Longidaza
Longidaza: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Longidaza
ATX code: V03AX
Active ingredient: bovgialuronidase azoximer (Bovhyaluronidasum azoximerum)
Manufacturer: NPO Petrovax Pharm LLC (Russia)
Description and photo update: 2019-10-09
Prices in pharmacies: from 1586 rubles.
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Longidase is an enzymatic drug.
Release form and composition
Dosage forms:
- Lyophilisate for the preparation of a solution for intramuscular (i / m) and subcutaneous (s / c) administration: porous hygroscopic mass of white with a yellow tint or white (5 ampoules or vials in a blister strip, in a cardboard box 1 package);
- Suppositories for rectal or vaginal administration: torpedo-shaped, light yellow, marbling is possible, with a slight specific aroma of cocoa butter (5 pcs. In a blister strip, 2 packs in a cardboard box).
Each pack also contains instructions for the use of Longidase.
The active ingredient is longidase with hyaluronidase activity:
- 1 ampoule: 1500 international units (IU), 3000 IU;
- 1 bottle: 1500 IU, 3000 IU;
- 1 suppository: 3000 IU.
Auxiliary components:
- Lyophilisate: mannitol;
- Suppositories: cocoa butter.
Pharmacological properties
Longidase has a prolonged proteolytic activity, antioxidant, immunomodulatory, chelating, and moderate anti-inflammatory effects.
Pharmacodynamics
The active substance of the Longidase preparation, bovhyaluronidase azoxymer, is a conjugate of the proteolytic enzyme hyaluronidase and a high-molecular carrier from the group of poly-1,4-ethylenepiperazine N-oxide derivatives, which has the entire spectrum of pharmacological effects inherent in drugs with hyaluronidase activity.
Specific substrates of hyaluronidase are chondroitin, hyaluronic acid, chondroitin-4-sulfate, chondroitin-6-sulfate, and other glycosaminoglycans, which form the basis of the intercellular substance of the connective tissue (extracellular matrix). Due to depolymerization (breaking the bond between C 1 acetylglucosamine and C 4glucuronic / induronic acid), the basic properties of glycosaminoglycans change: viscosity, hygroscopicity, and the ability to bind metal ions decrease, the permeability of tissue barriers temporarily increases, fluid movement in the intercellular space is accelerated, and the elasticity of connective tissue improves. The pharmacological effect of bovgialuronidase azoxymer is expressed in the flattening of scars, reducing tissue swelling, increasing the volume of motion of joints, reducing contractures and preventing their formation, and inhibiting the adhesion process.
As a result of biochemical, immunological, histological and electron microscopic studies, it was proved that Longidase does not have a damaging effect on normal connective tissue, it has a destructive effect exclusively on the connective tissue changed in composition and structure in the area of fibrosis.
An increase in the duration of action of the enzyme is achieved by its covalent binding to azoxymer (physiologically active polymeric carrier). Longidase has an anti-fibrotic effect, facilitates the course of the inflammatory process in the acute phase, normalizes the synthesis of inflammatory mediators such as interleukin-1 and tumor necrosis factor alpha (TNF-α), increasing or decreasing it depending on the initial level, enhances the body's humoral immune response and resistance to infection.
The pronounced anti-fibrotic efficacy of Longidase is provided by the conjugation of hyaluronidase and the carrier, which greatly increases the resistance of the drug to denaturation and the effect of inhibitors. When heated to 37 ° C, the enzymatic activity of bovhyaluronidase azoxymer remains for 20 days, under the same conditions, native hyaluronidase loses its activity in 1 day.
Due to the simultaneous local presence of the hyaluronidase enzyme and the carrier (capable of binding heparin, iron ions, copper, as well as other enzyme inhibitors and collagen synthesis stimulators, which are released during the hydrolysis of matrix components - glycosaminoglycans), Longidase not only depolymerizes in fibrous-granxulomatous tissue, but also connective tissue and inhibits the reverse regulatory reaction aimed at the synthesis of connective tissue elements.
With subcutaneous or intramuscular administration in conjunction with other injectable drugs, Longidaza enhances their absorption, and with the introduction of local anesthetics, it accelerates pain relief.
Bovhyaluronidase azoxymer is a practically non-toxic compound that does not interfere with the normal function of the immune system. In experiments on animals, it was determined that the substance does not affect the reproductive function of rats (both males and females), the pre- and postnatal development of their offspring, and also does not have a mutagenic and carcinogenic effect.
It has been experimentally proven that in Longidase, the irritating and allergenic effect of the enzyme hyaluronidase is reduced. The drug used in therapeutic doses is well tolerated by patients and does not cause local / general hypersensitivity reactions.
The use of therapeutic doses of Longidase during surgery or after surgical treatment does not adversely affect recovery in the postoperative period, does not cause progression of the infectious process, does not slow down bone resorption.
Pharmacokinetics
After parenteral administration, bovgialuronidase, azoxymer rapidly penetrates into the systemic circulation. C max (maximum concentration) in the blood reaches 20-25 minutes later. With rectal administration of Longidase, the time to reach C max is 1 hour. The substance is distinguished by a high rate of distribution in tissues and organs.
The half-life reaches about half an hour. T 1/2 (half-life) due to intramuscular injection is 36 hours, after subcutaneous administration - approximately 45 hours, with rectal administration - 42–84 hours. The apparent volume of distribution (V d) is 0.43 l / kg.
Conjugation does not reduce the high bioavailability of hyaluronidase, which, with any method of administration of Longidase, remains at a level of at least 90%.
Bovhyaluronidase azoxymer penetrates into all tissues and organs, including through the blood-brain and blood-ophthalmic barriers. In the course of research, the absence of accumulation of the substance in the tissues was established.
Hyaluronidase is metabolized by hydrolysis, the carrier breaks down to oligomers, low molecular weight compounds, excreted mainly through the kidneys in two phases. On the first day, 45-50% of the substance is excreted by the kidneys, up to 3% through the intestines, after which the rate of excretion decreases. The drug is completely eliminated on days 4–5.
Indications for use
Lyophilisate for preparing a solution for intramuscular and subcutaneous administration
Longidaza is recommended for use in adult patients as part of the complex treatment and prevention of diseases accompanied by connective tissue hyperplasia:
- Gynecology: adhesions in the small pelvis due to inflammatory diseases of the internal genital organs, including tubal-peritoneal infertility, chronic endometritis, intrauterine synechiae;
- Urology: chronic prostatitis, interstitial cystitis;
- Surgery: adhesions after surgery on the abdominal organs, hypertrophic scars formed after burns, trauma, surgery, pyoderma, long-term non-healing wounds;
- Dermatovenereology and cosmetology: limited scleroderma, keloid, hypertrophic, forming scars after burns, trauma, surgery, pyoderma;
- Pulmonology and phthisiology: pneumosclerosis, fibrosing alveolitis, tuberculosis (infiltrative, cavernous-fibrous, tuberculoma);
- Orthopedics: joint contracture, arthrosis, ankylosing spondylitis, hematomas.
Longidase is administered together with antibacterial drugs in gynecology, urology, dermatovenerology, surgery, pulmonology (in order to increase their bioavailability), as well as with local anesthetics (to enhance the analgesic effect).
Suppositories for rectal or vaginal administration
The use of suppositories is indicated for adult patients and adolescents over 12 years of age for complex treatment or monotherapy of diseases / inflammations complicated by connective tissue hyperplasia:
- Gynecology: chronic endomyometritis, intrauterine synechiae, tubal-peritoneal infertility, prevention and treatment of adhesions in the small pelvis in the chronic form of inflammatory pathologies of the internal genital organs, treatment and prevention of adhesions in the small pelvis after artificial abortions, previous operations on the pelvic organs and other gynecological manipulations;
- Urology: chronic prostatitis, strictures of the ureters and urethra, Peyronie's disease, the initial stage of benign prostatic hyperplasia, interstitial cystitis; after surgery on the bladder, urethra, ureters in order to prevent scars and strictures;
- Dermatovenereology: limited scleroderma, prevention of fibrotic complications of infectious diseases transmitted through sexual contact;
- Phthisiology and pulmonology: interstitial pneumonia, pneumofibrosis, tuberculosis (infiltrative, tuberculoma, cavernous fibrous), fibrosing alveolitis, siderosis, pleurisy;
- Surgery: non-healing wounds, prevention and treatment of adhesions after operations on the abdominal organs.
In addition, Longidase suppositories are prescribed in gynecology, urology, dermatovenerology, pulmonology and surgery to increase the bioavailability of antibiotic therapy.
Contraindications
Absolute:
- Hemoptysis, pulmonary bleeding;
- Fresh hemophthalmus (vitreous hemorrhage);
- Malignant tumors;
- ARF (acute renal failure);
- Pregnancy and lactation period;
- Children and adolescents: for solution - up to 18 years, for suppositories - up to 12 years;
- Acute infectious diseases (for solution);
- Increased individual sensitivity to drugs based on hyaluronidase and any components of Longidase.
All dosage forms of the drug are prescribed with caution in chronic renal failure, provided that they are used no more than once a week. Suppositories are also recommended to be used with caution if there is a history of pulmonary bleeding.
For adolescents aged 12 to 18 years, Longidaza suppositories are administered only rectally.
Longidaza, instructions for use: method and dosage
Lyophilisate for preparing a solution for intramuscular and subcutaneous administration
The lyophilisate is intended for preparation of a solution for i / m, s / c or intradermal (i / c) administration. Immediately before injection, 1.5-2 ml of a 0.5% or 0.25% solution of procaine, 0.9% sodium chloride solution or water for injection should be added to the contents of the ampoule or vial.
The prepared solution for parenteral administration cannot be stored.
The doctor sets the method of administration and dosage regimen individually based on clinical indications, the severity of the disease and the patient's age.
Subcutaneous injections of Longidase are injected under scar tissue or near the site of injury.
Recommended dosage: 3000 IU once a day every 3-10 days; taking into account the severity of the disease, 5 to 15 injections are prescribed.
If necessary, a second course of treatment should be carried out after 2-3 months.
After a standard course of therapy for diseases complicated by a severe chronic form of the productive process in the connective tissue, the patient is prescribed a maintenance dose of 3000 IU per day with an interval between injections of 10-14 days.
Recommended schemes for Longidase use:
- Respiratory organs: i / m - 3000 IU once every 3-5 days, the course of treatment is 10 injections; then treatment is possible for 3-12 months at the same dose with an interval between injections of 10-14 days;
- Pelvic organs: i / m - 3000 IU once every 3-5 days, course - 5-15 injections;
- Limited scleroderma of various localization and form: i / m - 3000-4500 IU per day every 3 days, course - 5-15 injections; the duration of the course and the dose is selected for each patient individually, taking into account the localization of the disease, its clinical course and stage, as well as the tolerability of the drug;
- Keloid, hypertrophic scars after burns, pyoderma, operations: i / m - 3000 IU (in 1-2 ml of solution) per day with an interval between injections of 3-5 days, the course - no more than 10 injections and / or s / c (or i / c) - 1-2 times a week, a course of 5-10 injections;
- Long-term non-healing wounds: i / m - 1500-3000 IU per day every 5 days, course of treatment - 5-7 injections;
- Joint contractures, arthritis, hematomas: IM - 3000 IU per day every 3-7 days, general course - 7-15 injections;
- Adhesive disease: i / m - 3000 IU per day after 3-5 days, course of treatment 7-15 injections;
- Increasing the bioavailability of diagnostic and medicinal products (antibiotics, anesthetics, chemotherapy drugs): 1500 IU 1 time per 3 days, course - no more than 10 injections.
Suppositories for rectal or vaginal administration
Longidaza suppositories are intended for rectal or intravaginal administration once a day before bedtime. Intravaginally, suppositories are inserted into the vagina while lying down. For rectal administration, suppositories should be used after preliminary bowel cleansing.
The general course of treatment is 10-20 suppositories.
The appointment and frequency of administration of Longidase depend on the severity, stage and duration of the disease.
Recommended therapy regimen:
- Urology: 1 suppository 1 time in 2 days - 10 injections, then with an interval of 2-3 days - 10 injections, the general course of treatment is 20 injections;
- Gynecology (rectally or intravaginally): 1 suppository 1 time in 2 days - 10 injections (if necessary, supportive therapy may be prescribed);
- Dermatovenereology: 1 suppository every 1-2 days, course - 10-15 injections;
- Surgery: 1 suppository 1 time in 2-3 days, course - 10 injections;
- Pulmonology and phthisiology: 1 suppository 1 time in 2-4 days, course - 10-20 leads;
- Supportive therapy: 1 suppository 1 time in 5-7 days, duration - 3-4 months.
A repeated course is possible after 3 months or later.
In patients with renal insufficiency, the frequency of administration of a lyophilisate or Longidase suppositories should not exceed 1 time in 7 days.
Side effects
The use of Longidase in rare cases can cause the development of allergic reactions.
An undesirable effect when the solution is injected may be a feeling of pain at the injection site, sometimes - swelling at the injection site, skin hyperemia. These side reactions are transient and go away after 2-3 days.
The use of suppositories Longidaza in very rare cases can cause local hypersensitivity reactions, manifested by redness, edema, itching of the perianal zone, vaginal itching.
Overdose
Symptoms of an overdose of bovgialuronidase azoxymer can be chills, fever, dizziness, hypotension.
It is recommended to stop using Longidaza and prescribe symptomatic therapy.
special instructions
With the development of an allergic reaction, the use of Longidase should be immediately canceled.
The introduction of the solution into the tumor, acute inflammation or infectious lesion is contraindicated.
In case of exacerbation of infectious processes, the use of the drug should be prescribed simultaneously with antimicrobial agents.
If it is necessary to discontinue therapy with Longidase, the drug can be discontinued without a gradual dose reduction.
Having missed the introduction of the next dose, the subsequent use of the drug is carried out in the standard mode specified in the instructions or recommended by the doctor. Do not use a double dose to compensate for the missed dose.
Before starting therapy, the patient is obliged to inform the attending physician about all drugs taken at the moment or recently.
Longidase should not be used if there are visual signs of the unsuitability of the drug (packaging defects, discoloration of the lyophilized powder / suppositories).
The use of the drug is required in accordance with the instructions set out in the instructions. For all questions arising during treatment, you should contact your doctor or pharmacist.
The appearance of the described adverse reactions, as well as other side effects not mentioned in the instructions, requires contacting your doctor.
Influence on the ability to drive vehicles and complex mechanisms
The use of Longidaza does not affect the ability to perform types of work that require increased concentration of attention and accelerated psychomotor reactions, including driving a vehicle.
Application during pregnancy and lactation
Due to the lack of experience in the clinical use of Longidase, pregnant and lactating women are contraindicated in prescribing the drug during these periods.
Pediatric use
Due to the lack of experience in the clinical use of Longidase in pediatrics, it is prohibited to use:
- Lyophilisate for the preparation of a solution for intramuscular and subcutaneous administration - for children and adolescents under 18;
- Suppositories for rectal or vaginal administration - for children under 12 years of age.
For adolescents aged 12 to 18 years, suppositories are administered only rectally.
With impaired renal function
The use of all forms of Longidase is contraindicated in patients with acute renal failure.
For patients with chronic renal failure, the drug is prescribed no more than once a week.
Drug interactions
The use of Longidase is indicated in combination with antibiotics, bronchodilators, glucocorticosteroids, cytostatics, antifungal, antiviral, antihistamines.
Salicylates, adrenocorticotropic hormone, cortisone, high doses of estrogens and antihistamines can reduce the action of the enzyme hyaluronidase.
Longidase increases the bioavailability of drugs and accelerates the action of local anesthetics (with simultaneous use).
When prescribing Longidaza in combination with other drugs, to increase their bioavailability, it is necessary to take into account the degree of increase in their absorption and systemic action.
Analogs
Analogs of Longidase are: Lidase, Lidase-M, Lidase for injection, Ronidase.
Terms and conditions of storage
Keep out of the reach of children.
Store at 2-15 ° C in a dark, dry place.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Lyophilisate is available with a prescription, candles - without a prescription.
Reviews about Longidaz
Almost all patients leave extremely positive reviews about Longidaz. Both suppositories and lyophilisate are effective for fresh adhesions, promote the resorption of old scars and prevent the formation of new ones.
For women, the drug most often helps with problems in gynecology. Men generally describe the positive results of using the drug for the treatment of prostatitis. The absence of side effects and the convenience of its use are especially noted.
As disadvantages, some patients point to the specific smell of suppositories, calling it unpleasant, and when using Longidaz injections, they speak of pain at the injection site.
The cost of the drug is often called high.
Price for Longidaza in pharmacies
The approximate price for Longidaza is:
- Suppositories in a dosage of 3000 ME for 10 pcs. in the package - 1733 rubles, for 20 pcs. in the package - 3077 rubles;
- Lyophilisate for preparation of solution for injection at a dosage of 3000 IU in 1 bottle for 5 pcs. in the package - 2069 rubles.
Longidaza: prices in online pharmacies
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Drug name Price Pharmacy |
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Longidaza 3000 IU, vaginal and rectal suppositories 10 pcs. 1586 RUB Buy |
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Longidaza 3000 IU lyophilisate for preparation of solution for injection 5 pcs. 1850 RUB Buy |
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Longidase vaginal suppositories. and rectal. 3 thousand meters 10 pcs. 1873 RUB Buy |
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Longidaza lyoph. for prig solution for injection. 3000 me 5 pcs. 2186 RUB Buy |
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Longidaza 3000 IU, vaginal and rectal suppositories 20 pcs. 2693 RUB Buy |
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Longidase suppositories for vaginals. and rectal. entered 3 thousand meters 20 pcs. RUB 3184 Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
