Triamcinolone

Pharmacological properties

the active substance of Focort-Darnitsa cream is triamcinolone acetonide - GC, containing fluorine, with topical application it has anti-inflammatory, anti-allergic and antipruritic effect.

The pharmacological action of GCS is based on the regulation of the synthesis of specific proteins of the body and ensuring the bodys adaptability to stressful situations by reducing glucose utilization and enhancing gluconeogenesis. They contribute to the deposition of glycogen, especially in the liver, due to increased secretion of insulin in hyperglycemia. Reduce the synthesis and enhance protein catabolism of muscle, skin and bone tissue; contribute to lipolysis. They constrict blood vessels, reduce their permeability and swelling of tissues.

Numerous corticosteroids receptors are also found in the tissues of the brain and heart. GCS enhance β-adrenergic reactions in the lungs, expand the bronchi and reduce vascular resistance in the lungs.

The esterification of the GC molecule with fatty acids in the 17th and 21st positions significantly enhances its effect on the skin. The location of cyclic acetonide in the 16th and 17th positions enhances the local anti-inflammatory effect, without affecting the systemic effect of corticosteroids. Fluoride contributes to a further increase in the local activity of the drug.

Pharmacokinetics Triamcinolone penetrates well into the deeper layers of the skin, partially enters the bloodstream. When applying an occlusive dressing to the affected skin, it is absorbed in an amount sufficient to provide a systemic effect. GCS is rapidly distributed in the tissues of the body. The main metabolite of triamcinolone - 6-β-hydroxytriamcinolone, is metabolized by the liver, kidneys, excreted in feces and urine in equal proportions. T_½ from blood plasma is about 5 hours, half-life is 18–36 hours.

Indications

Skin diseases in which treatment with corticosteroids is indicated (eczema, vulgar psoriasis, allergic dermatitis).

Application

For external use.

Adults: apply a thin layer of cream 2-3 times a day to the affected area of ​​the skin (maximum dose - no more than 15 g of cream per day) or use the drug under an occlusive dressing (maximum dose - no more than 10 g of cream per day). The duration of treatment is determined by the doctor individually.

Children: over the age of 1 year, a thin layer of cream is applied a maximum of 2 times a day on the affected area of ​​the skin. The duration of the drug in children should not exceed 5 days. The use of an occlusive dressing in children is contraindicated.

Prescribing cream to children is possible only in exceptional cases.

In elderly patients, the drug must be used with caution and for a short time, since it should be borne in mind that in this category of patients the skin is thinner.

Contraindications

Hypersensitivity to triamcinolone acetonide or excipients of the drug. tuberculosis, viral skin lesions, especially with herpes simplex and chickenpox, skin manifestations of syphilis, skin reactions after vaccination, perianal and genital itching, common plaque psoriasis, varicose veins, leg ulcers; facial skin lesions (rosacea, acne vulgaris, perioral dermatitis); diaper rash caused by wet diapers; use as monotherapy without specific treatment for fungal and bacterial skin infections, treatment of dry peeling of the skin, skin cancer, children under 1 year old.

Side effects

For topical glucocorticosteroid drugs, local side reactions are characteristic, however, depending on the amount of the substance that has entered the systemic circulation, systemic effects are possible.

With prolonged use on large surfaces, inhibition of the function of the adrenal cortex is possible, especially in children, as well as with the use of occlusive dressings; negative nitrogen balance is possible due to increased protein breakdown.

From the immune system: hypersensitivity reactions.

On the part of water-electrolyte metabolism: inhibition of the function of the adrenal cortex (secondary insufficiency of the adrenal cortex), hypokalemic alkalosis, delay in the body of water and sodium, hypokalemia, hypertension.

From the side of the central nervous system: mental disorders, convulsions, dizziness, headache, increased intracranial pressure, insomnia.

From the side of the organ of vision: cataract, posterior subcapsular cataract, exophthalmos, glaucoma, optic nerve edema, corneal ulcer, exophthalmos. The likelihood of developing cataracts is higher in children.

From the cardiovascular system: heart failure, hypertension.

From the digestive system: gastric bleeding, gastrointestinal bleeding, gastrointestinal perforation, esophagitis, pancreatitis, peptic ulcer.

On the part of the skin: dermatitis, burning sensation, folliculitis, acneiform rashes, contact dermatitis, dryness and thinning of the skin, erythema, hirsutism, increased sweating, diaper rash, itching, skin atrophy, hypopigmentation, irritation, stretch marks, telangiectasia, slow healing of wounds.

From the musculoskeletal system: growth retardation in children, steroid myopathy, osteoporosis, osteonecrosis, aseptic necrosis.

Laboratory abnormalities: increased intraocular pressure, negative nitrogen balance, slowing down reactions in skin tests.

Infections and parasitic diseases: activation of latent infections, masking the course of infections, opportunistic infections.

special instructions

If skin irritation occurs, stop using Focort Darnitsa Cream and continue treatment with another drug.

When applying occlusive dressings and treating large body surfaces, a systemic effect of the drug is possible - in such cases, special care is required.

When applying the cream, microorganisms located on the skin (primarily pyogenic microorganisms, sometimes blastomycetes) can penetrate through the loosened stratum corneum and cause various pyoderma, which are treated with washable disinfectants. Fungal diseases are possible. Sometimes bruising may occur under an occlusive dressing. With prolonged use of the cream on the same part of the body, especially in young patients, atrophy can develop. Long-term use of the drug on the skin of the face is not recommended because of the risk of skin atrophy.

Some parts of the body, such as armpits, inguinal folds (where there is natural occlusion and the skin is more delicate and thin) are more prone to the development of stretch marks and easily noticeable atrophy of this area of ​​the skin, which is irreversible. Therefore, the use of cream in these areas of the skin should be short-lived.

In the case of the development of a fungal or bacterial infection of the skin, additional application of local or systemic therapy is necessary.

The use of cream on the scalp is not recommended.

Long-term use of the drug on the skin of the face is not recommended because of the risk of skin atrophy. Avoid contact with eyes. In case of contact with eyes, rinse with plenty of running water and consult a doctor.

In the treatment of psoriasis, withdrawal syndrome, steroid dependence, the development of generalized pustular psoriasis and local or systemic toxicity due to impaired skin barrier function are possible. Treatment of patients with psoriasis with local corticosteroids is possible only under the strict supervision of a physician.

Prescribing cream to children over the age of 1 year is possible only in exceptional cases. The duration of the use of the drug in children should not exceed 5 days. The use of an occlusive dressing in children is contraindicated.

If used in children, it is necessary to take into account the possibility of signs of depression of the hypothalamic-pituitary-adrenal system and Cushings syndrome, which occur in children more often than in adults, due to the greater ratio of skin area to body weight and, accordingly, children are more prone to systemic toxicity. In children receiving topical corticosteroids, acute adrenal cortex insufficiency, Cushings syndrome, increased intracranial pressure were noted.

Use during pregnancy and lactation. The use of cream in the first trimester of pregnancy is contraindicated. Data confirming the safety of the drug during pregnancy, in the II and III trimester, is insufficient. The doctor decides on the use of the drug during pregnancy, in the II and III trimester of pregnancy and during lactation individually in each case, carefully weighing the ratio of the expected effect of treatment for the mother and the potential risk to the fetus / child. Data confirming the safety of the drug during pregnancy is not enough.

The absorption of GCS into the circulatory system is accompanied by their penetration into the mother’s breast milk and the effect on the adrenal cortex and the growth of the child.

Applying cream to the mammary glands immediately before breastfeeding is contraindicated.

Children. In children under the age of 1 year, the use of cream is contraindicated.

The ability to influence the reaction rate when driving vehicles or other mechanisms. There are no messages at this time. But when driving vehicles or working with other mechanisms, special caution is recommended, given the possibility of developing undesirable reactions from the nervous system.

Interactions

With topical use of steroids, interaction with other drugs is unknown.

Overdose

Depending on the amount of corticosteroids that have been ingested, both local and systemic adverse reactions may develop. with an overdose of the drug, treatment should not be abruptly stopped - this is done gradually, reducing the dose of the drug. with the development of symptoms of adrenal insufficiency, intravenous administration of hydrocortisone may be required.

Storage conditions

In the original packaging at a temperature not exceeding 25 ° C.