Imacort

Imacort is a corticosteroid, which is used in dermatology in combination therapy.

Indications of the imacorta

Shown in the following situations:

• at infectious processes in the skin (in particular, provoked by Candida fungi or dermatophytes) with a severe degree of inflammation;
• infected form of eczema or the risk of infection (for example, against the background of seborrheic dermatitis);
• inflammatory form of mycosis (in particular, it concerns mycosis in the region of the feet);
• Candidiasis in the groin area or in skin folds;
• superficial type of pyoderma.

Release form

Produced in the form of cream in tubes of 20 g. One package contains 1 tube of cream.

Pharmacodynamics

The drug has anti-allergic, anti-inflammatory and anti-exudative properties (the effect of prednisolone), and at the same time a wide range of antifungal effects (clotrimazole), which is enhanced by hexamidine, which spreads the effect of the drug on gram-negative and gram-positive pathogens.

Clotrimazole has antimycotic activity, which is provided by the slowing down of the processes of biosynthesis of ergosterol, which is part of the fungal cell membrane. The range of exposure to the substance includes dermatophytes (such as Trichophyton mentagrophytes, trichophyton red and other fungi of the genus trichophyton, flaky epidermophyton and fungi of the genus microsporium), yeast fungi (from the genus Trichosporone and Candida (including Candida albicans)) and mold for example, from the genus Aspergillus). The substance has an antimicrobial effect on individual gram-positive microbes (streptococci, staphylococcus, vulgar proteus), and at the same time against corynebacteria and nocardia.

Hexamidine diisothionate increases the properties of clotrimazole, in particular with respect to candida fungi, and further extends the range of its effects, including gram-negative microbes, which are an important part of the development of infections in foot mycoses.

Prednisolone is an unhalogenized, relatively weak GCS (1st strength category), which, in addition to the above properties, is able to relieve itching. Thanks to the combination of a corticosteroid and a disinfectant, it decreases the sensitivity of the skin and its inflammation, and along with it the sensation of itching in the development of mycosis. In addition, this combination allows you to protect the inflamed skin from secondary infections, the tendency for which the skin acquires due to the use of GCS.

At the heart of the product is a hydrophilic, slightly greasy emulsion of the oil-in-water form. It is great for removing subacute and acute forms of pathology.

Pharmacokinetics

No studies have been conducted regarding the absorption or penetration of the above combination of components into the body. In the literature, there is information that after local application of clotrimazole the concentrations necessary for the bactericidal action of the substance reach in the deep dermal layers, and a level sufficient for bacteriostatic exposure - inside the dermis.

The suction index is very low (<5%), and when the clotrimazole is applied tightly (dosage 0.8 g), the plasma index is below the minimum detection limit, which is 0.001 μg / ml. This allows you to ignore systemic absorption.

The action of hexamidine diisothionate is mainly surface, the substance is able to concentrate up to 90-100% within the stratum corneum after a long period of application. Approximately 0.03-0.1% of the applied component can be found inside the upper layers of the dermis or in the epidermis. Inside the lower layers of the dermis, this element is almost not detected. Effective medicinal values were observed inside the layers at the level of cutaneous scallops. Absorption under the skin is low - within the healthy skin it is 0.009-0.017%, and in the injured skin - 0.071% of the deposited substance in 48 hours.

The level of absorption of prednisolone without the use of occlusion is 1-2%.

Passage of corticoids can increase due to the use of hermetic bandages or with diaper rash. The weakened protective function of the stratum corneum greatly contributes to this. As a consequence, the passage of the substance of prednisolone acetate depends on the age of the person, the location of the injury, the condition of the skin, the form of the medicine used, and the way the dressing is applied.

Use of the imacorta during pregnancy

The medicine can not be administered to pregnant women. When used during lactation, breastfeeding should be abolished.

Contraindications

Among the contraindications:

• hypercorticoid syndrome, tuberculosis, chickenpox, levitic infectious processes (or provoked by the virus) within the skin;
• In addition, usual herpes, the period of vaccination and the presence of local reactions to it, skin ulcers or tumors, scabies, trophic ulcers, and with it pink acne, acne, as well as a perioral form of dermatitis;
• You can not use the cream in the presence of intolerance relative to the active components of drugs or other antimycotic drugs of the imidazole group;
• It is forbidden to prescribe for the elimination of infectious processes on the scalp, as well as in the treatment of nails;
• not assigned to children.

Side effects of the imacorta

As a result of using the cream, the following side effects can develop.

Subcutaneous tissue, as well as the skin: intolerance of the active components of the drug, and also any of the auxiliary elements is possible. With such a reaction, you must cancel the use of drugs. The reaction of hypersensitivity to clotrimazole can manifest itself in the form of such symptoms: burning, irritation, redness and itching with swelling on the skin. In addition, there are also watery blisters, blisters, scaling, rashes, pain and discomfort. There may be fever or urticaria, and with it allergic manifestations (such as dyspnoea, fainting and decreased blood pressure).

Hexamidine is able to cause sensitization, the risk of developing it increases depending on the increase in the strength of lesions of the skin. A drug-induced contact type of dermatitis is associated with the Arthus phenomenon, which may be a sign of involvement in this process of humoral immunological reactions. In this case, the clinical signs of the disease often differ from the standard eczema of the contact type: rashes mainly with infiltrates, on the skin you can see vesicular or papular hemispherical formations that are grouped in one place or isolated from each other. There are so many of them on the application areas of the disinfectant that they can even merge with each other. Usually such a rash is very slow. After local use, there may also occur systemic allergic manifestations.

Perhaps the emergence of local reactions to corticosteroids - swelling, rashes, hyperemia, urticaria and purpura in the treatment site. In addition, the appearance of burning, dryness, irritation and itching. After prolonged use of the cream, atrophy or telangiectasia often develops, stretch marks, steroid type acne, bleeding, a perioral type of dermatitis resembling rosacea, and hypertrichosis in addition. Continuous use of the cream can cause the emergence of secondary infectious processes in the skin.

Endocrine system: as a result of prolonged application to extensive areas of the body, the development of systemic exposure is possible. Among the violations: depression of the internal synthesis of corticosteroids, hypercorticosis with swelling, stretching atrophic type, development of latent diabetes, and in addition, osteoporosis, as well as stunting in children. But the development of such symptoms is almost impossible for weak corticosteroids, in which the group includes prednisolone acetate.

The medicine contains butylhydroxyanisole (or E 320), which can provoke local skin reactions (for example, contact form of dermatitis) or eye irritation along with mucous membranes.

Dosing and administration

Imacorta should be applied twice a day to inflamed areas, as well as areas adjacent to them. Before the procedure, you need to thoroughly wash and dry the skin.

To eliminate mycosis requires a long course; when Candidiasis, it is no more than 2 weeks, and to eliminate the infectious processes provoked by dermatophytes, a maximum of 6 weeks is required.

After the inflammatory process is stopped, it is required to continue treatment, using a similar disinfecting drug, but without containing corticosteroids in its composition.

Interactions with other drugs

Prednisolone is able to weaken the activity of other steroid antibiotics used topically. Among them, fusidic acid, as well as drugs for chemotherapy, based on ammonium quaternary type.

Local application of clotrimazole can cause antagonistic effects on amphotericin or other antibiotics with a large range of action. 

During the therapeutic course, smallpox vaccination or other immunization procedures can not be performed, since glucocorticoids have immunosuppressive properties.

Storage conditions

Keep the cream is required in a place inaccessible to children, and also in conditions of temperature not more than 25 ° C.

Shelf life

Imacort is suitable for use within 3 years from the date of release of the medicinal product.