Hydrocortisone eye ointment 0.5% 3g

Hydrocortisone ophthalmic ointment 0.5%

Packaging

In the tube 3 g ointment. In the package 1 tube.

Mechanism of action

GKS. Suppresses the function of leukocytes and tissue macrophages. Limits the migration of leukocytes to the area of ​​inflammation. Violates the ability of macrophages to phagocytosis, as well as the formation of interleukin-1. It contributes to the stabilization of lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of ​​inflammation. Reduces capillary permeability due to histamine release. Suppresses the activity of fibroblasts and the formation of collagen.

Inhibits the activity of phospholipase A₂, which leads to the suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.

Reduces the number of circulating lymphocytes (T-and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed to the lymphoid tissue; inhibits the formation of antibodies.

Hydrocortisone inhibits the release of ACTH and β-lipotropin by the pituitary gland, but does not reduce the level of circulating β-endorphin. It inhibits the secretion of TSH and FSH.

With the direct application of the vessels has a vasoconstrictor effect.

Hydrocortisone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys and increases the activity of gluconeogenesis enzymes. In the liver, hydrocortisone enhances the deposition of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from the products of protein metabolism. An increase in blood glucose activates insulin secretion.

Hydrocortisone inhibits glucose uptake by fat cells, which leads to activation of lipolysis. However, due to an increase in insulin secretion, lipogenesis is stimulated, which leads to fat accumulation.

It has a catabolic effect in the lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. To a lesser extent than mineralocorticoids, it affects the processes of water and electrolyte metabolism: it promotes the excretion of potassium and Calcium ions, and the delay in the body of sodium and water ions. Osteoporosis and Itsenko-Cushing syndrome are the main factors limiting long-term therapy of corticosteroids. As a result of the catabolic effect, growth can be suppressed in children.

In high doses, hydrocortisone can increase the excitability of the brain tissue and contributes to lowering the threshold of convulsive readiness. Stimulates excessive production of hydrochloric acid and pepsin in the stomach, which contributes to the development of peptic ulcers.

With systemic use, the therapeutic activity of hydrocortisone is due to the anti-inflammatory, antiallergic, immunosuppressive and antiproliferative effects.

When applied topically and locally, the therapeutic activity of hydrocortisone is due to the anti-inflammatory, antiallergic, and anti-exudative (due to the vasoconstrictor effect) action.

In anti-inflammatory activity 4 times weaker than prednisolone, in mineralocorticoid activity superior to other GCS.

Pharmacokinetics

Binding to plasma proteins - 40-90%. Metabolized mainly in the liver. T_1/2 - 80-120 minutes Excreted by the kidneys mainly in the form of metabolites.

Indications and usage

Inflammation of the anterior part of the eyeball with undisturbed corneal epithelium and after injuries and surgical interventions on the eyeball.

Contraindications

Actual, viral, fungal diseases of the eye, eye tuberculosis, trachoma, violation of the integrity of the eye epithelium.

Pregnancy and Breastfeeding

Use during pregnancy is possible only when the intended benefit to the mother outweighs the potential risk to the fetus; It is recommended to use the minimum dose and short-term therapy. Children whose mothers received hydrocortisone during pregnancy should be carefully monitored to detect signs of adrenal insufficiency.

If necessary, use during lactation should decide on the termination of breastfeeding.

AT experimental studies shown that GCS can cause abnormal fetal development. Currently, there is no clear evidence of this data in humans.

It is not recommended to exceed the course of treatment. During treatment, you must refrain from using contact lenses. When using other eye drops, the time interval between their application and application of the ointment is at least 15 minutes. If used for more than 2 weeks and there is a history of open or closed angle glaucoma, control of intraocular pressure is necessary.
Pediatric use: Hydrocortisone may be used for treating children as prescribed by the attending physician if the expected therapeutic effect exceeds the risk of possible side effects. Children have a higher likelihood of systemic action of hydrocortisone than adults. Therefore, in children, the drug should be used carefully, if possible, a short course (5-7 days).
Influence on ability to drive motor transport and control mechanisms: the drug does not limit the psychophysical activity, ability to drive vehicles and maintain moving mechanisms. Patients whose visual clarity is temporarily lost after the application are not recommended to drive a car or work with a complicated technique immediately after the drug is applied.

Composition

1 g of 0.5% ointment contains: hydrocortisone acetate 5.0 mg.
Excipients: methyloxybenzoate, white petrolatum.

Dosage and administration

Conjunctival 2–3 times a day in a small amount for 2 weeks (hereinafter - only as directed by a doctor).

Adverse reactions

Local reactions: allergic reactions, burning, sclera injections, increased intraocular pressure, exophthalmos.

In case of violation of the integrity of the corneal epithelium, it is possible to delay healing and perforation of the cornea.

The accession of a secondary infection.

With prolonged use may develop steroid glaucoma.

Frequent repeated treatments can lead to the development of cataracts.

Drug Interactions

During treatment should not be vaccinated against smallpox. Other types of immunization should not be planned during treatment, due to the immunosuppressive effect of the drug. With improper and prolonged use of the drug with possible resorption of the drug into the general circulation, hydrocortisone reduces the effectiveness of insulin, oral hypoglycemic drugs, antihypertensive drugs, anticoagulants, reduces the concentration of salicylates in the blood, reduces the serum concentration of praziquantel.
Increase the risk of side effects: androgens, estrogens, oral contraceptives, anabolic steroids (hirsutism, acne); antipsychotics, bucarban, azathioprine (cataract); m-holinoblokatory,antihistamines, tricyclic antidepressants, nitrates (glaucoma), diuretics (hypokalemia); cardiac glycosides (digitalis intoxication).
The drug can not be applied topically with lead and silver preparations due to their mutual inactivation.

Overdosage

Symptoms: excessive and frequent use during the day or use in children can cause a systemic effect of the drug.
Treatment: with the abolition of the drug overdose phenomena themselves pass.

Storage conditions

Store at 5-15 ° C.