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Erythema of the face for rosacea treatment - alpha2-adrenomimetik selective. Brimonidine is a highly selective alpha2-adrenergic receptor agonist: its affinity for alpha2-adrenergic receptors is 1000 times greater than the affinity for alpha1-adrenergic receptors. Applying a highly selective alpha 2 adrenergic receptor agonist to the skin leads to a decrease in erythema due to direct vasoconstriction of the skin vessels.
For external use only. A small amount of the gel is applied in a thin layer on the skin of each of the 5 face zones (forehead, chin, nose, cheeks) 1 time per day in the presence of erythema. The maximum recommended daily dose of the drug, divided into 5 parts in accordance with the areas of application, is 1 g. When applied to the skin, Mirvazo® Derm Gel should be spread evenly in a thin layer over the face, avoiding contact with the eyes, eyelids, lips, mouth and nasal mucosa. The gel should be applied only to the face.
Treatment of face erythema with rosacea.
1 g of gel contains: Active substance: Brimonidine tartrate - 5.0 mg. Excipients: carbomer - 12.5 mg, methyl parahydroxybenzoate - 1.0 mg, phenoxyethanol - 4.0 mg, glycerol - 55.0 mg, titanium dioxide - 0.625 mg, propylene glycol - 55.0 mg, sodium hydroxide - to pH 6 , 0, purified water - up to 1000 mg.
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Dosage and Administration
Inside Once a day, preferably at the same time of day. The doctor determines the dose, mode and duration of use of Warfarex for each patient individually, guided by the severity of the disease and the results of blood coagulation control (INR). Without the permission of the physician, it is impossible to arbitrarily change the dose or stop the treatment with Warfarex. The initial dose is 2.5–5 mg per day for the first 2 days, then it is gradually adjusted according to the patient’s individual blood coagulation reaction (INR). After reaching the desired level of INR (2.0–3.0, and in some cases 3.0–4.5), a maintenance dose is prescribed. Older, debilitated, or at-risk patients are prescribed lower initial doses and use caution when raising them. Children Varfereks usually not prescribed. At the beginning of treatment, laboratory monitoring of the INR is carried out every day, for the next 3-4 weeks monitoring is carried out 1–2 times a week, and later every 1–4 weeks. More frequent additional control is necessary in cases when the patient’s state of health changes, before a planned surgery or other procedure, and also when any other medication is prescribed or canceled.
The most frequent side effects observed during treatment with anticoagulants are bleeding and hemorrhages in various organs and tissues. The possible risk of these side effects can be significantly reduced by strictly following the doctor's recommendations regarding the use of Warfarex. In some cases, treatment with anticoagulants can cause impaired blood circulation in the limbs or internal organs. Disturbance of blood circulation is most often indicated by pain and the dark red color of the skin of the toes. If these symptoms appear, you should immediately consult a doctor. Other rare side effects are skin allergies (pruritus, urticaria, dermatitis), nausea, vomiting, diarrhea, abdominal pain, abnormal liver activity (increased liver enzymes in the blood, jaundice), fever, general weakness, changes in the blood picture, transient baldness.
- hypersensitivity to the components of Warfarex;
- bleeding (or the threat of its development) in some serious diseases;
- bacterial endocarditis;
- severe deficiency and severe liver or kidney disease;
- obstructive jaundice;
- acute DIC;
- deficiency of proteins C and S;
- hemorrhagic diathesis;
- peptic ulcer and duodenal ulcer in the acute stage;
- cerebral hemorrhage;
- severe arterial hypertension;
- recent or suspected complex surgery and diagnostic procedures;
- lack of assessment of the state of the blood coagulation system using laboratory methods;
High levels of vitamin K in foods (spinach, broccoli, lettuce, and other leafy vegetables) can reduce the effect of Warfrex. However, one should not change the diet too abruptly, use vitamins and nutritional supplements without consulting a doctor. Smoking can reduce the anticoagulant effect of the drug. The effect of Warfarex can change under the influence of a large number of drugs. NSAIDs, dipyridamole, valproic acid, cytochrome P450 inhibitors, cimetidine, chloramphenicol, laxatives - increase the risk of bleeding. The combined use of these drugs and Varferex should be avoided (cimetidine can be replaced by ranitidine or famotidine). If treatment with chloramphenicol is necessary, anticoagulant therapy may be temporarily stopped. Diuretics can reduce the effect of anticoagulants (in the case of pronounced hypovolemic action, which can lead to an increase in the concentration of coagulation factors).Weaken the effect: barbiturates, vitamin K, gluthethimide, griseofulvin, dicloxacillin, carbamazepine, mianserin, paracetamol, retinoids, rifampicin, sucralfate, phenazone, cholestyramine. Enhance the action: allopurinol, amiodarone, anabolic steroids (alkylated at the C-17 position), acetylstechracidic acid and other NSAIDs, heparin, glibenclamide, glucagon, danazol, diazoxide, disopyramide, disulfiram, isoniazid, ketoconazole, clarithmicine, clarithimethyne, and disithiramide, disulfiram, isoniazid, ketoconazole, clarithmicine, and clarithimethyne, and disithiramide, disulfiram, isoniazid, ketoconazole, clarithmicine, and clarithimethyne, and disithiramide, disulfiram, isoniazid, ketoconazole, clarithmicine, and glycine chyne, and disithiramide, disulfiram, isoniazid, ketoconazole, clarithycidine, and glycine chyne, as well as glyphenyl acetate; miconazole, nalidixic acid, nilutamide, omeprazole, paroxetine, proguanil, oral hypoglycemic agents - sulfonamide derivatives, sulfonamides, tamoxifen, thyroxin, quinine, quinidine, fluvoxamine, fluconazole, fluorouracil, quinolone , Chloral hydrate, chloramphenicol, cephalosporins, cimetidine, erythromycin, ethacrynic acid, ethanol. When using Warfarex in combination with the above drugs, it is necessary to monitor the INR at the beginning and end of treatment and, if possible, 2-3 weeks from the start of therapy. When using drugs that can increase the risk of bleeding due to a decrease in normal coagulation (inhibition of blood coagulation factors or liver enzymes), the strategy of anticoagulant therapy should be determined by the possibility of carrying out laboratory monitoring. If frequent laboratory control is possible, then, if therapy with such means is necessary, the dose of Warfarex can be reduced by 5-10%. If carrying out laboratory control is difficult, then treatment with Varferex should be stopped if necessary, the appointment of these drugs.
Pregnancy and Lactation
Warfarex should not be prescribed to pregnant women in connection with the identified teratogenic effects, the development of bleeding in the fetus and his death. The drug is excreted with maternal milk in small quantities and has almost no effect on blood coagulation in a child, so this medicine can be used during lactation, but it is desirable to refrain from breastfeeding in the first 3 days of warfarin therapy.
The use of anticoagulants increases the risk of bleeding. In order to monitor the state of the blood coagulation system, during the period of treatment with Varferex, you should regularly visit the doctor and carry out prescribed tests. When referring to doctors, dentists or pharmacists, you must inform them that you are taking Warfarex. You should consult your doctor if digestive disorders occur, accompanied by diarrhea (diarrhea), fever. Pregnancy during the treatment with Warfarex is highly undesirable, therefore it is necessary to use effective methods of its prevention. It is necessary to be careful when handling sharp and traumatic objects, to avoid activities associated with the risk of injury and subsequent bleeding. During the period of treatment it is necessary to refrain from the use of ethanol (the risk of hypoprothrombinemia). The safety of the drug in children in clinical studies has not been studied enough. There is no data on the adverse effects of Warfarexan on the ability to drive vehicles and maintain other mechanisms. Patients with lactose intolerance should be borne in mind that 1 tab. Warfarex contains 106–112 mg of lactose.
Symptoms of chronic intoxication: bleeding from the gums, nasal bleeding, excessive menstrual bleeding, severe or prolonged bleeding with minor superficial lesions, hemorrhages in the skin, the presence of blood in urine and feces, etc.
Treatment: with minor bleeding, it is necessary to reduce the dose of the drug or stop treatment for a short period. In the case of the development of severe bleeding, transfusion of concentrates of factors of the prothrombin complex, or fresh frozen plasma, or whole blood.
- Brand name: Brintellix®
- Active ingredient: Vortioxetine
- Manufacturer: Lundbeck AS
- Country of Origin: Denmark
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