Hypersensitivity to the active substances of the preparation or any component of the preparation, rosacea, acne, skin reactions after vaccination, perioral dermatitis, widespread plaque psoriasis, perianal and genital itching, varicose veins, diaper dermatitis, skin manifestations of syphilis, chickenpox, skin tuberculosis, other bacterial and fungal skin infections without appropriate antibacterial and antifungal therapy, herpes zoster, herpes simplex, molluscum contagiosum, dermatomycosis.
When using local corticosteroids, the following undesirable effects are possible: burning, itching, irritation, dry skin, folliculitis, hypertrichosis, acne-like rashes, hypopigmentation, perioral dermatitis, allergic contact dermatitis. the following side reactions more often occur when using occlusive dressings: skin maceration, secondary infection, skin atrophy, striae, prickly heat. striae and vasodilation, mainly on the face, can be the result of prolonged continuous application of the preparation.
Special instructions
The preparation is not used in ophthalmology; contact with the eyes, mucous membranes, wound surfaces and ulceration should be avoided. if irritation or hypersensitivity occurs during the use of the preparation, treatment should be discontinued. in case of infection, appropriate therapy should be prescribed.
When dandruff or keratinization disappears, treatment is continued only with corticosteroids. Any side effects that are detected with the systemic use of corticosteroids, including inhibition of the function of the adrenal cortex, can also be observed with local administration of corticosteroids, especially in children. Systemic absorption of corticosteroids or salicylic acid when applied topically increases when applied to large body surfaces or when using an occlusive dressing. In such cases, as well as with prolonged use of the preparation, caution should be exercised, especially when treating children.
If excessive dryness or irritation of the skin develops, the preparation should be discontinued.
GCS for topical use can contribute to the onset of psoriasis, including the recurrence of symptoms with the subsequent development of tolerance, the risk of developing pustular psoriasis and local systemic toxicity due to a decrease in the protective function of the skin. Patients with impaired liver function are more susceptible to negative systemic effects. Constant monitoring of such patients is required.
GCS for local use can distort the clinical picture of the disease.
A relapse of the disease is possible if treatment is interrupted. It is also possible to exacerbate the infection and slow down the healing process. The preparation should not be applied to mucous membranes or skin around the eyes due to the keratolytic action of salicylic acid. It is contraindicated to apply the preparation to areas with skin atrophy.
Diprosalik in the form of a lotion is not used under occlusive dressings.
Use during pregnancy and lactation. The safety of using topical GCS during pregnancy has not been established, and therefore the use of the preparation is possible when the expected benefit to the mother outweighs the potential threat to the fetus. Preparationin this group are contraindicated for pregnant women in high doses for a long time.
It has not been established whether GCS for topical use due to systemic absorption can penetrate into breast milk, therefore, a decision should be made to stop breastfeeding or to discontinue the use of the preparation.
Children. The preparation is used in children over the age of 2 years. In children, there may be a more frequent occurrence of signs of suppression of the hypothalamic-pituitary-adrenal system when using local GCS than in adult patients, which is associated with a higher absorption of the preparation due to the greater value of the ratio of skin area to body weight. In children, with local application of GCS, suppression of adrenal function, Cushing's syndrome, growth retardation, insufficient increase in body weight, and increased intracranial pressure were noted.
Manifestations of suppression of the adrenal cortex: a decrease in the level of cortisol in the blood plasma and the absence of a reaction to the sample when stimulating the adrenal glands with the use of ACTH preparations. An increase in intracranial pressure is manifested by protrusion of the crown, headache, bilateral edema of the optic nerve head.
The use of the preparation is possible only when the expected benefit outweighs the potential risk of adverse reactions.
The preparation does not affect the reaction rate when driving or operating other mechanisms.
Interactions
Not described.
Overdose
With prolonged or excessive use of topical corticosteroids, it is possible to suppress the function of the pituitary-adrenal system with the development of secondary adrenal insufficiency and symptoms of hypercortisolism, including Cushing's syndrome. prolonged or excessive use of topical salicylic acid preparations can cause the development of symptoms of salicylism.
Treatment. Appropriate symptomatic therapy is prescribed. Symptoms of acute hypercortisolism are usually reversible. If necessary, the water-electrolyte balance is corrected. In the case of chronic toxic effects, gradual withdrawal of the preparation is recommended.
Treatment of salicylism is symptomatic. The measures are aimed at faster elimination of salicylates from the body. Sodium bicarbonate is used orally to alkalize urine and increase urine output. In case of excessive growth of resistant microorganisms, it is recommended to suspend preparation treatment and prescribe the necessary therapy.
Storage conditions
At a temperature not higher than 25 ° C.