Гидрокортизон является синтетическим глюкокортикостероидным препаратом для наружного применения. Оказывает противовоспалительное, противоотечное, противозудное действие. Тормозит высвобождение цитокинов (интерлейкинов и интерферона) из лимфоцитов и макрофагов, угнетает высвобождение эозинофилами медиаторов воспаления, нарушает метаболизм арахидоновой кислоты и синтез простагландинов. Стимулируя глюкокортикостероидные рецепторы, индуцирует образование липокортина. Уменьшает воспалительные клеточные инфильтраты, снижает миграцию лейкоцитов, в том числе лимфоцитов в область воспаления. При назначении в рекомендуемых дозах не вызывает системных побочных эффектов.ФармакокинетикаПосле аппликации накапливается в эпидермисе (в основном в зернистом слое). Метаболизируется непосредственно в эпидермисе, а в дальнейшем в печени. Выводится почками и кишечником.
Показания к применению
Воспалительные и аллергические заболевания кожи немикробной этиологии (в том числе сопровождающиеся зудом.
Противопоказания
С осторожностью: сахарный диабет, туберкулез (системное поражение).
Способ применения и дозы
Местно. Мазь наносят тонким слоем на пораженные участки кожи 2-3 раза в день. Продолжительность курса лечения зависит от характера заболевания и эффективности терапии, составляя, как правило, 6-14 дней; при упорном течении болезни он может быть продлен до 20 дней. На ограниченных очагах для усиления эффекта можно использовать окклюзионные повязки. При применении мази у детей от 2 лет и старше следует ограничивать общую продолжительность лечения и исключать мероприятия, ведущие к усилению резорбции всасывания стероида (согревающие, фиксирующие и окклюзионные повязки)
Побочное действие
Атрофия кожи, гипертрихоз, вторичная инфекция, отечность, зуд, гиперемия, аллергические реакции. При длительном использовании больших доз — побочные эффекты, характерные для системного использования глюкокортикоидов.
Взаимодействие с другими лекарственными средствами
Барбитураты, противоэпилептические и антигистаминные препараты снижают эффективность.Парацетамол способствует развитию гепатотоксичности.Уменьшает активность салицилатов, гипогликемических средств, увеличивает - антикоагулянтов.Сердечные гликозиды и некалийсберегающие диуретики усиливают гипокалиемию, анаболические стероиды - повышение гидрофильности тканей.При сочетании с амфотерицином В возможно развитие дилатационного поражения миокарда и сердечной недостаточности.
Особые указания
В случаях применения препарата у детей, на область лица или под окклюзионные повязки продолжительность курса лечения необходимо сокращать.В детском возрасте подавление функции коры надпочечников может развиться быстрее.Кроме того, может наблюдаться снижение экскреции гормона роста. При применении препарата в течение длительного времени необходимо наблюдать за массой тела, ростом, уровнем кортизола плазмы.Следует избегать попадания мази в глаза. Детям до 12 лет препарат назначают только под строгим врачебным контролем. Если после 7 дней применения не наступает улучшения или наблюдается ухудшение состояния, а также в случае возобновления симптомов через несколько дней после отмены препарата, применение препарата следует прекратить и проконсультироваться с врачом. При длительном лечении и/или нанесении на большие поверхности рекомендуется назначать диету с ограничением натрия и повышенным содержанием К+; вводить в организм достаточное количество белка.Необходимо контролировать АД, содержание глюкозы в крови, свертываемость крови, диурез, массу тела больного, уровень кортизола плазмы.
Форма выпуска
Мазь для наружного применения
Условия хранения
При температуре ниже 25 °C.
Условия отпуска
Нет
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