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Complex drug, the action of which is due to its constituent components.
Benzocaine is a local anesthetic that reduces pain when swallowing, which often accompanies infectious and inflammatory processes in the mouth and throat.
Benzalkonium chloride is a Quaternary ammonium compound, refers to cationic surfactants, interacts with lipoproteins and violates the permeability of cell membranes. It has antiseptic properties, is active against gram-positive bacteria, has a fungicidal effect on Candida albicans and some lipophilic viruses.
Tyrothricin - a local antibiotic, is a mixture of antimicrobial linear and cyclic polypeptides isolated at the fermentation stage of Brevibacillus brevis Dudos, consisting mainly of gramicidin and thyrocidin. Tyrothricin acts bactericidal, causing rupture of phosphorylation processes in the chain of cellular respiration and destroying the membranes of bacterial cells. Due to the specific mechanism of action of thyrothricin, which is absent from systemic antibiotics, cross-resistance to the drug does not occur.
Benzocaine is poorly soluble in water, which causes its slow absorption. Like all ether derivatives of para-aminobenzoic acid, esterase cleaves in the blood plasma and liver. As a result, para-aminobenzoic acid and ethyl alcohol are metabolized to acetyl coenzyme A.
Para-aminobenzoic acid is conjugated with glycine or excreted by the kidneys unchanged.
Benzalkonium chloride is practically not absorbed, has no resorptive action and is excreted by the kidneys. Not detected accumulation of substances in the tissues of the body.
Tyrothricin - due to low systemic absorption data on pharmacokinetics are not available. Does not affect the intestinal microflora.
Infectious and inflammatory diseases of the oral cavity and pharynx, accompanied by pain:
- pharyngitis, laryngitis, initial stage of tonsillitis;
- inflammation of the gums and oral mucosa (gingivitis, stomatitis).
1 tablet contains:
Active substances: benzalkonium chloride 1 mg; benzocaine 1.5 mg; thyrothricin 0.5 mg;
Excipients: sorbitol 871 mg, talc 80 mg, povidone (polyvidone K25) 10 mg, carmellose sodium 10 mg, sucrose stearate 20 mg, peppermint oil 5 mg, sodium saccharinate 1 mg.
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Dosage and Administration
The drug is taken orally, regardless of the meal. The recommended dose of the drug is 100 mg, taken 30 minutes before the intended sexual activity.
The dose can be increased to 200 mg, taking into account the individual efficacy and tolerability of the drug.
The maximum recommended frequency of use is once a day.
Side effects observed during clinical trials of udenafil, depending on the frequency of their occurrence: very often - ≥10% of cases; often 1–10%; sometimes 0.1–1%.
Since the cardiovascular system: very often - hot flashes to the face.
From the side of the central nervous system: sometimes dizziness, stiff neck muscles, paresthesia.
From the organs of vision: often - redness of the eyes; sometimes - blurred vision, pain in the eyes, increased tearing.
From the skin: sometimes - swelling of the eyelids, swelling of the face, hives.
From the digestive system: often - dyspepsia, abdominal discomfort; sometimes nausea, toothache, constipation, gastritis.
On the part of the respiratory system: often - nasal congestion; sometimes - shortness of breath, dry nose.
From the musculoskeletal system: sometimes - periarthritis.
The body as a whole: often - headache, chest discomfort, heat sensation; sometimes - chest pain, abdominal pain, fatigue, thirst.
In the process of post-marketing observations when using udenafil, other adverse events were also described: heart palpitations, nose bleeding, tinnitus, diarrhea, allergic reactions (skin rash, erythema), prolonged erection, feeling of general discomfort, feeling cold or fever, postural dizziness, cough.
Caution should be taken with udenafil in patients with uncontrolled hypertension (blood pressure> 170/100 mmHg), hypotension (blood pressure) Consider the potential risk of complications during sexual activity in patients with cardiovascular diseases such as unstable angina or angina occurring during intercourse; chronic heart failure (NYHA Class II-IV functional class (New York Heart Association, New York Heart Association), azvivshayasya during the last 6 months. uncontrolled heart rhythm disorders Caution should be used udenafil in patients with predisposition to priapism, as well as in patients with anatomical deformation of the penis, in the presence of the implant of the penis.
Cytochrome P450 CYP3A4 isoenzyme inhibitors (ketoconazole, itraconazole, ritonavir, indinavir, cimetidine, erythromycin, grapefruit juice) can enhance the effect of udenafil.
Ketoconazole (at a dose of 400 mg) increases bioavailability and Cmax udenafil (at a dose of 100 mg) is almost twice (212%) and 0.8 times (85%), respectively. Ritonavir and indinavir significantly enhance the effect of udenafil. Dexamethasone, rifampin and anticonvulsant drugs (carbamazepine, phenytoin and phenobarbital) can speed up the metabolism of udenafil, so co-administration with the above drugs weakens the effect of udenafil.
Combined administration of udenafil (30 mg / kg, oral) and nitroglycerin (2.5 mg / kg once intravenously) did not show any effect on the pharmacokinetics of udenafil in experimental studies, however, the simultaneous use of nitroglycerin and udenafil is not recommended due to the possible reduction of arterial pressure.
Udenafil and drugs from the group of alpha-blockers are vasodilators, therefore, when administered jointly, should be administered in minimal doses.
Sexual activity has a potential risk for patients with cardiovascular diseases, therefore, treatment of erectile dysfunction, including the use of udenafil, should not be carried out in men with heart disease, in which sexual activity is not recommended.
Patients with impaired outflow of blood from the left ventricle (aortic stenosis) may be more sensitive to the action of vasodilators, including PDE inhibitors.Despite the absence in clinical studies of cases of prolonged erection (more than 4 hours) and priapism (painful erection lasting more than 6 hours), such phenomena are characteristic of this class of drugs. In the case of an erection lasting more than 4 hours (regardless of the presence of pain), patients should immediately seek medical help. In the absence of timely treatment, priapism can lead to irreversible damage to erectile tissue and erectile function.
Due to the lack of clinical data on the use of udenafil in patients older than 71 years of age in this category of patients, this drug is not recommended. It is not recommended to use udenafil in combination with other types of treatment for erectile dysfunction.
With a single dose of 400 mg, the adverse events were comparable to those observed with lower doses of udenafil, but were more common.
Treatment: symptomatic. Dialysis does not accelerate the removal of udenafil.
- Brand name: Dorithricin
- Active ingredient: Tyrothricin, Benzalkoniya chloride, Benzocaine
- Dosage form: Lozenges
- Manufacturer: Mediche
- Country of Origin: Germany