Elokom S
Latin name: Elocom S
ATX code: D07XC03
Active ingredient: mometasone + salicylic acid (mometasone + salicylic acid)
Producer: Schering-Plow (Portugal), Zentiva Saglik Urunleri Sanayi ve Ticaret AS (Turkey)
Description and photo update: 2018-26-10
Elokom S - combined drug for the treatment of skin diseases; glucocorticosteroid (GCS) + keratolytic agent.
Release form and composition
Elokom S is produced in the form of an ointment for external use: a homogeneous mass of almost white or white color (15 or 45 g in an aluminum or plastic tube, 1 tube in a cardboard box).
1 g of ointment contains:
- active substances: mometasone furoate - 1 mg, salicylic acid - 50 mg;
- additional components: white petrolatum, propylene glycol stearate, white beeswax, hexylene glycol, purified water.
Pharmacological properties
Pharmacodynamics
Mometasone - GCS for local and external use, showing antipruritic, anti-inflammatory and vasoconstrictor properties. The mechanism of anti-inflammatory action of topical GCS is not fully understood. It is believed that glucocorticosteroids enhance the production of proteins belonging to the lipocortin family and inhibiting phospholipase A 2. These proteins are believed to control the biosynthesis of potent inflammatory mediators such as leukotrienes and prostaglandins by blocking the release of arachidonic acid, which is their common precursor. Arachidonic acid, as a result of the action of phospholipase A 2, is released from phospholipids included in cell membranes.
In experiments in vitro, it was demonstrated that mometasone has a pronounced opposition to the production of three cytokines involved in the initial development of the inflammatory process and ensuring its course: interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα).
Salicylic acid promotes exfoliation of the stratum corneum and does not cause quantitative or qualitative changes in the structure of the viable epidermis. The mechanism of action of this active component is the result of the dissolution of the intercellular binder.
Pharmacokinetics
12 hours after a single external application of Elocom S on areas of skin with psoriatic lesions without using an occlusive dressing, approximately 1.5% of the applied dose is subjected to systemic absorption, the average plasma concentration of salicylic acid in the blood is 0.0908 mg / dl. As a rule, systemic toxic reactions to the presence of salicylic acid occur at a higher plasma concentration (30–40 mg / dL).
In the process of studies of the effect of a one-component agent in the form of an ointment, the active ingredient of which is mometasone furoate, its effect on the hypothalamic-pituitary-adrenal system (HPA) was not observed when using up to 15 g of the drug per day for 6 weeks of treatment or with subsequent repeated short course. It has also been proven that the combined use of mometasone and salicylic acid as a keratolytic drug does not affect the safety profile of mometasone in relation to HPAI when compared with a single-component ointment.
After applying Elokom C 2 times a day for 21 days without the use of occlusive dressings, the level of salicylates in the blood plasma was less than 5 mg / dl, which is less than the detection limit and laboratory norm of the concentration of these substances in the blood (15-30 mg / dl).
Since when applied externally, there is a slight absorption of mometasone, its distribution was studied after intravenous (i / v) administration of a solution containing this substance at a dose of 1 mg / ml. The apparent volume of distribution (V d) was 917 liters, which indicated a wide distribution of mometasone. In human blood plasma, 99% of the substance is present in a bound form.
After absorption, an intensive biotransformation of mometasone occurs with the formation of many metabolites (without the formation of the main one), exhibiting stronger polar properties than mometasone. Due to the high polarity, the resulting metabolites have no pharmacological activity. With intravenous injection of mometasone, the total rate of its metabolic excretion from the serum was 976 ml / min, which also confirms the intensive metabolism of the substance.
When used externally, Elocom C, the main metabolites of salicylic acid, quantitatively determined in blood plasma, were salicyluric and gentisic acids.
Both active ingredients of the drug, as well as their metabolites, are excreted by the kidneys and through the intestines. Salicylic acid has a half-life of 2.8 hours.
Indications for use
According to the instructions, Elokom S is recommended for use to relieve hyperkeratosis and inflammatory manifestations in the following skin lesions:
- psoriasis;
- seborrheic dermatitis;
- atopic dermatitis.
Contraindications
- bacterial, fungal and viral (shingles, chickenpox, herpes simplex) skin infections;
- perioral dermatitis;
- rosacea;
- syphilis;
- tuberculosis;
- post-vaccination reactions;
- age up to 12 years;
- hypersensitivity to any of the constituents of the drug.
It is not recommended to use Elokom S in the area of natural skin folds.
Instructions for the use of Elocom S: method and dosage
Elokom S ointment is applied externally, applying a thin layer to the affected areas of the skin 2 times a day - in the morning and in the evening. The maximum permissible daily dose is 15 g, the duration of treatment is set by the attending physician.
Side effects
Against the background of drug therapy, the following disorders may appear: weak / moderate burning sensation at the site of ointment application, irritation, peeling, dry skin, skin maceration, itching, skin atrophy, acne, folliculitis, hypopigmentation, prickly heat, the appearance of atrophic skin stripes, allergic contact dermatitis, perioral dermatitis, hypertrichosis, secondary infections.
In addition, in children, when using Elocom S, it is possible to suppress the function of the HPA, including the development of Itsenko-Cushing's syndrome.
Overdose
Long-term therapy of corticosteroids, when applied topically in an excessive dose, can cause inhibition of HPA and secondary adrenal insufficiency. If there are signs of suppression of HPA, it is necessary to stop treatment with the drug or reduce the frequency of applications.
In case of toxicity due to salicylic acid, the application of the ointment should be stopped. The excretion of salicylates in the urine is facilitated by the introduction of fluid. If necessary, it is possible to prescribe oral administration or intravenous administration of sodium bicarbonate and potassium salts.
special instructions
In order to avoid complications, Elokom S should be used strictly according to the doctor's prescription.
When using the ointment on large areas of the skin for a long time, there is a risk of developing systemic action of GCS, especially in children. As a result, patients need to take appropriate precautions and be monitored for the appearance of signs of suppression of HPA and the occurrence of Itsenko-Cushing syndrome.
Elokom S ointment should not be used in ophthalmology.
GCS can lead to a change in the appearance of the affected areas of the skin, which can interfere with the correct diagnosis.
If skin irritation occurs, including its excessive dryness, it is required to stop using the drug and conduct appropriate treatment.
Against the background of a long course, the development of a concomitant skin infection is possible. In this case, the appointment of an antifungal or antibacterial agent is required. If you cannot achieve a quick positive response to treatment, you need to stop using Elokom S until this complication is completely eliminated.
With prolonged treatment with GCS, a sudden interruption of the course can provoke the development of a rebound syndrome, expressed in the form of dermatitis with severe skin hyperemia and a burning sensation. Therefore, in order to avoid the appearance of these disorders at the end of a long course, the withdrawal of the drug must be carried out gradually, including carrying out therapy according to an intermittent scheme.
Elokom S ointment is not recommended for use under occlusive dressings, including plastic panties and diapers.
The product should not be applied to the face or armpits and groin areas.
Before prescribing the drug, you should assess the risk and expected effect of its use in the presence of the following diseases:
- inflammation / damage to peripheral vessels;
- diabetes;
- skin irritation or infection.
Influence on the ability to drive vehicles and complex mechanisms
The effect of the drug on the ability of patients to drive complex equipment, including vehicles, was not observed.
Application during pregnancy and lactation
Well controlled and adequate studies of the use of the drug during pregnancy have not been conducted. For pregnant women, Elokom S can be used only after a careful assessment of the ratio of the expected benefits of therapy and the possible threat to the fetus.
There is no data that with topical application of salicylic acid or corticosteroids, their systemic action can be observed and drugs can be detected in human milk. However, if long-term use of corticosteroids in high doses is required, it is recommended to stop breastfeeding.
Pediatric use
Elokom S is contraindicated for use in patients under 12 years of age.
If it is necessary to apply the drug to large areas of the skin or conduct long-term treatment in children, it is necessary to take into account that the ratio of body weight and skin surface is higher in them than in adults, as a result of which, during GCS therapy, children are more prone to inhibition of HPA and the development of Cushing's syndrome …
Since long-term treatment with GCS can have a negative impact on the development and growth of children, they need to prescribe these drugs in minimal doses that allow them to obtain a therapeutic effect.
Drug interactions
Interactions of Elokoma C with other medicinal substances / preparations have not been registered.
When used in combination with salicylic acid, there is theoretically the possibility of displacing drug compounds such as pyrazinamide, methotrexate, tolbutamide (butamide), heparin, indirect anticoagulants and drugs that promote the excretion of uric acid from the bond with proteins. Ammonium sulfate and other corticosteroids can affect the concentration of salicylic acid. This information should be taken into account when using the ointment together with these compounds.
Analogs
The analogue of Elokom S is Momat-S.
Terms and conditions of storage
Keep out of reach of children at temperatures between 2 and 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Elocom S
According to reviews, Elokom S is an effective agent used to treat inflammation and hyperkeratosis in psoriasis, atopic and seborrheic dermatitis. Patients point out that the drug quickly and effectively removes psoriasis plaques and prevents the development of new ones, heals damaged skin areas, relieves flaking and itching, soothes the skin and restores it to a healthy look.
Almost all patients consider the disadvantage of Elocom S that it is hormonal, as a result of which it cannot be used often and for a long time, and can be addictive. There are practically no reports of the development of negative reactions. Some patients attribute its high cost to the disadvantages of the drug.
Price for Elokom S in pharmacies
The price for Elokom S in pharmacies varies from 595 to 850 rubles for 1 tube containing 15 g of ointment.
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!
