Лонгидаза Лиофилизат, флакон, 5 шт, 3000 МЕ, для инъекций, для приготовления раствора

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Бовгиалуронидаза азоксимер обладает всем спектром\nфармакологических свойств, присущих лекарственным средствам с гиалуронидазной\nактивностью. Специфическим субстратом гиалуронидазы являются гликозаминогликаны\n(гиалуроновая кислота, хондроитин, хондроитин-4-сульфат, хондроитин-6-сульфат)\n– «цементирующее» вещество соединительной ткани. В результате гидролиза\n(деполимеризации) уменьшается вязкость гликозаминогликанов, способность\nсвязывать воду и ионы металлов. Как следствие, увеличивается проницаемость\nтканей, улучшается их трофика, уменьшаются отеки, рассасываются гематомы,\nповышается эластичность рубцово-измененных участков, устраняются контрактуры и\nспайки, увеличивается подвижность суставов. Эффект наиболее выражен в начальных\nстадиях патологического процесса."}},{"type":"paragraph","data":{"text":"Клинический\nэффект Бовгиалуронидаза азоксимер значительно выше, чем эффект нативной гиалуронидазы.  Конъюгация повышает устойчивость фермента к\nдействию температуры и ингибиторов, увеличивает его активность и приводит к\nпролонгированию действия. Ферментативная активность Бовгиалуронидаза азоксимер\nсохраняется при нагревании 37 °С в течение 20 суток, в то время как нативная\nгиалуронидаза в этих же условиях утрачивает свою активность в течение суток. В\nБовгиалуронидаза азоксимер сохраняются и фармакологические свойства носителя,\nобладающего хелатирующей, антиоксидантной, противовоспалительной и\nиммуномодулирующей активностью. Бовгиалуронидаза азоксимер способна связывать\nосвобождающиеся при гидролизе гликозаминогликанов ионы железа – активаторы\nсвободнорадикальных реакций, ингибиторы гиалуронидазы и стимуляторы синтеза\nколлагена, и тем самым подавлять обратную реакцию, направленную на синтез\nкомпонентов соединительной ткани. Политропные свойства Бовгиалуронидаза\nазоксимер реализуются в выраженном противофиброзном действии, экспериментально\nдоказанном биохимическими, гистологическими и электронно-микроскопическими\nисследованиями на модели пневмофиброза."}},{"type":"paragraph","data":{"text":"Бовгиалуронидаза\nазоксимер регулирует (повышает или снижает в зависимости от исходного уровня)\nсинтез медиаторов воспаления (интерлейкин-1 и фактор некроза опухоли-альфа), способна\nослаблять течение острой фазы воспаления, повышать гуморальный иммунный ответ и\nрезистентность организма к инфекции. Указанные свойства позволяют применять\nБовгиалуронидаза азоксимер во время или после хирургического лечения с целью\nпрофилактики грубого рубцевания и спаечного процесса. Применение Бовгиалуронидаза\nазоксимер в терапевтических дозах во время или после оперативного лечения не\nвызывает ухудшение течения послеоперационного периода или прогрессирования\nинфекционного процесса; не замедляет восстановления костной ткани."}},{"type":"paragraph","data":{"text":"Бовгиалуронидаза\nазоксимер при совместном подкожном или внутримышечном введении увеличивает\nвсасывание препаратов, ускоряет обезболивание при введении местных анестетиков."}},{"type":"paragraph","data":{"text":"Бовгиалуронидаза\nазоксимер относится к практически нетоксическим соединениям, не нарушает\nнормального функционирования иммунной системы, не оказывает влияния на\nрепродуктивную функцию самцов и самок крыс, на пре- и постнатальное развитие\nпотомства, не обладает мутагенным и канцерогенным действием. Экспериментально\nдоказано, что в Бовгиалуронидаза азоксимер снижены раздражающие и\nаллергизирующие свойства фермента гиалуронидаза. В терапевтических дозах\nБовгиалуронидаза азоксимер хорошо переносится пациентами."}},{"type":"paragraph","data":{"text":"\u003cb\u003eФармакокинетика:\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"При\nпарентеральном введении Бовгиалуронидаза азоксимер быстро всасывается в системный\nкровоток и достигает максимальной концентрации в крови через 20-25 минут,\nхарактеризуется высокой скоростью распределения в организме. Период\nполураспределения – около 0,5 часа, период полувыведения (Т½) при\nвнутримышечном введении – 36 часов, при подкожном – около 45 часов. Кажущийся\nобъем распределения 0,43 л/кг. Конъюгация не снижает высокой биодоступности\nфермента – биодоступность не менее 90 %."}},{"type":"paragraph","data":{"text":"Действующее\nвещество проникает во все органы и ткани, в том числе через\nгематоэнцефалический и офтальмический барьеры."}},{"type":"paragraph","data":{"text":"В\nорганизме гиалуронидаза подвергается гидролизу, а носитель распадается до\nнизкомолекулярных соединений (олигомеров), которые выводятся преимущественно\nчерез почки в две фазы. В течение первых суток через почки выводится 45-50 %, через\nкишечник – не более 3 %. Далее скорость выведения замедляется, к 4-5 суткам\nпрепарат выводится полностью."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Взрослым в\nсоставе комплексной терапии для лечения и профилактики заболеваний,\nсопровождающихся гиперплазией соединительной ткани:"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв гинекологии\u003c/b\u003e – лечение и профилактика спаечного\nпроцесса в малом тазу при воспалительных заболеваниях внутренних половых\nорганов, в том числе трубно-перитонеальном бесплодии, внутриматочных синехиях,\nхроническом эндометрите;"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nурологии – \u003c/b\u003eлечение\nхронического простатита, интерстициального цистита;"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nхирургии\u003c/b\u003e – лечение\nи профилактика спаечного процесса после оперативных вмешательств на органах\nбрюшной полости и длительно незаживающих ран;"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nдерматовенерологии и косметологии – \u003c/b\u003eлечение\nограниченно й склеродермии, неинфекционной ониходистрофии, келоидных,\nгипертрофических рубцов после пиодермии, травм, ожогов, операций, вульгарных\nугрей II-IV ст. с рубцовыми деформациями (постакне);"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв пульмонологии\nи фтизиатрии\u003c/b\u003e –  лечение пневмосклероза, фиброзирующеrо\nальвеолита, туберкулеза (кавернозно-фиброзный, инфильтративный, туберкулема);"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nревматологии –\u003c/b\u003e  лечение контрактуры суставов, в том числе\nконтрактуры Дюпюитрена и сrибательных тендогенных контрактур кисти, артрозов,\nанкилозирующего спондилоартрита, гематом;"}},{"type":"paragraph","data":{"text":"\u003cb\u003eдля\nувеличения биодоступности – \u003c/b\u003eпри\nсовместном применении антибактериальных препаратов в урологии, гинекологии,\nхирургии, дерматовенерологии, пульмонологии, для усиления действия местных\nанестетиков."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"-           гиперчувствительность к бовгиалуронидаза\nазоксимер и другим компонентам препарата;"}},{"type":"paragraph","data":{"text":"-           острые инфекционные состояния без\nсочетанного применения антимикробных средств;"}},{"type":"paragraph","data":{"text":"-           легочное кровотечение и\nкровохарканье;"}},{"type":"paragraph","data":{"text":"-           свежее кровоизлияние в стекловидное\nтело;"}},{"type":"paragraph","data":{"text":"-           злокачественные новообразования;"}},{"type":"paragraph","data":{"text":"-           острая почечная недостаточность;"}},{"type":"paragraph","data":{"text":"-           возраст до 18 лет (данные по эффективности\nи безопасности отсутствуют);"}},{"type":"paragraph","data":{"text":"-           беременность и период грудного\nвскармливания."}},{"type":"paragraph","data":{"text":"\u003cb\u003eПротивопоказания\nпри введении препарата с помощью физиотерапевтических процедур:\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"-           Повышенная чувствительность к лазерному\nизлучению и ультразвуковому воздействию."}},{"type":"paragraph","data":{"text":"-           Фотодерматит."}},{"type":"paragraph","data":{"text":"-           Прием пациентом стероидных\nгормональных препаратов."}},{"type":"paragraph","data":{"text":"-           Воспалительный процесс в области\nсуставов."}},{"type":"paragraph","data":{"text":"-           Соматические заболевания, при которых\nпротивопоказано проведение физиотерапевтических процедур."}}]},{"id":14,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"хроническая\nпочечная недостаточность (применяют не чаще 1 раза в неделю)."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Противопоказано\nприменение препарата Лонгидаза беременным и женщинам в период грудного\nвскармливания."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Лонгидаза применяется: подкожно, внутримышечно, наружно."}},{"type":"paragraph","data":{"text":"Способы\nприменения выбираются врачом в зависимости от диагноза, тяжести и клинического\nтечения заболевания."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПриготовление\nраствора:\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"1.             \nДля\nподкожного или внутримышечного введения содержимое флакона препарата Лонгидаза 3000 МЕ растворяют в 1,0-2 ,0 мл 0,5 % раствора прокаина (новокаина). В случае\nнепереносимости прокаина (новокаина) препарат Лонгидаза растворяют в том же\nобъеме раствора натрия хлорида 0,9 % для инъекций или воды для инъекций."}},{"type":"paragraph","data":{"text":"2.             \nПри\nприменении с помощью фотофореза для лечения ониходистрофии содержимое флакона\nпрепарата Лонгидаза 3000 МЕ разводят в 0,5 мл дистиллированной воды,\nрастворяют в течение 3-4 минут, наносят по 1 капле (около 300 МЕ препарата Лонгидаза)\nна дистальные фаланги пальцев."}},{"type":"paragraph","data":{"text":"3.             \nДля\nпроведения фотофореза или ультрафонофореза при лечении вульгарных угрей 1\nфлакон препарата Лонгидаза 3000 МЕ разводится в 2-5 мл геля для\nультразвукового воздействия («Медиагель-Т») и наносится на очаг поражения."}},{"type":"paragraph","data":{"text":"4.             \nДля\nвведения препарата с помощью ультразвука при лечении контрактур содержимое\nфлакона с Лонгидазой 3000 МЕ растворяют в 1,0 мл физиологического раствора,\nсмешивают с 5-7 г вазелина и наносят на область рубца."}},{"type":"paragraph","data":{"text":"5.             \nПри\nприменении с целью повышения биодоступности содержимое флакона препарата Лонгидаза 3000 МЕ растворяют в 2,0 мл раствора хлорида натрия 0,9 % для инъекций.\nРастворитель во флакон необходимо вводить медленно, выдержать 2-3 минуты,\nосторожно перемешать, не встряхивая, чтобы не вспенить белок."}},{"type":"paragraph","data":{"text":"\u003cb\u003eПриготовленный\nраствор для парентерального введения хранению не подлежит. Не вводить\nвнутривенно!\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003cb\u003eРекомендуемые\nсхемы профилактики и лечения\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"·      \n\u003cb\u003e\u003ci\u003eДля\nпрофилактики\u003c/i\u003e\u003c/b\u003e\nспаечной болезни и грубого рубцевания после оперативных вмешательств на органах\nбрюшной полости и малого таза внутримышечно по 3000 МЕ 1 раз в 3 дня курсом 5\nинъекций. При необходимости применение препарата Лонгидаза может быть\nпродолжено общим курсом до 10 инъекций при введении 1 раз в 5 дней."}},{"type":"paragraph","data":{"text":"·      \n\u003cb\u003e\u003ci\u003eДля\nлечения\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nгинекологии:\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"-           спаечного процесса в малом тазу при\nвоспалительных заболеваниях внутренних половых органов внутримышечно по 3000 МЕ\n1 раз в 3-5 дней, курсом 10-15 инъекций;"}},{"type":"paragraph","data":{"text":"-           трубно-перитонеального бесплодия\nвнутримышечно 110 3000 МЕ, общим курсом до 15 инъекций: первые 5 инъекций 1 раз\nв 3 дня, далее 1 раз в 5 дней;"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nурологии:\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"-           хронического простатита внутримышечно\nпо 3000 МЕ 1 раз в 5 дней, курсом 10-15 инъекций;"}},{"type":"paragraph","data":{"text":"-           интерстициального цистита\nвнутримышечно по 3000 МЕ 1 раз в 5 дней, курсом до 10 инъекций;"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nхирургии:\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"-           спаечной болезни после оперативных\nвмешательств на органах брюшной полости внутримышечно по 3000 МЕ 1 раз в 3-5\nдней курсом от 10 до 15 инъекций;"}},{"type":"paragraph","data":{"text":"-           длительно незаживающих ран\nвнутримышечно по 3000 МЕ 1 раз в 5 дней, курсом 5-10 инъекций;"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nдерматовенерологии, косметологии:\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"-           ограниченной склеродермии\nвнутримышечно 1 раз в 3-5 дней, курсом до 20 инъекций. Дозу и курс подбирают\nиндивидуально в зависимости от клинического течения, стадии, локализации\nзаболевания и индивидуальных особенностей пациента;"}},{"type":"paragraph","data":{"text":"-           неинфекционной ониходистрофии:\nнаносят по I капле приготовленного раствора (примерно 300 МЕ препарата\nЛонгидаза) на область проекции заднего ногтевого валика, без временного\nинтервала осуществляется воздействие низкоинтенсивным инфракрасным лазерным\nизлучением с частотой следования импульсов 80-1500 Гц, длительностью импульса\n110-160 нс, при импульсной мощности 4-6 Вт/импульс. Фотофорез проводят по\nконтактно-стабильной методике, по 1 минуте на поле, общее время воздействия до 10\nминут при изолированном поражении ногтей кистей рук или стоп и до 20 минут при\nсочетанном поражении ногтей кистей рук или стоп. Курс 15 процедур, ежедневно;"}},{"type":"paragraph","data":{"text":"-           келоидных, гипертрофических и\nформирующихся рубцов после пиодермии, ожогов, операций, травм: внутрирубцовое\nили подкожное вблизи места поражения введение 1 раз в 3 дня, курсом до 15\nинъекций. Объем разведения препарата Лонгидаза выбирается врачом в зависимости\nот количества точек введения. При необходимости курс может быть продолжен по\nсхеме 1 раз в 5 дней до 25 инъекций. В зависимости от площади поражения кожи,\nдавности образования рубца возможно чередование подкожного и внутримышечного\nвведения 1 раз в 5 дней курсом до 20 инъекций;"}},{"type":"paragraph","data":{"text":"-           вульгарных угрей П-IV ст. с рубцовой\nдеформацией (постакне): внутримышечно по 3000 МЕ, 2 инъекции в неделю курсом до\n10 инъекций."}},{"type":"paragraph","data":{"text":"Препарат\nЛонгидаза может вводиться с помощью процедуры фотофореза или ультрафонофореза\nежедневно, 5 дней в неделю – 3 недели, 15 сеансов на курс. Приготовленный\nраствор наносится на область поражения и без временного интервала осуществляется\nвоздействие низкоинтенсивноrо инфракрасного лазерного излучения с частотой\nследования импульсов 80-1500 Гц или ультразвуком с частотой 880 кГц – 1 МГц в\nнепрерывном или импульсном режиме. При локализации очага поражения на лице\nинтенсивность ультразвукового воздействия составляет 0,2-0,4 Вт/см\u003csup\u003e2\u003c/sup\u003e.  В зависимости от площади воздействия\nиспользуется малый излучатель – 1 см\u003csup\u003e2\u003c/sup\u003e, средний – 2 см\u003csup\u003e2\u003c/sup\u003e\nили большой – 4 см\u003csup\u003e2\u003c/sup\u003e. Методика воздействия контактная лабильная.\nОбщая площадь воздействия не должна превышать 50 см\u003csup\u003e2\u003c/sup\u003e. Общее время\nвоздействия 5 минут."}},{"type":"paragraph","data":{"text":"\u003cb\u003eв пульмонологии\nи фтизиатрии:\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"-           пневмосклероза внутримышечно по 3000\nМЕ 1 раз в 5 дней курсом 10 инъекций;"}},{"type":"paragraph","data":{"text":"-           фиброзирующеrо альвеолита\nвнутримышечно 3000 МЕ 1 раз в 5 дней курсом 15 инъекций, далее поддерживающая\nтерапия 1 раз в 10 дней, общим курсом до 25 введений;"}},{"type":"paragraph","data":{"text":"-           туберкулеза внутримышечно 3000 МЕ 1\nраз в 5 дней, курсом до 25 инъекций. В зависимости от клинической картины и\nтяжести течения заболевания возможна длительная   терапия (от 6 месяцев до 1 года 1 раз в 10 дней);"}},{"type":"paragraph","data":{"text":"\u003cb\u003eв\nревматологии:\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"-           контрактуры суставов, в том числе\nконтрактуры Дюпюитрена и сгибательных тендогенных контрактур кисти, подкожно в\nобласть контрактуры в дозе 3000 МЕ 1 раз в день, ежедневно в течение 5 дней с\nдальнейшим перерывом на два дня, курсом до 15 инъекций. Повторный курс через\n1,5 месяца."}},{"type":"paragraph","data":{"text":"При\nразвитии местных реакций на инъекционное введение препарат Лонгидаза может\nвводиться методом фонофореза на область контрактуры, через день, 3 раза в\nнеделю, курсом до 12 процедур. Приготовленный раствор наносят на область рубца,\nвоздействуют ультразвуковым датчиком по лабильной методике при интенсивности\nультразвука 0,2 Вт/см\u003csup\u003e2\u003c/sup\u003e, в непрерывном режиме, продолжительность\nпроцедуры 10 минут. Повторный курс через 1,5 месяца;"}},{"type":"paragraph","data":{"text":"-           артрозов, анкилозирующеrо\nспондилоартрита подкожно вблизи места поражения по 3000 МЕ 1 раз в 3 дня,\nкурсом до 15 инъекций; при необходимости лечение может быть продолжено\nинъекциями 1 раз в 5 дней. Длительность поддерживающей терапии выбирается\nврачом в зависимости от тяжести заболевания;"}},{"type":"paragraph","data":{"text":"-           гематом подкожно вблизи места\nпоражения в дозе 3000 МЕ 1 раз в  3 дня,\nкурсом до 5 инъекций."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Классификация\nпобочных реакций по органам и системам с указанием частоты их возникновения:\nочень часто ( > 1/10), часто ( > 1/100, < 1/10), нечасто ( > 1/1000,\n< 1/100), редко ( > 1/10000, < 1/1000), очень редко ( < 1/10000), в том\nчисле отдельные сообщения, частота неизвестна (частота не может быть оценена на\nоснове имеющихся данных)."}},{"type":"paragraph","data":{"text":"Нарушения\nсо стороны кожи и подкожных тканей: нечасто – покраснение кожи, зуд и отек в\nместе введения/нанесения препарата. Все местные реакции проходят самостоятельно\nчерез 48- 72 часа."}},{"type":"paragraph","data":{"text":"Общие\nрасстройства и состояния в месте введения: часто – болезненность в месте\nвведения. Нарушения со стороны иммунной системы: очень редко аллергические\nреакции, в том числе немедленного типа."}},{"type":"paragraph","data":{"text":"Лабораторные\nи инструментальные данные: очень редко – возможно повышение температуры тела."}},{"type":"paragraph","data":{"text":"Если Вы заметили\nкакие-либо побочные эффекты, не указанные в инструкции, сообщите об этом врачу."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы\nпередозировки могут проявляться ознобом, повышением температуры,\nголовокружением, снижением артериального давления.  Введение препарата прекращают и назначают симптоматическую\nтерапию."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Препарат\nЛонгидаза можно комбинировать с антибиотиками, противовирусными,\nпротиво­грибковыми препаратами, бронхолитиками."}},{"type":"paragraph","data":{"text":"При\nприменении в комбинации с другими лекарственными средствами (антибиотики, местные\nанестетики, диуретики) Лонгидаза увеличивает биодоступность и усиливает их\nдействие. При совместном применении с гепарином, большими дозами нестероидных\nпротивовоспалительных средств (НПВС), кортизона, адренокортикотропного гормона\n(АКТГ), эстрогенов или антигистаминных препаратов может быть снижена\nферментативная активность препарата Лонгидаза."}},{"type":"paragraph","data":{"text":"Не следует\nприменять препарат Лонгидаза одновременно с фуросемидом, бензодиазепинами,\nфенитоином и адреналином."}}]},{"id":9,"name":"Особые указания","slug":"","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При\nразвитии аллергической реакции следует прекратить применение препарата Лонгидаза и обратиться к врачу."}},{"type":"paragraph","data":{"text":"При\nнеобходимости прекращения приема препарата Лонгидаза отмену можно осуществить\nсразу, без постепенного уменьшения дозы."}},{"type":"paragraph","data":{"text":"В случае\nпропуска введения очередной дозы препарата, последующее его применение следует\nпроводить в обычном режиме, как указано в данной инструкции или рекомендовано\nврачом. Пациент не должен вводить удвоенную дозу с целью компенсации\nпропущенных доз. Не используйте препарат при наличии визуальных признаков его\nнепригодности (дефект упаковки, изменение цвета порошка)."}},{"type":"paragraph","data":{"text":"Не следует\nвводить препарат Лонгидаза в зону острого инфекционного воспаления из-за\nопасности распространения локализованной инфекции."}},{"type":"paragraph","data":{"text":"В случае\nлечения заболеваний, сопровождающихся тяжелым хроническим продуктивным\nпроцессом в соединительной ткани, после стандартного курса рекомендуется\nдлительная поддерживающая терапия препаратом Лонгидаза 3000 МЕ с перерывами\nмежду инъекциями в 10-14дней."}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Применение\nпрепарата не оказывает влияния на способность к выполнению потенциально опасных\nвидов деятельности, требующих повышенной концентрации внимания и быстроты\nпсихомоторных реакций (управление транспортными средствами, работа с\nдвижущимися механизмами, работа диспетчера и оператора)."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Лиофилизат\nдля приготовления раствора для инъекций."}},{"type":"paragraph","data":{"text":"По 20 мг\nво флаконы вместимостью 3 мл темного стекла 1 гидролитического класса. По 5\nфлаконов в контурной ячейковой упаковке из пленки поливинилхлоридной. Одну\nконтурную ячейковую упаковку вместе с инструкцией по применению помещают в\nпачку из картона."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить\nпри температуре не выше 8°С. Не замораживать. Хранить в недоступном для детей\nместе."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года. Не\nприменять после истечения срока годности."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают\nпо рецепту."}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Производитель\nи владелец регистрационного удостоверения:"}},{"type":"paragraph","data":{"text":"ООО «НПО\nПетровакс Фарм»"}},{"type":"paragraph","data":{"text":"Юридический\nадрес / Адрес производства / Адрес для предъявления претензий потребителей: Россия,\n142143, Московская обл., г. Подольск, с. Покров, ул. Сосновая, д. 1,"}},{"type":"paragraph","data":{"text":"тел./\nфакс: +7 (495) 926-21-07, e-mail: info@petrovax.ru;"}},{"type":"paragraph","data":{"text":"для\nпредъявления претензий: тел.: +7 (495) 730-75-45, 8 (800) 234-44-80, e-mail:\nadr@ petrovax.ru"}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Фармакодинамика:Бовгиалуронидаза азоксимер представляет собой конъюгат протеолитического фермента гиалуронидаза с высокомолекулярным носителем из группы производных N-оксида поли-1,4-этиленпиперазина. Бовгиалуронидаза азоксимер обладает всем спектром фармакологических свойств, присущих лекарственным средствам с гиалуронидазной активностью. Специфическим субстратом гиалуронидазы являются гликозаминогликаны (гиалуроновая кислота, хондроитин, хондроитин-4-сульфат, хондроитин-6-сульфат) – «цементирующее» вещество соединительной ткани. В результате гидролиза (деполимеризации) уменьшается вязкость гликозаминогликанов, способность связывать воду и ионы металлов. Как следствие, увеличивается проницаемость тканей, улучшается их трофика, уменьшаются отеки, рассасываются гематомы, повышается эластичность рубцово-измененных участков, устраняются контрактуры и спайки, увеличивается подвижность суставов. Эффект наиболее выражен в начальных стадиях патологического процесса. Клинический эффект Бовгиалуронидаза азоксимер значительно выше, чем эффект нативной гиалуронидазы. Конъюгация повышает устойчивость фермента к действию температуры и ингибиторов, увеличивает его активность и приводит к пролонгированию действия. Ферментативная активность Бовгиалуронидаза азоксимер сохраняется при нагревании 37 °С в течение 20 суток, в то время как нативная гиалуронидаза в этих же условиях утрачивает свою активность в течение суток. В Бовгиалуронидаза азоксимер сохраняются и фармакологические свойства носителя, обладающего хелатирующей, антиоксидантной, противовоспалительной и иммуномодулирующей активностью. Бовгиалуронидаза азоксимер способна связывать освобождающиеся при гидролизе гликозаминогликанов ионы железа – активаторы свободнорадикальных реакций, ингибиторы гиалуронидазы и стимуляторы синтеза коллагена, и тем самым подавлять обратную реакцию, направленную на синтез компонентов соединительной ткани. Политропные свойства Бовгиалуронидаза азоксимер реализуются в выраженном противофиброзном действии, экспериментально доказанном биохимическими, гистологическими и электронно-микроскопическими исследованиями на модели пневмофиброза. Бовгиалуронидаза азоксимер регулирует (повышает или снижает в зависимости от исходного уровня) синтез медиаторов воспаления (интерлейкин-1 и фактор некроза опухоли-альфа), способна ослаблять течение острой фазы воспаления, повышать гуморальный иммунный ответ и резистентность организма к инфекции. Указанные свойства позволяют применять Бовгиалуронидаза азоксимер во время или после хирургического лечения с целью профилактики грубого рубцевания и спаечного процесса. Применение Бовгиалуронидаза азоксимер в терапевтических дозах во время или после оперативного лечения не вызывает ухудшение течения послеоперационного периода или прогрессирования инфекционного процесса; не замедляет восстановления костной ткани. Бовгиалуронидаза азоксимер при совместном подкожном или внутримышечном введении увеличивает всасывание препаратов, ускоряет обезболивание при введении местных анестетиков. Бовгиалуронидаза азоксимер относится к практически нетоксическим соединениям, не нарушает нормального функционирования иммунной системы, не оказывает влияния на репродуктивную функцию самцов и самок крыс, на пре- и постнатальное развитие потомства, не обладает мутагенным и канцерогенным действием. Экспериментально доказано, что в Бовгиалуронидаза азоксимер снижены раздражающие и аллергизирующие свойства фермента гиалуронидаза. В терапевтических дозах Бовгиалуронидаза азоксимер хорошо переносится пациентами.Фармакокинетика:При парентеральном введении Бовгиалуронидаза азоксимер быстро всасывается в системный кровоток и достигает максимальной концентрации в крови через 20-25 минут, характеризуется высокой скоростью распределения в организме. Период полураспределения – около 0,5 часа, период полувыведения (Т½) при внутримышечном введении – 36 часов, при подкожном – около 45 часов. Кажущийся объем распределения 0,43 л/кг. Конъюгация не снижает высокой биодоступности фермента – биодоступность не менее 90 %. Действующее вещество проникает во все органы и ткани, в том числе через гематоэнцефалический и офтальмический барьеры. В организме гиалуронидаза подвергается гидролизу, а носитель распадается до низкомолекулярных соединений (олигомеров), которые выводятся преимущественно через почки в две фазы. В течение первых суток через почки выводится 45-50 %, через кишечник – не более 3 %. 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