin tumors (skin cancer, nevus, atheroma, epithelioma, melanoma, hemangioma, xanthoma, sarcoma). Infants and young children; pregnancy.
    Carefully:Birthmarks, hairy warts, warts in the genital area or face, childhood, pregnancy, skin diseases, accompanied by inflammation, wetness.
    Pregnancy and lactation:

    Action category for the fetus by FDA - not determined.

    Adequate and well-controlled studies in humans and animals have not been conducted. There is no information on the penetration into breast milk. Do not apply!

    Dosing and Administration:

    Outwardly. A thin layer of ointment is applied to the painfully altered skin surface 2-3 times a day. After the complete disappearance of the painful manifestations, the treatment is carried out for another 3-4 days. In chronic skin lesions, treatment should not last more than 3 weeks.Ointment can also be used in the form of an occlusive dressing, which should be changed every 24-48 hours. In the treatment of lesions on dry and defatted skin areas characterized by severe infiltration, lichenization, desquamation and hyperkeratosis, and also homosexuality, the degree of moistening can be regulated by the thickness of the applied layer.

    Side effects:

    Burning, itching, striae, dry skin, folliculitis. With long-term use - skin atrophy, hirsutism, telangiectasia, purpura, pigmentation disorders; when applied to large surfaces, systemic manifestations (including ulceration of the gastrointestinal mucosa) are possible.

    Overdose:

    Not described.

    Interaction:

    Hypoglycemic agents, derivatives of sulfonylureas - enhancing their action. Methotrexate - it is possible to increase its side effects. Resorcinol is a pharmaceutical incompatibility (melting mixtures are formed). Means for topical application - increasing their absorption. Zinc oxide is a pharmaceutical incompatibility (an insoluble zinc salicylate is formed).

    Special instructions:

    Do not allow the drug to enter the mucous membranes and conjunctiva.Avoid repeated application to large areas of the skin of patients with severe renal insufficiency (possibly the systemic action of salicylic acid). The degree of moistening can be adjusted by the thickness of the applied layer. Excess ointment, left after rubbing, can be removed from the surface of the skin with a dry cloth. Ointment does not contaminate clothes and bed linens. The solution is colorless, does not stick together hair and quickly penetrates into the skin. After drying, leaves no visible traces.

    Instructions
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