Triderm cream 15g — Made in Belgium — Free Delivery
Treatment of glucocorticoid-sensitive dermatoses in the presence (or suspicion) of bacterial and / or fungal infections caused by microorganisms sensitive to the components of the preparation.
For adults, triderm is applied in a thin layer to the entire affected surface and adjacent areas of the skin 2 times a day, morning and evening, and gently rubbed. the duration of treatment depends on the clinical response of the patient to treatment, as well as clinical and microbiological parameters. in cases of athlete's foot, a longer course of treatment (2-4 weeks) may be required.
The preparation is contraindicated in patients with hypersensitivity to active substances or to any other component of the preparation, other aminoglycoside antibiotics (cross-allergic reactions to gentamicin) or imidazole derivatives (cross-allergic reactions to clotrimazole). as well as skin tuberculosis, skin manifestations of syphilis, skin reactions after vaccination, skin ulcers, acne, widespread plaque psoriasis, viral skin infections (for example, herpes simplex, herpes zoster), varicose veins, perioral dermatitis, rosacea, chicken pox, others bacterial and fungal infections of the skin without proper antibacterial and antifungal therapy.
Triderm is not indicated for use under occlusive dressings.
Triderm should not be applied to mucous membranes, eyes or the area near the eyes.
Do not use the cream to treat nails or scalp infections.
Start of treatment. skin: rarely - skin irritation, burning, itching, dry skin, hypersensitivity reactions to one of the components of the preparation and skin discoloration.
Application on large areas of the skin, under occlusive dressings and / or for a long time: when used on large areas of the skin, under occlusive dressings and / or for a long time, local changes on the skin may occur. When applied to large areas of the skin, systemic reactions may occur (adrenal depression, syncope, arterial hypotension, shortness of breath, discomfort / pain, malaise).
It should be remembered that there is an increased risk of developing secondary infections due to a decrease in local resistance to infections.
Skin: local skin changes, such as atrophy of the skin (particularly of the face), telangiectasias, exudation, blistering, edema, urticaria, skin maceration, miliaria, pigmentation disorders (hypopigmentation), hypochromia, striae, patchy, lamellar peeling of the skin, skin tingling, skin induration, skin fissures, sensation of warmth, follicular rash, erythema, stretch marks, subcutaneous hemorrhage, purpura, steroid acne, rosacea-like/perioral dermatitis, hypertrichosis, and skin discoloration. It is not known whether these skin color changes are reversible; infrequently - contact sensitization to gentamicin.
Possible photosensitivity has been observed in some patients; however, this effect is not reproduced with repeated use of gentamicin followed by exposure to ultraviolet irradiation.
Endocrine system: suppression of the synthesis of endogenous corticosteroids, excessive activity of the adrenal glands with edema.
Metabolism: the appearance of latent diabetes mellitus.
Organs of vision: blurred vision.
Ear, inner ear/kidneys: With the simultaneous administration of systemic aminoglycoside antibiotics, cumulative ototoxicity/nephrotoxicity may occur when applied to large areas of the body or to areas of affected skin.
Musculoskeletal system: osteoporosis, growth retardation (in children).
Cetostearyl alcohol, which is part of the cream, can lead to local limited skin reactions (eg contact dermatitis).
Triderm ointment is particularly suitable for use on dry or rough skin.
Cream Triderm is particularly suitable for use in the treatment of disorders in the exudative stage.
Triderm is not intended for use in ophthalmology.
With the development of skin irritation or manifestations of hypersensitivity during treatment with Triderm, the use of the preparation should be discontinued and appropriate therapy should be selected for the patient.
When applied topically, systemic absorption of active ingredients may be higher when the preparation is used on large areas of the skin, with prolonged use or when applied to damaged areas of the skin. In this case, there may be side effects that are observed after the systemic use of active substances.
With simultaneous systemic administration of aminoglycoside antibiotics, in case of increased absorption, the likelihood of a cumulative toxic effect (oto-/nephrotoxicity) should be taken into account.
In particular, cross-allergic reactions with other aminoglycoside antibiotics should be borne in mind.
Prolonged topical use of antibiotics can sometimes lead to the growth of resistant microflora. In this case, as well as with the development of superinfection, appropriate treatment should be prescribed.
Use the preparation in high doses, on large surfaces of the body or under occlusive dressings, or use strong or very strong corticosteroids should only be under regular medical supervision; especially with regard to the inhibition of the hypothalamic-pituitary-adrenal system and the possible metabolic effect. If depression develops, the preparation should be discontinued, the frequency of application reduced, or the patient switched to a corticosteroid preparation with a weaker effect. The function of the hypothalamic-pituitary-adrenal system, as a rule, is restored when the preparation is discontinued. In some cases, withdrawal symptoms may develop, requiring the addition of a systemic corticosteroid.
Avoid applying the preparation to open wounds or damaged skin.
Continuous treatment for more than 2-3 weeks is not recommended.
Very strong, strong and intermediate corticosteroids should be used with caution when applied to the skin of the face and genitals. In such cases, the course of treatment should not exceed 1 week.
In general, only low-dose corticosteroids can be used around the eyes (risk of glaucoma).
Corticosteroids may mask the symptoms of an allergic reaction to one of the components of the preparation. The patient should be instructed to use the preparation only personally for the treatment of an existing skin disease and not to transfer to other persons.
When using corticosteroids of systemic and local action (including intranasal, inhalation and intraocular routes of administration), visual impairment is possible. If symptoms such as blurred vision or other visual disturbances occur, the patient should be evaluated by an ophthalmologist to evaluate possible causes of visual impairment, which may include cataracts, glaucoma, or rare diseases such as central serous chorioretinopathy, which have been reported after the use of systemic corticosteroids and local action.
Pediatric patients may be more sensitive to topical corticosteroid-induced hypothalamic-pituitary-adrenal depression and Itsenko-Cushing's syndrome than adult patients, due to the greater skin area to body weight ratio.
In children treated with topical corticosteroids, depression of the hypothalamic-pituitary-adrenal system, Cushing's syndrome, growth retardation, insufficient weight gain, and increased intracranial pressure were noted.
Manifestations of suppression of the function of the adrenal cortex: a low level of cortisol in the blood plasma and a lack of response to the test for stimulation of the adrenal glands using ACTH preparations. An increase in intracranial pressure is manifested by a protrusion of the fontanel, headache, and bilateral papilledema.
Use during pregnancy and lactation. Pregnancy. In experimental studies involving animals, the teratogenic effect of topical corticosteroids has been established. There are no data on its use during pregnancy in humans.
Aminoglycosides cross the placental barrier and may cause harm to the fetus when used in pregnant women. There have been reports of cases of complete irreversible bilateral congenital deafness in children whose mothers received aminoglycosides (including gentamicin) during pregnancy. There are insufficient data on the topical use of gentamicin in pregnant women. There are insufficient data on the use of clotrimazole in pregnant women.
Animal studies have not shown a risk of preparation effects on the fetus.
Triderm should be used only in cases of emergency.
Triderm should not be used in high doses, on large areas of the skin and for a long time.
Lactation. It is not known whether gentamicin, clotrimazole and corticosteroids, when applied topically, can pass into breast milk. However, systemic corticosteroids are detected in breast milk.
Triderm should not be applied to the mammary glands during breastfeeding.
Children. It is not recommended to prescribe to children, since there is no experience of using the preparation in patients of this age category.
The ability to influence the reaction rate when driving vehicles or working with other mechanisms. The effect on the ability to drive vehicles or work with other automated systems has not been studied.
When using the preparation on the skin of the genital organs and the anus, the presence of soft paraffin or liquid paraffin (auxiliary substances in the composition of the preparation) can reduce the tensile strength of latex condoms, which reduces their reliability when used. Clotrimazole, when applied topically, may be an antagonist of amphotericin B and other polyene antibiotics.
Symptoms. with prolonged or excessive use of local corticosteroids, it is possible to suppress the pituitary-adrenal system with the development of secondary adrenal insufficiency and the appearance of symptoms of hypercortisolism, including Cushing's disease. it cannot be ruled out that a single overdose of gentamicin leads to overdose symptoms. excessive or prolonged use of gentamicin can lead to overgrowth of antibiotic-insensitive microorganisms at the site of skin lesions.
Treatment. Assign appropriate symptomatic therapy. The symptoms of acute hypercortisolism are usually reversible. If necessary, carry out a correction of the electrolyte balance. In case of chronic toxic effects, gradual withdrawal of corticosteroids is recommended. In case of excessive growth of resistant microorganisms, it is recommended to stop treatment with Triderm and prescribe the necessary antifungal and antibacterial therapy.
Keep out of the reach of children at a temperature not exceeding 25 ° C.
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