Антибиотик группы линкозамидов для местного применения.; Клиндамицина фосфат не активен in vitro, но быстро гидролизуется in vivo с образованием клиндамицина, обладающего антибактериальной активностью.; Клиндамицин ингибирует синтез белка в микробной клетке за счет взаимодействия с 50S-субъединицей рибосом.;In vitro к клиндамицину чувствительны следующие микроорганизмы, вызывающие бактериальные вагинозы: Gardnerella vaginalis, Mobiluncus spp., Mycoplasma hominis, Bacteroides spp., Peptostreptococcus spp.
Показания к применению
— бактериальный вагиноз.
Противопоказания
Антибиотик-ассоциированный колит в анамнезе
Возраст до 18 лет (данные по безопасности, эффективности отсутствуют)
Повышенная чувствительность к клиндамицину, линкомицину или любому компоненту препарата
Применение при беременности и в период грудного вскармливания
Адекватных и контролируемых исследований по применению препарата в I триместре беременности не проводилось. Применение Далацина в I триместре беременности возможно только по абсолютным показаниям, т.е. в том случае, если предполагаемая польза терапии препаратом для матери превосходит потенциальный риск для плода.; В исследованиях на животных при введении клиндамицина п/к или внутрь каких-либо отрицательных влияний на плод не обнаружено, за исключением случаев приема препарата в дозах, токсичных для матери.; При применении клиндамицина интравагинально во II и III триместрах беременности не отмечалось увеличения частоты врожденных аномалий плода. Аномальные роды имели место у 1.1% женщин по сравнению с 0.5% в группе плацебо, если Далацин; крем вагинальный применялся во II триместре в течение 7 дней. Применение препарата во II-III триместре беременности возможно, если потенциальная польза для матери превосходит риск для плода.; Неизвестно, выделяется ли клиндамицин с грудным молоком после интравагинального применения. Клиндамицин обнаруживается в грудном молоке после приема внутрь или парентерального введения. Поэтому в период лактации следует либо отменить применение препарата, либо прекратить грудное вскармливание, учитывая степень важности применения препарата для матери.
Способ применения и дозы
1 полный аппликатор (5 г крема, примерно 100 мг клиндамицина) вводят во влагалище предпочтительно перед сном в течение 3 или 7 дней подряд.; Правила использования препарата; В упаковке с 20 г крема находится 3 пластмассовых аппликатора, а в упаковке с 40 г - 7 аппликаторов, предназначенных для правильного введения крема во влагалище.; 1. Снять колпачок тюбика с кремом. Навинтить пластмассовый аппликатор на снабженное резьбой горлышко тюбика.; 2. Скатывая тюбик с противоположного конца, следует осторожно выдавить крем в аппликатор. Аппликатор заполнен, когда его поршень доходит до упора.; 3. Отвинтить аппликатор от тюбика и завернуть колпачок.; 4. В положении лежа на спине подтянуть колени к груди.; 5. Держа аппликатор горизонтально, следует осторожно ввести его во влагалище как можно глубже, не вызывая неприятных ощущений.; 5. Медленно нажимая на поршень до упора, ввести крем во влагалище.; 6. Осторожно извлечь аппликатор из влагалища и выбросить его.
Побочное действие
Наиболее часто - сухость кожи. ; Реже: боль в животе, раздражение кожи, желудочно-кишечные расстройства (диарея, тошнота, рвота), контактный дерматит, чувство жжения в глазах, фолликулит, вызванный грамотрицательной флорой, повышение продукции сальных желез. ; В крайне редких случаях возможно развитие колита. ; Клиндамицина фосфат при местном применении может всасываться в количествах, вызывающих системные эффекты.
Передозировка
При интравагинальном применении крема Далацин; возможна абсорбция клиндамицина в количествах, достаточных для развития системных реакций.; Случайное попадание препарата в ЖКТ также может вызвать системные эффекты, сходные с теми, которые возникают после приема внутрь клиндамицина в терапевтических дозах. К возможным системным побочным эффектам можно отнести диарею, геморрагическую диарею, включая псевдомембранозный колит.; Лечение: при необходимости проводят симптоматическую и поддерживающую терапию.
Особые указания
До назначения препарата с помощью специальных лабораторных методов следует исключить следующих возможных возбудителей вульвовагинита: Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans и вирус Herpes simplex.; Интравагинальное применение Далацина может привести к усиленному росту нечувствительных к препарату микроорганизмов, особенно дрожжеподобных грибов.; При применении клиндамицина (как и практически всех антибиотиков) внутрь или интравагинально возможно развитие тяжелой диареи и в ряде случаев псевдомембранозного колита. В связи с этим при возникновении на фоне терапии Далацином выраженной или длительной диареи следует отменить препарат и при необходимости провести диагностические и лечебные мероприятия.; Пациентка должна быть информирована о том, что во время применения вагинального крема следует избегать половых контактов, а также использования других видов изделий, предназначенных для интравагинального введения (например, тампонов, спринцеваний).; Не рекомендуется применение препарата Далацин; в период менструации. Следует отложить начало терапии до окончания менструации.; Далацин; содержит компоненты, которые могут уменьшать прочность изделий из латекса или каучука (презервативы, противозачаточные вагинальные диафрагмы). Поэтому использование подобных изделий во время лечения Далацином и в течение 72 ч после применения не рекомендуется.; Влияние на способность к вождению автотранспорта и управлению механизмами; Нет оснований полагать, что применение препарата может оказывать влияние на способность к вождению автомобиля и управлению механизмами.
Форма выпуска
Крем вагинальный.
Условия хранения
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Срок годности
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Отвинтить аппликатор от тюбика и завернуть колпачок.; 4. В положении лежа на спине подтянуть колени к груди.; 5. Держа аппликатор горизонтально, следует осторожно ввести его во влагалище как можно глубже, не вызывая неприятных ощущений.; 5. Медленно нажимая на поршень до упора, ввести крем во влагалище.; 6. 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В связи с этим при возникновении на фоне терапии Далацином выраженной или длительной диареи следует отменить препарат и при необходимости провести диагностические и лечебные мероприятия.; Пациентка должна быть информирована о том, что во время применения вагинального крема следует избегать половых контактов, а также использования других видов изделий, предназначенных для интравагинального введения (например, тампонов, спринцеваний).; Не рекомендуется применение препарата Далацин; в период менструации. Следует отложить начало терапии до окончания менструации.; Далацин; содержит компоненты, которые могут уменьшать прочность изделий из латекса или каучука (презервативы, противозачаточные вагинальные диафрагмы). 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