Ивинак-СОЛОфарм Капли, флакон, 1 шт, 5 мл, 0.09 %

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Концентрация полумаксимального ингибирования (IC50) для бромфенака (1,1 мкмоль) была ниже, чем для индометацина (4,2 мкмоль) и пранопрофена (11,9 мкмоль)."}},{"type":"paragraph","data":{"text":"В экспериментальной модели увеита у кроликов бромфенак в концентрациях 0,02 %, 0,05 %, 0,1 % и 0,2 % ингибировал практически все симптомы глазного воспаления."}},{"type":"header","data":{"text":"Фармакокинетика","level":4}},{"type":"paragraph","data":{"text":"Всасывание"}},{"type":"paragraph","data":{"text":"Бромфенак эффективно проникает через роговицу пациентов, страдающих катарактой: при однократном введении средняя пиковая концентрация в водянистой влаге составляет 79 ± 68 нг/мл через 150-180 минут после применения. Данная концентрация сохраняется в течение 12 часов в водянистой влаге с сохранением поддающихся измерению уровней концентрации в основных тканях глаза, включая сетчатку, до 24 часов. При применении глазных капель бромфенака два раза в день концентрации в плазме не поддавались количественному измерению."}},{"type":"paragraph","data":{"text":"Распределение"}},{"type":"paragraph","data":{"text":"Бромфенак активно связывается с белками плазмы. По данным исследования in vitro связывание с белками в плазме крови человека составило 99,8 %."}},{"type":"paragraph","data":{"text":"Исследования in vitro не выявили биологически значимого связывания с меланином."}},{"type":"paragraph","data":{"text":"По данным исследования у кроликов с использованием радиактивно-меченного бромфенака максимальная концентрация после местного применения наблюдается в роговице, высокая – в конъюнктиве и водянистой влаге глаза. Низкая – в хрусталике и стекловидном теле."}},{"type":"paragraph","data":{"text":"Метаболизм"}},{"type":"paragraph","data":{"text":"По результатам исследования in vitro основной метаболизм бромфенака осуществляется ферментом CYP2C9, который отсутствует в иридоцилиарной зоне, сетчатке и сосудистой оболочке. Уровень этого фермента в роговице составляет менее 1 % по сравнению с соответствующим печеночным уровнем."}},{"type":"paragraph","data":{"text":"При пероральном приеме у человека в плазме в основном обнаруживается неизмененное исходное вещество. Выделено несколько конъюгированных и неконъюгированных метаболитов, основным из которых является циклический амид, который выводится с мочой."}},{"type":"paragraph","data":{"text":"Выведение"}},{"type":"paragraph","data":{"text":"При закапывании в глаза период полувыведения бромфенака из водянистой влаги глаза составляет около 1,4 ч, что свидетельствует о быстрой элиминации."}},{"type":"paragraph","data":{"text":"После перорального приема 14С-бромфенака здоровыми добровольцами было установлено, что препарат преимущественно выводится с мочой (около 82 % введенной дозы), в то время как с калом выводится порядка 13 % введенной дозы."}}]},{"id":7,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Лечение неинфекционных воспалительных заболеваний переднего отрезка глаза и послеоперационного воспаления (после экстракции катаракты и др.)."}}]},{"id":8,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Препарат противопоказан пациентам, у которых в анамнезе присутствует гиперчувствительность к любому компоненту препарата."}},{"type":"paragraph","data":{"text":"Препарат противопоказан пациентам, у которых приступы бронхиальной астмы, крапивницы и симптоматика острого ринита усиливаются при приеме ацетилсалициловой кислоты и других НПВП."}},{"type":"paragraph","data":{"text":"Возраст до 18 лет (безопасность и эффективность применения препарата у детей не исследовались)."}}]},{"id":10,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Достаточные данные о применении бромфенака беременными женщинами отсутствуют. Исследования на животных продемонстрировали наличие репродуктивной токсичности. Потенциальный риск для человека неизвестен. Поскольку системное воздействие после лечения препаратом у небеременных женщин является незначительным, риск во время беременности можно считать низким."}},{"type":"paragraph","data":{"text":"Однако из-за известных эффектов лекарственных препаратов, ингибирующих биосинтез простагландинов, на сердечно-сосудистую систему плода (закрытие протока) применения данного препарата в третьем триместре беременности следует избегать."}},{"type":"paragraph","data":{"text":"В целом применение данного препарата во время беременности не рекомендуется, за исключением случаев, когда польза превышает потенциальный риск."}}]},{"id":11,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Инстилляции в конъюнктивальный мешок."}},{"type":"paragraph","data":{"text":"По 1-2 капли препарата в конъюнктивальный мешок два раза в день в течение не более 15 дней."}},{"type":"paragraph","data":{"text":"В случае пропуска дозы препарата его следует применять как можно скорее в дозировке, указанной в инструкции по применению. Если пропуск дозы лекарственного препарата составляет около 24 ч, препарат следует применять в следующее запланированное время, не удваивая дозу для компенсации пропущенной дозы."}},{"type":"paragraph","data":{"text":"Лечение послеоперационного воспаления: по одной капле один раз в день. Лечение начинают за 1 день до хирургического вмешательства и продолжают в течение первых 14 дней послеоперационного периода (включая день операции)."}},{"type":"paragraph","data":{"text":"Лечение неинфекционных воспалительных заболеваний переднего отрезка глаза: по одной капле два раза в день. Курс лечения определяется врачом в зависимости от тяжести состояния."}},{"type":"paragraph","data":{"text":"Порядок работы с флаконом (без упора):"}},{"type":"paragraph","data":{"text":"1. Вращающими движениями против часовой стрелки открыть флакон и снять колпачок."}},{"type":"paragraph","data":{"text":"2. Осторожно, не касаясь пальцами наконечника флакона, перевернуть флакон, зафиксировать между большим и указательным пальцами одной руки."}},{"type":"paragraph","data":{"text":"3. Запрокинуть голову назад, расположить наконечник флакона над глазом и указательным пальцем другой руки оттянуть нижнее веко вниз. Слегка надавить на флакон и закапать необходимое количество препарата в конъюнктивальный мешок глаза."}},{"type":"paragraph","data":{"text":"Необходимо избегать контактов наконечника открытого флакона с поверхностью глаза и руками."}},{"type":"paragraph","data":{"text":"4. После использования надеть колпачок на флакон и закрыть вращающими движениями по часовой стрелке."}},{"type":"paragraph","data":{"text":"Порядок работы флаконом, снабженным упором:"}},{"type":"paragraph","data":{"text":"1. Достать упор и флакон из пачки."}},{"type":"paragraph","data":{"text":"2. Вращающими движениями против часовой стрелки открыть флакон с помощью упора и снять колпачок."}},{"type":"paragraph","data":{"text":"3. Осторожно, не касаясь пальцами наконечника флакона, закрепить упор на горлышке флакона."}},{"type":"paragraph","data":{"text":"4. Запрокинуть голову назад, установить упор на веко так, чтобы наконечник флакона находился напротив глазного яблока, слегка надавить на флакон и закапать необходимое количество препарата."}},{"type":"paragraph","data":{"text":"5. Снять упор с горлышка флакона, надеть колпачок на флакон и закрыть вращающими движениями по часовой стрелке."}},{"type":"paragraph","data":{"text":"После вскрытия флакона препарат можно использовать в течение 1 месяца. По истечении этого срока препарат следует выбросить."}},{"type":"paragraph","data":{"text":"При видимых повреждениях флакона применять препарат не следует"}}]},{"id":12,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Нежелательные реакции на препарат отмечались у 72 из 3843 пациентов (1,87 %), данные о которых были получены в рамках клинических исследований или при пострегистрационном применении. Серьезные нежелательные реакции включали эрозию роговицы в 16 случаях (0,42 %), конъюнктивит (включая конъюнктивальную инъекцию и конъюнктивальные фолликулы) в 11 случаях (0,29 %), блефарит в 9 случаях (0,23 %), раздражение в 8 случаях (0,21 %), боль в глазу [транзиторная] в 8 случаях (0,21 %), поверхностный точечный кератит в 6 случаях (0,16 %), зуд в 6 случаях (0,16 %), отслойка эпителия роговицы в 1 случае (0,03 %) и чувство жжения [веки] в 1 случае (0,03 %)."}}]},{"id":13,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"На данный момент информация о передозировке при местном применении у человека отсутствует."}},{"type":"paragraph","data":{"text":"По данным зарубежных отчетов у пациентов, которые принимали препарат бромфенака натрия внутрь в общей дозе, превышающей 1500 мг, в течение длительного периода времени более 1 месяца, наблюдались серьезные нарушения функции печени (включая летальные случаи). В связи с этим при обнаружении отклонений, которые предположительно связаны с ранними симптомами печеночной недостаточности, необходимо прекратить лечение данным препаратом и принять соответствующие меры."}},{"type":"header","data":{"text":"Применение у пациентов с печеночной и почечной недостаточностью","level":4}},{"type":"paragraph","data":{"text":"Действие препарата у пациентов с печеночной и почечной недостаточностью не изучено."}}]},{"id":14,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Исследований взаимодействия бромфенака с другими лекарственными средствами не проводилось. "}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат должен применяться в рамках симптоматического лечения, а не в целях этиотропной терапии."}},{"type":"paragraph","data":{"text":"Препарат следует использовать только в качестве глазных капель."}},{"type":"paragraph","data":{"text":"Все местные НПВП могут замедлить или отсрочить заживление подобно местным глюкокортикостероидам. Совместное применение НПВП и местных стероидов может увеличить вероятность возникновения проблем с заживлением."}},{"type":"header","data":{"text":"Перекрестная чувствительность","level":4}},{"type":"paragraph","data":{"text":"Существует вероятность перекрестной чувствительности к ацетилсалициловой кислоте, производным фенилацетиловой кислоты и другим НПВП. Поэтому следует соблюдать осторожность при лечении лиц, у которых ранее наблюдалась чувствительность к данным лекарственным препаратам, и следует тщательно оценивать потенциальные риски и пользу."}},{"type":"header","data":{"text":"Особые группы пациентов","level":4}},{"type":"paragraph","data":{"text":"У восприимчивых пациентов длительное применение местных"}},{"type":"paragraph","data":{"text":"НПВП, включая бромфенак, может привести к разрыву эпителия, истончению роговицы, эрозии роговицы, изъязвлению роговицы или перфорации роговицы. Данные события могут угрожать потерей зрения. Пациентам с признаками разрушения эпителия роговицы следует немедленно прекратить применение местных НПВП и необходимо внимательно следить за здоровьем роговицы. Следовательно, у пациентов, подверженных риску, одновременное применение офтальмологических кортикостероидов с НПВП может привести к повышенному риску нежелательных явлений со стороны роговицы."}},{"type":"paragraph","data":{"text":"Пострегистрационный опыт применения"}},{"type":"paragraph","data":{"text":"Пострегистрационный опыт применения местных НПВП свидетельствует, что у пациентов с осложнениями после офтальмологических хирургических вмешательств, с денервацией роговицы, дефектами эпителия роговицы, сахарным диабетом и поверхностными заболеваниями глаз, ревматоидным артритом или повторными офтальмологическими хирургическими вмешательствами, проведенными в течение короткого периода времени, может наблюдаться повышенный риск нежелательных явлений со стороны роговицы, которые могут стать угрожающими потерей зрения. Местные НПВП у таких пациентов следует применять с осторожностью."}},{"type":"paragraph","data":{"text":"Сообщалось, что офтальмологические НПВП могут вызывать повышенную кровоточивость в тканях глаза (в том числе гифему) в сочетании с офтальмологическим хирургическим вмешательством. Местные НПВП должны применяться с осторожностью у пациентов, в анамнезе которых зафиксирована склонность к кровотечению, или если пациенты получают другие лекарственные препараты, которые могут повышать время свертываемости крови."}},{"type":"paragraph","data":{"text":"Инфекции глаз"}},{"type":"paragraph","data":{"text":"Следует тщательно контролировать применение препарата и с осторожностью назначать его пациентам с воспалениями, вызванными инфекциями, так как препарат может маскировать симптомы инфекционных заболеваний глаз."}},{"type":"paragraph","data":{"text":"Использование контактных линз"}},{"type":"paragraph","data":{"text":"В целом ношение контактных линз в период лечения препаратом не рекомендуется. В связи с этим пациентам не рекомендуется носить контактные линзы, если не получены четкие указания лечащего врача."}},{"type":"paragraph","data":{"text":"Вспомогательные вещества"}},{"type":"paragraph","data":{"text":"Бензалкония хлорид, который часто используется в офтальмологических препаратах в качестве консерванта, может вызвать точечную кератопатию и/или токсическую язвенную кератопатию. Поскольку препарат содержит бензалкония хлорид, необходим тщательный мониторинг в случае частого или длительного применения у пациентов с синдромом «сухого» глаза или в случаях повреждения роговицы. Бензалкония хлорид может изменить цвет мягких контактных линз. Необходимо снимать мягкие контактные линзы перед применением препарата и надевать их снова через 15 минут после закапывания."}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"После инстилляции может отмечаться преходящее затуманивание зрения. В случае развития затуманивания зрения после инстилляции необходимо воздержаться от управления транспортными средствами и механизмами до восстановления четкости зрения. "}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Капли глазные 0,09 %."}},{"type":"paragraph","data":{"text":"По 2,5 мл или 5 мл во флакон с капельницей из полиэтилена низкой плотности и крышкой с контролем первого вскрытия или во флакон-капельницу из полиэтилена высокого давления в комплекте с крышкой навинчиваемой и пробкой-капельницей, или во флакон из полиэтилена низкой плотности в комплекте с пробкой-капельницей и крышкой с контролем первого вскрытия, или во флакон из полиэтилентерефталата с капельницей пластиковой и крышкой с контролем первого вскрытия."}},{"type":"paragraph","data":{"text":"По 1 флакону в пакете из фольгированной пленки или без пакета."}},{"type":"paragraph","data":{"text":"По 1 флакону или по 1 пакету из фольгированной пленки вместе с инструкцией по применению, упорным устройством или без него в пачке из картона."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. После вскрытия флакона – 1 месяц."}},{"type":"paragraph","data":{"text":"Не применять после окончания срока годности!"}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают по рецепту"}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ООО «Гротекс»"}},{"type":"paragraph","data":{"text":"195279, Санкт-Петербург"}},{"type":"paragraph","data":{"text":"Индустриальный пр., д. 71, к. 2, лит. А"}},{"type":"paragraph","data":{"text":"Тел.: +7 812 385 47 87"}},{"type":"paragraph","data":{"text":"Факс: +7 812 385 47 88"}},{"type":"paragraph","data":{"text":"www.solopharm.com"}},{"type":"paragraph","data":{"text":"www.ivinak.ru"}}]}],"source":null},"description_toggle":false,"short_description":"Бромфенак – нестероидный противовоспалительный препарат (НПВП), противовоспалительное действие которого реализуется за счет блокирования синтеза простагландинов при ингибировании циклооксигеназы 1 и 2. В исследованиях in vitro бромфенак ингибировал синтез простагландинов в цилиарном теле кролика. Концентрация полумаксимального ингибирования (IC50) для бромфенака (1,1 мкмоль) была ниже, чем для индометацина (4,2 мкмоль) и пранопрофена (11,9 мкмоль). В экспериментальной модели увеита у кроликов бромфенак в концентрациях 0,02 %, 0,05 %, 0,1 % и 0,2 % ингибировал практически все симптомы глазного воспаления. Всасывание Бромфенак эффективно проникает через роговицу пациентов, страдающих катарактой: при однократном введении средняя пиковая концентрация в водянистой влаге составляет 79 ± 68 нг/мл через 150-180 минут после применения. Данная концентрация сохраняется в течение 12 часов в водянистой влаге с сохранением поддающихся измерению уровней концентрации в основных тканях глаза, включая сетчатку, до 24 часов. При применении глазных капель бромфенака два раза в день концентрации в плазме не поддавались количественному измерению. Распределение Бромфенак активно связывается с белками плазмы. По данным исследования in vitro связывание с белками в плазме крови человека составило 99,8 %. Исследования in vitro не выявили биологически значимого связывания с меланином. По данным исследования у кроликов с использованием радиактивно-меченного бромфенака максимальная концентрация после местного применения наблюдается в роговице, высокая – в конъюнктиве и водянистой влаге глаза. Низкая – в хрусталике и стекловидном теле. Метаболизм По результатам исследования in vitro основной метаболизм бромфенака осуществляется ферментом CYP2C9, который отсутствует в иридоцилиарной зоне, сетчатке и сосудистой оболочке. Уровень этого фермента в роговице составляет менее 1 % по сравнению с соответствующим печеночным уровнем. При пероральном приеме у человека в плазме в основном обнаруживается неизмененное исходное вещество. Выделено несколько конъюгированных и неконъюгированных метаболитов, основным из которых является циклический амид, который выводится с мочой. Выведение При закапывании в глаза период полувыведения бромфенака из водянистой влаги глаза составляет около 1,4 ч, что свидетельствует о быстрой элиминации. 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