Omnadren cycle – glucocorticosteroid agent. Anti-inflammatory effect. Omnadren cycle inhibits the release of cytokines (interleukins and interferon) from lymphocytes and macrophages, eosinophils inhibits the release of inflammatory mediators, reduces the intensity of arachidonic acid metabolism and prostaglandin synthesis. Activates steroid receptors induces lipokortinov having antiedematous activity. It reduces inflammatory cell infiltration, prevents the migration of leukocytes and lymphocytes to sites of inflammation. In high doses, it inhibits the development of lymphoid and connective tissue. By reducing the number of mast cells, reduces the formation of hyaluronic acid; It inhibits hyaluronidase, thereby reducing capillary permeability. It is intended for intramuscular, intra- and periarticular administration to provide systemic or topical anti-inflammatory activity. With intraarticular injection therapeutic effect occurs within 6-24 hours and last for several days or weeks. Lidocaine – a local anesthetic membrane-stabilizing effect in the short term has analgesic effect. Pharmacokinetics: In intra-articular and periarticular administration of omnadren cycle penetrates into the systemic circulation.Communication with the proteins – more than 90%. It is metabolized in the liver and tetragidrokortizon tetrahydrocortisol that the kidneys in a conjugated form.Penetrates through the placental barrier. Lidocaine is well absorbed, it has a high affinity to plasma proteins. It is metabolized primarily in the liver. The half -. 1-2 hours lidocaine passes into breast milk, placental and blood-brain barriers.
Rheumatic diseases accompanied by arthritis, including osteoarthritis in the presence of synovitis (except for tubercular, gonorrheal, septic arthritis and other infection); rheumatoid arthritis, frozen shoulder, bursitis, epicondylitis, tenosynovitis.
Hypersensitivity to any component of the drug; the infected joint; Cushing’s syndrome; the tendency to thrombosis; I trimester of pregnancy; systemic infection without specific treatment; diseases of the Achilles tendon.
Intra-articular administration is contraindicated when moved arthroplasty, abnormal bleeding (endogenous or caused by anticoagulants), intra-articular fracture of the bone, infectious (septic) arthritis and periarticular infections (including history), general infectious disease marked periarticular osteoporosis, osteoarthritis without synovitis (the so-called “dry” joints), joint laxity, aseptic necrosis of the formative joint epiphyses of bones, severe bone destruction and deformation of the joint (a significant narrowing of the joint space, ankylosis).
Precautions: gastric ulcer and duodenal ulcer; herpes simplex, including the eye (the possibility of perforation of the cornea); arterial hypertension; diabetes, including family history; osteoporosis (postmenopausal osteoporosis risk increases); chronic psychotic reactions; tuberculosis in history; glaucoma; steroid myopathy; epilepsy; measles; chronic heart failure; advanced age (over 65 years), pregnancy (II-III trimester), lactation.
Pregnancy and lactation
Pregnant women in the first trimester of the appointment of omnadren cycle-Richter is contraindicated due to the lack of adequate data on the safety of the drug in this group. In the second and third trimesters of pregnancy and lactating women receiving omnadren cycle-Richter is possible when the expected benefit to the mother outweighs the potential risk to the fetus or child.
The use of omnadren cycle-Richter during lactation may lead to a breach of adrenal function and lag in infant development, that is. to. omnadren cycle and lidocaine get into breast milk.
DOSAGE AND ADMINISTRATION
Intra- and periarticular. One day Richter omnadren cycle may be administered no more than 3 of the joint. Repeated injection is subject to the 3-week interval. Introduction omnadren cycle Richter directly into the joint may have an adverse effect on the hyaline cartilage, so the same joint can be treated with no more than 3 times a year.
If tendinitis injection should be done in the vagina tendon – directly into the tendon can not be entered. Adults: depending on joint size and severity of the disease, 5-50 mg intra- and periarticular. Children: 5-30 mg / day, divided into several doses. A single dose of periarticular administration to children aged from 3 months. up to 1 year: 25 mg; from 1 to 6 years: 25-50 mg; from 6 to 14 years: 50-75 mg.
Side effect From endocrine system: reduction of glucose tolerance and increase the need for hypoglycemic agents; manifestation of latent diabetes mellitus; steroid diabetes. With long-term treatment – inhibition of adrenal function; Cushing’s syndrome; growth retardation in children and adolescents. On the part of the gastrointestinal tract: nausea; vomiting; pancreatitis; peptic ulcer; esophagitis; bleeding and perforation of the gastrointestinal tract; increased appetite; flatulence; hiccups; . in rare cases – increase in liver transaminases and alkaline phosphatase, Cardio-vascular system: lidocaine may cause a violation of the conductivity (in doses exceeding therapeutic), peripheral vasodilation; at higher doses of omnadren cycle: high blood pressure; hypokalemia and peculiar to her ECG changes;thromboembolism; heart failure. From the nervous system: insomnia, irritability, restlessness, agitation, euphoria, epileptiform convulsions; mental disorders; delirium; disorientation; hallucinations; worsening of manic-depressive psychosis in patients receiving the drug; depression; paranoia; increased intracranial pressure with swelling of the optic nerve papilla, dizziness; pseudotumor cerebellum; headache. On the part of metabolism: increased body weight, negative nitrogen balance, increased sweating. On the part of the organ of vision: corneal ulceration; posterior capsular cataract (more likely in children);increased intraocular pressure with possible damage to the optic nerve; secondary bacterial, fungal, viral infections of the eye; trophic changes of the cornea; exophthalmos, glaucoma. From the musculoskeletal system: slowing growth and ossification processes in children (premature closure of epiphyseal growth zones); osteoporosis; very rare – pathological fractures; aseptic necrosis of the humeral head and femur; muscle tendon rupture; steroid myopathy; decrease in muscle mass; . arthralgia Effects due to mineralocorticoid activity of the drug: fluid retention and sodium with the formation of peripheral edema; hypernatremia; hypokalemia, arrhythmia, myalgia, muscle spasm, increased weakness, fatigue. Immune system: opportunistic infections, exacerbation of latent tuberculosis, hypersensitivity reactions; Local and generalized: skin rash, itching; anaphylactic shock; delayed wound healing; the tendency to the development of pyoderma and candidiasis, aggravation of infection, especially if vaccination and simultaneous treatment with immunosuppressive agents. On the part of the skin and mucous membranes: petechiae; ecchymosis; hyper- or hypopigmentation; steroid acne;striae; folliculitis, hirsutism, telangiectasia. Local reactions: swelling of the tissues, and pain at the injection site, which spontaneously disappear after a few hours, increased pain in the joint at the introduction of the drug into the joint, burning, numbness, paraesthesia at the injection site, atrophy of the skin and subcutaneous tissue at the site of injection (in case of accidental introduction into the deltoid muscle), rarely – necrosis of surrounding tissue, scarring at the injection site. Miscellaneous: malaise, a syndrome of “cancellation” (high fever, myalgia, arthralgia, adrenal insufficiency); leucocyturia, leukocytosis. In elderly patients, the risk of adverse reactions higher. With long-term treatment and high doses of omnadren cycle and lidocaine may develop systemic side effects. anti estrogens & fat loss