Lamisil
Lamisil
LamisilPharmacological properties
Antimicotic preparation for intake.
Lamisil possesses a wide spectrum of action concerning the mushrooms causing diseases of a skin, hair and fingernails, including dermatophytes, such as Trichophyton (for example, T. rubrum, T. mentagrophytes, T. verrucosum, T. tonsurans, T. violaceum), Microsporum (for example, M. canis), Epidermophyton floccosum, and also yeast mushrooms of sort Candida (for example, C. albicans) and Pityrosporum.
Lamisil specifically suppresses an early stage of biosynthesis of sterols in a mushroom cell. Lamisil does not render influence on a metabolism of hormones or other medicinal preparations.
At Lamisil appointment inside in a skin, hair and fingernails concentration are framed.
Pharmacokinetics
After unitary Lamisil reception inside in a dose of 250 mg its maximum concentration in plasma is reached in 2 hours and makes 0.97 mkg/ml. The semiabsorption period makes 0.8 hours, and the semidistribution period - 4.6 hours. Though Lamisil bioavailability moderately changes under the influence of nutrition, but not in such degree that correction of a dose of a preparation was required.
Lamisil substantially contacts fibers of a blood plasma (99 %). It quickly gets through a layer of a skin and concentrates in a lipophilic cornual layer. Lamisil also gets into a secret of sebaceous glands that leads to creation of high concentration in hair follicles, hair and in a skin rich with sebaceous glands.
Lamisil is metabolized quickly and in essential degree at participation at least seven isoenzymes of cytochrome Р 450, thus the basic role is played by isoenzymes CYP2C9, CYP1A2, CYP3A4, CYP2C8 and CYP2C19. As a result of a Lamisil biotransformation the metabolites not possessing antimicotic activity and deduced mainly with urine are formed. The final period of semideducing makes 17 hours. Any proofs of a cumulation of a preparation in an organism is not available. It is not taped changes of equilibrium Lamisil concentration in plasma depending on age, but at patients with disturbance of function of kidneys or a liver rate of deducing of a preparation that leads to higher concentration in blood can be slowed down.
Indications to application
Onychomycosis (fungoid infection of fingernails), caused by mushrooms dermatophytes.
Mycoses of a pilar part of a head.
Fungoid infections of a skin - treatment of dermatomycoses of a trunk, anticnemions, feet, and also yeast infections of the skin, caused comes Candida (for example, Candida albicans) - when localisation, expression or prevalence of an infection cause expediency of peroral therapy.
Contraindications
Hypersensibility to Lamisil or to any other ingredient of a preparation.
Safety measures
Patients with accompanying stable chronic disturbance of function of a liver should prescribe half of usual recommended dose of a preparation. Before the treatment beginning it is necessary to estimate initial indicators of function of a liver and to provide their regular control in the course of treatment. If at the patient the phenomena, allowing to assume presence of disturbance of function of a liver become perceptible, such as an inexplicable proof nausea, absence of appetite, weariness, an icterus, dark urine or the decolorized feces, in this case it is necessary to confirm a hepatic parentage of these symptoms and to cancel Lamisil treatment.
Patients with disturbance of function of kidneys (a clearance of a creatinine less than 50 ml/mines or level of a creatinine of blood serum more than 300 mkmol/l) should receive half of usual dose of a preparation.
Influence on ability to drive the car and to work with mechanisms
Data about Lamisil influence on ability to drive the car and to work with mechanisms are absent.
Application during the pregnancy and lactemia periods
As clinical experience of Lamisil application at pregnant women is very limited, a preparation during pregnancy to apply does not follow, if only the potential medical effect does not exceed possible risk of therapy.
Way of application and dose
Duration of treatment depends on the indication and gravity of a current of disease.
Children. Data about application of a preparation for children is more younger 2th years (which mass of a body usually less than 12 kg) are not available.
Preparation prescribe once a day. The single dose depends on mass of a body and makes: for children with mass of a body less than 20 kg - 62.5 mg (half of tablet on 125 mg); from 20 to 40 kg - 125 mg (one tablet on 125 mg); more than 40 kg - 250 mg (two tablets on 125 mg).
Adults. 250 mg once a day.
Infections of integuments
Recommended duration of treatment:
Dermatomycosis of feet (interdigital, plantar or as socks): 2-6 weeks.
Dermatomycosis of a trunk, anticnemions: 2-4 weeks.
Skin candidiasis: 2-4 weeks.
Infections of hair and a pilar part of a head
Recommended duration of treatment:
Mycosis of a pilar part of a head: 4 weeks
Mycoses of a pilar part of a head are observed mainly at children.
Onychomycosis
Duration of effective treatment makes at the majority of patients from 6 till 12 weeks. At an onychomycosis of brushes in most cases there are enough 6 weeks of treatment. At an onychomycosis of feet in most cases there are enough 12 weeks of treatment. Some patient who have the lowered growth rate of fingernails, longer treatment can be demanded.
Side-effects
Lamisil as a whole it is transferred well. Side effects usually weakly or are moderately expressed and have transient character. Symptoms from a gastroenteric tract (feeling of overflow of a stomach, appetite loss, a dyspepsia, a nausea weakly expressed to an abdominal pain, a diarrhoeia), not serious dermal reactions (an eruption, an urticaria), musculoskeletal reactions (an arthralgia) most often become perceptible.
Sometimes: disturbances of gustatory sensations, including their loss (restoration occurs within several weeks after the treatment termination).
Very seldom: there are reports on serious dermal reactions (including about Stevens-Johnson's syndrome, a toxic epidermal necrolysis) and anaphylactoid reactions. If the progressing dermal eruption develops, Lamisil treatment should be stopped.
Very seldom: there are reports on hematological disturbances, such as a neutropenia, an agranulocytosis or a thrombocytopenia.
Very seldom: there are reports on abaissement of hair though the causal relationship with preparation reception is not established.
Overdosage
There are reports on several cases of an overdosage (the accepted dose of a preparation has made to 5) at which became perceptible a headache, a nausea, a pain in epigastric area and giddiness.
Treatment recommended in case of an overdosage includes actions for preparation deducing, first of all by appointment of the activated coal, and, at necessity, use of a symptomatic maintenance therapy.
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