Локоид является синтетическим негалогенизированным глюкокортикостеродом для наружного применения. Этерификация молекулы гидрокортизона остатком масляной кислоты (бутиратом) позволила радикально повысить активность препарата по сравнению с нативным гидрокортизоном. Локоид оказывает быстро наступающее противовоспалительное, противоотечное, противозудное действие. Применение Локоида в рекомендуемых дозах не вызывает подавления гипоталамо-гипофизарно-адреналовой системы. Хотя применение больших доз препарата в течение длительного времени, особенно при использовании окклюзионных повязок, может привести к увеличению содержания кортизола в плазме крови, это обычно не сопровождается снижением реактивности гипофизарно-надпочечниковой системы, а отмена препарата приводит к быстрой нормализации продукции кортизола.
Показания к применению
Поверхностные, неинфицированные, чувствительные к местным глюкокортикостероидам заболевания кожи:
Дерматиты, в том числе атопический, контактный, себорейный
Экзема
Псориаз
Противопоказания
Гиперчувствительность к гидрокортизону или вспомогательным компонентам препарата
Бактериальные инфекции кожи (стрепто- и стафилодермии, грамотрицательный фолликулит и т.д.)
Неопластические изменения кожи (доброкачественные и злокачественные опухоли)
Акне, розацеа, периоральный дерматит
Поствакцинальный период
Нарушение целостности кожных покровов (раны, язвы). С осторожностью: беременность, период лактации
Применение при беременности и в период грудного вскармливания
Применять с осторожностью при беременности, в период лактации. Глюкокортикостероиды проникают через плаценту. Воздействие на плод может быть особенно выраженным при нанесении препарата на большие поверхности. Нет данных о количестве гидрокортизона, выделяющегося с грудным молоком; рекомендуется соблюдать особую осторожность при назначении препарата в период лактации.
Способ применения и дозы
Наружно. Локоид крем предпочтительно применять при острых и подострых кожных процессах (без мокнутия). Препарат наносят на пораженные участки кожи тонким слоем 1-3 раза/сут. Для улучшения проникновения препарат наносят легкими массирующими движениями. При появлении положительной динамики кратность применения препарата можно уменьшить до 2-3 раз в неделю. Доза препарата, используемая в течение недели, не должна превышать 30-60 г.
Побочное действие
Местные реакции: раздражение кожи, в редких случаях - другие местные реакции, характерные для наружной стероидной терапии. Системные реакции: при длительном применении, нанесении на большие поверхности и/или использовании окклюзии могут наблюдаться побочные эффекты, характерные для системных глюкокортикостероидов. Риск возникновения местных и системных побочных эффектов при применении Локоида ниже, чем при использовании фторированных стероидов.
Передозировка
Данных о передозировке Локоида нет. При длительном применении препарата в высоких дозах возможно усиление описанных выше побочных эффектов. При появлении симптомов гиперкортицизма препарат следует отменить.
Особые указания
Не следует наносить Локоид на периорбитальную область в связи с риском развития глаукомы. При систематическом попадании на конъюнктиву возникает риск увеличения внутриглазного давления. При локализации процесса на волосистой части головы и при экссудативном воспалении предпочтительно использовать Локоид в форме Крело. В случаях резистентного течения заболеваний, например, при локализации плотных псориатических бляшек на локтевых областях, коленях, выраженной лихенификации, сухости лучше отдавать предпочтение Локоиду в форме мази или Липокрема, в случае необходимости - под окклюзионными повязками. Препарат не желательно использовать при наличии атрофических изменений кожи. Риск возникновения местных и системных побочных эффектов увеличивается при нанесении на обширные участки поражения, длительном применении, использовании окклюзии и в детском возрасте. При отсутствии эффекта в течение 2-х недель непрерывного лечения, следует уточнить диагноз. Как и при использовании любого глюкокортикостероидного препарата, желательно ограничивать продолжительность применения и курсовую дозу минимально достаточной для купирования кожного процесса. Влияние на способность управлять транспортными средствами и работать с механизмами Данных о влиянии Локоида на способность управлять транспортными средствами и работать с механизмами нет.
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