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Elidel
Last reviewed: 10.08.2022
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Indications of the elidela
It is used to eliminate the atopic form of dermatitis (medium or mild degree), when it is impossible to use local corticosteroids. Among such cases:
- increased sensitivity to local corticosteroids;
- lack of the required result from the use of corticosteroids;
- the need to apply on the neck or a person in the field of which the periodic, prolonged use of corticosteroids may not be appropriate.
[6]
Pharmacodynamics
The element pimecrolimus is an ascomycin macrolactam derivative possessing anti-inflammatory properties, but selectively slows down the formation and release of cytokines (inflammatory conductors).
A significant part of pimecrolimus is specifically synthesized with the substance of macrophilin-12, and also inhibits calcium-dependent phosphatase, an element of calcineurin. As a result, the activation of T-lymphocytes is suppressed - due to the blocking of the transcription of the previously identified cytokines.
The active component of Elidel combines a strong anti-inflammatory effect, as well as a weak effect on general immune manifestations.
Pharmacokinetics
When treating the surface of the skin with cream, the indices of its active substance inside the blood are very low, so that it is not possible to determine the metabolic processes of the drug.
In vitro tests on synthesis with a plasma protein determined that 99.6% of the substance is synthesized with it. The largest plasma fraction of pimecrolimus is synthesized with various lipoproteins.
Inside the skin there is no metabolism of drugs (during in vitro tests).
[14]
Dosing and administration
The duration of the course of therapy is prescribed by the doctor, taking into account the degree of severity, as well as the stage of the disease.
The cream is allowed to use short-term courses to remove the symptoms and manifestations of eczema atopic type, and in addition periodically to apply for a long period of time - as a prevention of exacerbation of pathology.
Therapy is required to begin immediately after the onset of the first symptoms of atopic dermatitis. Cream should only be treated areas affected by the disease. The medicine is used in short courses, only during periods of exacerbation of pathology. After the disappearance of the signs of the violation, it is required to stop using Elidel. The course of therapy should be short-term and periodic.
The medicine is applied to the affected areas in a thin layer - 2 times a day.
According to the tests, periodic use of the cream is possible for up to 1 year.
If after the lapse of 6 weeks of the course there is no improvement or vice versa will be noted deterioration, treatment should be canceled. At the same time, it is also necessary to re-diagnose the disease and think over the scheme of the subsequent treatment measures.
Cream is allowed to treat all areas of the skin (also neck with head and face, and with it intertriginoznye zones - in the genital area with inguinal folds), excluding only areas of mucous membranes. It is also forbidden to cover places of treatment with tight bandages.
It is also recommended immediately after applying the cream to treat the skin with emollients.
The sizes of doses and the method of using the cream for children are similar to those described above.
Use of the elidela during pregnancy
There is insufficient information on the use of drugs in pregnant women. Animal tests were not demonstrated after external treatment of a direct or indirect adverse effect on fetal development in the womb. But tests of oral intake of medication on animals revealed the development of reproductive toxicity.
Since pimecrolimus is absorbed into the body in minimal amounts with local application, the probability of developing complications in humans is considered to be rather low. But at the same time doctors still do not recommend using this cream during pregnancy.
Elidel should be used with caution in the period of breastfeeding. It is forbidden to treat cream areas of the sternum and mammary glands to avoid the possibility of accidental penetration of drugs into the baby's mouth.
Side effects of the elidela
The use of the cream can cause some side effects:
- infectious diseases: molluscum contagiosum;
- Immune disorders: manifestations of anaphylaxis (this includes also severe forms of pathology);
- disorders of metabolic processes: lack of tolerance to alcoholic beverages (often after the use of alcohol appear rashes, flushing, swelling, or itching);
- problems with the skin and subcutaneous layer: infectious processes on the skin (for example, folliculitis), and in addition impetigo and furuncles, herpes zoster or simple type, herpes form of dermatitis (eczema of the herpetic type) and skin papilloma. Allergy reactions can occur, including hives and rashes, Quincke edema and changes in the shade of the skin (hypo- or hyperpigmentation);
- systemic disorders and local manifestations: a burning sensation in the area of cream treatment, as well as various reactions in this area (such as itching, pain, dryness and irritation, and in addition erythema, rashes, peeling with paresthesias and swelling).
During the post-marketing use of the cream, occasionally malignant tumors developed in patients (including also lymphomas of cutaneous and other types), and in addition melanoma. But to establish the relationship with the use of Elidel in this case was not possible.
There is information about the appearance of lymphadenopathy (identified during postmarketing as well as clinical tests), but it also failed to relate to the use of the cream.
[17]
Interactions with other drugs
A systematic evaluation of possible interactions of the cream with other medications was not performed. The substance pimecrolimus is metabolized only with the element CYP 450 3A4. Since Elidel has a low degree of absorption, the likelihood of its interaction with systemic medicines is rather low.
The existing information confirms that the drug is allowed to be used in combination with antihistamines, antibiotics, and also SCS (nasal, oral or inhalation type).
The possibility of drug interaction during vaccination is also very low (but only theoretically, because such tests were not performed). Because of this, people with pathologies of disseminated or common type are required to perform vaccination in those periods when the cream is not used.
There is no information on the combined use of immunosuppressors used to eliminate eczema atopic type (among them UV B radiation, as well as A spectra, and in addition, PUVA therapy (substance psoralen together with UV irradiation of the A spectrum), cyclosporin type A and azathioprine ).
It is necessary to avoid excessive UV irradiation of the skin (this includes PUVA-, as well as UV therapy and the use of solariums) during the treatment with cream.
Occasionally, cases with the appearance of rash, redness, itching, burning or swelling immediately after drinking were used in people who used the cream.
Special instructions
Reviews
Elidel is mainly evaluated by patients positively, because it demonstrates real effectiveness. Although many are deterred by the fact that the cream has a lot of side effects, the main one of which is the risk of oncological pathologies.
In this case, medical reviews of the drug indicate that the frequency of development of negative manifestations in the cream is much lower than that of hormone-type drugs.
Another drawback of Elidel patients consider it a relatively high price.
[24]
Attention!
To simplify the perception of information, this instruction for use of the drug "Elidel" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.