Heparidex gel, 50 g

• Swelling, hematomas and inflammation of soft tissues, muscles, tendons, tendon sheaths after bruises, compression, injuries (including sports);

• scapular periarthritis, shoulder epicondylitis ('tennis elbow'), tendinitis, tendovaginitis, bursitis, neuralgia.

The drug is used externally. The gel is applied in a thin layer on clean, dry skin over the affected area and evenly distributed with light rubbing movements, 1-4 times / day.

The duration of treatment depends on the severity of the symptoms and the severity of the disease. Usually the drug is used for 7-10 days or until the symptoms of the disease (pain, swelling, inflammation) disappear.

When using the drug under the bandage, apply the gel and wait a few minutes so that it is absorbed by the skin and the isopropanol evaporates. An occlusive dressing can then be applied. The drug can be used for iontophoresis. The gel is applied under the cathode.

The drug as a contact gel can be used in ultrasound therapy (phonophoresis). The active substances of the gel complement the therapeutic effect of the ultrasonic waves.

sodium heparin on dry matter basis, dexpanthenol, dimethyl sulfoxide

• Severe liver failure;

• severe renal failure;

• bronchial asthma;

• severe violations of the cardiovascular system (including angina pectoris IV FC according to the classification of the Canadian Cardiological Society, myocardial infarction, stroke, severe general atherosclerosis);

• open wounds at the site of application of the drug;

• pregnancy;

• lactation period;

• children under 5 years of age;

• hypersensitivity to heparin, dimethyl sulfoxide, dexpanthenol and other components of the drug.

pharmachologic effect

Combined preparation for external use, the action of which is due to the active substances included in its composition. Heparin is a direct-acting anticoagulant. Due to inactivation of biogenic amines and blocking of lysosomal enzymes in tissues, it has an anti-inflammatory effect; promotes the regeneration of connective tissue by inhibiting the activity of hyaluronidase. It has a dose-dependent antithrombotic effect, enhancing the inhibitory activity of antithrombin III on the activation of prothrombin and thrombin. The penetration of heparin through healthy skin is dose dependent and is confirmed for doses starting at 300 IU / g. Accelerates the dissolution of microthrombi in the area of ??subcutaneous capillaries; improves local blood flow. When applied externally, it also has a decongestant effect.Dexpanthenol has anti-inflammatory and dermatoprotective effects. When applied topically, it is transformed in the skin into pantothenic acid (vitamin B). The effectiveness of dexpanthenol is comparable to that of pantothenic acid. Pantothenic acid, as a component of coenzyme A, is involved in various catabolic and anabolic processes in tissues; by improving the processes of granulation and epithelialization, it promotes the regeneration of damaged skin areas. Dimethyl sulfoxide has anti-inflammatory, anti-edematous and local anesthetic effects, and has a moderate fibrinolytic activity. Anti-inflammatory activity is associated with several pharmacological effects, the most significant of which is the inactivation of hydroxyl radicals,produced in large quantities during the process of inflammation and have a destructive effect on tissues. Dimethyl sulfoxide has a local anesthetic effect by reducing the rate of conduction of nociceptive impulses in peripheral neurons. The anti-edematous effect is provided by the inactivation of hydroxyl radicals and the improvement of the subcutaneous metabolic reaction at the site of application of the drug. To a certain extent, the hygroscopic properties of DMSO are also responsible for its anti-edema effect. Dimethyl sulfoxide (50% or more) penetrates biological membranes, incl. through the skin, contributing to a better and deeper penetration into the tissues of other drugs used simultaneously with it.Dimethyl sulfoxide has a local anesthetic effect by reducing the rate of conduction of nociceptive impulses in peripheral neurons. The anti-edematous effect is provided by the inactivation of hydroxyl radicals and the improvement of the subcutaneous metabolic reaction at the site of application of the drug. To a certain extent, the hygroscopic properties of DMSO are also responsible for its anti-edema effect. Dimethyl sulfoxide (50% or more) penetrates biological membranes, incl. through the skin, contributing to a better and deeper penetration into the tissues of other drugs used simultaneously with it.Dimethyl sulfoxide has a local anesthetic effect by reducing the rate of conduction of nociceptive impulses in peripheral neurons. The anti-edema effect is provided by the inactivation of hydroxyl radicals and the improvement of the subcutaneous metabolic reaction at the site of application of the drug. To a certain extent, the hygroscopic properties of DMSO are also responsible for its anti-edema effect. Dimethyl sulfoxide (50% or more) penetrates biological membranes, incl. through the skin, contributing to a better and deeper penetration into the tissues of other drugs used simultaneously with it.To a certain extent, the hygroscopic properties of DMSO are also responsible for its anti-edema effect. Dimethyl sulfoxide (50% or more) penetrates biological membranes, incl. through the skin, contributing to a better and deeper penetration into the tissues of other drugs used simultaneously with it.To a certain extent, the hygroscopic properties of DMSO are also responsible for its anti-edema effect. Dimethyl sulfoxide (50% or more) penetrates biological membranes, incl. through the skin, contributing to a better and deeper penetration into the tissues of other drugs used simultaneously with it.

Pharmacokinetics

Heparin sodium

When applied externally, it quickly penetrates the skin. One hour after the application of the gel to the skin, the concentration in the underlying tissues is comparable to the concentration observed after intravenous (intravenous) administration of 5000 IU of heparin. Heparin does not cross the placental barrier and is not excreted in breast milk.

Dexpanthenol

After resorption into the skin, it turns into pantothenic acid (vitamin B5), which, being an integral part of coenzyme A, is involved in numerous metabolic processes.

Dimethyl sulfoxide

It enters the systemic circulation, the half-absorption period is 3-4 hours. Dimethyl sulfoxide passes into breast milk. 6 hours after application of the drug, Cmax in blood plasma reaches 120 ng / ml and lasts up to 12 hours after application. After 60 hours after application, the concentration of dimethyl sulfoxide in the blood plasma reaches a physiological level of 40 ng / ml. It is excreted mainly by the kidneys. 12-25% of absorbed dimethyl sulfoxide is excreted within the first 24 hours and 37-48% is excreted within 7 days unchanged or as a metabolite (dimethyl sulfone). 3.5-6% of dimethyl sulfoxide is excreted through the lungs in the form of dimethyl sulfide 6-12 hours after drug administration. When using dimethyl sulfoxide at a dose of 1 g 3 times / day for 5 days, its average content at the site of application to the skin is 3 mg / g,the average content in the underlying muscle tissues and synovial membrane at the site of the synovial junction is 7-10 ?g / ml, in the synovial fluid - 0.8 ?g / g. The concentration of dimethyl sulfoxide in blood plasma is 0.5 ?g / g. T1 / 2 of dimethyl sulfoxide is 11-14 hours.

Side effect

Local reactions: possible skin reactions (redness, itching, burning sensation at the site of application of the gel), which usually disappear during further treatment. Allergic reactions: sometimes - skin manifestations, incl. hives; in isolated cases - Quincke's edema. Others: in rare cases - the smell of garlic from the mouth (caused by dimethyl sulfide, which is a product of the metabolism of dimethyl sulfoxide), a change in taste is possible (disappear a few minutes after applying the gel); when applying the drug to large areas of the body, it is extremely rare - nausea, diarrhea, difficulty breathing, headache, chills.

Application during pregnancy and lactation

The use of the drug is contraindicated in pregnancy due to the lack of clinical trial data. The use of the drug during breastfeeding is contraindicated, because dimethyl sulfoxide is excreted in breast milk.

Application for violations of liver function

The use of the drug is contraindicated in severe hepatic insufficiency.

Application for impaired renal function

The use of the drug is contraindicated in severe renal failure.

Application in children

The use of the drug is contraindicated in children under 5 years of age.

special instructions

Before applying the gel, you should thoroughly cleanse the skin from other medicines, cosmetics or any chemicals. The drug should not be applied to the mucous membranes of the eyes, nasal cavity and mouth, open wounds or damaged skin areas (due to radiation, severe sunburn, postoperative scars). During treatment with the drug, the photosensitivity of the skin may increase, therefore, during the period of application of the gel, intense sunbathing and visits to the solarium should be limited. If allergic skin reactions occur, treatment should be discontinued.

Influence on the ability to drive vehicles and mechanisms

The drug does not affect the ability to drive vehicles and other activities that require increased concentration of attention and speed of psychomotor reactions. Drug interactions

With simultaneous external use, the drug can enhance the penetration of other drugs through the skin. With the simultaneous use of the drug with drugs containing sulindac (NSAIDs), the development of peripheral neuropathy is possible.