ETHOXISKLEROL Aethoxysklerol Polidocanol 1% solution for injection 20mg/2ml ampoules 2ml №5

ETHOXISKLEROL Aethoxysklerol Polidocanol 1% solution for injection 20mg/2ml ampoules 2ml №5

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Composition active ingredient: lauromacrogol 400 (polidocanol) 2 ml of solution for injection contains 400 Lauromacrogol 10 mg or 20 mg, or 60 mg Auxiliary substances: ethanol 96%; sodium phosphate, dihydrate; potassium dihydrophosphate; water for injection. Dosage form The solution for injection. Pharmacological group Sclerosing agents for local administration. PBX code S05V B02. Indications Sclerotherapy of vascular nets, varicose veins of the branches of the Central vein, reticular veins, small, medium and large varices hemorrhoids the 1-St and 2-nd degree. Depending on the size of varices using different concentrations of the drug for the treatment of hemorrhoids apply Ethoxysclerol 3%. pokazyvaetsya Ethoxysclerol 0.5%1% 3%method of application vascular net in the form of solution Varicose branches of the Central venich In the form of a solution reticular varicose x in solution Small varicose nodes x in the form of solution and foam Medium and large varices. the form of a solution and foam Hemorrhoids the 1-St and 2-nd degree. a solution Contraindications In the treatment of varicose veins, the drug is contraindicated in the following cases: absolute contraindications to the use of the drug: known hypersensitivity to Lauromacrogol 400 or other components of the drug acute severe systemic diseases (especially incurable) chained to the bed; obliterating endarteritis of III and IV degree; thromboembolic disease; high risk of thrombosis (e.g. hereditary thrombophilia or in patients with multiple risk factors such as hormone replacement therapy, use of hormonal contraceptives, obesity, Smoking, all diseases and conditions that are accompanied by restriction of free movement); absolute contraindications to the use of the drug in the form of foam (additional): symptomatic "open oval window" in history relative contraindications to the use of the drug: fever; bronchial asthma or a known tendency towards allergies; General debility ogranizma; occlusive disease of II degree swelling of the legs (not corrected by compression method) inflammatory skin diseases at the injection site symptoms of microangiopathy or neuropathy; limited mobility in the patient; relative contraindications for the use of the drug in the form of foam (optional): asymptomatic "open oval window" in history mental, neurological symptoms or symptoms of the organs of vision. In the treatment of hemorrhoids, the drug is contraindicated in the following cases: absolute contraindications to the use of the drug in the case of hemorrhoids: known hypersensitivity to Lauromacrogol 400 or other components of the drug acute severe systemic diseases (especially incurable) acute inflammation in the anal area; relative contraindications for the use of the drug in the case of hemorrhoids: fever; bronchial asthma or a known tendency towards allergies; General debility ogranizma; chronic inflammatory bowel disease (e.g. Crohn's disease) known hypercoagulation. Method of application and doses The concentration of the drug is selected depending on the diameter of the vein and the individual condition of the individual patient. It is necessary to apply the minimum possible concentration of the drug. Dosing (single and daily doses). Do not exceed the dose of lauromacrogol 400 at the rate of 2 mg/kg body weight per day. For example, a patient weighing 70 kg can be given a maximum dose of 140 mg (except for dosing in case of hemorrhoids). 140 mg Lauromacrogol 400 contains Ethoxysclerol 0,5%: 28 ml solution for injection Ethoxysclerol 1%: 14 ml solution for injection Ethoxysclerol 3% with 4.6 ml of solution for injection. Optionally, you can enter the drug in the form of foam. For the preparation of standardized homogeneous viscous foam, see the instruction for individual systems. When applying the drug in the form of foam should not exceed a dose of 10 ml of foam per session and per day, regardless of the patient's body weight. Large varicose veins need to be treated over several sessions. For patients with varicose veins, subject to hypersensitivity reactions, during the first treatment session, only one injection is used. Depending on the results of treatment and the size of the area of proliferation of obliteration in the next treatment session, you can do several injections, not exceeding the maximum dose. Sclerotherapy of vascular nets: depending on the size of varicose veins is prescribed according to 0.1-0.2 ml of Ethoxysclerol 0,5% vnutricostna. Sclerotherapy of varicose veins of the branches of Central veins: depending on the size of varices appoint 0.1-0.2 ml of Ethoxysclerol 1% vnutricinovialnoe. Sclerotherapy of reticular veins: depending on the size of varices appoint 0.1-0.3 ml of Ethoxysclerol 1% intravascular. Small varices: depending on the size of varices appoint 0.1-0.3 ml of Ethoxysclerol 1% in solution vnutricinovialnoe. When using Ethoxysclerol 1% in the form of foam, for example, for the treatment of varicose collateral veins appoint up to 4 ml (maximum - 6 ml) per injection. For the treatment of perforating veins designate up to 2 ml of the solution (maximally 4 ml) per injection. In this case, do not exceed the maximum daily dose. Medium varices: depending on the size of varices, the first application appoint 0.5-1 ml of Ethoxysclerol 3% in the form of a solution intravascular. Depending on the flow and size of the varicose nodes, 2 ml of the solution is injected in the following sessions, not exceeding the maximum daily dose. Ethoxysclerol 3% in the form of foam (for example, for the treatment of large and small saphenous veins) injected at 4 ml per injection (maximum - 6 ml for the treatment of great saphenous veins). In this case, do not exceed the maximum daily dose. Large varices: the first application is prescribed 1 ml of Ethoxysclerol 3% in solution. Depending on the flow and size of varicose veins appoint several injections (2-3) to 2 ml in the following sessions. In this case, do not exceed the maximum daily dose. Ethoxysclerol 3% in the form of foam (for example, for the treatment of large and small saphenous veins), injected at 4 ml per injection (maximum - 6 ml for the treatment of great saphenous veins). In this case, do not exceed the maximum daily dose. The concentration of the drug in the form of foam, depending on the indications. 1% *3% * Varicose collateral varvarigos great saphenous veins Varicose veins perforating varvarigos small saphenous veins * These concentrations relate to Ethoxysclerol in the form of solution for preparation of foam. Hemorrhoids: during a single treatment session should not exceed the dose of 3 ml of Ethoxysclerol 3%. Depending on the course of the disease, 1 ml of solution is injected for each node by injection directly under the mucous membrane. The exception is 11-hour knots in men, when administered a maximum of 0.5 ml. Method and duration of application. Sclerotherapy of vascular nets Sclerotherapy of varicose veins of the branches of the Central vein Sclerotherapy of reticular varicose veins Small varicose veins Sclerosis is carried out when the leg is in a horizontal position or slightly raised at an angle of 30-45 °. All injections are administered only intravenously, including in the treatment of vascular mesh. Apply very thin needles (eg insulin) and syringes with a smooth piston. Puncture is carried out by tangent, the drug is administered slowly. When applying the drug in the form of foam needle size should be at least 25 g. Medium and large varicose veins Regardless of the method of venepunction (the patient who is in standing position-only with the help of a cannula, the patient who is in a sitting position, with the help of a finished syringe for injection) sclerosis is carried out when the leg is in a horizontal position or slightly raised at an angle of 30-45 °. All injections are carried out only intravenously. The introduction of the drug in the form of foam by direct injection into the invisible crancularn veins, perforating veins and varices in angularly area or popliteal fossa should be carried out with ultrasound (preferably in duplex mode). In sclerotherapy of varicose veins of other invisible nodes to puncture and injection is also recommended the use of ultrasound. Depending on the level and degree of varicose veins may require several courses of therapy. Blood clots, sometimes can be formed, are removed by a puncture-incision and extrusion. Compression therapy after the introduction of Ethoxysclerol in the form of a solution. After administration of the drug in the form of a solution, the injection site should be tightly clamped with a gauze swab and apply a tight elastic compression bandage. The patient should immediately after administration of the drug walk at least 30 minutes, preferably within the hospital. Compression therapy after the introduction of Ethoxysclerol in the form of foam. After administration of the drug in the form of foam, the patient's leg should be fixed for 2-5 minutes. Valsava maneuver and muscle activation in the patient should be avoided. You should also refrain from the imposition of bandages at once. Compression bandage is applied after about 10 minutes in the treatment of large and small subcutaneous veins and after about 5 minutes in the treatment of collateral varicose veins, recurrent varicose veins or perforant veins. Duration of compression therapy. The bandage should be worn 2-3 days after sclerotherapy of vascular nets, in other cases - for 5-7 days. The bandage should be worn for 3-5 weeks after sclerotherapy of medium-sized and large varicose veins. Patients with extensive varicose veins recommended compression therapy with short-pull bandages for several months. In order to avoid sliding of a bandage, especially on a hip, under a compression bandage it is recommended to impose a bandage from porous synthetic material. The success of sclerotherapy depends on further appropriate compression treatment. Sclerotherapy of hemorrhoids. The drug is injected under the mucous membrane directly into the hemorrhoidal the node or upper part of the hemorrhoidal node in the supply section. Sclerotherapy in the area of the internal anal sphincter should be carried out with extreme caution due to the risk of damage and subsequent incontinence. Obliteration of nodes of medium and large sizes is carried out only intravenously, preventing air embolism. In the treatment of 11-time nodes in men, the maximum administered 0.5 ml of Ethoxysclerol 3% due to proximity to the urethra and prostate gland. The number of repeated treatments is determined depending on the degree of hemorrhoids. Adverse reaction Sclerotherapy of varicose veins The adverse reactions described below are based on reports of the use of Lauromacrogol 400 from around the world. In some cases, adverse reactions were severe, but in most cases - temporary. Often such reports were spontaneous, without belonging to a certain group of patients, without any control group, and therefore it is impossible to accurately assess the frequency, as well as to accurately determine the dependence of the occurrence of adverse reactions from the drug. Local adverse reactions (e.g. necrosis), especially skin and adjacent tissues (rarely nerve endings), were observed after accidental injection into surrounding tissues (paravenous injection). The risk of such reactions increases with the concentration and volume of Ethoxysclerol. Adverse reactions are given at the same frequency of occurrence (according to MedDRA): very often ? 10%, common: ? 1% to <10%, uncommon ? 0.1% to <1%; rare ? 0.01% to <0,1%; very rare <0,01%. From the immune system: very rarely - anaphylactic shock, angioedema, generalized urticaria, asthma (asthma attacks). From the nervous system: very rarely - a violation of cerebral circulation, headache, migraine (rarely - when using the drug in the form of foam), local sensitivity disorders, loss of consciousness, confusion, dizziness, loss of speech, ataxia, hemiparesis, oral hypesthesia. From the organ of vision: very rarely (rarely when using the drug in the form of foam) - visual impairment. From the heart: very rarely-cardiac arrest, abnormal heart rate, heartbeat. From the vascular system: often-the appearance of blood vessels in the area of sclerosis, hematoma; infrequently-superficial thrombophlebitis, phlebitis; rarely - deep vein thrombosis, possibly caused by the underlying condition; very rarely - pulmonary embolism, vasovagal loss of consciousness, collapse, vasculitis. From the side of respiratory system: rarely - shortness of breath, sensation of pressure in the chest, cough. From the digestive system: very rarely - dysgeusia, nausea, vomiting. From the skin and subcutaneous tissue: often-changes in skin color (hyperpigmentation, ecchymosis) infrequently-allergic dermatitis, contact urticaria, skin reaction, erythema very rare hypertrichosis in the field of sclerotherapy. On the part of muscles and connective tissue: rarely - pain in the limbs. General reactions: often-pain at the injection site (short-term), local (at the injection site) blood clot in the varicose node; infrequently - necrosis, compaction, swelling of tissues, very rarely - fever, blood spills, asthenia, malaise. Laboratory indicators: deviation from the norm of blood pressure indicators. Injury, poisoning and procedural complications: rarely, nerve damage. sclerotherapy of hemorrhoids In the treatment of hemorrhoids before and after injection, there were local adverse reactions, such as heat sensation, pain, discomfort, pressure sensation, especially in 11-hour nodes in men (in the prostate). Such reactions are short-term and can rarely last 2-3 days. Sclerosis of hemorrhoids is painless, if the right technique is chosen and the injection site is forum sensitive nerve fibers. Adverse reactions are at the same frequency of occurrence (according to MedDRA): very often ? 10%, common: ? 1% to <10%, uncommon ? 0.1% to <1%; rare ? 0.01% to <0,1%; very rare <0,01%. From the immune system: very rarely - anaphylactic shock, angioedema, generalized urticaria, asthma (asthma attacks). With hand nervous system: very rarely - loss of consciousness, confusion consciousness, dizziness. From the heart: heartbeat. From the vascular system: very rarely-vasovagal loss of consciousness, collapse. From the digestive system: infrequently-proktit, anal itching is very rare-nausea. The skin and subcutaneous tissue: rarely - allergic dermatitis, contact urticaria, skin reaction. From the reproductive system: very rarely - violation of erectile function. Common reactions: often - burning sensation of the mucosa, pain at the injection site, feeling of discomfort, sensation of pressure; rarely, seal, rarely - necrosis (local, rarely spreads to nearby tissues), bleeding at the injection site, thrombosis at the injection site (intrahepatically) very rare - pyrexia. Laboratory indicators: very rarely-deviation from the norm of blood pressure. Overdose Event first aid and antidotes anaphylactic reaction Anaphylactic reactions occur rarely, but may pose a potential threat to life. In the case of sclerosing therapy should always be prepared preparations for countermeasures. Treatment of intoxication after local misapplication of the drug of varicose veins of the legs: intra-arterial injection 1. Leave the cannula at the injection site if the cannula has already been removed, the puncture is moved. 2. Enter 5-10 ml of local anesthetic without the addition of adrenaline. 3. Enter heparin 10000 MO. 4. The ischemic leg should be wrapped with cotton wool and lowered downwards. 5. Hospitalize the patient to the vascular surgery Department. paravenous injection Depending on the dose and concentration of drug, injected paravenoznoe, administered 5-10 ml of 0.9% solution of sodium chloride, together with hyaluronidase. In case of acute pain, a local anesthetic (without adrenaline) is administered. Application during pregnancy and lactation Data on the use of the drug is not enough for pregnant women. In animal studies, the drug showed reproductive toxicity but had no teratogenic effect. The drug should be used by pregnant women only when the potential benefit exceeds the risk to the fetus. Unknown, penetrates lauromacrogol 400 in breast milk. If sclerotherapy is necessary, breast-feeding should be stopped for 2-3 days. Children The drug is not used for children. Application features The drug contains 5% (vol./On.) Alcohol should be taken into account in patients with a history of alcoholism. The drug contains potassium (less than 39 mg per ampoule) and sodium (less than 23 mg per ampoule). Sclerotherapy of varicose veins Like all sclerosis agents, Lauromacrogol 400 can never be injected into, this can lead to severe necrosis, which can in turn lead to amputation. In such cases, you should immediately contact a vascular surgeon. For all sclerosing agents there is a strict determination of the indications for use on the face, since after intravascular injection may change blood pressure and cause irreversible damage to the eyes, which can lead to blindness. You should also consider the risk of accidental intra-arterial injection in place of the foot or ankle. If obliteration of the ankle to avoid excessive occlusive reactions give only a small dose of low concentration under surveillance. The recommended total volume of foam per session - 2 to 8 ml, the maximum volume of foam (for one or more injections) is 10 ml. In the treatment of truncular veins, foam injection is administered at a minimum distance of 8-10 mm from the safeno-femoral message. If the ultrasound examination shows a foam embolism in the deep vein system, the patient needs to perform muscle activation, for example, by bending back the ankle joint. sclerotherapy of hemorrhoids With extreme caution should be carried out sclerotherapy of hemorrhoids, due to the risk of damage to the internal anal sphincter and further incontinence. In the treatment of 11-time nodes in men, the maximum administered 0.5 ml of Ethoxysclerol 3% due to proximity to the urethra and prostate gland. The ability to influence the reaction rate when driving motor transport or operating other mechanisms There were no reports of a negative impact on the ability to drive and operate machinery. Interaction with other medicinal products and other forms of interaction Lauromacrogol is a 400-seat anesthetic. With simultaneous use with other anesthetics, there is a threat of increasing their influence on the cardiovascular system. Pharmacological properties Pharmacodynamics. Lauromacrogol 400 sclerotherapy and at the same time having a local analgesic effect. Due to this, almost painless obliteration of varicose nodes is provided. The action is directed mainly at the endothelium. Lauromacrogol 400 has a high affinity for the damaged endothelium, it does not act on intact areas, so the sclerosing effect occurs only in a really varicose modified, not in a cylindrical moderately dilated vein. The basis of sclerosing action irritation of the damaged endothelium of the vein, which involves local thrombosis. Due to the tight fixing bandage, which is applied after injection, the walls of the vein are compressed, and this prevents the recanalization of the blood clot, which is formed, and therefore - there is a transformation of the blood clot into fibrous scar TYAZH. In the case of the correct choice of concentration and dosage, as well as the correct treatment techniques and patient care at the stage of recovery (compression treatment) Lauromacrogol 400 provides a reliable and long obliteration. Pharmacokinetics. Lauromacrogol 400: after 12: 00 after the injection 89% of the administered Lauromacrogol 400 is excreted from the blood. In the study in patients with varicose veins (diameter > 3 mm) after the introduction of Ethoxysclerol 3% were established the following indicators: the final half - life-0,94 - 1,27 hours, the volume of distribution - 17,9 l, the total clearance-12,4 l/hour. Basic physico-chemical properties transparent solution from colorless to slightly greenish-yellow. Incompatibility Compatibility studies have not been carried out, this drug can not be mixed in the same container with other drugs. Shelf life 3 years. Storage conditions Store at a temperature not exceeding 25 ° C in its original packaging. Keep out of reach of children. Packaging 2 ml solution in an ampoule, 5 ampoules in a cardboard package. Category home away from home By prescription. Manufacturer The SCP Avocats Factories, Kreussler & Ko. GmbH. Location Rheingaustrasse 87-93 65203 Wiesbaden, Germany. PILLS FOZIKARD N N 30 Fozikard N tablets №30 has kaliysberegayuschimi, hypotensive, and diuretic and great vazodilatiruushimi action. The drug has a antihypertensive pronounced effect, reducing peripheral resistance of blood vessels and contributing to their expansion. The composition and appointment of The composition of the drug includes: Hydrochlorothiazide, increases the synthesis of aldosterone, as well as plasma activity renin. Fosinopril. The tool is intended for the treatment of patients suffering from hypertension, who need combination therapy. The therapeutic effect after taking the pill comes in an hour. Antihypertensive effect of the drug remains in the body after a single use during the day. Dosage and mode of use Tablets should be taken orally. Adults and children aged 16 and over are recommended to take 1 tablet of the drug once a day. If necessary, the dosage can be increased to 2 tablets per day. The period of therapy is determined for each patient individually, the average treatment should be from 2 weeks to a month. The drug is not intended for use in pregnant women and children under 16 years of age.

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