active ingredients:1 g gel contains 20 mg lidocaine hydrochloride and 0.5 mg chlorhexidine dihydrochloride;
Excipients:hydroxyethyl cellulose, glycerin, sodium lactate solution, water for injection.The
Drugs for local anesthesia. Lidocaine, combinations.
ATC Code N01B B52.
For local anesthesia of the mucous membranes and as a lubricant when:The
Hypersensitivity to the drug, as well as increased sensitivity to other local anaesthetics of the amide type; bulbocavernosus (urethrostenosis) reflux; severe heart failure (FC IV NYHA classification) severe bradycardia (
Cathejell with lidocaine enters solely a doctor or specially trained medical personnel. The dose is selected individually.
use of the drug when injecting a catheter, endoscope or other medical instruments into the urethra.
Corrugated syringe tube contains 12.5 g gel, of which about 10 g fall into the urethra during instillation.
Recommended doses for adult males:12.5 g of the drug is used to fill the urethra sufficiently. The contents of one corrugated syringe tube is enough to fill the urethra. For carrying out one manipulation it is not recommended to use more than one tube. The onset of action of the drug occurs after 5 to 10 minutes.
Women, children (age 2-12 years) and adolescents (aged 12 years):the recommended dosage in these patients are lacking. Do not use more than 4 doses within 24 hours.
1. Clean and disinfect the outer opening of the urethra.
2. Remove the paper, which is covered with a transparent blister pack with a conical end.
3. Break off the tip of the tube; if possible, leaving the tube in the blister.
4. To remove the tip of the tube completely, to avoid accidentally getting it in your urethra.
5. Squeeze out a drop of gel to facilitate the introduction of the tip.
6. Easily by clicking on the tube, slowly insert the gel into the urethra.
the rest of the gel should be discarded.
anaesthesia to undergo a General and tracheal intubation
Adults and children over 15:distribute approximately 5 ml of gel evenly over the bottom third of the tube. To avoid drying out, the gel is applied to the tool before use. The gel should not get in the lumen of the tube. For adults with average body weight maximum dose of lidocaine Cathejell with is 16.
Doses for children from 2 to 15 years:children under 15 years dose should not exceed 6 mg lidocaine (0.3 ml gel/kg body weight). Do not use more than 4 doses within 24 hours.
dosage Guidelines for patients at risk.
for elderly, weakened and seriously ill patients, as well as in violation of liver function or severe renal insufficiency dose should be selected individually.
The maximum single dose is calculated in milligrams of lidocaine hydrochloride per kilogram of body weight (2.9 mg lidocaine hydrochloride/kg body weight).
Adverse reactions after the application of Cathejell with lidocaine are rare (<1/10000), if the drug is used in accordance with the recommendations for dosage and method of administration.
there may Rarely be cases of local and/or systemic hypersensitivity reactions to lidocaine and/or chlorhexidine. Systemic adverse reactions can be caused by high levels of active substance in blood plasma, which can be caused by rapid absorption, overdose, hypersensitivity, individual intolerance or decreased tolerance with the possible appearance of such symptoms: withsides of the Central nervous system (CNS): nervousness, dizziness, blurred vision, tremor, drowsiness, loss of consciousness, respiratory arrest; sides of the cardiovascular system: arterial hypotension, bradycardia, asystole; withsides of the immune system:bronchospasm, respiratory failure syndromehypersensitivity reactions:bronchospasm, respiratory failure syndrome, anaphylactic shock, urticaria, edema, skin lesions,reactions at the site of application:itching hoarseness (endotracheal intubation).
in professional applications, Cathejell with lidocaine in plasma are not attained toxic concentrations of the drug (> 5 µg/ml). However, the joint use of other local anesthetics can cause an additive effect, which, in turn, can lead to an overdose of the drug with the development of systemic toxic reactions.
If symptoms of systemic intoxication still occur, the nature of these symptoms will be similar to those that may develop with other methods of local anesthetics (e.g. infiltration anesthesia and conduction anesthesia), primarily lidocaine (see symptoms of lidocaine intoxication).
lidocaine Intoxication occurs in two-phase:
Stimulation: low toxic concentrations of lidocaine acts as a stimulant of the Central nervous system, resulting in excitation of the CNS, accompanied by anxiety, dizziness, tremor, and stimulation of the cardiovascular system, namely increased heart rate, increased blood pressure and redness of the skin.
Depression: in the range of high toxic doses, CNS and cardiovascular function may be inhibited (drowsiness, sedation, pallor, coma).
Reactions that occur due to the toxic effects of lidocaine on the Central nervous system are usually preceded by reactions from the cardiovascular system, since the previous ones are observed at lower concentrations of the drug in blood plasma.
the first symptom of lidocaine overdose is arousal; patients become restless, complaining of dizziness, hearing and vision impairment, tingling in the tongue and lip area or nystagmus. Sub-convulsions of lidocaine level in blood plasma often lead to drowsiness and sedative effect. Trembling and twitching muscles are the forerunners of inevitable generalized seizures. As a result of increasing the effect of the drug on the Central nervous system significantly disturbed function of the brain stem, accompanied by symptoms of respiratory depression and even the wrist.
lowering blood pressure and bradycardia are the first symptoms of toxic effects of lidocaine on the cardiovascular system, resulting in a weakening of the myocardium and increase in ventricular activity. Adverse reactions from the cardiovascular system are usually observed at a very high concentration of lidocaine in the blood plasma and have little clinical significance.
during pregnancy, Cathejell with lidocaine can be applied only after a thorough analysis by the physician of the benefit/risk after the establishment of the individual dose. Repeated use of the drug during pregnancy is not recommended.
In the period of breast-feeding, Cathejell with lidocaine should be used only if necessary; doses should be individualized. The interval between the instillation of Cathejell with lidocaine and subsequent breast-feeding should be 12:00. Repeated use of the drug during breastfeeding is not recommended.The
Cathejell with lidocaine should not be administered to children under 2 years.
avoid contact, Cathejell with lidocaine in the eye.
Cathejell with lidocaine should be used with caution in patients with severe liver dysfunction (III i IVстадии), impaired renal function (creatinine clearance,
Special care is recommended in the following cases:The
Suppose that, Cathejell with lidocaine gel can influence the course of porphyria, and should not be used in patients with acute porphyria, if no compelling indications for its use.
When the use of contents of more than one syringe-tubes, or if a large amount of gel gets into the bladder or the urethra is inflamed/peptic ulcer may increase absorption of lidocaine, especially in children and the elderly, which in turn leads to overdose of the drug with the side effect on the Central nervous and cardiovascular system.
patients with myasthenia gravis are particularly sensitive to local anesthesia.The
Cathejell with lidocaine does not affect the ability to drive vehicles or work with mechanisms, but its influence cannot be completely ruled out in cases of increased individual sensitivity.The
Cathejell with lidocaine should not be used together with preparations containing lidocaine hydrochloride or other local anesthetics of the amide type, because it can lead to unpredictable mutual influence of drugs.
because Of possible additive effects on the heart lidocaine should be used with caution in patients who simultaneously receive antiarrhythmic drugs, such as meksiletin and cocaine, beta-blockers (eg, propranolol) or calcium channel antagonists (e.g. diltiazem, verapamil).
Propranolol, diltiazem and verapamil lead to a significant prolongation of elimination half-life due to reduction in clearance of lidocaine. Drugs that reduce clearance of lidocaine may result in potentially toxic concentrations in blood plasma, if lidocaine is used repeatedly in large doses for a long time. Therefore, when the short-term treatment of Cathejell with lidocaine at recommended doses, these interactions have no clinical significance.
no Special studies have been carried out on the interactions between lidocaine and class III antiarrhythmic agents (e.g. amiodarone), but caution is recommended in their joint application.
caution Must be exercised in a joint application, Cathejell with lidocaine with cimetidine, an antagonist of the H2receptors. The concentration of lidocaine in blood plasma may increase due to a decrease in hepatic perfusion and inhibition of microsomal enzymes.The
Cathejell with lidocaine is a sterile antiseptic gel with local anesthetic effects. By local surface anesthesia, Cathejell with lidocaine provides anesthesia of the mucous membranes, which leads to fast symptomatic reduction of pain. The beginning of the action comes in 5-10 minutes after application and lasts 20-30 minutes. In addition to analgesic action, Cathejell with lidocaine largely prevents urinary tract infection after catheterization.
Lidocaine- an anesthetic of the amide group has been clinically tested for topical use. Lidocaine reversibly and locally inhibits the conductivity of sensitive nerve fibers. Sensitivity decreases consistently: cold/warm, touch and pressure. With local anesthesia the onset of action usually occurs within 3-5 minutes. In inflamed tissues, its effect is reduced using an acid pH level, which dominates there. In addition to anesthetic effect, lidocaine also has anti-arrhythmic effect. Unlike most other local anesthetics, lidocaine has no vasodilating effect.
Chlorhexidineis an antimicrobial drug active against most gram - positive and gram-negative bacteria, as well as against a number of fungi and viruses. As part of the drug acts as a prophylactic to prevent iatrogenic infections with topical application.
AbsorptionLidocaineis rapidly absorbed into the blood through the mucous membranes. The amount of lidocaine absorbed after topical application on mucous membranes depends on the concentration and the total dose applied, the specific application location and duration of application. Local anesthetics are usually rapidly absorbed after intratracheal and bronchial use, which can lead to rapid growth or to a very high concentration of lidocaine in blood plasma with an increased risk of intoxication. Lidocaine is rapidly absorbed in the gastrointestinal tract, despite the fact that only a small amount of the active substance enters the bloodstream through metabolic decay in the liver ( "the effect of the first pass").
45-60 minutes after instillation intrauretralno 10-40 ml of 2% gel (200-800 mg of lidocaine), the maximum concentration of lidocaine in blood plasma made of 0.06-0.2 µg/ml. These values are in the 7.5-27.5 times lower than plasma concentration (1,5-5,5 µg/ml) that have therapeutic value for anti-arrhythmic effect and is 30 times lower than the toxic concentration in the blood plasma (5 to 8 µg/ml).
it should be remembered that severe inflammation of the urethral mucosa and hypertrophy of the surface due to the expansion of the urethra can lead to increased absorption of lidocaine.
the Absorption ofchlorhexidineis extremely low when applied locally.
the Volume of distribution of lidocaine is 1.3-1.6 l/kg, it is rapidly distributed to all tissues, especially at highly vascularized organs, such as lungs, kidneys and skeletal muscles. About 65% of lidocaine binds to blood plasma proteins and alpha-1 acid glycoprotein (AAGs).
Lidocaine is metabolized to a large extent during the first passage through the liver. Approximately 90% dose of lidocaine dealkiliruetsa quickly and metabolized in the liver to monoethylglycinexylidide (MEGC) or glycinexylidide (GK). As blockers of sodium tubules, MEGC and GC are less active than lidocaine. Other metabolites are 2.6-xylidine and 4-hydroxy-2.6-xylidine. The end half-life of 1.8 hours represents primarily hepatic metabolism, but it can be extended to 2.3 h in elderly patients. The half-life of active metabolites is 0.9 hours.
the total clearance of 0.95 l/min can be reduced in patients with heart or liver failure. When renal failure may occur accumulation of metabolites. Less than 5% of lidocaine is excreted in the urine unchanged.
Kinetics in hepatic, renal and cardiac insufficiency
as a result of the rapid biotransformation of lidocaine in the liver, the half-life of it can be extended by 2 or more times in patients with impaired liver function, for example, at 4,5-6 hours in chronic liver diseases caused by alcohol abuse. In patients with severe heart failure, the half-life can be extended to 4-10 hours. Renal failure can lead to the accumulation of metabolites.
the sterile, water soluble, clear, colorless gel.The
3 years old.
Keep out of reach of children and away from light.The
Corrugated syringe tubes №1, №5, №25The
According to the recipe.The
Pharmazeutische Fabrik MONTAVIT GmbH, Austria
Farmaceutiche Factories MONTAVIT GmbH, Austria.The
Salzbergstrasse 96, 6067 Absam, Austria,
Dalbergstrasse 96, 6067 Absam, Austria
Gel Cathejell used as a local analgesic in a range of operations and medical sensing, installing the catheter, endoscopy, etc. In the basis of the composition of this tool is the lidocaine provides analgesic effect. The gel structure of the drug gives it additional properties of the lubricant, facilitating the introduction of probes, catheters and other foreign objects into the body.
the decision on the application to patient dose Katedrala can take only doctor performing a medical procedure. The dose is determined each time individually, taking into account the patient's condition and the necessary research.