Комбинированный препарат для наружного применения, действие... Инструкция
Показания к применению
Тромбофлебит поверхностных вен, локализованные инфильтраты и отеки мягких тканей, травмы сухожилий и суставов, ушибы мягких тканей и суставов.
Противопоказания
Гиперчувствительность к компонентам препарата, детский возраст, язвенно - некротические процессы при тромбофлебите, пониженная свёртываемость крови, тромбоцитопения, нарушение целостности кожных покровов (в связи с возможностью усиления кровотечения). Гепарин натрия противопоказан при геморрагическом диатезе, лейкозах, анемии, повышенной проницаемости сосудов, полипах, злокачественных новообразованиях и язвенных поражениях ЖКТ, тяжелых нарушения функции печени и почек, операциях на мозге и позвоночнике. Бензилникотинат противопоказан при пароксизмальной тахикардии. Бензокаин (анастезин) противопоказан при гиперчувствительности к данному препарату.
Комбинированный препарат для наружного применения, действие которого обусловлено свойствами входящих в его состав компонентов. Антикоагулянт прямого действия. Постепенно высвобождающийся из мази гепарин натрия уменьшает воспалительный процесс и оказывает антитромботическое действие. Способствует рассасыванию уже имеющихся и препятствует образованию новых тромбов. Блокирует синтез тромбина, уменьшает агрегацию тромбоцитов. Угнетает активность гиалуронидазы, активирует фибринолитические свойства крови. Бензилникотинат оказывает сосудорасширяющее, спазмолитическое действие. Непосредственно уменьшает сократительную активность гладких мышц сосудов и внутренних органов. Бензилникотинат, расширяя поверхностные сосуды, способствует всасыванию гепарина. Местный антисептик бензокаин (анастезин), уменьшая проницаемость клеточной мембраны для ионов натрия, блокирует проведение нервных импульсов. Препятствует возникновению болевых импульсов в окончаниях чувствительных нервов и их проведению по нервным волокнам, уменьшает выраженность болевых ощущений. При нанесении на кожу оказывает местное анальгезирующее действие. При местном применении в системное кровообращение всасывается лишь незначительное количество гепарина натрия, которое выводится преимущественно почками. Фармакокинетика действующих веществ - бензилникотината и бензокаина (анастезина) - при местном применении не изучалась.
Показания к применению
Тромбофлебит поверхностных вен, локализованные инфильтраты и отеки мягких тканей, травмы сухожилий и суставов, ушибы мягких тканей и суставов.
Противопоказания
Гиперчувствительность к компонентам препарата, детский возраст, язвенно - некротические процессы при тромбофлебите, пониженная свёртываемость крови, тромбоцитопения, нарушение целостности кожных покровов (в связи с возможностью усиления кровотечения). Гепарин натрия противопоказан при геморрагическом диатезе, лейкозах, анемии, повышенной проницаемости сосудов, полипах, злокачественных новообразованиях и язвенных поражениях ЖКТ, тяжелых нарушения функции печени и почек, операциях на мозге и позвоночнике. Бензилникотинат противопоказан при пароксизмальной тахикардии. Бензокаин (анастезин) противопоказан при гиперчувствительности к данному препарату.
С осторожностью
Осторожность в применении гепарина требуется при язвенных и опухолевых поражениях желудочно-кишечного тракта, кахексии, высоком артериальном давлении, в ближайшем послеродовом и послеоперационном периоде (в течение первых 3 - 8 сут). Ограничением к применению бензилникотината является аденома предстательной железы с нарушением оттока мочи. Ограничение к применению бензокаина (анастезина) являются: грудное вскармливание (следует приостановить), младенческий возраст (до 1 года).
Применение при беременности и в период грудного вскармливания
Применение препарата в период беременности и в период грудного вскармливания возможно только по строгим показаниям под тщательным медицинским контролем. Препарат не назначается в ближайшем послеродовом периоде (в течении первых 3 - 8 сут) в связи с возможностью усиления кровотечения в результате действия гепарина натрия и бензилникотината. Грудное вскармливание следует приостановить, если применение препарата необходимо в этот период (в связи с наличием в составе бензокаина (анастезина).
Способ применения и дозы
Наружно. Мазь наносят тонким слоем на область поражения и осторожно втирают в кожу, не массируя, 2 - 3 раза в день до исчезновения воспалительных явлений, в среднем от 3 до 14 дней. Максимальная суточная доза препарата - 25,0 г. Возможность проведения более длительного курса лечения определяется врачом. При тромбозе наружных геморроидальных узлов применяют ректальные тампоны, пропитанные мазью, которые вводят в задний проход. Либо мазь наносят на бязевую или полотняную прокладку, которую накладывают непосредственно на тромбированные узлы и фиксируют. Мазь следует применять ежедневно, до исчезновения симптомов, в среднем от 3 до 14 дней. При трофических язвах голени мазь наносят только на окружающие участки кожи с ненарушенной целостностью кожного покрова.
Побочное действие
Возможны аллергические реакции - кожная сыпь, ангионевротический отек. При появлении таких симптомов применение препарата прекращают и назначают десенсибилизирующие препараты. При применении гепарина необходимо учитывать возможность развития геморрагий. Наряду с геморрагиями применение гепарина может приводить к развитию тромбоцитопении, остеопороза, алопеции и гипоальдостероизма. При применении бензилникотината возможно преходящее повышение активности печеночных трансаминаз, тахикардия, лейкопения, иногда нарушение функции почек. При применении бензокаина (анестезина) изредка возможен контактный дерматит; снижение чувствительности в месте применения; редко, при чрезмерном использовании - метгемоглобинемия (особенно у младенцев и детей младшего возраста).
Передозировка
Поскольку препарат в терапевтических дозах обладает преимущественно местным действием, случаи передозировки маловероятны. При длительном применении и на больших поверхностях возможны геморрагические осложнения (гепарин). В этих случаях применение препарата прекращают и назначают симптоматическую терапию. Симптомы передозировки входящих в состав компонентов при их местном применении не изучались.
Взаимодействие с другими лекарственными средствами
Действие гепарина усиливают антикоагуляционные препараты, ацетилсалициловая кислота и другие нестероидные противовоспалительные средства (повышается риск кровотечений), ослабляют - сердечные гликозиды (препарат наперстянки), тетрациклины, блокаторы Н1 - гистаминовых рецепторов, никотиновая кислота, этакриновая кислота. Бензилникотинат увеличивает вероятность возникновения тахиаритмий на фоне симпатомиметиков и риск угнетения сердечной деятельности под влиянием калийвыводящих препаратов. Ингибиторы холинэстеразы тормозят метаболизм бензокаина (анестезина).
Особые указания
Не следует наносить мазь на открытые раны, слизистые оболочки, при наличии на коже гнойных процессов. Применение препарата не рекомендуется при глубоком венозном тромбозе. При длительном применении гепарина необходим контроль времени свертывания крови. При длительном применении бензилникотината необходим контроль функции печени и общего анализа крови.
Влияние на способность управлять автомобилем и движущимися механизмами
Препарат не влияет на способность управлять транспортными средствами и заниматься другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
Форма выпуска
Мазь.
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вещества: гепарин натрия - 10000 МЕ (0,83 г), бензокаин (анастезин) - 4,0 г, бензилникотинат - 0,08 г."}},{"type":"paragraph","data":{"text":"Вспомогательные вещества: глицерол - 15,0 г, вазелин - 6,0 г, стеариновая кислота - 5,0 г, масло кукурузное - 5,0 г, эмульгатор №1 - 8,0 г, метилпарагидроксибензоат - 0,148 г, пропилпарагидроксибензоат - 0,048 г, вода очищенная - до 100,0 г."}}]},{"id":6,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"Комбинированный препарат для наружного применения, действие которого обусловлено свойствами входящих в его состав компонентов. Антикоагулянт прямого действия. Постепенно высвобождающийся из мази гепарин натрия уменьшает воспалительный процесс и оказывает антитромботическое действие. Способствует рассасыванию уже имеющихся и препятствует образованию новых тромбов. Блокирует синтез тромбина, уменьшает агрегацию тромбоцитов. Угнетает активность гиалуронидазы, активирует фибринолитические свойства крови. Бензилникотинат оказывает сосудорасширяющее, спазмолитическое действие. Непосредственно уменьшает сократительную активность гладких мышц сосудов и внутренних органов. Бензилникотинат, расширяя поверхностные сосуды, способствует всасыванию гепарина. Местный антисептик бензокаин (анастезин), уменьшая проницаемость клеточной мембраны для ионов натрия, блокирует проведение нервных импульсов. Препятствует возникновению болевых импульсов в окончаниях чувствительных нервов и их проведению по нервным волокнам, уменьшает выраженность болевых ощущений. При нанесении на кожу оказывает местное анальгезирующее действие. При местном применении в системное кровообращение всасывается лишь незначительное количество гепарина натрия, которое выводится преимущественно почками. Фармакокинетика действующих веществ - бензилникотината и бензокаина (анастезина) - при местном применении не изучалась."}}]},{"id":7,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Тромбофлебит поверхностных вен, локализованные инфильтраты и отеки мягких тканей, травмы сухожилий и суставов, ушибы мягких тканей и суставов."}}]},{"id":8,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к компонентам препарата, детский возраст, язвенно - некротические процессы при тромбофлебите, пониженная свёртываемость крови, тромбоцитопения, нарушение целостности кожных покровов (в связи с возможностью усиления кровотечения). Гепарин натрия противопоказан при геморрагическом диатезе, лейкозах, анемии, повышенной проницаемости сосудов, полипах, злокачественных новообразованиях и язвенных поражениях ЖКТ, тяжелых нарушения функции печени и почек, операциях на мозге и позвоночнике. Бензилникотинат противопоказан при пароксизмальной тахикардии. Бензокаин (анастезин) противопоказан при гиперчувствительности к данному препарату."}}]},{"id":9,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Осторожность в применении гепарина требуется при язвенных и опухолевых поражениях желудочно-кишечного тракта, кахексии, высоком артериальном давлении, в ближайшем послеродовом и послеоперационном периоде (в течение первых 3 - 8 сут). Ограничением к применению бензилникотината является аденома предстательной железы с нарушением оттока мочи. Ограничение к применению бензокаина (анастезина) являются: грудное вскармливание (следует приостановить), младенческий возраст (до 1 года)."}}]},{"id":10,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение препарата в период беременности и в период грудного вскармливания возможно только по строгим показаниям под тщательным медицинским контролем. Препарат не назначается в ближайшем послеродовом периоде (в течении первых 3 - 8 сут) в связи с возможностью усиления кровотечения в результате действия гепарина натрия и бензилникотината. Грудное вскармливание следует приостановить, если применение препарата необходимо в этот период (в связи с наличием в составе бензокаина (анастезина)."}}]},{"id":11,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Наружно. Мазь наносят тонким слоем на область поражения и осторожно втирают в кожу, не массируя, 2 - 3 раза в день до исчезновения воспалительных явлений, в среднем от 3 до 14 дней. Максимальная суточная доза препарата - 25,0 г. Возможность проведения более длительного курса лечения определяется врачом. При тромбозе наружных геморроидальных узлов применяют ректальные тампоны, пропитанные мазью, которые вводят в задний проход. Либо мазь наносят на бязевую или полотняную прокладку, которую накладывают непосредственно на тромбированные узлы и фиксируют. Мазь следует применять ежедневно, до исчезновения симптомов, в среднем от 3 до 14 дней. При трофических язвах голени мазь наносят только на окружающие участки кожи с ненарушенной целостностью кожного покрова."}}]},{"id":12,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Возможны аллергические реакции - кожная сыпь, ангионевротический отек. При появлении таких симптомов применение препарата прекращают и назначают десенсибилизирующие препараты. При применении гепарина необходимо учитывать возможность развития геморрагий. Наряду с геморрагиями применение гепарина может приводить к развитию тромбоцитопении, остеопороза, алопеции и гипоальдостероизма. При применении бензилникотината возможно преходящее повышение активности печеночных трансаминаз, тахикардия, лейкопения, иногда нарушение функции почек. При применении бензокаина (анестезина) изредка возможен контактный дерматит; снижение чувствительности в месте применения; редко, при чрезмерном использовании - метгемоглобинемия (особенно у младенцев и детей младшего возраста)."}}]},{"id":13,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Поскольку препарат в терапевтических дозах обладает преимущественно местным действием, случаи передозировки маловероятны. При длительном применении и на больших поверхностях возможны геморрагические осложнения (гепарин). В этих случаях применение препарата прекращают и назначают симптоматическую терапию. Симптомы передозировки входящих в состав компонентов при их местном применении не изучались."}}]},{"id":14,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Действие гепарина усиливают антикоагуляционные препараты, ацетилсалициловая кислота и другие нестероидные противовоспалительные средства (повышается риск кровотечений), ослабляют - сердечные гликозиды (препарат наперстянки), тетрациклины, блокаторы Н1 - гистаминовых рецепторов, никотиновая кислота, этакриновая кислота. Бензилникотинат увеличивает вероятность возникновения тахиаритмий на фоне симпатомиметиков и риск угнетения сердечной деятельности под влиянием калийвыводящих препаратов. Ингибиторы холинэстеразы тормозят метаболизм бензокаина (анестезина)."}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Не следует наносить мазь на открытые раны, слизистые оболочки, при наличии на коже гнойных процессов. Применение препарата не рекомендуется при глубоком венозном тромбозе. При длительном применении гепарина необходим контроль времени свертывания крови. При длительном применении бензилникотината необходим контроль функции печени и общего анализа крови. "}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат не влияет на способность управлять транспортными средствами и заниматься другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Мазь."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не ниже 8 °С. Хранить в недоступном для детей месте."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. Не применять по истечении срока годности."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Без рецепта."}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/manufacturer/zelenaya_dubrava/\"\u003eЗеленая Дубрава, Россия\u003c/a\u003e."}}]}],"source":{"title":"ЗдравСити","url":"https://zdravcity.ru"}},"description_toggle":false,"short_description":"Комбинированный препарат для наружного применения, действие которого обусловлено свойствами входящих в его состав компонентов. Антикоагулянт прямого действия. Постепенно высвобождающийся из мази гепарин натрия уменьшает воспалительный процесс и оказывает антитромботическое действие. Способствует рассасыванию уже имеющихся и препятствует образованию новых тромбов. Блокирует синтез тромбина, уменьшает агрегацию тромбоцитов. Угнетает активность гиалуронидазы, активирует фибринолитические свойства крови. 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