Комбинированный препарат для наружного применения, действие которого обусловлено входящими в его состав компонентами. Оказывает противовоспалительное, противоаллергическое, противозудное, кератолитическое действие.
Бетаметазон тормозит высвобождение медиаторов воспаления, предупреждает краевое скопление нейтрофилов, уменьшает воспалительный экссудат и продукцию цитокинов, снижает миграцию макрофагов, приводя к уменьшению процессов инфильтрации и грануляции.
Наличие салициловой кислоты смягчает кожу, устраняет роговые наслоения и способствует более глубокому проникновению бетаметазона.
Фармакокинетика
Данные о фармакокинетике препарата Редерм® не предоставлены.
Показания к применению
Лечение подострых и хронических дерматозов, сопровождающихся гиперкератозом и шелушением:
псориаз;
дисгидротический дерматит;
экзема;
нейродермит;
красный плоский лишай;
ихтиоз и ихтиозные поражения кожи;
атопический дерматит;
диффузный нейродермит;
простые и аллергические дерматиты;
крапивница;
многоформная экссудативная эритема;
простой хронический лишай (ограниченный нейродермит);
дерматозы, не поддающиеся лечению другими ГКС (особенно красный бородавчатый лишай);
повышенная чувствительность к компонентам препарата.
С осторожностью
С осторожностью: печеночная недостаточность; детский возраст старше 2 лет; длительная терапия, особенно с использованием окклюзионных повязок.
Способ применения и дозы
Препарат применяют наружно. Наносят на пораженные участки кожи из расчета: столбик мази длиной 0.5 см на участок кожи размером примерно 7×7 см, слегка втирая, тонким слоем 2 раза/сут. Другая частота применения может быть установлена врачом, исходя из тяжести заболевания.
В легких случаях мазь достаточно применять, как правило, 1 раз/сут; при более тяжелых поражениях может понадобиться более частое применение.
При необходимости накладывают окклюзионные повязки, которые меняют каждые 24 ч.
Продолжительность лечения зависит от эффективности и переносимости терапии и составляет 2-4 недели.
Если клиническое улучшение не наступает, необходимо уточнить диагноз.
Побочное действие
Со стороны кожи и подкожной клетчатки: жжение, раздражение, сухость, гипопигментация, зуд кожи, фолликулит, гипертрихоз, дерматит, акнеподобные высыпания.
При нанесении на большие поверхности: системные проявления побочных действий ГКС (задержка роста, синдром Иценко-Кушинга, повышение внутричерепного давления после окончания лечения, гипергликемия, глюкозурия, гипокалиемия, повышение АД) или салицилатов (бледность, повышенная утомляемость, сонливость, гипервентиляция на фоне тахипноэ, тошнота, рвота, нарушение слуха, спутанность сознания).
Передозировка
Симптомы: острая передозировка маловероятна, однако, при чрезмерном или длительном применении препарата возможна хроническая передозировка, сопровождающаяся признаками гиперкортицизма (гипергликемия, глюкозурия, обратимое угнетение функции коры надпочечников, проявление синдрома Кушинга).
Лечение: показано соответствующее симптоматическое лечение. В случае хронического токсического действия рекомендуется постепенная отмена препарата.
Особые указания
Следует избегать попадания препарата в глаза, нельзя наносить на кожу вблизи глаз и на слизистые оболочки. Препарат не предназначен для применения в офтальмологии.
При продолжительном лечении, нанесении препарата на обширные поверхности кожи, использовании окклюзионных повязок возможна системная абсорбция ГКС.
Не рекомендуется длительное применение на коже лица - возможно развитие дерматита по типу розацеа, периорального дерматита, атрофии кожи и акне; избегать применения в аногенитальной области.
Мазь наиболее пригодна для лечения больных с сухой и хрупкой кожей.
Если отмечаются признаки повышенной чувствительности или раздражения кожи, связанные с применением препарата, следует прекратить лечение и подобрать пациенту адекватную терапию.
При длительном применении препарата его отмену следует проводить постепенно.
Использование в педиатрии
Детям с 2 лет препарат назначают только по строгим показаниям и под врачебным контролем, т.к. возможно развитие системных побочных эффектов, связанных с бетаметазоном. Длительность лечения должна быть максимально короткой. При применении препарата на обширных поверхностях и/или под окклюзионной повязкой возможно подавление функции гипоталамо-гипофизарно-надпочечниковой системы и развитие симптомов гиперкортицизма, может наблюдаться снижение экскреции гормона роста, повышение внутричерепного давления.
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