Действующее вещество: имихимод (imiquimod)Концентрация действующего вещества (мг): имихимод 5 мг
Фармакологические свойства
Иммуномодулятор. Имихимод - действующее вещество препарата Алдара - является модификатором иммунного ответа. Имихимод не обладает прямым противовирусным действием, его действие обусловлено индукцией интерферона альфа и других цитокинов.
Показания к применению
лечение наружных остроконечных кондилом в месте локализации на наружных половых органах или в перианальной области у взрослых.
Противопоказания
детский возраст до 18 лет (в связи с отсутствием данных); повышенная чувствительность к имихимоду или любым другим компонентам крема.
Способ применения и дозы
Крем Алдара наносится 3 раза в неделю (например, понедельник, среда и пятница или вторник, четверг и суббота) перед сном, и оставляется на коже, приблизительно, на 6-10 ч, в течение этого времени не следует принимать душ или ванну. На участок применения крема не следует наносить повязку. По прошествии этого периода крем необходимо смыть водой с мягким мылом. Лечение следует продолжать до исчезновения видимых генитальных или перианальных кондилом, но не более 16 недель. Крем Алдара упакован в одноразовые пакетики-саше, содержащие необходимое количество крема для нанесения на пораженный участок, площадью 20 см2. Не следует применять крем более 1 раза/сут. Не допускается использования избыточного количества крема.
Побочное действие
Местные кожные реакции: очень часто - зуд и боль в месте нанесения крема; часто - инфекция, эритема, эрозия, экскориация/шелушение и отек; нечасто - кожный зуд, дерматит, фолликулит, эритематозная сыпь, экзема, крапивница; редко - индурация, изъязвление, образование струпьев и появление пузырьков, локальная гипопигментация и гиперпигментация. Со стороны ЦНС и периферической нервной системы: часто - головная боль, головокружение; нечасто - бессонница, депрессия, раздражительность, парестезия, мигрень, сонливость, звон в ушах. Со стороны пищеварительной системы: часто - тошнота; нечасто - боль в животе, диарея, рвота, анорексия, боль в области ануса, поражения прямой кишки. Со стороны половой системы: нечасто - грибковая и бактериальная инфекция, простой герпес, вагинит, вульвит, болезненный половой акт, боль в половом члене, влагалище, атрофический вагинит. Со стороны системы кроветворения: очень редко - снижение гемоглобина, лейкопения, абсолютная нейтропения и тромбоцитопения. Со стороны костно-мышечной системы: нечасто - боль в пояснице, артралгия. Со стороны дыхательной системы: нечасто - фарингит, ринит. Со стороны организма в целом: часто - инфекция, миалгия, лихорадка, гриппоподобные симптомы, утомляемость; нечасто - повышенная потливость, лимфоаденопатия. При появлении местных побочных эффектов крем следует удалить, смыв его водой с мылом. Лечение можно возобновить после купирования кожной реакции.
Передозировка
В случае наружного применения вероятность системной передозировки крема Алдара мала в связи с низким всасыванием препарата через кожу. При случайном употреблении внутрь имихимода в дозе 200 мг, что соответствует содержимому приблизительно 16 пакетиков, могут наблюдаться тошнота, рвота, головная боль, миалгия и лихорадка. Наиболее серьезным с клинической точки зрения побочным эффектом приема внутрь нескольких доз по 200 мг является артериальная гипотензия, которая купируется путем введения жидкости внутрь или в/в.
Особые указания
Крем Алдара наносится только на пораженные участки. Следует избегать попадания крема на слизистые оболочки, контакта крема с глазами. При попадании крема в глаза рекомендуется промыть их водой. Крем Алдара применяется перед сном. Использование избыточного количества крема или более длительный контакт крема с кожей может вызвать выраженную местную реакцию. Не допускается повторное использование вскрытого пакетика. Следует тщательно вымыть руки до и после нанесения крема. Мужчины, которым не выполнялось обрезание, при лечении остроконечных кондилом, расположенных под крайней плотью, должны ежедневно промывать область поражения, оттянув крайнюю плоть. Рекомендуется немедленно прекратить лечение в случае обнаружения ранних признаков фимоза. Если местная реакция на препарат служит причиной серьезного дискомфорта для больного, либо если в зоне применения крема развивается инфекционный процесс, разрешается сделать перерыв в лечении на несколько дней. В случае развития инфекции принимаются необходимые меры. Крем Алдара может вызывать обострение воспалительных заболеваний кожи. Не рекомендуется использовать крем Алдара до заживления кожи после других видов медикаментозного или хирургического лечения. Не следует приступать к лечению кремом Алдара на участках с открытыми язвами или ранами до их заживления. Наполнители метилпарагидроксибензоат, пропилпарагидроксибензоат, цетиловый спирт и стеариловый спирт могут вызывать аллергическую реакцию. При выявлении реакции гиперчувствительности рекомендуется прекратить терапию. Не рекомендуется использовать окклюзионную повязку во время лечения препаратом Алдара. Использование имихимода в дозах, превышающих рекомендуемые, может привести к повышению риска развития тяжелых местных реакций. В период применения крема Алдара, следует избегать или минимизировать воздействие солнечного света (включая лампы солнечного света), поскольку существует угроза получения солнечных ожогов. Так как имихимод не обладает прямым противовирусным и цитотоксическим действием, после проведенной терапии возможно возникновение новых кондилом генитальной и перианальной областей. На основании имеющихся в настоящее время знаний лечение уретральных, интравагинальных, цервикальных, ректальных или интраанальных остроконечных кондилом кремом Алдара не рекомендовано. Перед половым контактом крем Алдара следует смыть с поверхности кожи. Крем Алдара способен снижать эффективность презерватива или вагинальной диафрагмы, поэтому не рекомендуется применять эти противозачаточные средства при использовании крема Алдара. Следует выбрать альтернативный метод контрацепции. У больных с иммунодефицитом не рекомендуется использовать крем Алдара повторно. Влияние на способность управлять транспортными средствами и работать с механизмамиИсследования влияния препарата на способность управлять автомобилем и работать с механизмами не проводились.
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