100 г: Бетаметазона дипропионат 64 мг, что соответствует содержанию бетаметазона 50 мг, гентамицин (в форме сульфата) 100 мг. Вспомогательные вещества: метилпарагидроксибензоат - 0.2 г, пропиленгликоль - 21.7 г, парафин жидкий - 20 г, макрогола цетостеарат - 1.3 г, цетостеариловый спирт - 5.7 мг, динатрия эдетат - 0.5 г, натрия гидрофосфата додекагидрат - 0.1 г, калия дигидрофосфат - 0.9 г, вода очищенная - до 100 г.
Фармакологические свойства
Комбинированный препарат для наружного применения, оказывающий противовоспалительное, противоаллергическое и антибактериальное действие. Бетаметазона дипропионат - ГКС, оказывает противовоспалительное, противоаллергическое, антиэкссудативное и противозудное действие. Тормозит накопление лейкоцитов, высвобождение лизосомальных ферментов и медиаторов воспаления в очаге воспаления, угнетает фагоцитоз, уменьшает сосудисто-тканевую проницаемость, препятствует образованию воспалительного отека. Гентамицин - антибиотик широкого спектра действия из группы аминогликозидов. Оказывает бактерицидное действие в отношении возбудителей первичных и вторичных бактериальных инфекций кожи. Активен в отношении грамотрицательных бактерий: Pseudomonas aeruginosa, Aerobacter aerogenes, Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae; грамположительных бактерий: Streptococcus spp. (чувствительные штаммы бета- и альфа-гемолитического стрептококка группы A), Staphylococcus spp. (коагулаза-положительные, коагулаза-отрицательные и некоторые штаммы, продуцирующие пенициллиназу). Неактивен в отношении анаэробов, грибов и вирусов.
Показания к применению
Дерматиты (простой и аллергический), особенно вторично инфицированные
Экзема (атопическая, детская, монетовидная)
Атопический дерматит (нейродермит диффузный)
Простой хронический лишай (нейродермит ограниченный)
Солнечный дерматит
Эксфолиативный дерматит
Радиационный дерматит
Опрелости
Псориаз
Зуд
Противопоказания
Туберкулез кожи
Кожные проявления сифилиса
Ветряная оспа
Простой герпес
Кожные поствакцинальные реакции
Открытые раны
Период лактации (грудное вскармливание)
Детский возраст до 1 года
Повышенная чувствительность к компонентам препарата
Применение при беременности и в период грудного вскармливания
Безопасность местного применения ГКС у беременных не установлена. Поэтому назначение лекарственных препаратов этой группы при беременности возможно только в том случае, если потенциальная польза превышает возможный риск. При необходимости применения Акридерма Гента при беременности не следует применять препарат в высоких дозах или длительное время. Не установлено, выделяется ли бетаметазон при местном применении Акридерма Гента, поэтому при необходимости применения препарата в период лактации следует решить вопрос о прекращении грудного вскармливания.
Способ применения и дозы
Препарат применяют наружно. Крем наносят тонким слоем на пораженный участок кожи 2 раза/сут ( утром и вечером). Кратность применения препарата устанавливается исходя из тяжести заболевания. В легких случаях крем достаточно применять 1 раз/сут; при более тяжелых поражениях возможно более частое применение. Продолжительность лечения зависит от эффективности и переносимости терапии и составляет 2-4 недели. При отсутствии клинического улучшения необходимо уточнить диагноз.
Побочное действие
Местные реакции: при местном применении ГКС могут наблюдаться жжение, раздражение, сухость кожи, фолликулит, гипертрихоз, акнеподобные высыпания, гипопигментация, периоральный дерматит, аллергический контактный дерматит. При длительном применении, а также при использовании окклюзионных повязок - мацерация кожи, вторичная инфекция, атрофия кожи, потница, пурпура. Системные реакции: при нанесении на обширные поверхности тела, в основном у детей, возможно возникновение системных побочных эффектов ГКС (гипергликемия, глюкозурия, обратимое угнетение функции коры надпочечников, проявления синдрома Кушинга) и гентамицина (нефротоксическое и ототоксическое действие).
Передозировка
Острая передозировка маловероятна, однако при чрезмерном или длительном применении препарата возможна хроническая передозировка, сопровождающаяся признаками гиперкортицизма: гипергликемия, глюкозурия, обратимое угнетение функции коры надпочечников, проявления синдрома Кушинга. Лечение: показано соответствующее симптоматическое лечение. В случае хронического токсического действия рекомендуется постепенная отмена препарата.
Особые указания
Если отмечаются признаки повышенной чувствительности или раздражения кожи, связанные с применением препарата, следует прекратить лечение и подобрать пациенту адекватную терапию. При продолжительном лечении, при нанесении препарата на обширные поверхности кожи, при использовании окклюзионных повязок, а также у детей возможна системная абсорбция ГКС. На коже лица чаще, чем на других поверхностях тела, после длительного лечения ГКС для местного применения могут проявляться атрофические изменения. Курс лечения в этом случае не должен превышать 5 дней. Акридерм Гента не предназначен для применения в офтальмологии. Следует избегать попадания препарата в глаза. При длительном использовании препарата его отмену следует проводить постепенно. Использование в педиатрииДетям с 1 года препарат назначают только по строгим показаниям и под врачебным контролем, т.к. возможно развитие системных побочных эффектов, связанных с бетаметазоном. При применении препарата на обширных поверхностях и/или под окклюзионной по вязкой возможно подавление функции гипоталамо-гипофизарно-надпочечниковой системы и развитие симптомов гиперкортицизма, может наблюдаться снижение экскреции гормона роста, повышение внутричерепного давления.
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