Universal reference book for medicines
Product name: LORINDEN ® C (LORINDEN C)

Active substance: clioquinol, flumetasone

Type: The drug with antibacterial, antifungal and anti-inflammatory action for external use

Manufacturer: PHARMACEUTICAL WORKS JELFA (Poland)
Composition, form of production and packaging
Ointment of
white color with a light yellow or gray tinge, oily.

1 g

flumethasone pivalate 200 μg

clioquinol 30 mg

Excipients: beeswax white - 10 mg, Vaseline - up to 1 g.

15 g - aluminum tubes (1) - cardboard packs.

INSTRUCTION FOR THE SPECIALIST.

The product description was approved by the manufacturer for the 2009 print edition.

PHARMACHOLOGIC EFFECT

The drug with antibacterial, antifungal and anti-inflammatory effect for external use.

Flumethasone is a synthetic bifluoride GCS for external use.
Has anti-inflammatory, antiallergic, antipruritic, decongestant and vasoconstrictive effect. When exposed to the skin, prevents the accumulation of neutrophils, which leads to a decrease in inflammatory exudate and production of lymphokines, inhibition of migration of macrophages, a reduction in the processes of infiltration and granulation. Reduces the production of prostaglandins and leukotrienes by inhibiting the activity of phospholipase A 2 and reducing the release of arachidic acid from the phospholipids of the cell membrane. It causes reduction of the main substance of connective tissue, weakens proliferative and exudative reactions in the skin. It is an inhibitor of cellular kinins, which have proteolytic activity.
Clioquinol (iodochlorooxyquinoline) is a derivative of 8-hydroxyquinolines.
It is active against dermatophytes, yeast fungi (Microsporum spp., Trichophyton spp., Candida albicans) and Gram-positive bacteria (Staphylococcus spp., Enterococcus spp.). Enhances the antiexudative effect of flumethasone.
As a result of the combined effect of flumethasone and clioquinol (iodochloroquinoline), the drug inhibits the development of inflammatory-allergic reactions from the skin, complicated by bacterial and fungal infection.

The fatty base of the ointment has a softening effect, has a water-repellent effect and forms a protective film protecting the skin from the effects of external moisture.Due to the peculiarities of the ointment base the preparation can be used in patients with dry and thin skin.

PHARMACOKINETICS

Suction and distribution

When the ointment is applied to the skin, the active components easily penetrate the stratum corneum.

Flumethasone pivalate is almost not absorbed into the bloodstream and does not have systemic effects.
Absorption increases with frequent application of the drug and / or application to large areas of the skin, when applied on the face, in the area of ​​skin folds, in areas of skin with damaged epidermis, and when using an occlusive dressing that increases the humidity and local temperature (penetration into the deeper layers of the skin under the occlusal bandage is approximately 100 times greater than when applied simply to the affected areas).
The absorption of flumethasone pivalate from the skin in children is more pronounced than in adults.

Clioquinol when used as an ointment can be slightly absorbed through the skin and bind to blood plasma proteins.

Metabolism and excretion

Flumethasone pivalate is not practically metabolized in the skin.
After absorption, the drug is mainly metabolized in the liver. Derived in the form of metabolites and a small amount in unchanged form with urine and bile.
Clioquinol is partially biotransformed in the liver and excreted in the urine.

INDICATIONS

Allergic dermatoses, complicated by the attachment of a bacterial infection caused by microorganisms sensitive to clioquinol:

- dermatitis (including allergic, contact, professional, seborrhoeic, sunny);

- eczema;

- psoriasis (especially chronic cases, including psoriasis of the scalp);

- erythema multiforme;

- erythroderma;

- Atopic dermatitis (common neurodermatitis);

- pruritis;

- dermatoses that do not respond to SCS therapy (including red flat lichen, discoid lupus erythematosus);

- hives;

- secondary infections with insect bites.

Bacterial and fungal skin infections complicated by the development of local allergic reactions:

- impetigo;

- infected diaper rash;

- dermatomycosis, actinomycosis, blastomycosis, sporotrichosis.

DOSING MODE

Outwardly.
The ointment is applied a thin layer on the skin in the affected area. At the beginning of therapy the drug should not be used more often 2-3 times / day;when there is a positive dynamics 1-2 times / day.
The drug should not be used for more than 2 weeks.

If it is necessary to use a bandage, a bandage that passes air should be used.
When excessive lichenization and hyperkeratosis ointment is used only under the occlusive dressing 1 time in 24-48 hours. In this case, the duration of the drug - no more than 1 week.
It is not recommended to apply a day more than 2 g of ointment.

In children and adolescents older than 10 years, the drug can be used only in exceptional cases in limited areas of the skin and avoid applying ointment to the skin of the face.

SIDE EFFECT

Local reactions: rarely - burning, itching, steroid acne, striae, dry skin, folliculitis;
with prolonged use - skin atrophy, local hirsutism, telangiectasia, purpura, pigmentation disorders.
Systemic reactions: with prolonged use and / or application to large areas of the skin, side effects, characteristic of GCS, are possible.

CONTRAINDICATIONS

- viral skin diseases (herpes, chicken pox);

- Tuberculosis of the skin;

- cutaneous manifestations of syphilis;

- neoplasms of the skin and precancerous skin conditions (skin cancer, nevus, atheroma, epithelioma, melanoma, hemangioma, xanthoma, sarcoma);

- vulgar and rosacea;

- perioral dermatitis;

- trophic ulcers of the legs, associated with varicose veins;

- condition after vaccination;

- skin infections (for use with an occlusive dressing);

- children's age till 10 years;

- Hypersensitivity to the components of the drug.

PREGNANCY AND LACTATION

Contraindicated use of the drug in the I trimester of pregnancy.

Controlled studies of possible teratogenic effects with topical application of flumethasone and iodochloroquinoline in pregnancy have not been performed, so the drug can be administered only if the intended benefit to the mother exceeds the possible risk to the fetus.

It is not known to what extent flumethasone and clioquinol when excreted are excreted in breast milk.
Special care should be taken when prescribing the drug during lactation (breastfeeding). The use is possible only in exceptional cases, for a short time and in limited areas of the skin (can not be applied to the skin of the mammary glands).
SPECIAL INSTRUCTIONS

It is not recommended to apply the drug on the face, avoid getting the ointment in the eyes.

It is not recommended to increase the duration of the course of treatment or to apply long on large areas of the skin.
With prolonged use of the drug over a large surface area of ​​the skin, the risk of developing systemic side effects of GCS increases.
When a secondary infection occurs at the site of ointment use, agents with a more pronounced antibacterial or antifungal effect should be used.

With caution should be used during atrophic skin changes, especially in the elderly.

With prolonged use, the development of microflora resistance to clioquinol is possible.

In fungal diseases with secondary allergic reactions Lorinden C is used in exceptional cases, under medical supervision.

Impact on the ability to drive vehicles and manage mechanisms

The drug does not limit psychophysical activity, ability to drive vehicles and service moving mechanisms.

OVERDOSE

Cases of overdose are rare.

Symptoms: if improper, frequent or prolonged use in significant amounts in large areas may cause systemic side effects of GCS.

Treatment: gradual withdrawal of the drug;
symptomatic therapy.
DRUG INTERACTION

During therapy with Lorinden C, vaccination and immunization should not be performed due to the immunosuppressive effect of the drug.

The drug should not be administered in combination with other medicines for external use.

When the drug is absorbed into the systemic circulation, flumethasone reduces the effectiveness of insulin, oral hypoglycemic agents, antihypertensive drugs, anticoagulants, and reduces the concentration of salicylates and praziquantel in the blood serum.

When combined, the risk of side effects of androgens, estrogens, oral contraceptives, anabolic steroids (hirsutism, acne) increases;
antipsychotic drugs, bucarban, azathioprine (cataract); holinoblokatorov, antihistamines, tricyclic antidepressants, nitrates (glaucoma); diuretics (hypokalemia), cardiac glycosides (digitalis intoxication).
TERMS OF RELEASE FROM PHARMACY

The drug is released by prescription.

TERMS AND CONDITIONS OF STORAGE

List B. The drug should be stored out of reach of children at a temperature of no higher than 25 ° C.
Shelf life - 3 years.
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