Flosteron Betamethasone suspension for injections ampoules 1ml №5

Flosteron Betamethasone suspension for injections ampoules 1ml №5

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Composition active substance: 1 ml of suspension (1 ampoule) contains 2 mg betamethasone in the form of betamethasone sodium phosphate and 5 mg betamethasone in the form of betamethasone dipropionate; Auxiliary substances: sodium phosphate dihydrate, sodium chloride, sodium edetate, Polysorbate 80, benzyl alcohol, methylparaben (E 218), propylparaben (E 216), sodium carmelose, polyethylene glycols, concentrated hydrochloric acid, water for injection. Dosage form. Suspension for injection. Basic physico-chemical properties: transparent colorless slightly viscous liquid containing white particles that are easily suspended and in which there are no foreign particles. Pharmacological group Corticosteroids for systemic use. Glucocorticoid. Code ATH N02A B01. Pharmacological properties Pharmacodynamics. Betamethasone is a synthetic GCS with anti-inflammatory and immunosuppressive action. In addition, it acts on energy metabolism, glucose homeostasis and (through negative feedback) on the secretion of the hypothalamic activation factor and alimentary hormone from the adenohypophysis. Steroids 1, 2 bonds in the ring And other substituents at C16 of the D ring, 9-alpha-fluoro-derivatives, corticosteroids have a strong effect. These substituents at C16 are actually lower mineralocorticoid effect. The effect of corticosteroids has not yet been fully clarified. There is enough evidence indicating that the main mechanism of their action is at the cellular level. In cellular cytoplasm, there are two clearly established receptor systems. Through GCS receptors corticosteroids form anti-inflammatory and immunosuppressive effect and regulate glucose homeostasis and through mineralocorticoid receptors they regulate sodium and potassium metabolism and water-electrolyte balance. Corticosteroids are fat-soluble and easily penetrate the cell membrane into the target cell. Binding the hormone to the receptor leads to a change in the conformation of the receptor, increases its affinity for DNA. The hormone/receptor complex enters the cell nucleus and binds to the DNA molecule regulation site known as the "GCS-responsible element" (GRE). The activated receptor that is associated with the GRE or specific genes, regulates the transcription of the mRNA. It can increase or decrease it. Again mRNA is transported to the ribosome, which leads to the emergence of new proteins. Depending on the target cells and cellular processes, the formation of new proteins may increase (tyrosine transaminase in liver cells) or decrease (IL-2 in lymphocytes). Since GCS receptors are present in all tissues, it is believed that they act in most cells of the body. Immunoregulatory and anti-inflammatory action of corticosteroids is based on the molecular and biochemical actions. The molecular anti-inflammatory effect comes from binding corticosteroids with GCS receptors and from changes in the expression of a number of genes regulating the formation of a number of information molecules, proteins and enzymes involved in the anti-inflammatory reaction. Biochemical anti-inflammatory effect of corticosteroids occurs in preventing the formation and functioning of humoral inflammatory mediators prostaglandins, thromboxane, cytokines and leukotrienes. Betamethasone reduces the formation of leukotrienes by releasing arachidonic acid from cellular phospholipids, achieved by inhibiting the action of phospholipase a 2 . The effect on phospholipase is not direct, but through an increase in the concentration of lipocortin (macrocortin), which is an inhibitor of phospholipase a 2 . The inhibitory effect of betamethasone on prostaglandin and thromboxane formation is the result of its lowering effect on the formation of specific mRNA and cyclooxygenase. In addition, due to an increase in the concentration of lipocortin betamethasone reduces the formation of platelet activation factors (PAF). Another biochemical anti-inflammatory action involves reducing the formation of tumor necrosis factors TNF and IL-1. Corticosteroids regulate glucose homeostasis and affect the metabolism of sodium, potassium, the balance of electrolytes and water. The anti-inflammatory effect of betamethasone exceeds the action of hydrocortisone by 30 times; it is not mineral corticoid activity. Pharmacokinetics. Betamethasone sodium phosphate is an easily soluble component rapidly absorbed in tissues and provides rapid action. Prolonged action provides betamethasone dipropionate, which has a slow absorption. The combination of these components achieves a fast and prolonged action. Depending on the method of administration (intraarticular, periarticular, the site of the lesion, intradermal, in some cases - intramuscularly) achieved systemic or local effect. After intraarticular injection, the maximum concentration of a combination of betamethasone in blood plasma is achieved within 30 minutes. After absorption, corticosteroids metabolised via pharmacokinetic path in the same way as with systemic corticosteroids. Corticosteroids bind to blood proteins in varying degrees. Basically, they are processed in the liver and excreted in the urine. Some topical corticosteroids and their metabolites are excreted in the bile. Metabolites disintegrate in the liver, excreted mainly by the kidneys and only a small part is excreted in the bile. Indications Dermatological diseases. Atopic dermatitis (nummular eczema), neurodermatitis, contact dermatitis, pronounced solar dermatitis, urticaria, lichen planus, insulin lipodystrophy, female alopecia, diskoidna lupus erythematosus, psoriasis, keloids, ordinary pemphigus, herpetic dermatitis, cystic acne. Rheumatic disease. Rheumatoid arthritis, osteoarthritis, bursitis, tendosynovitis, tendonitis, peritendinitis, ankylosing spondylitis, epicondylitis, radiculitis, coccydynia, sciatica, lumbago, stiff neck, ganglion cyst, exostosis, fasciitis, acute gouty arthritis, synovial cyst, Morton's disease, inflammation of the cuboid bone, foot disorders, bunion on the background of hard corns, spurs, stiff big toe. Allergic condition. Bronchial asthma, status asthmaticus, hay fever, severe allergic bronchitis, seasonal and aperiodic allergic rhinitis, angioedema, contact dermatitis, atopic dermatitis, serum sickness, hypersensitivity reactions to drugs or insect bites. Collagen diseases. Systemic lupus erythematosus, scleroderma, dermatomyositis, nodular periarteritis. Oncological disease. Palliative therapy of leukemia and lymphoma in adults, acute leukemia in children. Other disease. Adrenogenital syndrome, ulcerative colitis, Crohn's disease, sprue, pathological blood changes requiring GCS therapy, nephritis, nephrotic syndrome. Primary and secondary insufficiency of adrenal cortex (with obligatory simultaneous introduction of mineralocorticoids). Contraindications Hypersensitivity to betamethasone, other components of the drug or other GCS. Systemic mycoses. M administration to patients with idiopathic thrombocytopenic purpura. Interaction with other medicinal products and other forms of interaction Simultaneous administration of phenobarbital, rifampicin, phenytoin or ephedrine may enhance the metabolism of the drug, reducing its therapeutic activity. Patients receiving treatment of GKS, it is impossible to vaccinate against smallpox. Should not be undertaken other immunization among patients receiving corticosteroids (especially in high doses), given the risk of neurological complications and a low immune reaction (absence of antibody). In the case of substitution therapy (eg, Addison's disease) immunization is possible. The combination with thiazide diuretics can increase the risk of glucose intolerance. While the use of corticosteroids and estrogens may require correction doses of the drug (because of the threat of overdose). Simultaneous reception of the drug Flosteron with diuretics that promote the excretion of potassium, increases the probability of developing hypokalemia. Simultaneous use of GCS and cardiac glycosides increases the risk of arrhythmia or digitalis intoxication (through hypokalemia). Flosteron may increase the excretion of potassium caused by the intake of amphotericin-B. all patients receiving either of these combinations of medicines should carefully monitor electrolytes in blood serum, in particular serum potassium. Simultaneous reception of the drug Flosteron and anticoagulants can lead to a change in speed of blood clotting, which requires dose adjustment. When combined use of GCS with nonsteroidal anti-inflammatory drugs or ethanol and drugs containing ethanol, it is possible to increase the frequency of occurrence or intensity of erosive-ulcerative lesions of the gastrointestinal tract. With simultaneous use of GCS can reduce the concentration of salicylates in blood plasma. When reducing the dose of corticosteroids or discontinuation of treatment of patients should be observed to identify possible poisoning salicylic acid. The combination of corticosteroids with salicylates can increase the frequency and severity of gastrointestinal ulcers. For patients with diabetes, sometimes it is necessary to adapt doses of oral antidiabetic drugs or insulin, taking into account the property of corticosteroids to cause hyperglycemia. Simultaneous administration of corticosteroids and growth hormone can slow the absorption of the latter. Doses of betamethasone, which exceeds 300-450 µg (0.3-0.45 mg) per 1 m 2 of the body surface per day, should be avoided when using somatotropin. Interaction with laboratory tests. GCS may influence recovery test and nitro blue tetrazolium and give false-negative results. When the patient is undergoing treatment with corticosteroids, should be considered when interpreting the biological parameters and tests (skin tests, hormonal parameters, thyroid). Application features Suspension Flosteron is not intended for intravenous or subcutaneous administration . Strict adherence to aseptic technique is mandatory when using the drug. Any drug (soft tissue, lesion, intra-articular) can cause systemic effects with simultaneous pronounced local action. Abrupt cancellation or reduction of the dose with constant use (in the case of very high doses, after a short period of application) or an increase in the need for corticosteroids (due to stress: infection, trauma, surgery) can increase the insufficiency of the adrenal cortex. In this case, it is necessary to gradually reduce the dose. In the case of stress, it is sometimes necessary to take corticosteroids again or increase the dosage. It is necessary to reduce the dosage under strict control, and sometimes it is necessary to monitor the patient's condition for a period of up to 1 year after the termination of long-term treatment or the use of elevated doses. Rare cases of anaphylactic reactions were observed in patients who were administered parenteral corticosteroids; therefore, appropriate measures should be taken before administration of the drug, especially if the patient has a history of allergies to one of the components of the drug. With long - term therapy with corticosteroids, it is necessary to provide for a transition from parenteral to oral administration after assessing the potential benefits and risks. Intramuscular injections of GCS should be administered deep into the muscle to prevent local tissue atrophy. Intra-articular injections should be carried out only by medical personnel. Necessary to analyze the synovial fluid to exclude a septic process. Should not be administered in the case of intra-articular infection. A noticeable increase in morbidity, edema, an increase in the temperature of the surrounding tissues and further restriction of joint mobility indicate septic arthritis. When confirming the diagnosis, antibacterial therapy should be prescribed. Should not use corticosteroids in unstable joints, infected areas, intervertebral spaces and. Repeated injections into the joint with osteoarthritis can increase the risk of joint destruction. You need to avoid injecting corticosteroids directly into a tendon, because in the future there may be small gaps. After successful intra-articular therapy, the patient should avoid joint overloads. The introduction of corticosteroid in soft tissue or in the lesion and around the joint can cause systemic and local effects. Special groups of patients. Patients with diabetes betamethasone can be used only for a short period and only under strict medical supervision, given its GCS properties (transformation of proteins into glucose). There is an increase in the effect of GCS in patients with hypothyroidism or cirrhosis of the liver. You must avoid using the drug Flosteron patients with herpetic eye disease (because of possible corneal perforation). Against the background of drug possible mental disorders (especially in patients with emotional instability or a tendency to psychosis). Measures are necessary in the following cases: in ulcerative colitis, the risk of perforation, abscess or other pyogenic infections; in the diverticula; intestinal anastomoses; peptic ulcer of stomach and duodenum; renal disease hypertension; osteoporosis; severe myasthenia gravis; glaucoma; acute psychosis; viral and bacterial infections; stunted growth; tuberculosis; Cushing's syndrome; diabetes, heart failure complex for the treatment of case of epilepsy the tendency to thromboembolism or thrombosis; in pregnancy. Patients receiving treatment of GKS, it is impossible to vaccinate against smallpox. Should not be undertaken other immunization among patients receiving corticosteroids (especially in high doses), given the risk of neurological complications and a low immune reaction (absence of antibody). In the case of substitution therapy (eg, Addison's disease) immunization is possible. Patients, in particular children receiving Flosteron in doses that suppress the immune system, avoid contact with sick chicken pox and measles. Corticosteroids may mask some signs of infection. Due to the reduction of resistance in the application may be new infection. The appointment of the drug in active tuberculosis is possible only in cases of cursory or disseminated tuberculosis, combined with adequate TB therapy. If corticosteroids are prescribed to patients with latent tuberculosis, or to those who react to tuberkulin, strict control is necessary, since it is possible to resume the disease. In long-term therapy with corticosteroids, patients should also receive chemoprophylaxis. If rifampicin is used in the chemoprophylaxis program, it is necessary to monitor the amplifying effect of corticosteroids of metabolic clearance in the liver; it may be necessary to correct the dose of corticosteroids. Prolonged use of GCS can lead to the development of posterior subcapsular cataract (especially in children), glaucoma with possible optic nerve damage and can contribute to the development of secondary eye infection (fungal or viral). Need to undergo regular eye examination, especially for patients receiving Flosteron for more than six weeks. Corticosteroids may exacerbate systemic fungal infections and therefore should not be applied in the presence of such infections requiring antifungal treatment. The results of a single, multicenter, randomized, controlled study of other GCS (methylprednisolone hemisuccinate) showed an increase in early mortality (2 weeks) and late mortality (6 months) in patients with traumatic brain injury receiving methyl prednisolone compared to placebo. The causes of mortality in the methylprednisolone group have not been established. It should be noted that this study excluded patients who felt that they had obvious indications for the use of corticosteroids. Medium and high doses of corticosteroids can cause an increase in blood pressure, fluid retention and sodium in the tissues and increase the excretion of potassium from the body (which may manifest edema, heart disorders). It is recommended diet with restriction of salt and additional reception of the preparations containing potassium. With caution should take aspirin in combination with drug gipoprotrombinemii due to the possibility of increasing the bleeding. It should also be remembered about the possibility of developing secondary adrenal cortex insufficiency within a few months after the end of therapy. When using GCS may change the mobility and number of sperm. Excipients benzyl alcohol that the composition of Flosteron is contraindicated in infants and children up to 3 years. Methylparaben and propylparaben typically cause delayed-type reactions such as contact dermatitis, and rarely cause immediate reactions such as urticaria and bronchospasm. This drug contains less than 1 mmol of sodium (23 mg) in 1 dose, that is, in fact, can be considered to be sodium-free. Application during pregnancy and lactation Due to the lack of controlled studies of the safety of the drug pregnant, breastfeeding, and women of reproductive age should be appointed after a thorough evaluation of the benefit to the mother and the potential risk to the fetus/child. In some cases, it is necessary to carry out a course of treatment with corticosteroids during pregnancy or even increase the dosage (for example, in the case of substitution therapy with corticosteroids). M betamethasone leads to a significant decrease in the frequency of dyspnea in the fetus, if the drug is administered more than 24 hours before delivery (before the 32nd week of pregnancy). Corticosteroids are not to appoint for treatment of the disease hiliary membranes after birth. In in preterm infants, it is not necessary to administer corticosteroids to pregnant women with preeclampsia and eclampsia, or those who have placental lesions, in the case of preventive treatment for the disease of giliary membranes. Children born to mothers who were administered high doses of corticosteroids during pregnancy should be monitored (for early detection of signs of adrenal cortex insufficiency). Corticosteroids cross the placental barrier and in breast milk. Because corticosteroids cross the placenta, newborns and infants mothers who received corticosteroids during the greater part of pregnancy or during certain part of pregnancy, you need to carefully examine to detect possible congenital cataract rarely. If necessary, the appointment of the drug Flosteron should decide the issue of termination of breastfeeding, taking into account the importance of therapy for the mother (because of possible unwanted side effects, in children). Women who received corticosteroids during pregnancy need an audit during and after contractions and during childbirth to identify any adrenal cortex deficiency due to stress caused by the birth of the child. The ability to influence the reaction rate when driving motor transport or operating other mechanisms Usually Flosteron not affect the speed of response of the patient when driving motor transport or operating other mechanisms, but in rare cases there may be muscle weakness, convulsions, visual disturbances, dizziness, headache, mood change, depression (with severe psychotic reactions), irritability, so it is recommended to refrain from driving vehicles or operating other mechanisms during treatment. Method of application and doses. Flosterone is recommended to be administered intramuscularly if necessary, systemic intake of GCS into the body; directly into the affected soft tissue or in the form of intra-articular and periarticular injections in arthritis, in the form of intradermal injections in various diseases of the skin; in the form of local injections into the lesion of some diseases of the foot. The dosage regimen and method of administration are determined by the doctor individually depending on the indications, the severity of the disease and the patient's response to treatment. The dose should be minimal, and the period of use - as short as possible. The dose should be selected to obtain a satisfactory clinical effect. If a satisfactory clinical effect is not manifested within a certain period of time, treatment should be discontinued by progressive dose reduction and other appropriate therapy. In the event of favourable responses is necessary to determine the appropriate dose, which you need to stick with gradually decreasing the initial dose with reasonable intervals until you reach the minimum dose with the appropriate clinical response. Suspension Flosteron is not intended for intravenous or subcutaneous administration . The system application. The initial dose in most cases is 1-2 ml. of the Introduction to repeat if necessary, depending on the condition of the patient. The drug is administered deeply intramuscularly into the buttock: in severe conditions (lupus erythematosus or status asthmaticus) requiring emergency action, the initial dose can be 2 ml; with various dermatological diseases, as a rule, 1 ml of the drug is enough in diseases of the respiratory system effect of the drug begins within a few hours after the injection of the drug Flosteron. With bronchial asthma, hay fever, allergic bronchitis and allergic rhinitis, a significant improvement is achieved after the administration of 1-2 ml of the drug acute and chronic bursitis dose for intramuscular injection is 1-2 ml of the drug. If necessary to carry out a few re-introductions. Local application. The simultaneous use of local anesthetic drug is needed only in rare cases (the injection is virtually painless). If simultaneous administration of an anesthetic is desirable, then use 1% or 2% solution of procaine hydrochloride or lidocaine, or similar local anesthetic, applying dosage forms that do not contain parabens. It is not allowed to use anesthetics containing methylparaben, propylparaben, phenol and other similar substances. When applying the anesthetic in combination with the drug Fluosterone, first dial into the syringe from the vial the necessary dose of the drug, then into the same syringe to collect from the ampoule the required amount of local anesthetic and shake the syringe for a short period of time. In acute bursitis (subdeltoid, subscapularis, and ulnar peregrinaciones) injection of 1-2 ml of the drug in the synovial Flosteron bag can relieve pain and to restore mobility in a few hours. Treatment of chronic bursitis should be carried out with smaller doses of the drug after relief of an acute attack of the disease. In acute, tendosynovit, tendinitis and peritendinitis a single injection of the drug Flosteron facilitates the patient's condition is chronic - it is necessary to repeat injection of the drug depending on the response. It is necessary to avoid the introduction of the drug directly into the tendon. With rheumatoid polyarthritis and osteoarthritis, intra-articular administration of the drug at a dose of 0.5-2 ml reduces pain, pain and stiffness of the joints within 2-4 hours after administration. The duration of therapeutic action of the drug varies significantly and can be 4 weeks or more. Recommended doses of the drug when administered in large joints-1-2 ml in the middle-0.5 - 1 ml in small-0.25-0.5 ml. In the case of dermatological diseases effective intradermal administration directly into the lesion. To introduce 0.2 ml/cm2 of the drug Flosteron into the skin (under the skin) using a tuberculin syringe and needle, with a diameter of about 0.9 mm. the Total amount of drug administered per injection site should not exceed 1 ml. In the case of foot diseases sensitive to GCS . You can overcome bursitis under the corn by two consecutive injections of 0.25 ml each. In diseases such as stiffness of the big toe, varus the small toe, and acute gouty arthritis relief can occur very quickly. The recommended single dose of the drug Flosteron (between inputs 1 week): when solid corn - 0.25-0.5 ml under calcaneal - 0.5 ml; with stiffness of the big toe - 0,5 ml, with varus of the small toes - 0.5 ml, with synovial cyst - 0.25 to 0.5 ml when tendosynovit - 0.5 ml; inflammation of the cuboid bone - 0.5 ml; acute gouty arthritis, 0.5 to 1 ml. For administration it is recommended to use tuberculin syringe with needle which has a diameter of about 1 mm. In the event of or threat of a stressful situation (not related to the disease), it may be necessary to increase the dose of the drug. Elimination of the drug after long-term therapy should be carried out by gradual dose reduction. Monitoring of the patient is carried out at least for a year after the end of long-term therapy or after the use of the drug in high doses. Children There is not enough clinical data on the use of the drug in children, so it is undesirable to apply it to patients of this age group (perhaps lagging behind in the growth and development of secondary adrenal cortex insufficiency). Overdose Acute overdose betamethasone does not create life-threatening situations. The introduction of high doses of GCS within a few days does not lead to undesirable consequences (except for the use of very high doses or in the case of diabetes, glaucoma, exacerbation of erosive and ulcerative lesions of the gastrointestinal tract, or in the case of patients who are simultaneously treated with cardiac glycosides, indirect anticoagulants or diuretics that remove potassium). Treatment. Careful medical monitoring of the patient's condition is required. It is necessary to maintain the optimal flow of liquid and control the electrolyte content in blood plasma and urine (especially the balance in the body of sodium and potassium). If an imbalance of these ions is detected, appropriate therapy should be carried out. Adverse reaction Undesirable phenomena, as with other GCS, due to the dose and duration of the drug. These reactions are usually reversible and can be reduced by lowering the dose. Violation of water-electrolyte balance: sodium, increased potassium, hypokalemic alkalosis, increased calcium excretion, fluid retention in the tissues. From the side of cardiovascular system: congestive heart failure in patients predisposed to this disease; hypertension. From the side of musculoskeletal system: muscle weakness, myopathy, loss of muscle mass, worsening of myasthenic symptoms in severe psevdoparalitichesky myasthenia gravis, osteoporosis, sometimes with severe pain in the bones and spontaneous fractures (compression fractures of the spine), aseptic necrosis of the femoral or humerus heads, pathological fractures of the tubular bones, ruptures of tendons, instability of the joints (after repeated injections). From the digestive system: hiccups, erosive and ulcerative lesions of the stomach with possible perforation and bleeding, esophageal ulcers, pancreatitis, flatulence, intestinal perforation, nausea, vomiting. From the skin and subcutaneous tissue: deterioration of wound healing; skin atrophy; thinning and weakening of the skin, petechia and ecchymosis, bruising; erythema; increased sweating; skin reactions such as allergic dermatitis, urticaria, angioedema hirsutism; striae; acne. From the nervous system: convulsions, increased intracranial pressure with edema of the optic disc (pseudonana of the brain) usually after treatment; vertigo headache; migraine euphoria; mood changes; personality changes and severe depression irritability insomnia psychotic reactions, particularly in patients with psychiatric history; depression. Endocrine disorders: menstrual disorders; clinical symptomology of Cushing's syndrome; delayed fetal development or growth of the child; impaired carbohydrate tolerance; manifestations of latent diabetes mellitus, increased need for insulin injections or oral antidiabetic agents in patients with diabetes. From the side of organs of vision: the rear subcapsular cataracts; increased intraocular pressure; glaucoma exophthalmos. Metabolic disorders: negative nitrogen balance due to protein catabolism; lipomatosis, including mediastinum and epidural lipomatosis, which can lead to neurological complications; weight gain. From the immune system: corticosteroids can cause inhibition of skin tests, hide the symptoms of infection and activate latent infections, as well as reduce resistance to infections, in particular to mycobacteria, white Candida and viruses; hypersensitivity reactions, including anaphylactic reactions, antihypertensive reactions. General disorders and disorders at the injection site: General disorders and disorders at the injection site include single cases of blindness accompanying local application at the face and head level; Hyper - or hypopigmentation; subcutaneous and cutaneous atrophy; aseptic abscesses; exacerbation after injection (intra-articular injection) and arthropathy of sharko. Secondary depression of the pituitary and adrenal cortex in case of stress (trauma, surgery or illness). After repeated intra-articular injection may damage the joints. There is a risk of infection. Shelf life 3 years. Storage conditions Store at a temperature not exceeding 25 ° C in the original package for protection from light. Keep out of reach of children. Incompatibility Flosteron suspension can be mixed with local anesthetics in the same syringe; however, the work always needs to be monitored. Packaging 1 ml of suspension for injection in ampoules; 5 vials in blister, 1 blister in a cardboard box. Category home away from home By prescription. Manufacturer KRKA, DD, Novo mesto/KRKA, dd, Novo mesto Manufacturer's location and address of the place of business Smarjeska cesta 6, 8501 Novo mesto, Slovenia/Smarjeska cesta 6, 8501 Novo mesto, Slovenia FLOSTERON SUSPENSION FOR INJECTION Flosterone in the form of a suspension for injection is a hormonal drug that has pronounced anti-inflammatory, immune depressive, anti-allergic and anti-rheumatic properties. Most often, this drug is prescribed if necessary, treatment of rather severe forms of diseases, where conventional nonsteroidal agents are not sufficiently effective. Basically Flosteron used for local treatment and is injected directly into the site of inflammation, it may be periarticular and intra-articular administration of the suspension. It is used in the following forms of diseases: All types of rheumatic inflammatory diseases of varying severity and its progressive types. Inflammation of the periarticular tissues. All kinds of skin diseases, including allergic. Drug Flosteron prescribed for allergic reactions to medications, insect bites and angioedema and allergic rhinitis. The dosage of the drug is determined by the doctor only on an individual basis, taking into account the type of disease, its stage, severity and the process of occurrence. It is strictly prohibited intravenous administration, in some cases, permissible intramuscular.

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