повышенная индивидуальная чувствительность к любому из компонентов препарата; - вирусные или грибковые инфекции, туберкулез, гнойное воспаление глаз, трахома; - нарушение целостности эпителия роговицы и истончение склеры; - герпетический кератит (древовидная язва роговицы) (возможно увеличение размеров язвы и значительное ухудшение зрения); - глаукома; - перфорация барабанной перепонки (проникновение препарата в среднее ухо может привести к развитию ототоксического действия); - беременность и период кормления грудью; - дети грудного возраста. С осторожностью: детям младшего возраста (особенно при назначении препарата в больших дозах и длительно - риск развития системых эффектов и подавления функции надпочечников).
Действующее вещество: фрамицетина сульфат 5 мг, грамицидин 50 мкг, дексаметазон (в форме натрия метасульфобензоата) 500 мкгВспомогательные вещества: лития хлорид, натрия цитрат, лимонной кислоты моногидрат, фенилэтанол, этанол 99. 5%, полисорбат 80, вода д/и. Концентрация действующего вещества (мкг): 5550 мкг
Фармакологические свойства
Фрамицетина сульфат - антибиотик из группы аминогликозидов, действует бактерицидно. Обладает широким спектром антибактериального действия, активен в отношении грамположительных микроорганизмов, включая золотистый стафилококк, и большинства клинически значимых грамотрицательных микроорганизмов (кишечная палочка, палочка дизнтерии, протей и др.). Малоэффективен в отношении стептококков. Не действует на патогенные грибы, вирусы, анаэробную флору. Устойчивость микроорганизмов к фрамицетин сульфату развивается медленно. Грамицидин - оказывает бактерицидное и бактериостатическое действие, расширяет спектр антимикробного действия фрамицетина за счет своей активности в отношении стафилококков, так как тоже обладает противостафилококковым эффектом. Дексаметазон - ГКС, оказывающий выраженное противовоспалительное, противоаллергическое и десенсибилизирующее действие. Дексаметазон подавляет воспалительные процессы, угнетая выброс медиаторов воспаления, миграцию тучных клеток и уменьшая проницаемость капилляров. При закапывании в глаза уменьшат боль, жжение, слезотечение, светобоязнь. При закапывании в уши уменьшает симптомы отита наружного уха (покраснение кожи, боль, зуд, жжение в наружном слуховом проходе, ощущение заложенности уха).
повышенная индивидуальная чувствительность к любому из компонентов препарата; - вирусные или грибковые инфекции, туберкулез, гнойное воспаление глаз, трахома; - нарушение целостности эпителия роговицы и истончение склеры; - герпетический кератит (древовидная язва роговицы) (возможно увеличение размеров язвы и значительное ухудшение зрения); - глаукома; - перфорация барабанной перепонки (проникновение препарата в среднее ухо может привести к развитию ототоксического действия); - беременность и период кормления грудью; - дети грудного возраста. С осторожностью: детям младшего возраста (особенно при назначении препарата в больших дозах и длительно - риск развития системых эффектов и подавления функции надпочечников).
Применение при беременности и в период грудного вскармливания
Препарат противопоказан во время беременности и в период лактации.
Способ применения и дозы
При заболеваниях глаз: при легком течении инфекционного процесса закапывают по 1-2 капли препарата в конъюнктивальный мешок глаза каждые 4 ч. В случае развития тяжелого инфекционного процесса препарат закапывают каждый час. По мере уменьшения воспалительных явлений частота инстилляций препарата снижается. При заболеваниях уха: закапывают по 2-3 капли 3-4 раза/сут, в наружный слуховой проход можно закладывать марлевый тампон, смоченный раствором. Длительность применения препарата не должна превышать 7 дней, кроме случаев явной положительной динамики заболевания (ГКС может маскировать скрыто протекающие инфекции, а длительное использование антимикробных компонентов препарата способствовать развитию устойчивой флоры).
Побочное действие
Аллергические реакции обычно отсроченного типа, проявляющиеся раздражением, жжением, болью, зудом, дерматитом. При длительном применении кортикостероидов местного действия возможно: повышение внутриглазного давления с развитием симптомо комплекса глаукомы (поражение зрительного нерва, снижение остроты зрения и появление дефектов полей зрения), поэтому при более чем 7-дневном применении препаратов, содержащих глюкокортикостероиды, следует регулярно измерять внутриглазное давление; развитие задней супкапсулярной катаракты (особенно при частом закапывании); истончение роговицы или склеры, которое может привести к перфорации; присоединение вторичной (грибковой) инфекции.
Передозировка
Длительное и интенсивное местное использование может привести к появлению системных эффектов. Лечение симптоматическое. При проглатывании содержимого одного флакона (до 10 мл раствора) маловероятно развитие серьезных побочных эффектов.
Особые указания
При длительном применении препарата, как и при длительном применении других противомикробных средств, возможно развитие суперинфекций, вызванных устойчивыми к препарату микроорганизмами, включая грибки. Продолжительное закапывание препаратав глаза может приводить к истончению роговицы с развитием ее перфорации, а также к повышению внутриглазного давления. Лечение препаратами, содержащими кортикостероиды, не должно проводится повторно или длительно без регулярного контроля внутриглазного давления, обследования глаз на предмет развития катаракты или вторичных инфекций. Местные ГКС никогда не должны применяться у пациентов с гиперемией глаза неустановленной элиологии, т.к. несоответствующее использование препарата может привести к значиельному ухудшению зрения. Входящий в состав препарата фрамицетина сульфат является антибиотиком из группы аминогликозидов, которым свойственно развитие нефро- и ототоксических эффектов при системном применении или местном нанесении на открытую рану или поврежденную кожу. Эти эффекты зависят от дозы и увеличиваются и почечной или печеночной недостаточности. Хотя развития этих эффектов не наблюдалось при закапыывании препарата в глаза, следует принимать во внимание возможность их возникновения в случае местного применения высоких доз препарата у детей. Длительность применения препарата не должна превышать 7 дней, кроме случаев явной положительной динамики заболевания, т.к. длительное использование ГКС, входящего в его состав, может маскировать скрыто протекающие инфекции, а длительное использование антимикробных составляющих - способствовать развитию устойчивой флоры. Влияние на способность к вождению автотранспорта и управлению механизмами. Пациентам, у которых после закапывания в глаз препарата временно теряется четкость зрения, не рекомендуется сразу после закапывания препарата водить машину или работать со сложной техникой, станками или каким-либо другим сложным оборудованием, требующим четкости зрения. Флакон необходимо закрывать после каждого использования. Не следует прикасаться кончиком пипетки к глазу. После вскрытия флакона препарат следует использовать в течение 1 месяца.
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Дексаметазон - ГКС, оказывающий выраженное противовоспалительное, противоаллергическое и десенсибилизирующее действие. Дексаметазон подавляет воспалительные процессы, угнетая выброс медиаторов воспаления, миграцию тучных клеток и уменьшая проницаемость капилляров. При закапывании в глаза уменьшат боль, жжение, слезотечение, светобоязнь. При закапывании в уши уменьшает симптомы отита наружного уха (покраснение кожи, боль, зуд, жжение в наружном слуховом проходе, ощущение заложенности уха)."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Бактериальные заболевания переднего отрезка глаза. - блефариты; - конъюнктивиты; - кератиты (без повреждения эпителия); - иридоциклиты; - склериты, эписклериты; - инфицированная экзема кожи век; - отит наружного уха."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["повышенная индивидуальная чувствительность к любому из компонентов препарата; - вирусные или грибковые инфекции, туберкулез, гнойное воспаление глаз, трахома; - нарушение целостности эпителия роговицы и истончение склеры; - герпетический кератит (древовидная язва роговицы) (возможно увеличение размеров язвы и значительное ухудшение зрения); - глаукома; - перфорация барабанной перепонки (проникновение препарата в среднее ухо может привести к развитию ототоксического действия); - беременность и период кормления грудью; - дети грудного возраста. 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При длительном применении кортикостероидов местного действия возможно: повышение внутриглазного давления с развитием симптомо комплекса глаукомы (поражение зрительного нерва, снижение остроты зрения и появление дефектов полей зрения), поэтому при более чем 7-дневном применении препаратов, содержащих глюкокортикостероиды, следует регулярно измерять внутриглазное давление; развитие задней супкапсулярной катаракты (особенно при частом закапывании); истончение роговицы или склеры, которое может привести к перфорации; присоединение вторичной (грибковой) инфекции."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Длительное и интенсивное местное использование может привести к появлению системных эффектов. Лечение симптоматическое. 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Местные ГКС никогда не должны применяться у пациентов с гиперемией глаза неустановленной элиологии, т.к. несоответствующее использование препарата может привести к значиельному ухудшению зрения. Входящий в состав препарата фрамицетина сульфат является антибиотиком из группы аминогликозидов, которым свойственно развитие нефро- и ототоксических эффектов при системном применении или местном нанесении на открытую рану или поврежденную кожу. Эти эффекты зависят от дозы и увеличиваются и почечной или печеночной недостаточности. Хотя развития этих эффектов не наблюдалось при закапыывании препарата в глаза, следует принимать во внимание возможность их возникновения в случае местного применения высоких доз препарата у детей. 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