дерматомикозы; - грибковый кератит; - онихомикозы, вызванные дерматофитами и/или дрожжами и плесневыми грибами; - системные микозы: системный аспергиллез и кандидоз, криптококкоз (включая криптококковый менингит), гистоплазмоз, споротрихоз, паракокцидиоидомикоз, бластомикоз и другие системные или тропические микозы; - кандидомикозы с поражением кожи или слизистых, в том числе вульвовагинальный кандидоз; - глубокие висцеральные кандидозы; - отрубевидный лишай.
Противопоказания
Индивидуальная повышенная чувствительность к препарату или его составным частям.
Одновременный прием препаратов, метабодизирующихся с участием фермента CYP3A4: терфенадин, астемизол, мизоластин, цизаприд, дофетилид, хинидин, пимозид, нгибиторы редуктазы ГМК-КоА такие, как симвастатин и ловастатин, триазолам и мидазолам (см. также раздел "Взаимодействия с другими лекарственными средствами").
Противогрибковый препарат широкого спектра действия, производное триазола. Нарушает синтез эргостерола клеточной мембраны грибов.; Активен в отношении дрожжевых грибов Candida spp. (включая Candida albicans, Candida glabrata, Candida krusei).
Показания к применению
дерматомикозы; - грибковый кератит; - онихомикозы, вызванные дерматофитами и/или дрожжами и плесневыми грибами; - системные микозы: системный аспергиллез и кандидоз, криптококкоз (включая криптококковый менингит), гистоплазмоз, споротрихоз, паракокцидиоидомикоз, бластомикоз и другие системные или тропические микозы; - кандидомикозы с поражением кожи или слизистых, в том числе вульвовагинальный кандидоз; - глубокие висцеральные кандидозы; - отрубевидный лишай.
Противопоказания
Индивидуальная повышенная чувствительность к препарату или его составным частям.
Одновременный прием препаратов, метабодизирующихся с участием фермента CYP3A4: терфенадин, астемизол, мизоластин, цизаприд, дофетилид, хинидин, пимозид, нгибиторы редуктазы ГМК-КоА такие, как симвастатин и ловастатин, триазолам и мидазолам (см. также раздел "Взаимодействия с другими лекарственными средствами").
С осторожностью: детский возраст, тяжелая сердечная недостаточность, заболевания печени (в том числе сопровождающиеся печеночной недостаточностью), хроническая почечная недостаточность.
Применение при беременности и в период грудного вскармливания
Противопоказано назначение препарата в I триместре беременности. Во II и III триместрах беременности применение препарата возможно только в том случае, если ожидаемая польза для женщины превышает потенциальный риск для плода.; При необходимости применения Ирунина в период лактации грудное вскармливание следует прекратить.
Способ применения и дозы
Внутрь, после еды.; Показание Доза Продолжительность; Вульвовагинальный кандидоз 200 мг 2 раза в сутки; или 200 мг 1 раз в сутки 1 день; 3 дня; Отрубевидный лишай 200 мг 1 раз в сутки 7 дней; Дерматомикозы гладкой кожи 200 мг 1 раз в сутки; 100 мг 1 раз в сутки 7 дней; 15 дней; Грибковый кератит 200 мг 1 раз в сутки 21 день; Поражения высококератинизированных областей кожного покрова, таких, как кисти рук и стоп, требуют дополнительного лечения в течение 15 дней по 100 мг в сутки.; Оральный кандидоз 100 мг 1 раз в сутки 15 дней; Биодоступность итраконазола при пероральном приеме может быть снижена у некоторых пациентов с нарушенным иммунитетом, например, у больных с нейтропенией, больных СПИДом или с пересаженными органами. Следовательно, может потребоваться двукратное увеличение дозы.; Онихомикоз ; Пульс-терапия (см. таблицу). ; Один курс пульс-терапии заключается в ежедневном приеме по 2 капсулы Ирунина; два раза в сутки (по 200 мг два раза в сутки) в течение одной недели. ; Для лечения грибковых поражений ногтевых пластинок кистей рекомендуется два курса. Для лечения грибковых поражений ногтевых пластинок стоп рекомендуется три курса (см. таблицу). Промежуток между курсами, в течение которого не нужно принимать препарат, составляет 3 недели. ; Клинические результаты станут очевидны после окончания лечения, по мере отрастания ногтей.; Локализация онихомикозов 1-я нед. 2-янед. 3-я нед. 4-я нед. 5-я нед. 6-я нед. 7-я нед. 8-я нед. 9-я нед.; Поражение ногтевых пластинок стоп с поражением или без поражения ногтевых пластинок кистей 1-й курс Недели, свободные от приема Ирунина; 2-й курс Недели, свободные от приема Ирунина; 3-й курс; Поражение ногтевых пластинок кистей 1-й курс Недели, свободные от приема Ирунина; 2-й курс ; ИЛИ ; Непрерывное лечение: По две капсулы в день (по 200 мг один раз в сутки) в течение 3-х месяцев. ; Выведение Ирунина; из кожи и ногтевой ткани осуществляется медленнее, чем из плазмы. Таким образом, оптимальные клинические и микологические эффекты достигаются через 2-4 недели после окончания лечения при заболеваниях кожи и через 6-9 месяцев после окончания лечения заболеваний ногтей.; Системные микозы (рекомендуемые дозировки варьируют в зависимости от вида инфекции); Показание Доза Средняя продолжительность Замечания; Аспергиллез 200 мг 1 раз в сутки 2-5 месяцев Увеличить дозу до 200 мг 2 раза в сутки в случае инвазивного или диссеминированного заболевания; Кандидоз 100-200 мг 1 раз в сутки от 3 недель до 7 месяцев; Криптококкоз;(кроме менингита) 200 мг 1 раз в сутки от 2-х месяцев до 1 года Поддерживающая терапия (случаи менингита) 200 мг 1 раз в сутки; Криптококковый; менингит 200 мг два раза в сутки; Гистоплазмоз от 200 мг 1 раз в сутки до 200 мг два раза в сутки 8 месяцев ; Споротрихоз 100 мг 1 раз в сутки 3 месяца; Паракокцидиоидомикоз 100 мг 1 раз в сутки 6 месяцев; Хромомикоз 100-200 мг 1 раз в сутки 6 месяцев; Бластомикоз от 100 мг 1 раз в сутки до 200 мг два раза в сутки 6 месяцев
Побочное действие
Со стороны желудочно-кишечного тракта: диспепсия, тошнота, боль в животе и запор, обратимое повышение активности печеночных ферментов, холестатическая желтуха, гепатит, анорексия. В очень редких случаях при применении Ирунина; развивалось тяжелое токсическое поражение печени, в том числе случай острой печеночной недостаточности с летальным исходом; ; Со стороны центральной нервной системы: головная боль, утомляемость, головокружение, периферическая нейропатия; ; Со стороны сердечно-сосудистой системы: застойная сердечная недостаточность и отек легких; ; Со стороны других органов и систем: нарушения, менструального цикла, аллергические реакции (такие, как зуд, сыпь, крапивница и ангионевротический отек), синдром Стивенса-Джонсона, алопеция, гипокалиемия, отеки, окрашивание мочи в темный цвет, гиперкреатининемия.
Передозировка
Применение препарата в высоких дозах не вызывает каких-либо реакций и состояний, опасных для жизни.; При случайном приеме препарата внутрь следует провести промывание желудка и назначить внутрь активированный уголь. Специфического антидота нет.
Особые указания
Для предотвращения реинфекции необходимо одновременное лечение половых партнеров, также следует соблюдать правила гигиены.; В период лечения рекомендуется воздерживаться от половых контактов.; Если клинические признаки инфекции сохраняются после завершения лечения, следует провести повторное микробиологическое исследование с целью подтверждения диагноза.; При возникновении аллергической реакции лечение следует прекратить. При необходимости препарат может быть удален путем промывания влагалища кипяченой водой.; Влияние на способность к вождению автотранспорта и управлению механизмами; Препарат не оказывает влияния на способность к управлению автомобилем и деятельность, связанную с необходимостью высокой концентрации внимания и быстроты психомоторных реакций.
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