Autoimmune thyroiditis what can be antiviral. online consultations

Autoimmune thyroiditis (AIT) is a chronic pathological disorder of the thyroid gland, which is caused by autoimmune reactions. The disease is characterized by damage to the follicular structures responsible for the formation of thyroid hormones as a result of an attack of T-lymphocytes due to an error in identifying the cells of one's own body.

This disease is not rare, since it accounts for about a third of all thyroid disorders. Women are more prone to the disease, in men a similar disorder is diagnosed twenty times less often. Pathology develops mainly from 40 to 55 years, but in recent decades there has been a tendency to the disease in younger individuals and children.

Autoimmune thyroiditis is several pathological conditions similar in genesis.

There are such types of the disease:

1. Chronic AIT, an older name for this disease -. The chronic form may also be called lymphomatous or lymphocytic thyroiditis. The essence of the pathology is the abnormal penetration of T-lymphocytes into the underlying glandular tissue. This pathological process causes an abnormally high concentration of antibodies in relation to parenchymal cells, which causes disruption of the organ and even its structure. In this case, the concentration of iodine-containing thyroid hormones in the blood decreases, and hypothyroidism is formed. This type of disease is chronic, inherited through generations, and may be one of many autoimmune processes in the body.
2. - the most studied form of the disease, since this pathology is much more common than other variants of AIT. The reason is the excessive reactivation of defense mechanisms after childbirth (during pregnancy, a woman's immunity is suppressed, which is of great biological importance for the fetus). If a woman in labor has a predisposition, then the likelihood of developing pathology is quite high.
3. Painless or silent AIT- this is similar to postpartum thyroiditis, but the pathology has no connection with the bearing of a child and the exact causes of its occurrence are currently unknown. Differs in the absence of pain syndrome.
4. Cytokine-induced thyroiditis- a pathology that occurs as a side effect of long-term use of interferon in people with blood diseases or hepatitis C.

The note. All the above types of pathology, except for chronic thyroiditis, are similar in the same sequence of pathological processes in the organ. The first stages are characterized by the development of destructive thyrotoxicosis, which is later replaced by transient hypothyroidism.

Clinical forms of the disease

Autoimmune thyroiditis differs in symptomatic and morphological features, so it is customary to divide it into forms indicated in the table.

Table. Clinical forms of autoimmune thyroiditis:

Form of the disease	Description
	The clinical picture is absent, but there are immunological symptoms. The thyroid gland is not changed or slightly enlarged, but not more than 2 degrees. The parenchyma is homogeneous, without seals, slight signs of thyro-or are allowed. The secretion of hormones is not disturbed.
	There is a goiter (enlargement of the thyroid gland). Signs are due to mild manifestations of low or high secretion of thyroid hormones. Ultrasound shows a diffuse increase in the entire organ or the presence of nodules, as well as both signs at the same time, which happens somewhat less frequently. This form is more often characterized by the preservation of normal synthetic activity or moderate hypersecretion, but as the disease progresses, the synthesis decreases, and the abundant production of hormones is replaced by hypothyroidism.
	The clinical picture corresponds to hypothyroidism, and the size of the organ remains normal or slightly reduced. This form of the disease is typical for the elderly, and in young patients this is possible only after exposure to significant doses of radiation.

Note. In the most severe cases of the atrophic form of autoimmune thyroiditis, a significant destruction of synthetic cells is observed, due to which a significant part of the thyroid gland is destroyed, while its functional activity drops to the lowest levels.

Stages of Hashimoto's disease:

	Stage 1 - hyperthyroidism	Stage 2 - euthyroidism	Stage 3 - irreversible hypothyroidism
Description	It is characterized by a sharp increase in antibodies to thyrocytes, their massive destruction and the release of a large amount of thyroid hormones into the blood.	Gradually, the concentration of hormones decreases to a normal level, and a period of imaginary well-being begins. Antibodies continue to destroy thyroid tissue	Due to the ongoing destruction of thyroid cells, its activity gradually decreases, and the patient develops irreversible hypothyroidism. The extreme degree of development of the disease is the complete replacement of the glandular cells of the thyroid gland with connective tissue.
Duration	The first 6 months from the onset of the disease	6-9 (up to 12) months from the onset of the disease	After 9-12 months from the onset of the disease and beyond
Characteristic symptoms	Irritability, insomnia Tachycardia, palpitations ("heart pounding") Feeling of a lump in the throat Sore throat, cough Various menstrual irregularities	At this stage of the disease, clinical symptoms are usually absent. The patient feels well, laboratory tests for thyroid hormones are within normal limits. Pathological changes in the organ can be seen only with the help of ultrasound: its structure becomes heterogeneous, cysts appear in it, and then dense connective tissue nodes	Drowsiness, weakness, fatigue Lethargy, decreased mental and motor activity Violation of all types of metabolism: fat (increased cholesterol levels in the blood), protein (acceleration of tissue breakdown), carbohydrate (increased risk of developing diabetes) and water-salt Dense swelling, puffiness of the face, hands and feet Brittle nails, hair loss Poor tolerance to low temperatures, chilliness Bradycardia (decreased heart rate), arrhythmia Menstrual dysfunction, infertility, early menopause in women Thyroid enlargement

Rare forms of the disease

In addition to the forms listed above, immune thyroiditis has several rather rare forms:

1. Juvenile.
2. With the formation of knots.

Now about each of them in more detail.

Juvenile form

It develops in childhood and, most often, adolescence.

Manifestations:

1. Specific changes detected during ultrasound.
2. Ab-TPO are found in the blood.

Juvenile autoimmune thyroiditis prognosis, which is quite favorable, most often spontaneously heals when the patient reaches the age of 18-20 years. But, in rare cases, the transition of pathology into a chronic form is still possible.

Why the disease develops is not completely clear to modern science. It is believed that it can be provoked by hormonal changes in the child's body during its transition to puberty.

Thyroiditis with nodules

This form manifests itself as an increase in the titer of AT-TPO, as well as changes in the picture that ultrasound gives - there is a continuous change in the configuration and size of the nodes, either merging, then dividing, then increasing, then decreasing. Confirmation of the diagnosis is made using a fine needle aspiration biopsy, which will provide accurate information about the tissue of which the nodes are composed.

This type of AIT can be left untreated, except in extreme cases, when the size of the thyroid gland has grown so much that the gland has displaced or squeezed other organs - the esophagus or trachea. This situation is an indication for surgical intervention.

Causes

One hereditary condition for the formation of the disease will not be enough.

In order to provoke the development of autoimmune thyroiditis, exposure to the adverse factors listed below will be required:

• a history of viral respiratory diseases;
• the presence of constant sources of infection and infectious foci, for example, sick tonsils, caries, chronic rhinitis of a bacterial nature and other diseases;
• adverse environmental circumstances: increased background radiation, iodine deficiency, the presence of toxins, especially chlorine and fluorine compounds, which provoke excessive aggressiveness of T-lymphocytes;
• self-treatment with hormonal and iodine preparations, or their long-term use;
• excessive passion for tanning, especially during hours of active infrared radiation;
• severe stressful situations.

Scientists have identified a relationship between the immune status of a person and his emotional sphere.

It manifests itself as follows:

• Stressful situations and depression provoke the production of certain hormones;
• These biologically active substances lead the body to attack itself;
• The antibodies involved in this attack target the thyroid gland.

As a result, autoimmune thyroiditis develops, the psychosomatics of which is initially expressed in frequent depressive states. Therefore, so often people suffering from this pathology are indifferent to what is happening in the world around them, often have a bad mood and low physical activity.

Interesting: Quite often it is a bad psychological, and not physical, condition that prompts patients to seek medical help for this pathology.

Symptoms

As mentioned above, the initial stages (euthyroid and subclinical phases) do not have a clearly defined clinical picture. Very rarely, during these periods, an increase in the organ in the form of a goiter is possible.

In this case, a person feels discomfort in the neck (pressure or lump), he quickly gets tired, the body weakens and slight joint pains can be observed. Most often, symptoms appear in the first few years, when the disease is just beginning to develop.

Signs are due to ongoing processes that correspond to the indicated phases. As the tissue structure is destroyed, the disease lingers in the euthyroid phase, after which it passes into persistent hypothyroidism.

Postpartum AIT manifests itself as non-intensive thyrotoxicosis at 4 months after birth. A woman is usually more tired and loses weight.

It is not often that the symptoms are more pronounced (sweating, tachycardia, feeling feverish, muscle tremors and other pronounced signs). The hypothyroid phase begins at the end of the fifth month after the birth of a child; infrequently, this may be associated with the development of a depressive postpartum state.

Note. Painless thyroiditis manifests itself as a barely noticeable, almost asymptomatic thyrotoxicosis.

Diagnostics

It is not so easy to diagnose AIT before the reduced concentration of hormones begins to appear. To make a diagnosis, the endocrinologist takes into account the symptoms and test results obtained during the diagnosis. If relatives have this disease, then this fact confirms the presence of autoimmune thyroiditis in a person.

Test results indicating the disease:

• leukocytosis in the blood;
• immunogram shows the presence of antibodies to thyroid hormones;
• a biochemical blood test shows a change in the content of thyroid hormones and TSH;
• Ultrasound helps to determine the echogenicity of the parenchyma, the size of the gland, the presence of nodules or seals;
• fine-needle biopsy will allow selecting thyroid tissue for histological analysis; in autoimmune thyroiditis, a pathologically large accumulation of lymphocytes in the tissues of the organ is detected.

An important feature of making a reliable diagnosis is the simultaneous presence of the following indicators:

• elevated levels of antibodies to the thyroid parenchyma (AT-TPO);
• hypoechogenicity of the tissue structure;
• the presence of signs characteristic of hypothyroidism.

If any of the above three signs is absent, then we can only talk about the likely presence of the disease, since the first two signs cannot reliably indicate the presence of AIT.

As a rule, therapy is prescribed when the disease enters the hypothyroid phase. This leads to the fact that before the onset of this phase there is no urgent need to determine the diagnosis and prescribe appropriate therapy.

Changes detected by ultrasound

In addition to objective and laboratory data, there are also echo signs of thyroiditis, which consist in a decrease in the echogenicity of the thyroid gland and the development of pronounced changes that are diffuse in nature.

The photo shows that the thyroid gland affected by autoimmune thyroiditis has a darker color than a healthy one, and its structure is very heterogeneous - its tissue is either darker or lighter in different places.

Quite often, specialists in ultrasound diagnostics, along with the heterogeneity of the structure of the organ, reveal darker foci. However, they are not always true knots.

This is how foci of pronounced inflammation look on ultrasound. Their name is "pseudo nodes". In order to clarify the nature of these seals that appeared in the tissues of the thyroid gland with autoimmune thyroiditis, if their size is 10 or more millimeters, a biopsy is performed.

Histological examination of the sample taken will help answer the question of its origin. Such structures can turn out to be “pseudonodes” against the background of AIT, and benign colloidal nodes, and malignant neoplasms.

Histological features

When examining a tissue sample of the thyroid gland, the following histological signs of thyroiditis can be detected:

1. Infiltration into the tissues of the organ of immune elements(lymphocytes penetrate them, impregnating their structure). Plasma cells are the predominant elements in this process. Infiltration can be of varying degrees of saturation, and is also divided into diffuse (common process) and focal (lymphomacytic elements are localized in certain places).
2. Growth of lymphoid follicles in which there are breeding centers.
3. The appearance of large cells of oxyphilic light epithelial tissue called Hürtl or Ashkinazi cells. They are formed due to the intensification of most of the processes occurring in the thyroid gland. Ashkinazi cells show powerful metabolic activity. However, their origin and development is not associated with the processes of destruction, dystrophy or oncogenesis in the affected thyroid gland. They are designed to enhance the natural processes for which the thyroid tissue is responsible and which suffer under the influence of the pathological process.
4. Regenerative processes. In contrast to the lymphocytic infiltration that develops during autoimmune thyroiditis, the thyroid gland tries to recover and forms areas of healthy functional epithelial cells, which in some cases have a papillary appearance. These growths are benign. In general, autoimmune processes are characterized by manifestations of reparative regeneration, which has a clear tendency to increase the volume of interfollicular epithelial tissue.
5. Fibrosis of thyroid tissue, at which there is a thickening of the network of argyrophilic fibers prone to collagenization. The result of such processes may be the division of the organ tissue into pronounced lobular segments. Tissue fibrosis is more characteristic of diffuse autoimmune thyroiditis than of focal thyroiditis.

Treatment

There is no specific treatment for autoimmune thyroiditis in medical practice today, so there is no way to stop the disease until the moment when the body begins to feel a lack of thyroid hormones. Under the hour of the thyrotoxic phase, doctors do not recommend the use of drugs that stabilize excessive hormone production (thiamazole, propylthiouracil, or others), because in this case there is no hypersecretion, and the hormonal level temporarily increases due to the collapse of the follicles and the release of thyroid-stimulating hormones. In case of violation of cardiac activity, the patient is prescribed beta-blockers

With hypofunction of the thyroid gland, a person will be forced to take hormonal drugs (hormone replacement therapy). Glucocorticoids are indicated if a combination of AIT with subacute thyroiditis is diagnosed.

This condition often occurs during cold seasons. The use of non-hormonal anti-inflammatory drugs, for example, diclofenac and others, is also shown. Be sure to prescribe medications that correct the activity of the immune system. In case of atrophy of the organ, surgical intervention is required.

Depending on the characteristics of the course, type and severity of Hashimoto's disease, treatment can be carried out in three directions:

1. Drug therapy with drugs of synthetic analogs of thyroid hormones (Eutiroks, L-thyroxine). Substitution treatment helps to fight progressive hypothyroidism, but the dose of the drug has to be constantly increased.
2. Surgical removal of thyroid tissue is usually prescribed for the almost complete destruction of the organ. After surgical treatment, lifelong hormone replacement therapy is also required.
3. Computer reflexology is one of the promising methods of treating Hashimoto's disease. It is based on the effect of low-frequency direct current on biologically active points, which leads to the stimulation of nervous, immune and endocrine processes in the tissues of the thyroid gland and the restoration of the organ. It is too early to say that an effective remedy for the treatment of autoimmune thyroiditis has been found, but the method gives positive results and is being successfully introduced into medical practice.

What are the restrictions?

Patients who suffer from AIT must adhere to certain restrictions so as not to provoke the development of another relapse.

Autoimmune thyroiditis - contraindications:

1. Many people mistakenly believe that iodine-containing drugs are necessary for thyroid dysfunction. In fact, these medicines can both help and harm, so in this case it is important not to self-medicate, even if we are talking about “useful” vitamins or mineral complexes. For example, iodine in autoimmune thyroiditis increases the amount of antibodies that destroy thyroid cells. Only a doctor, based on the result of T3 and T4 tests, has the right to prescribe iodine-containing drugs for the main treatment.
2. In cases of selenium deficiency, the conversion of T3 and T4 is disrupted, which leads to the development of hypothyroidism. In other words, this microelement synthesizes a hormone that creates energy in cells. When a violation occurs, the thyroid gland improves its work by increasing its surface area (it grows, nodes or cysts appear on it). But the trace element is still not enough! Thus, selenium plays an important role in autoimmune thyroiditis. However, it is not prescribed in all cases: if the patient has thyrotoxicosis, then this microelement is contraindicated.
3. Many patients are interested in whether it is possible to carry out vaccination (for example, against influenza) in case of impaired thyroid function? Endocrinologists note that autoimmune thyroiditis and vaccinations are not compatible concepts. The fact is that AIT is a severe immune disorder, so vaccination can only aggravate hormonal imbalance.

Forecast

In general, with the appointment of adequate treatment, the prognosis is relatively positive. If therapy is started during the first destructive transformations in the organ, then negative processes slow down, and the disease enters a period of protracted remission.

Quite often, a satisfactory condition persists for 12-15 years or more, although exacerbations are not ruled out during these periods. The presence of signs of AIT and the corresponding antibodies in the blood are symptoms indicating the formation of hypothyroidism in the future.

If the disease occurred after childbirth, then the probability of developing AIT during a second pregnancy is 70%. Of all women in labor who suffer from postpartum syndrome, a third develops a stable form of hypothyroidism.

Prevention

Specific prophylaxis, which would completely eliminate the development of the disease, does not currently exist. It is extremely important to detect signs of a developing disease as early as possible and start the right therapy in a timely manner in order to compensate for the insufficient production of thyroid hormones.

At risk are women with an increased immune response to thyroid cells (AT-TPO test) who are about to become pregnant. In such patients, strict control over the work of the organ during childbearing and after childbirth is necessary.

Questions

Hello, Doctor! I passed laboratory tests, in the results of which TSH in AIT is 8.48 μIU / ml (the norm is 0.27 - 4.2). The endocrinologist prescribed to take a decoction of walnut partitions, prescribed a course of admission and scheduled the next consultation in 3 weeks. Is this a qualified treatment for a disease? Or do I need to take medication? Maybe hormones?

Hello! Have you had an ultrasound? What changes have occurred in the thyroid gland since the last examination? Or was it original?

It is difficult to make recommendations with such a minor description of the symptoms. If your endocrinologist has on hand not only the results of laboratory tests, but also instrumental ones, then the treatment recommended to you is quite competent and must be followed.

Good evening! Tell me, when diagnosing AIT of the thyroid gland, how long do they live with it? My treating specialist did not give me an answer to this question. By the time I got home to contact you, I was exhausted. Thank you in advance for your answer.

Hello! Patients with autoimmune thyroiditis live long enough. The disease may not progress at all. With the development of hypothyroidism, medication is prescribed.

If the effectiveness of taking medications is low, the specialist may prescribe a surgical intervention, after which you will be prescribed hormone replacement therapy. Try not to focus too much on the disease, but at the same time follow all the recommendations of the specialist treating you. I wish you good luck with your treatment.

Licopid

ATH:

L03A Immunostimulants

Pharmacological group

Other immunomodulators

Nosological classification (ICD-10)

- A15-A19 Tuberculosis
- A41 Other septicemia
- A60 Anogenital herpetic viral infection
- B00 Herpes simplex infections
- B00.5 Herpetic eye disease
- B19 Viral hepatitis, unspecified
B34.4 Papovavirus infection, unspecified
D84.9 Immunodeficiency, unspecified
- J18 Pneumonia without specification of the causative agent
- J31 Chronic rhinitis, nasopharyngitis and pharyngitis
- J37 Chronic laryngitis and laryngotracheitis
J40 Bronchitis, not specified as acute or chronic
J42 Chronic bronchitis, unspecified
- K73 Chronic hepatitis, not elsewhere classified
L08.9 Local infection of skin and subcutaneous tissue, unspecified
- L40 Psoriasis
- Z100* CLASS XXII Surgical practice

Composition and form of release

Tablets 1 tab.
glucosaminylmuramyl dipeptide (GMDP):
- 1 mg
- 10 mg
excipients: lactose; sucrose; potato starch; methylcellulose; calcium stearate
in a blister pack 10 pcs.; in a pack of cardboard 1 or 2 packs.

Description of the dosage form

Round flat-cylindrical tablets of white color with a chamfer. Tablets with a dosage of 10 mg are at risk.

pharmachologic effect

Pharmacological action - immunomodulatory.

Pharmacokinetics

The bioavailability of the drug when taken orally is 7-13%. The degree of binding to blood albumin is weak. Does not form active metabolites. Tmax - 1.5 h, T1 / 2 - 4.29 h. Excreted from the body unchanged, mainly through the kidneys.

Pharmacodynamics

The biological activity of the drug is due to the presence of specific receptors (NOD-2) to glucosaminylmuramyl dipeptide (GMDP) localized in the endoplasm of phagocytes and T-lymphocytes. The drug stimulates the functional (bactericidal, cytotoxic) activity of phagocytes (neutrophils, macrophages), enhances the proliferation of T- and B-lymphocytes, increases the synthesis of specific antibodies. Pharmacological action is carried out by increasing the production of interleukins (IL-1, IL-6, IL-12), tumor necrosis factor-alpha, interferon gamma, colony-stimulating factors. The drug increases the activity of natural killer cells.

Indications for Likopid

Complex therapy of conditions accompanied by secondary immunodeficiencies in adults and children.

Adults (tablets 1 and 10 mg):
chronic lung infections;
acute and chronic purulent-inflammatory diseases of the skin and soft tissues, including purulent-septic postoperative complications;
herpetic infection (including with ophthalmic herpes);
papillomavirus infection;
chronic viral hepatitis B and C;
psoriasis (including arthropathic form);
pulmonary tuberculosis.

Children (only 1 mg tablets):
acute and chronic purulent-inflammatory diseases of the skin and soft tissues;
chronic infection of the upper and lower respiratory tract, both in the acute stage and in remission;
herpetic infections of any localization;
chronic viral hepatitis B and C.

Contraindications

individual hypersensitivity to the drug;
pregnancy;
lactation;
autoimmune thyroiditis in the acute phase;
conditions in diseases accompanied by high fever or hyperthermia (> 38 ° C).

Use during pregnancy and lactation

Contraindicated in pregnancy. At the time of treatment should stop breastfeeding.

Side effects of the drug Likopid

At the beginning of treatment, there may be a short-term increase in body temperature (not higher than 37.9 ° C), which is not an indication for discontinuation of the drug. No other side effects were observed during treatment with Likopid.

Interaction

The drug increases the effectiveness of semi-synthetic penicillins, fluoroquinolones, cephalosporins, polyene derivatives. There is synergism in relation to antiviral and antifungal drugs. Antacids and sorbents significantly reduce the bioavailability of the drug. GCS reduce the biological effect of Likopid. It is not advisable to co-administer Likopid with sulfa drugs, tetracyclines.

Overdose

Cases of overdose are unknown.

Dosage and administration

Adults: tab. 1 mg sublingually and tab. 10 mg orally, on an empty stomach, 30 minutes before meals.
To prevent postoperative complications, Likopid is prescribed 1 mg sublingually 1 time per day for 10 days.
For the treatment of purulent-septic lesions of the skin and soft tissues of moderate severity, incl. and postoperative - 2 mg sublingually 2-3 times a day for 10 days.
In the treatment of severe purulent-septic processes - 10 mg orally 1 time per day for 10 days.
In chronic lung infections - 1-2 mg sublingually 1 time per day for 10 days.
With pulmonary tuberculosis - 10 mg 1 time per day under the tongue for 10 days.
With mild herpes infection - 2 mg 1-2 times a day sublingually for 6 days; in severe forms - 10 mg 1-2 times a day sublingually for 6 days.
With ophthalmic herpes - inside 10 mg 2 times a day for 3 days. After a 3-day break, the course of treatment is repeated.
With lesions of the cervix with the human papillomavirus - 10 mg orally 1 time per day for 10 days.
In psoriasis - 10-20 mg orally 1-2 times a day for 10 days and then every other day, 10-20 mg for the next 10 days. In severe forms and extensive lesions (including arthropathic form) - 10 mg 2 times a day for 20 days.

Children aged 1-16 years Likopid - only in the form of tablets of 1 mg.
Newborns with a protracted course of infectious diseases (pneumonia, bronchitis, enterocolitis, sepsis, postoperative complications, etc.) - 0.5 mg orally 2 times a day for 7-10 days.
In the treatment of chronic respiratory tract infections and purulent skin infections - 1 mg orally 1 time per day for 10 days.
In the treatment of herpetic infection (regardless of location) - 1 mg 3 times a day orally for 10 days.
In the treatment of chronic viral hepatitis B and C - 1 mg orally 3 times a day for 20 days.

special instructions

Does not affect the ability to drive a car and complex mechanisms.

Shelf life of the drug Likopid

5 years.

Storage conditions of the drug Likopid

List B.: In a dry, dark place, at a temperature not exceeding 25 ° C.

angela 2018-11-13 22:15:08

Good afternoon! I am being treated by a herpes type 6 infectious disease specialist. After taking acyclovir 0.2 mg 5 tons per day for 7 days and licopid 10 mg. Once a day for 10 days, a herpes rash appeared on the body. Is this a normal situation?

Good afternoon. Did your doctor confirm your diagnosis? What is the rash really herpetic etiology? Consult a dermatologist for a diagnosis. This situation is casuistic.

Alena 2018-08-18 03:25:12

After I drank a course of licopid 10, the muscles of my legs (calves) began to hurt, it was when I went to bed that I could not bear the feeling when it would pass

Menshchikova Galina Vladimirovna Dermatovenereologist, dermatooncologist. Candidate of Medical Sciences. Doctor of the first category. Over 15 years experience:

Good afternoon. There are no side effects listed in the instructions.

Sergey 2018-07-25 23:20:46

Can it be used for psoriasis and HIV infection?

With these pathologies, only after agreement with the attending physician, because they can affect the course of the underlying somatic disease.

natalia 2018-02-07 17:39:04

My daughter has frequent colds, sore throats and tonsillitis. The doctor prescribed 10 mg licopid, and she is 16 years old, and the instructions say that this dose is from the age of 18, Tell me, is it dangerous for her to drink 10 mg?

Bagaeva Madina Dermatovenereologist, member of the Moscow Society of Dermatovenereologists and Cosmetologists. A. I. Pospelova answers:

The use of this drug at an earlier age is widely used.

Elena 2017-12-06 17:38:29

Is it possible to take Likopid and Anaferon for children at the same time?

Bagaeva Madina Dermatovenereologist, member of the Moscow Society of Dermatovenereologists and Cosmetologists. A. I. Pospelova answers:

Hello! Can.

Lyudmila 2017-11-19 09:21:55

Hello. My daughter (14 years old) had a temperature of 36.8 to 37.4 for two weeks, 10 mg of licopid was prescribed. Could there be a side effect in the form of pain in the knees?

First of all, an autoimmune disease develops when the immune system, which protects the body from disease, decides to attack healthy cells because it perceives them as foreign. Autoimmunity is most easily understood as a "hyperimmune" condition. Depending on the type of autoimmune disease, it can affect one or many different types of body tissues. Simply suppressing the immune system is also not enough to reverse all the inflammation, degeneration, and loss of tissue structure and function that occurs during the autoimmune process.

"Healthy eating" with an emphasis on alternating a cleansing and detox diet with a reparative diet is a natural way to curb an overreacting immune system. A variety of metabolic, functional laboratory tests are recommended in order to determine "immune stimulating" substances, and then to determine the diet, nutritional supplements and develop a lifestyle program to cope with the problem. Initially, most patients opt for a natural and medical approach. However, over time, as the body recovers, you may become less rigid in your adherence to these strategies in treating and controlling your disease.

Causes of Autoimmune Diseases

At present, scientists have paid little attention to identifying the causes or risk factors that contribute to the development of autoimmune conditions, such as multiple sclerosis, lupus, rheumatoid arthritis, scleroderma, and even some forms of diabetes. Constant stress, toxins, injuries and malnutrition, plus a genetic predisposition, contribute to the emergence of aggression of the immune system against the tissues of one's own body (sensitive body tissues are destroyed).

Autoimmune disease and thyroid function

Along with the obesity epidemic, hypothyroidism often occurs due to low thyroid function, causing the person to gain weight, and the two conditions are often linked. When the thyroid gland or its hormones become the target of an immune attack, an underactive thyroid can result, and this condition can be difficult to diagnose in its early stages. That is why it is extremely important for nutritionists, as well as medical professionals, to learn to recognize symptoms and manifestations in the early stages. Hypothyroidism, if left untreated, can contribute to unwanted weight gain and a host of debilitating symptoms that can lead to serious health problems.

What is the thyroid gland and how does it work

The thyroid gland is a small butterfly-shaped gland located at the base of the throat, under the Adam's apple, responsible for the production of several hormones that affect the energy production of almost every cell, tissue, and organ in the body. It controls metabolism, regulates body temperature, and affects body weight, muscle strength, energy levels, and fertility.

The primary hormones produced by the thyroid gland (T4 and T3) are formed from the amino acid tyrosine and iodine. Hormone production depends on the hypothalamus, which monitors the body's need for more thyroid hormones and signals the pituitary gland to release these hormones. The thyroid-stimulating hormone, released from the pituitary gland, controls and influences the production of the above hormones. TSH levels rise and fall in response to fluctuations in these hormones in the blood.

Hypothyroidism can occur when there is dysfunction in any of these glands, resulting in a lack of thyroid hormone production. It can also be the result of other problems, such as: inefficient conversion of the T4 prehormone to T3 hormone, or insensitivity of hormone receptors in cells. An underactive thyroid gland contributes to the development of a huge number of physiological effects throughout the body.

Autoimmune thyroiditis

Autoimmune thyroiditis is the most commonly diagnosed form of hypothyroidism in developed countries, with symptoms affecting approximately 2% of the population. What makes this disease more insidious is that a significant number of patients diagnosed with autoimmune thyroiditis do not have any symptoms. Another small percentage of men and women suffer from a subclinical form of this disease, i.e. their symptoms are almost invisible, and the disease is extremely difficult to detect using clinical tests.

Who is at risk for developing autoimmune thyroiditis?

Autoimmune thyroiditis can appear at any age, even in young children, and can occur in people of both sexes. However, this condition is most common among women, usually between the ages of 30 and 50. At the age of 60, according to scientists, 20% of women have hypothyroidism. According to various estimates, women get sick 10-50 times more often than men. This is thought to be due to the fact that in women, the immune system regulates the reproductive cycle as well.

What causes autoimmune thyroiditis?

Studies show that the combination of genetic predisposition and environmental pollution can be a significant risk factor for the development of autoimmune thyroiditis. Both autoimmune thyroiditis and Basedow's disease increase the risk of autoimmune disease in families with a history of autoimmune disease. In addition, there are many environmental factors that can provoke this disease. Experts believe that it is likely that many factors at once, and not just one, contribute to the onset of hypothyroidism.

Toxins are of particular concern, especially those created from petrochemicals such as plastics (found in the water bottles we drink), pesticides, fertilizers, dioxin, body care products, and air and water pollution. water - contain substances that mimic the body's estrogens. These xenoestrogens are powerful endocrine disruptors that affect hormone balance. In particular, both dental fillings and fluoride in toothpaste and water are also endocrine disruptors. Mercury amalgams are especially dangerous (since they are very close to the throat) and can pose a serious threat to the thyroid gland.

Possible risk factors:

• Viral, bacterial infections or candidiasis.
• Constant stress, enough to cause adrenal insufficiency, prevents the conversion of T4 to T3 and weakens the body's immune defenses.
• Pregnancy - causes changes in the hormonal and immune systems in sensitive women during pregnancy or after childbirth. (See Autoimmune Thyroiditis and Pregnancy)
• Injury - surgery or accident.
• Nutritional deficiencies - in particular iodine and/or selenium deficiencies.
• Bacteria in food are primarily Yersinia enterocolitica.

Symptoms

As stated above, autoimmune thyroiditis may be asymptomatic, but when symptoms do appear, they usually begin with a gradual enlargement of the thyroid gland (goiter) and/or gradual development of hypothyroidism, with the following symptoms:

• anemia (both iron deficiency and malignant)
• mental fog (forgetfulness, slow thinking, constant loss of energy)
• chest pain
• cold intolerance
• very cold hands and feet
• cold weather exacerbates symptoms
• dry, rough skin
• early graying of hair
• exhaustion after exercise
• frequent colds and flu (heavy recovery from these diseases)
• headaches, including migraines
• high cholesterol, especially LDL
• infertility and miscarriages
• low basal body temperature
• low libido
• muscle cramps and/or tenderness
• hair loss
• restless leg syndrome
• severe premenstrual syndrome
• sleep disorders
• slow speech
• fatigue and aching muscles
• weak, brittle nails
• weight gain (obesity)

There are other, less common symptoms, including high blood pressure and excess earwax. Underactive thyroid can also have profound health consequences, including short stature, decreased concentration, lower IQ in children born to mothers with hypothyroidism, and quite possibly an increased risk of cardiovascular disease.

What to eat with autoimmune thyroiditis

Once diagnosed with autoimmune thyroiditis, it is essential to balance your diet so that you can help your body stop inflammation, balance your hormones, and help your thyroid produce hormones and convert them properly. When antibodies to thyroid cells are detected in the body, doctors prescribe a synthetic T4 hormone (levothyroxine), and in addition to drug therapy, nutritionists recommend starting a specific therapeutic diet (see Diet for Autoimmune Thyroiditis).

Nutritional support for the thyroid gland is the shortest route to a cure. Eating a diet rich in high quality proteins and fats, abundant in fresh organic vegetables, fruits, nuts, seeds, certain types of whole grains, and other nutritious foods is key. It is highly recommended to consume an increased amount of protein, as an underactive thyroid reduces the body's ability to use consumed proteins. However, people whose metabolism is driven primarily by their adrenals, thyroid, or gonads need minor dietary changes despite a diagnosis of AIT. Also, in addition to the three main meals, try also having two or three snacks a day to keep your energy levels up throughout the day.

Squirrels

At each meal, it is recommended to consume 40 grams of protein, especially animal proteins. In addition, at least 20 grams of protein should be taken with every snack, and eating cold water fish is an exceptional choice because it contains omega-3 fatty acids. Whey protein is also a good source, but if you are a vegan or vegetarian, good plant-based protein sources for you include:

• tempe
• almond
• flax or hemp seeds

Healthy fats

Consume 4-6 tablespoons of "healthy fats" daily from avocados, nuts and seeds (especially pumpkin, chia and flax seeds), organic butter and ghee, olive oil and coconut milk, meat and vegetable oil. Coconut oil is very beneficial for the thyroid gland due to the lauric acid it contains, which calms the endocrine system. The medium chain fatty acids in coconut products are quickly absorbed and are an excellent source of energy for the body, and are also beneficial for weight loss!

Foods rich in antioxidants

People with autoimmune thyroiditis should also focus on eating plenty of foods rich in antioxidants, as they are essential to combat the damage caused by free radicals caused by inflammation. Emphasis should be placed on eating foods rich in vitamin A, as they are especially beneficial as people with autoimmune diseases often develop vitamin A deficiency. The reason for this is that their bodies often cannot convert beta -carotene to vitamin A. Other nutrients with antioxidant properties that people with autoimmune thyroiditis may be deficient in include vitamins C and E, iodine, zinc, and selenium.

• Foods rich in vitamin A and beta-carotene: Carrots, veal liver, fish oil, eggs, Greek yogurt, lightly cooked spinach, kale, collard greens, chard, zucchini, red peppers, apricots, cantaloupe, and sweet potatoes.
• Foods Rich in Vitamin C: red sweet pepper, parsley, broccoli, citrus fruits, romaine lettuce.
• Foods Rich in Vitamin E: lightly stewed mustard greens and swiss chard, sunflower seeds, almonds, avocado.
• Foods rich in iodine: seaweed (especially very high quality dulce and kelp), seafood (mercury-free and wild-caught, not farmed).
• Foods rich in zinc: oysters, crabs, beef (from natural cows), sesame and pumpkin seeds.
• Selenium Rich Foods: Brazil nuts, crimini mushrooms, cod, shrimp, halibut, perch, oats, sunflower seeds, brown rice (read more about selenium here - Selenium: benefits and harms to the body).

Vegetables

Consume at least 900 grams of multi-colored vegetables daily, lightly cooked or raw. Avoid eating cabbage family vegetables (kale, broccoli, cauliflower, turnips, etc.) raw as these vegetables suppress thyroid function. However, do not be too zealous - everything should be in moderation.

Carbohydrates

Fruits, grains, and starchy vegetables should be consumed in moderation. Eat 500 grams of fruit per day, plus 100 - 200 grams once or twice a day of whole grains or starchy vegetables. Whole grains should be consumed soaked or sprouted to make them more digestible. This is very important for people with poor digestion, as this condition is often seen in people with hypothyroidism.

Water

Drink at least 8 glasses of clean, filtered water daily. Avoid drinking water with chlorine and fluoride, as these elements are halogens and compete with iodine, which can lead to thyroid dysfunction. Also, remember: It's not smart to buy water in plastic bottles!

Functional nutrition and nutritional supplements

For people with a lot of health problems, taking dietary powder supplements is a great idea. You can take undenatured whey protein concentrate (or other protein powder for those who are intolerant to dairy or are vegan/vegetarian), seaweed, grass, sea vegetables, dietary fiber (fiber) blends, including flaxseed meal and apple pectin.

It is recommended to take anti-inflammatory extracts of organic fruits and vegetables, as well as other therapeutic ingredients such as aloe vera, detoxifying herbs, ionic minerals, probiotic bacteria (fermented milk products, probiotics, sauerkraut, etc.) and digestive enzymes. This combination provides the body with an easily digestible protein rich in sulfur-containing amino acids that help detoxify the body; healing chlorophyll and anti-inflammatory nutrients that help cool down an overheated immune system and cleanse the blood, thyroid, and thyroid hormones of impurities.

You can use these products as a meal replacement, as a smoothie or simply added to warm or cool liquids (water or tea). By mixing them with coconut water, you can improve your body even more.

Best Herbal Supplements

Herbal supplements are sold in many forms, mainly in the form of capsules and tablets, which should usually be taken in several doses several times a day. This supplementation schedule may not be strictly followed by everyone. Powders can be taken once a day and are much more convenient. Since different foods have different ingredients, it makes sense to use more than one and alternate between them. Some of the best such products are It Works Greens™, Athletic Greens® and Garden of Life Perfect Food Green. They can be mixed with water or added to puree. Again, a supplement cannot replace a healthy diet, but good herbal supplements can certainly make a huge difference in your diet.

What not to eat with autoimmune thyroiditis

Gluten is contraindicated in AIT

unsaturated oils(including canola oil): These oils promote hypothyroidism because they are high in inflammation-promoting omega-6 fatty acids, and they tend to go rancid before being bottled (or rancid in clear bottles).

GMO soy: Disruptive to the endocrine system, and is considered somewhat toxic. Soy is considered a good source of protein, but GMO soy is not recommended for patients with autoimmune thyroiditis, even in small amounts, as such soy damages the hormonal system. An exception to this rule is fermented soy products (from natural soy), such as tempeh, natto, and miso.

Spirulina and other algae: Although iodine deficiency can help cause hypothyroidism, American Thyroid Association warns that attempting to treat the disorder by consuming large doses of iodine, including the iodine present in sea vegetables such as spirulina, may worsen the symptoms of the condition. This is especially true if the hypothyroidism is caused by autoimmune thyroiditis (Hashimoto's disease), an autoimmune disease in which thyroid tissue is exposed to the body's own immune cells. Too much iodine can stimulate these cells to become more active, exacerbating the autoimmune process.

What else can be done with autoimmune thyroiditis

Because autoimmune thyroiditis can impair digestion, it's a good idea to support digestion with enzymes and probiotics, and supplement your diet with additional nutrients that the body is most often deficient in this condition.

• Natural multivitamins: Take as directed on the package.
• Antioxidant Supplements: Take as directed daily.
• Essential fatty acids: from fish or flax; 1000-2000 mg per day in two doses.
• B Vitamin Supplements: Take in capsule or tablet form, but nutritional yeast is preferred.
• Calcium: 250-300 mg (1-2 at bedtime). Calcium and iron need to be taken two hours before or after you take your thyroid medication so they won't interfere with your absorption. Read more about which form of calcium to choose and how they differ here - Which calcium is better - an overview of calcium forms.
• Magnesium: 200 mg 2 times a day.
• Selenium: Dietary supplementation with selenium supplements (200 mcg) for 3 months has been shown to significantly reduce thyroid peroxidase autoantibodies and significantly improve well-being and/or mood. Note: Selenomethionine is recommended. If you are pregnant, do not exceed 400 micrograms per day!
• Iodine: If supplements do not contain 150-200 micrograms of iodine, use kelp supplements at 2-3 grams per day. This has been shown to help lower antibody levels.
• Vitamin D3: In autoimmune diseases, the human body is deficient in vitamin D3, therefore, supplementation of this vitamin is recommended to ensure optimal immune function and production of thyroid hormones. Take 1,000-5,000 IU of vitamin D3 daily to bring your body's levels of this vitamin up to target. After that, it is necessary to adhere to maintenance dosages (as recommended by the doctor).
• L-tyrosine: Thyroid hormones are synthesized from tyrosine. Its reception makes it possible to improve the functions of the thyroid gland, adrenal glands and pituitary gland. L-tyrosine is recommended to be taken at 500 mg twice daily, but low enough levels of this amino acid are rare, so not all people with autoimmune thyroiditis and hypothyroidism need supplements.
• Chromium: 200 mcg per day.
• Iron: If the blood test shows an iron deficiency, take calcium and iron two hours before or after you take your thyroid medication, otherwise this drug will interfere with their absorption.
• Zinc: If tests show a zinc deficiency, take zinc supplements at 50 mg daily.

Additional nutritional supplements:

• Take a variety of free-form amino acids daily (two 500 mg capsules).
• Taurine (two 500 mg capsules daily).
• Proteolytic enzymes on an empty stomach to eliminate inflammation.

Vegans may need to supplement with nutrients that are usually not available in sufficient amounts in their diets that exclude animal foods. They are advised to supplement with vitamin B12, vitamin D, L-carnitine, zinc and selenium.

• Reduce your calorie intake by about 30%, and stop eating before you feel full, trying to eat nutrient-dense foods. (Shown to improve both immune and thyroid function.)
• “Eat breakfast like a king, lunch like a prince, and dinner like a pauper” to prevent nighttime food overload, as eating late at night can contribute to weight gain.

Licopid is a new generation immunomodulator that is used to restore immunity. Immunity disorders often develop against the background of long-term infectious and inflammatory diseases of various organs. The inclusion of licopid in the complex treatment of such diseases reduces the number and severity of relapses.

How lycopid works

The active ingredient of lycopid (glucosaminylmuramyl dipeptide - GMDP) is a part of the bacterial cell wall that is common to most bacteria. GMDP actively affects the immune system due to the fact that immune cells (macrophages, neutrophils, lymphocytes) have special receptors that are sensitive to this substance. By binding to immune cells, licopid increases the activity of cellular and humoral immunity cells.

This is a drug that is highly effective and safe, so it is prescribed for both adults and children. It is available in tablets of 1 and 10 mg. As a result of the action of licopid, the body's resistance to infectious factors increases, the reproduction of tumor cells is suppressed, and leukopoiesis is stimulated - the synthesis of leukocytes, the main function of which is to fight infection.

In what cases is it assigned

Likopid is prescribed for the treatment of chronic sluggish infectious and inflammatory diseases, in which there is a decrease in immunity. Most often these are diseases of the bronchi and lungs - chronic bronchitis, chronic obstructive (with impaired bronchial patency) lung disease (COPD), bronchiectasis , chronic pneumonia, tuberculosis lungs. With all these diseases, immunity is very important, and if it is affected, the disease proceeds with frequent exacerbations and constantly progresses.

Licopid is used in the treatment of chronic infectious and inflammatory diseases and other organs. It is actively used in the treatment of infections of ENT organs, soft tissues (including infected wounds), urological, gynecological, ophthalmological diseases. Likopid is also good for treating bacterial infections because it increases the effectiveness of antibacterial drugs, with the exception of sulfonamides and tetracyclines.

Good immunity is also necessary to fight chronic viral infection, so licopid is used in the treatment of recurrent herpes (including herpes infection of the eyes), chronic viral hepatitis, cytomegalovirus infection, genital warts caused by human papillomavirus. With all these diseases, licopid is part of complex therapy, enhancing the effect of antiviral drugs and allowing them to be reduced in dosage.

Likopid is also used in pediatric practice. There are no age restrictions for the use of this drug. It can be used both in the treatment of acute infectious and inflammatory diseases and chronic ones. Do not use licopid only at high temperatures - this can increase the fever. Licopid can be prescribed to children who often suffer from colds, intestinal infections, chronic diseases of the upper and lower respiratory tract, and so on.

How to take

Likopid is taken under the tongue or by the cheek. You can take the whole tablet, or you can grind it and use it as a powder. In acute bacterial or viral infections, exacerbations of chronic infections, adults are prescribed licopid tablets 1 mg once or twice a day half an hour before meals for 10 days.

To prevent recurrence of chronic often recurrent infections, including tuberculosis, take 10 mg tablets also once a day for ten days. Children under 16 years of age are prescribed 1 mg tablets, individually selecting the dose.

Licopid is a safe drug and there have been no cases of its overdose so far.

When is licopid contraindicated and does it have side effects

Licopid is contraindicated in case of its individual intolerance, high temperature (above 38°C), autoimmune thyroiditis Autoimmune thyroiditis is a disease of the thyroid gland

Immunomodulator

Active substance

Glucosaminylmuramyl dipeptide (GMDP)

Release form, composition and packaging

Pills white, round, flat-cylindrical, with a chamfer and a notch.

Excipients: lactose monohydrate - 184.7 mg, sugar (sucrose) - 12.5 mg, potato starch - 40 mg, methylcellulose - 0.3 mg, calcium stearate - 2.5 mg.

10 pieces. - cellular contour packings (1) - packs of cardboard.

pharmachologic effect

Pharmacodynamics

The active substance of Licopid tablets is glucosaminylmuramyl dipeptide (GMDP) - a synthetic analogue of the structural fragment of the shell (peptidoglycan) of bacterial cells. GMDP is an activator of innate and acquired immunity, enhances the body's defense against viral, bacterial and fungal infections; has an adjuvant effect in the development of immunological reactions.

The biological activity of the drug is realized through the binding of GMDP to the intracellular receptor protein NOD2, localized in the cytoplasm of phagocytes (neutrophils, macrophages, dendritic cells). The drug stimulates the functional (bactericidal, cytotoxic) activity of phagocytes, enhances the presentation of antigens by them, the proliferation of T- and B-lymphocytes, increases the synthesis of specific antibodies, and contributes to the normalization of the balance of Th1/Th2-lymphocytes towards the predominance of Th1. Pharmacological action is carried out by enhancing the production of key interleukins (interleukin-1, interleukin-6, interleukin-12), TNF alpha, interferon gamma, colony-stimulating factors. The drug increases the activity of natural killer cells.

Licopid has low toxicity (LD 50 exceeds the therapeutic dose by 49,000 times or more). In the experiment, when administered orally at doses 100 times higher than the therapeutic one, the drug does not have a toxic effect on the central nervous system and the cardiovascular system, does not cause pathological changes in the internal organs.

Likopid does not have embryotoxic and teratogenic effects, does not cause chromosomal, gene mutations.

In experimental studies conducted on animals, data were obtained on the antitumor activity of the drug Likopid (GMDP).

Pharmacokinetics

The bioavailability of the drug when taken orally is 7-13%. The degree of binding to the blood is weak. The time to reach Cmax is 1.5 hours after ingestion. T1 / 2 - 4.29 hours. Active metabolites do not form, it is excreted mainly through the kidneys unchanged.

Indications

The drug is used in adults in the complex therapy of diseases accompanied by secondary immunodeficiency states:

• acute and chronic purulent-inflammatory and soft tissues, including purulent-septic postoperative complications;
• sexually transmitted infections (papillomavirus infection, chronic trichomoniasis);
• herpetic infection (including with ophthalmic herpes);
• psoriasis (including);
• pulmonary tuberculosis.

Contraindications

• hypersensitivity to glucosaminylmuramyl dipeptide and other components of the drug;
• pregnancy;
• lactation period (breastfeeding);
• children's age up to 18 years;
• autoimmune in the acute phase;
• conditions accompanied by febrile temperature (> 38 ° C) at the time of taking the drug;
• rare congenital metabolic disorders (alactasia, galactosemia, lactase deficiency, sucrase / isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption);
• use in autoimmune diseases is not recommended due to lack of clinical data.

Likopid 10 mg carefully used in the elderly, strictly under the supervision of a physician.

Dosage

Licopid is taken orally on an empty stomach, 30 minutes before meals.

When you skip taking the drug if passed no more than 12 hours from the scheduled time, the patient may take the missed dose; in case it passed more than 12 hours from the scheduled time of admission, it is necessary to take only the next dose according to the scheme and not to take the missed one.

Purulent-inflammatory diseases of the skin and soft tissues, acute and chronic, severe course, including purulent-septic postoperative complications:

Herpetic infection (recurrent course, severe forms): 10 mg 1 time / day for 6 days.

With ophthalmic herpes: 10 mg 2 times / day for 3 days. After a break of 3 days, the course of treatment is repeated.

Sexually transmitted infections (papillomavirus infection, chronic trichomoniasis): 10 mg 1 time / day for 10 days.

Psoriasis: 10-20 mg 1 time / day for 10 days and then five doses every other day, 10-20 mg 1 time / day.

In severe psoriasis and extensive lesions (including psoriatic arthritis): 10 mg 2 times / day for 20 days.

Pulmonary tuberculosis: 10 mg 1 time / day for 10 days.

Side effects

Often (1–10%)- arthralgia (pain in the joints), myalgia (); at the beginning of treatment, there may be a short-term increase in body temperature to subfebrile values ​​​​(up to 37.9 ° C), which is not an indication for discontinuation of the drug. Most often, the above side effects are observed when taking Likopid tablets in high doses (20 mg).

Rarely (0.01-0.1%)- short-term increase in body temperature to febrile values ​​(>38.0°C). With an increase in body temperature> 38.0 ° C, it is possible to take antipyretics, which does not reduce the pharmacological effects of Likopid tablets.

Rarely (<0.01%) - diarrhea.

If any of the side effects indicated in the instructions are aggravated or the patient notices any other side effects, the doctor should be informed.

Overdose

Cases of drug overdose are unknown.

Symptoms: based on the pharmacological properties of the drug, in case of an overdose, there may be a rise in body temperature to subfebrile (up to 37.9 ° C) values.

Treatment: if necessary, symptomatic therapy (antipyretics) is carried out, sorbents are prescribed. The specific antidote is unknown.

drug interaction

The drug increases the effectiveness of drugs, there is synergism in relation to antiviral and antifungal drugs.

Antacids and sorbents significantly reduce the bioavailability of the drug.

GCS reduce the biological effect of the drug Likopid.

special instructions

At the beginning of taking the drug Likopid 10 mg, an exacerbation of the symptoms of chronic and latent diseases associated with the main pharmacological effects of the drug is possible.

In the elderly, Likopid 10 mg is used with caution, strictly under the supervision of a physician. Elderly patients are recommended to start treatment with half doses (1/2 of the therapeutic dose), in the absence of side effects, increasing the dose of the drug to the required therapeutic dose.

The decision to prescribe Licopid tablets 10 mg to patients with a combination of diagnoses of psoriasis and gout should be made by the doctor when assessing the risk/benefit ratio, due to the potential risk of exacerbation of gouty arthritis and joint edema. If the doctor decides to prescribe the drug Likopid 10 mg tablets in a situation where the patient has a combination of diagnoses of psoriasis and gout, treatment should be started at low doses, in the absence of side effects, increasing the dose to therapeutic.

Each Likopid 10 mg tablet contains sucrose in the amount of 0.001 XU (bread units), which should be taken into account in patients with diabetes mellitus.

Each Licopid 10 mg tablet contains 0.184 grams of lactose, which should be taken into account in patients suffering from hypolactasia (lactose intolerance, in which the body has a decrease in the level of lactase, an enzyme necessary for the digestion of lactose).

Influence on the ability to drive vehicles and control mechanisms

Does not affect the ability to drive vehicles and complex mechanisms.

Pregnancy and lactation

Taking the drug Likopid 10 mg is contraindicated in women during pregnancy and breastfeeding.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

The drug should be stored in a dry, dark place, out of the reach of children, at a temperature not exceeding 25°C. Shelf life - 5 years. Do not use after the expiration date.