Ointment with lidocaine for pain relief. Ointment with lidocaine: names, instructions for use

general characteristics

Basic physical and chemical properties

White homogeneous ointment, odorless.

Each gram contains:

active substance: lidocaine - 50 mg;

Excipients: polyethylene glycol 400, polyethylene glycol 4000, propylene glycol, purified water.

Pharmacological group and ATX code

local anesthetic. ATX code: N01BB02.

Pharmacological properties

A local anesthetic of the amide type. Provides local anesthesia by blocking the formation and passage of a nerve impulse. The mechanism of action is associated with the stabilization of the permeability of the neuronal membrane for sodium ions. The threshold of electrical excitability rises and, consequently, the conduction of the impulse is blocked.

Pharmacokinetics

Suction: when applied topically to mucous membranes, lidocaine is absorbed to varying degrees, depending on the dose and site of application. The rate of perfusion in the mucosa affects absorption.

Distribution: lidocaine is distributed in well-perfused organs, incl. in the kidneys, lungs, liver, heart, and also penetrates into adipose tissue. Penetrates the placenta by passive diffusion. Distribution in the placenta may be sufficient to penetrate the fetus and reach toxic levels. Lidocaine crosses the placenta rapidly, appearing in the fetal circulation within minutes of maternal administration.

The binding of lidocaine to plasma proteins is largely dependent on the concentration of the drug and alpha-1-acid glycoprotein (AAG) in plasma. There are reports of lidocaine binding to proteins by 60-80%. This indicates that plasma protein binding is increased in uremic patients and renal transplant recipients and is increased after acute myocardial infarction. The latter is also characterized by an increase in AAG levels. Increased protein binding may reduce the effect of free lidocaine or even cause an overall increase in plasma concentrations of the drug.

Metabolism: lidocaine is metabolized with the participation of microsomal liver enzymes, the decrease in alkalinity due to oxidation occurs within a few minutes. The metabolic rate is limited by blood flow to the liver and, as a result, may be impaired in patients with myocardial infarction and/or congestive heart failure. As a result of the biotransformation of lidocaine, metabolites are formed - monoethylglycine exylidide (MEGKS) and glycine exylidide, which have a much less pronounced antiarrhythmic activity.

Derivation: about 90% is excreted in the form of metabolites and 10% - unchanged by the kidneys. The excretion of unchanged drug in the urine depends in part on the pH of the urine. It is reported that acidic urine leads to an increase in the proportion excreted in the urine. The half-life (T 1/2) of lidocaine is longer in patients with liver disease.

Indications for use

Lidocaine, 5% ointment is used for local anesthesia of the skin and mucous membranes of the oral cavity and perianal area

Dosage and administration

The dose depends on the indication, the area of ​​the anesthetized surface, the vascularity of the tissue and on the individual tolerance of the patient. Use the lowest dose to achieve the desired effect. Do not use the drug for a long time

Adults and children over the age of 12

For pain relief– apply 1-2 g if necessary

Children (up to 12 years old)

In children under 12 years of age, 100% bioavailability after application to mucous membranes and damaged skin should be taken into account, and therefore the maximum amount of Lidocaine, 5% ointment administered to children, should not exceed 0.1 g ointment / kg body weight (corresponding to 5 mg lidocaine / kg of body weight). The minimum interval between doses in children should be 8 hours.

Side effect

Hypersensitivity reaction in the form of skin irritation (the drug contains propylene glycol), urticaria, edema, in severe cases, anaphylactic shock may develop.

Systemic toxicity with local anesthetics mainly includes CNS and cardiovascular side effects.

From the CNS — restlessness, anxiety, agitation, nervousness, disorientation, confusion, paresthesia, dizziness, tinnitus, miosis, blurred vision, nausea and vomiting, muscle spasms and tremors. Insensitivity of the tongue and around the mouth, absent-mindedness, irritation, depression and drowsiness, respiratory failure and coma.

From the side of the cardiovascular system: myocardial depression, peripheral vasodilation resulting from hypertension and bradycardia; arrhythmias and cardiac arrest.

Rarely: possible methemoglobinemia.

Contraindications

• Damaged mucosa (increased absorption of the anesthetic leading to an increased risk of systemic toxicity)
• Children's age up to 2 years
• Hypersensitivity to lidocaine.

Despite the low risk of systemic absorption, it should be taken with caution in anemia, congenital or acquired methemoglobinemia, glucose-6-phosphate dehydrogenase deficiency. If the patient has an allergic reaction, you should immediately stop using the drug and carry out symptomatic treatment.

Lidocaine should not be given to patients with hypovolemia, heart block, or other conduction disorders. Use with caution in congestive heart failure, bradycardia or respiratory depression.

Hypersensitivity: Lidocaine is used with caution in patients with hypersensitivity to it. In patients allergic to derivatives of para-aminobenzoic acid (procaine, tetracaine, benzocaine, etc.), cross-sensitivity to lidocaine is not observed.

Pregnancy: Relevant studies have not been conducted. However, the drug should be taken with caution in the early stages of pregnancy.

Lactation: Lidocaine is excreted in breast milk in small amounts, which may not pose a risk to the baby.

With kidney failure the pharmacokinetics of Lidocaine 5% ointment does not change.

With hepaticinsufficiency use with extreme caution, since lidocaine is metabolized mainly by the liver.

Avoid contact with eyes.

Overdose

Systemic toxicity with local anesthetics is mainly associated with high plasma concentrations and includes mainly CNS and cardiovascular side effects.

Symptoms

From the CNS : paresthesia, insensitivity of the tongue, dizziness and absent-mindedness, ringing in the ears, drowsiness, sensation of heat, cold or stiffness, tinnitus, trembling, unusual anxiety, agitation, nervousness or restlessness, diplopia, confusion, convulsions. Perhaps unconsciousness or small convulsions, which can last from a few seconds to several minutes.

From the side of the cardiovascular system : acute hypotension, bradycardia, arrhythmias, and cardiovascular collapse.

Treatment:symptomatic — it is necessary to ensure the free passage of the respiratory tract, the utilization of oxygen, the purification of carbon dioxide, the introduction of oxygen and / or the provision of artificial respiration. To relieve seizures, it is necessary to administer succinylcholine at a dose of 50-100 mg and / or diazepam at a dose of 5-15 mg. It is also possible to use short-acting barbiturates (sodium thiopental). In the acute phase of lidocaine overdose, dialysis is ineffective.

Interaction with other drugs

Antiarrhythmic drugs: There are reports of paralysis or cardiac arrest in patients treated with lidocaine with amiodarone or tocainide. Disorder of consciousness has been observed when used with procainamide.

Antiepileptic drugs: Phenytoin and barbiturates can reduce the concentration of lidocaine in the blood. In / in phenytoin enhances the cardiodepressive effect of Lidocainase.

Beta blockers: With simultaneous use with propranolol, the concentration of lidocaine in plasma increases significantly. A detailed interaction is observed with nadolol.

H 2 - antagonists: Cimetidine increases the hepatic metabolism of lidocaine, leading to an increased risk of lidocaine toxicity.

Hypokalemia caused by acetazolamide, loop and thiazide diuretics counteracts the effect of lidocaine.

Side effects are observed when used simultaneously with vasoconstrictors.

Release form and packaging

5% ointment in aluminum tubes of 15 g, together with a leaflet in a pack of cardboard.

Storage conditions

Keep out of the reach of children, dry, dark place at a temperature not exceeding 15˚C.

Shelf life

3 years. Do not use after the expiration date.

Holiday conditions

By prescription.

Lidocaine is used primarily as an anesthetic and comes in injectable ampoules. But potentially this substance has many other advantages, in particular, it has antiarrhythmic properties. But the main function of the drug is currently the most popular for use in medicine. In this regard, lidocaine is produced, in addition to the already known ampoules with solutions for injections of various concentrations, also in other dosage forms. One such form is lidocaine ointment, which can be used for a wide variety of conditions.

Composition and action of the drug

The main and only active ingredient in lidocaine ointment is lidocaine hydrochloride, which contains 2 mg in 1 gram of ointment. The basis for the ointment consists of excipients, which may vary depending on the manufacturer and the intended use of a particular ointment. It can be:

• glycerol;
• hyetellosis, etc.

The pharmacological properties of the drug are based on the fact that the substance reduces the permeability of the membranes of some neurons to sodium ions. Thus, fewer ions pass through the membrane, and numbness occurs at the injection site. The drug spreads extremely quickly through the surrounding tissues, so anesthesia begins quickly: within 10-15 minutes after application

The agent works for 2-3 hours. The route of administration does not affect the duration of action.

The substance is excreted from the body within 10-12 hours, which must be taken into account under certain circumstances during the treatment.

List of names of ointments with lidocaine

On the pharmaceutical market, there are a lot of different ointments, gels and creams containing lidocaine as the main substance:

• Emla cream from the Swedish pharmaceutical company AstraZeneca.
• Gel Kamistad.
• Domestic gels with lidocaine, which are usually called by the name of the main substance.
• Aurobin from the Hungarian company Gedeon Richter.
• Calgel is a dental gel used to anesthetize the oral mucosa and treat diseases such as stomatitis.

This is a list of the most popular versions of lidocaine in the dosage form of an ointment, there may also be less popular analogues, but at the moment, lidocaine-based ointments in pharmacy chains are represented by these names.

Comparison table of analogues of the drug by cost. The last data update was 03/29/2020 00:00.

Indications for use

Pain relief with lidocaine is a popular measure in a wide range of medical fields, from surgery to dentistry. The main indications for which it is necessary to use this tool:

• Surgical treatment, minor surgical interventions.
• Local anesthesia in traumatology, when the site of an injury needs to be anesthetized so that the patient does not experience pain during treatment.
• Lidocaine is very widely used in dental practice, as pain relief in dental treatment is one of the first places in importance. In this case, not only the injection of lidocaine familiar to everyone directly during treatment is used, but also an ointment with lidocaine for toothache, which helps to get to the doctor more comfortably or endure the postoperative period with less stress.
• In endoscopic manipulations, this drug is also used, but in this case, lidocaine in the form of a spray is more popular, in particular, because of the convenience of its use. However, in some cases, ointment is also used. It is applied to the surface of the device, which helps to additionally anesthetize the patient.

The popularity of the drug is due, in particular, not only to the versatility of the substance itself for pain relief, as well as the speed and safety of anesthesia with its help, but also to the fact that the drug, with all its useful properties, is also quite inexpensive.

Instructions for use

Different types of ointments can be used for different purposes, and the method of applying them may differ depending on this.

For toothache

If such a remedy is used to anesthetize the oral cavity, for example, in case of pain in the gums or teeth, then the drug must be applied with a special swab so as not to introduce an additional microbial infection.

Use for gums

The gums can hurt for a variety of reasons. To completely eliminate such pain, many diagnostic procedures are required, which are possible only in medical institutions. However, if it is impossible to get to the doctor at a particular moment, then the pain can be eliminated with the help of a medicine with an anesthetic. There is a fairly wide selection of dental gels on the pharmaceutical market, among which there is also a gel with lidocaine. Applying it is similar to applying the same gel for toothache. The agent begins to act in 10 minutes. The effect lasts 2-3 hours.

For joints

In some cases, lidocaine medicine is also used for joints, or rather, to relieve pain. In this case, it is advisable to use a small amount of the product, applying it strictly to the problem area, while trying not to touch the surrounding tissues. Remember that this drug does not cure joint problems, but is a symptomatic remedy that eliminates pain. For a complete treatment, you will need to visit a doctor.

For wounds

Doctors try not to treat open wounds with this remedy, as this will require applying the remedy to the damaged surface. But in some cases, the ointment is still used, as it is the easiest way to relieve the patient of pain. One such case is the appearance of hemorrhoids or bumps in a patient.

In the treatment of hemorrhoids, the drug is used very widely. And the application requires some preparatory procedures, in particular, it is necessary to empty the intestines and carry out hygiene procedures before application. After that, an anesthetic is applied to the anus 2 to 4 times a day. It is advisable to use the remedy only during the period of exacerbation, when the pain is strong enough and does not allow a person to lead a comfortable lifestyle for him.

Also, the remedy is indicated for bruises and slaughters, if there is no open wound.

Price and storage conditions

The price of certain ointments or gels depends very much on the pricing policy of a particular manufacturer. According to the already established tradition, domestic pharmaceutical manufacturers put cheaper products on the market, while foreign companies set higher prices. It is difficult to say how justified this approach is, but one way or another, each drug finds its patient and consumer. The average price of a medicine is from 20 to 100 rubles.

Storage conditions for the ointment are standard: from +15 to +25 degrees. But some individual ointments require mandatory storage in the refrigerator. Therefore, after the purchase, it is advisable to read the instructions for use, which indicates the specific requirement of the manufacturer for the storage of his particular ointment.

The drug should be protected from children and avoid exposure to sunlight.

It is possible to store the product for 2 years under the conditions specified in the instructions.

Efficiency

Easy to find in pharmacies

Side effects

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Ointment Lidocaine refers to local anesthetics and antiarrhythmic drugs. It reduces the level of excitability of sensory nerve endings of the mucous membranes and skin upon contact. The type of anesthesia depends on the dosage form in which the substance is used. Allocate terminal anesthesia, in which the anesthetic is applied to the surface and blocks the sensitive endings. The second type of anesthesia is infiltration - Lidocaine solution is injected into the skin and underlying tissues.

There are conduction anesthesia, when the substance is injected along the path of the nerve, causing a blockade of innervation, and spinal anesthesia - the agent is injected into the subarachnoid space of the spinal cord.

Manufacturer and country of production

Lidocaine is produced in the Hungarian capital, Budapest. Manufacturing plant - "EGIS".

Release form

There is Lidocaine in the form of a spray. One vial contains 650 doses. Prices range from 350 to 400 rubles. Compound:

Ask your question to a neurologist for free

Irina Martynova. Graduated from the Voronezh State Medical University. N.N. Burdenko. Clinical intern and neurologist of BUZ VO \"Moscow Polyclinic\".

• lidocaine - 3.8 g (active substance);
• ethyl alcohol (96%) - 27.3 g;
• propylene glycol - 6.82 g;
• peppermint leaf oil - 0.08 g.

Spray dosage varies depending on cause and application.

One dose of spray (equivalent to a single tap on the valve) contains 4.8 mg medication. Most often, 1-2 pressures are enough for adequate pain relief, but, for example, in obstetrics, it is advisable to produce about 15 pressures. The maximum allowable number of injections is 40 doses per 70 kg of body weight.

In medicine, Lidocaine is used in the form of a 2 ml solution. The price depends on the concentration- so, a 2% solution costs 75-100 rubles, and a 10% solution costs 350-400 rubles.

The composition includes:

• lidocaine hydrochloride anhydrous - 40 mg (active substance);
• sodium chloride - 12 mg;
• water for injection - up to 2 ml.

For the purpose of infiltration anesthesia, doctors use a solution of Lidocaine 5 mg per ml of solvent (the maximum allowable dosage is 400 mg).

To carry out peripheral neural blockade, a solution of 10-20 ml (10 mg per ml of solvent) is used.
For conduction and epidural anesthesia, it is required to dissolve 10-20 mg of Lidocaine in 1 ml.
With spinal anesthesia, 3-4 ml of a 20 mg / ml solution is administered.

On the pharmacological market, Lidocaine is also presented in the form of a 2% or 5% ointment for topical use in volumes of 15, 25 and 30 g. The price varies from 150 to 200 rubles.

The composition of the ointment includes:

• Lidocaine hydrochloride - 2 g;
• Chlorhexidine dihydrochloride - 0.5 mg;
• Gietellose - 1.5 g;
• Glycerol - 20 g;
• Water for injection - up to 100 g.

Application and doses

According to the instructions, Lidocaine ointment designed for outdoor use. It is recommended to apply it on the skin 3-4 times a day. For the purpose of local anesthesia of the mucous membranes of the respiratory and gastrointestinal tracts, it is applied to the surface of endoscopic instruments.

• To anesthetize the oral mucosa, 0.5-2 g of the drug is applied with a cotton swab.
• The maximum allowable dosage within 12 hours is 6 g of the drug.
• Urology female: 2-5 ml of 2% ointment is applied to the mucous membrane of the urethra before catheterization.
• Urology male: 5-10 ml of 2% ointment for catheterization. For the purpose of cystoscopy, 30 ml of a 2% ointment with Lidocaine is applied twice with an interval of 2-5 minutes.
• In order to relieve pain during an attack of cystitis, 10 g of the drug is administered 1 time per day for 5-7 days.
• In dental practice: applied to the mucosa in the intended area of ​​​​anesthetic injection with an interval of a couple of minutes.

Indications for use

Since Lidocaine belongs to two groups of drugs (antiarrhythmic and local anesthetics) according to its pharmacological action, it has a wide range of applications.
The indications include:

• tachyarrhythmia and ventricular extrasystole;
• ventricular fibrillation;
• local anesthesia for pain syndrome, surgical interventions, invasive diagnostic methods.

Contraindications

Contraindications are mainly due to individual intolerance to Lidocaine. These include:

• hypersensitivity to the substance;
• history of seizures in response to Lidocaine;
• cardiogenic shock;
• failure of the sinus node;
• atrioventricular, intraventricular, sinus-atrial blockade;
• liver pathology;
• Wolff-Parkinson-White syndrome.

special instructions

Instructions for use states that patients in conditions accompanied by a decrease in blood flow to the liver, with serious pathologies of the liver and kidneys the use of lidocaine is not recommended.

To prolong the activity of the analgesic drug, it is rational to add 1 drop of 0.1% epinephrine per 10 ml of Lidocaine.

Use during pregnancy and lactation

During gestation and breastfeeding, the use of an anesthetic is not prohibited. In studies of the effect of the drug on the embryo in animals, a negative effect has not been proven.

Features of the appointment of children and the elderly

Children and people over 65 years of age have restrictions on the use of the medication. The maximum allowable dosage for children is 4.5 mg per 1 kg of body weight. With regard to the elderly, the decision on the possibility of using the drug is made by the doctor.

Lidocaine is prescribed by the attending physician individually, according to the patient's comorbidities.

Overdose and side effects

In case of an overdose, various negative effects can be observed.

From the side of the central nervous system and analyzers:

• inhibition or activation of the central nervous system;
• neuroses;
• euphoric state;
• flashing "flies" before the eyes;
• photophobia;
• headache;
• noise in the auditory analyzer;
• double vision;
• changes in consciousness;
• respiratory failure or cessation;
• muscle fibrillation;
• trembling;
• loss of orientation in space;
• convulsive twitches.

From the side of the cardiovascular system and the hematopoietic system:

• sinus bradycardia;
• violation of the rhythm and conduction of the heart;
• hypertension;
• hypotension.

Allergic manifestations:

• anaphylaxis;
• angioedema;
• redness in the area of ​​influence of the agent, rashes;
• burning and itching in the area of ​​application.

In case of an overdose, the following symptoms may appear:

• psychomotor activation;
• dizziness;
• asthenic syndrome (weakness, apathy, lethargy);
• hypotension;
• twitching;
• convulsive seizures;
• disturbances of consciousness (stupor, stunning);
• atrioventricular block;
• suppression of the activity of the central nervous system;
• bradypnea.

Treatment tactics:

• drug withdrawal;
• artificial ventilation of the lungs;
• oxygenation;
• anticonvulsants;
• vasoconstrictor drugs (norepinephrine);
• with a decrease in heart rate - anticholinergic drugs (atropine).

Interaction with other drugs

Beta blockers increase the risk of a slow heart rate and a drop in blood pressure. According to the instructions for use, Norepinephrine, together with beta-blockers, by reducing the rate of blood flow in the liver, lowers the clearance of the drug, which increases its toxicity. Barbiturates potentiate the induction of microsomal enzymes, thereby reducing the activity of the drug. Anti-seizure drugs increase the rate of biological transformation of Lidocaine in hepatocytes. With intravenous administration, the negative effect on the heart is enhanced. Antiarrhythmic drugs exacerbate cardiac depression. Interaction with Novocainamide causes CNS activation.

The overwhelming effect of narcotic and hypnotic drugs on the respiratory center is increasing.

Storage, dispensing from pharmacies

Released strictly by prescription.

Analogues

Lidocaine belongs to local anesthetics and has a number of analogues. Among them are:

1. Dikain 1%, 2%, 5%, 10% ointment, the price is 150-200 rubles.
2. 2%, 5%, 10% ointment, the price is 125-175 rubles.
3. Helikain 2%, 5% ointment, the price is 140-195 rubles.
4. Dineksan 2%, 5% ointment, the price is 150-230 rubles.
5. Xicain 2%, 5% ointment, the price is 170-240 rubles.

Reviews

Reviews of patients with pathologies of various organ systems about Lidocaine are mostly positive. The local anesthetic effect, according to patients, is highly effective, they do not notice pain when performing medical procedures after the application of an anesthetic. However, patients with individual intolerance to the drug speak negatively about it, as they note the development of side effects.

Doctors of various specialties are quite satisfied with the action of Lidocaine and the speed of the onset of anesthesia.

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In addition to the anesthetic component, hemorrhoid ointments are enriched with ingredients that tend to stop inflammatory processes, inhibit pathogenic flora, dissolve blood clots, and heal tears and cracks in the anus. Such creams produce a complex therapeutic effect, which is very convenient for the patient.

Pain syndrome with hemorrhoids

The underlying symptom of hemorrhoids is aching and pulling or dull pain in the anus, radiating to the groin. Often, pain is accompanied by unbearable itching.

Soreness during illness during physical exertion and rest, in a sitting position in different groups of patients may differ. This feature is explained by the level of pain threshold and the pathological stage of the disease.

The appearance of pain is due to the fact that a huge number of nerve fibers are localized in the rectal area. When a pathological process occurs in this area, nerve cells along the afferent pathways signal the brain about the problem, provoking the appearance of unpleasant symptoms.

Pain in hemorrhoids negatively affects the emotional and psychological state of the patient, causing discomfort and worsening the quality of life. The appearance of severe pain provokes the development of fear of defecation, which inevitably leads to constipation, exacerbating the problem. Such a development of events requires overcoming the psychological barrier with the help of products containing local analgesic substances.

When exacerbations occur, the pain increases when you try to empty the intestines and becomes pulsating. A person suffering from severe hemorrhoids cannot fully move and sit, and the slightest strain during laughter or coughing causes increased soreness. Against the background of such symptoms, many patients are prone to the development of insomnia.

Therapeutic effect of lidocaine

Local anesthetics tend to block neural channels, interrupting the transition of the pain impulse from peripheral nerve endings to parts of the central nervous system. For the full relief of pain, ointments based on, for example, lidocaine should be used.

Such funds are prescribed both in the phase of exacerbation of the disease, and in the chronic form in the form of maintenance therapy.

Lidocaine ointments have proven to be highly effective at various stages of hemorrhoids, as well as during the rehabilitation period after surgical treatment in the anorectal zone.

The leading advantage of lidocaine ointments is their local effect and a slight negative effect on the human body. Their composition can be enriched with healing components, hemostatic, anti-inflammatory and antibacterial substances. The multicomponent composition is effective in combating pain and unbearable burning sensation, swelling, and inflammatory processes.

Among other things, ointments with lidocaine can prevent and eliminate the negative effects of hemorrhoids: anal fissures, thrombosis, bleeding from the rectum and paraproctitis.

The nuances of using drugs with lidocaine

The use of such a dosage form as an ointment requires the sequential performance of certain manipulations.

1. Before applying the product to the anus, it is recommended to empty the intestines, and then carry out hygienic treatment of the anus.
2. Then you need to wash your hands.
3. Ointment with lidocaine also implies an appointment for internal hemorrhoids, therefore, for a comfortable introduction into the rectum, many manufacturers include a special rectal nozzle in the kit.
4. Based on the severity of pain, the drug is used two to five times a day, the therapeutic course is from five days to a week. The competence of the proctologist is to regulate and adjust the duration of the use of the drug, while the frequency of use is individual for each patient.

For local anesthesia, it is allowed to use applications using a cotton-gauze swab soaked in the agent. Achieving the maximum therapeutic effect is possible with a preliminary study of the instructions and evaluation of specific instructions for a particular ointment.

Overview of ointments with lidocaine

The positive effect of ointments against hemorrhoids is based on the following indicators:

• dosage forms in the form of gels and ointments are convenient and easy to use;
• have a powerful effect in the area of ​​hemorrhoids;
• active ingredients penetrate to an impressive depth;
• suitable for use in such groups of patients as pregnant women and women who have given birth, children (of course, taking into account the instructions).

Any ointment containing lidocaine in its composition has a certain list of contraindications and side effects, so it is highly undesirable to treat yourself.

The selection of the optimal remedy is carried out by the proctologist based on the severity of the symptoms and the individual characteristics of the course of the disease.

As active ingredients in this cream, components such as lidocaine hydrochloride and tribenoside are used.

• Lidocaine instantly reduces the intensity of pain and burning sensation in the rectal area, which are provoked by the development of hemorrhoids.
• Tribenoside provides an impact on the causes and characteristic manifestations of the disease. Thanks to this ingredient, the tone of the veins of the anus increases, the nutrition of the affected areas normalizes and vascular permeability decreases, which leads to the relief of the inflammatory process.

The ointment is indicated for patients suffering from internal or external form of hemorrhoids. The dosage and frequency of daily use is determined by the attending physician. Usually, the ointment is injected into the anus with a special rectal nozzle or applied in a thin layer in the anus area 2-3 times a day until the exacerbation of the disease stops.

More detailed information about the features of use is presented in the article of a specialist proctologist.

During the use of Procto-Glivenol, a certain group of patients experience adverse reactions in the form of allergic symptoms (dermatitis, hyperemia of the skin in the area of ​​application, burning and rash, Quincke's edema, followed by the development of anaphylactic shock).

Therefore, hemorrhoid ointment is not recommended for use by persons prone to allergies to lidocaine. Procto-Glivenol is not prescribed for children and women in the first trimester of pregnancy. The use of the ointment by pregnant women in the 2nd-3rd trimesters and lactating women is allowed strictly when prescribed by the attending doctor and only if the intended effect exceeds the risk of a negative effect on the intrauterine development of the fetus.

Patients suffering from severe vascular pathologies, insufficiency of the kidneys and liver, the drug is recommended to be used with extreme caution.

Gel Lidocaine

Lidocaine gel contains lidocaine hydrochloride, chlorhexidine and auxiliary components (water, glycerol and hydroxyethylcellulose).

The gel exhibits antimicrobial and local anesthetic effects. The purpose of the drug for hemorrhoids is due to the occurrence of a strong burning sensation in the rectum and severe pain. The tool can be used after surgical treatment in areas of the rectum to relieve pain.

In some clinical cases, the use of the gel can provoke allergic reactions (dermatitis, burning and urticaria, angioedema and broncho-obstructive syndrome).

The drug includes components such as lidocaine, dexpanthenol and prednisolone. Among the auxiliary inclusions are glycerol and water, stearic acid, as well as triclosan, which has a powerful antimicrobial effect.

Such a hormonal component as prednisolone is prone to a decrease in the permeability of the capillaries of the anus and the relief of inflammatory phenomena.

Dexpanthenol refers to agents that increase the regeneration of affected cells, which helps to accelerate the scarring of ulcers and anal fissures.

The active components of Aurobin are able to penetrate into the bloodstream, having a systemic effect on the body, as well as locally anesthetize body parts in the anorectal region.

The drug is prescribed for the occurrence of external and internal hemorrhoids, anorectal eczema, anal fissures and tears.

The duration of therapy is adjusted by the doctor, but traditionally the course of treatment lasts 4-7 days. At the initial stage of the disease, the drug is applied to the anus two to four times a day, and with gradual relief of symptoms, one or two daily applications are sufficient.

This drug is known to be well tolerated, but in some clinical cases, adverse reactions, such as rash or flushing, are likely to occur.

Prolonged use of Aurobin provokes the development of the following conditions:

• suppression of adrenal function (Cushing's syndrome);
• decrease in the body's immune abilities;
• accession of various infectious pathologies;
• development of edema;
• dizziness and headaches;
• increased blood pressure;
• the appearance of insomnia;
• convulsions;
• arrhythmias;
• cataract;
• stomach ulcer.

Contraindications to the use of the drug are allergic reactions to the components of the ointment, lactation and pregnancy in the first trimester, malignant tumors of the colon, fungal, viral and bacterial damage to the tissues of the anorectal zone.

Under strict medical supervision, the remedy can be used among patients with diabetes mellitus, anemia, glaucoma and immunodeficiency.

This cream is a multicomponent drug based on lidocaine hydrochloride, bismuth and titanium dioxin, bufeksamak, which instantly stops unpleasant hemorrhoidal manifestations.

Bismuth and titanium dioxin have an astringent and drying effect, and have an antimicrobial effect. These components provide the fastest healing of cracks and ulcers of the anorectal zone, preventing possible infection of hemorrhoids.

Bufeksamak is an anti-inflammatory agent of non-hormonal origin, capable of relieving pain and relieving swelling of the anus.

Proctosan has established itself as an effective remedy for the occurrence of hemorrhoids and its undesirable consequences (paraproctitis, anal tears and eczema). The drug is widely used in the rehabilitation period after proctological interventions.

Adverse reactions occur in rare cases and are represented by allergic manifestations. Ointment from hemorrhoids is excluded for use in patients who are characterized by individual intolerance to the individual components of the drug, suffering from tuberculosis and syphilis of the anorectal region. It is not allowed to prescribe Proctosan to children under 18 years of age, lactating and pregnant women.

The use of Proctosan involves applying an ointment to the anus or introducing it into the rectum with a special nozzle twice a day. The duration of the therapeutic course is a week.

The undesirability of self-selection of drugs

Many drugs have been developed, including ointments, that effectively cope with hemorrhoids at the initial stage or significantly alleviate the patient's condition in advanced and especially severe cases. But a huge selection on the pharmacy counter should not encourage self-treatment, it is much more important to purchase the necessary funds after consulting a competent specialist.

Diagnostic examinations will reveal a reliable cause of the development of pathology and determine its stage. An experienced proctologist should develop an appropriate treatment regimen and prescribe medications, including hemorrhoid ointment with lidocaine.

Knowing that hemorrhoids can be both external and internal, as well as combined, the greatest therapeutic effect is achieved through an integrated approach to treatment. An important aspect is that a stable long-term effect can be achieved by following medical prescriptions and a healthy lifestyle.

Conclusion

A substance that can almost instantly suppress the unpleasant symptoms of hemorrhoids is lidocaine. By itself, this component does not cure pathological processes, but relieves the patient of excruciating pain and itchy sensations.

Lidocaine is included in a number of ointments, but only a specialist will help you choose an effective drug that should be used in a particular case.

Pharmacological action of the drug

The drug belongs to the antiarrhythmic class IB. Acts as a local anesthetic and is an acetanilide derivative. It is characterized by membrane stabilizing activity.

The remedy "Lidocaine" (ointment) reduces the duration of the exposure potential and the effective period and inhibits their independent activity. The drug blocks the electrical activity of depolarized, arrhythmogenic zones, but at the same time, to the smallest extent, it affects the electrical work of normal tissues.

When used in average therapeutic doses, the drug does not significantly affect myocardial contractility and does not slow down AV conduction. If "Lidocaine" is used as an antiarrhythmic drug and is administered intravenously, then the onset of its action occurs after 45-90 seconds, and the effect lasts about 10-20 minutes. With the / m administration of the drug, the effect can be felt after 5-15 minutes, and its duration is 60-90 minutes.

The drug is intended for terminal, infiltration and conduction anesthesia.

The drug can be applied externally to the problem area several times a day. The recommended number of applications is 3-4 times a day.

Quite often, 2% Lidocaine gel is used for injection into the esophagus or larynx of a medical instrument. The drug is applied with a special medical stick. If the anesthesia did not work or the effect of the drug was insignificant, the procedure for applying the agent is repeated.

In the same concentration, the ointment is used in studies in the urological field for women, where it is lubricated with the urethral mucosa. In this case, the consumption of the drug is influenced by the individual structure of the urethra. Another gel is used when inserting a catheter into the urethra in men, while spending up to 100 mg of the drug.

To reduce pain during inflammatory processes in the bladder, patients are administered one dose of ointment along with other medications once. This therapy lasts up to five days.

Gel with lidocaine is also used during the examination of the bladder with an endoscope. So, in order to fill and enlarge the urethra, use up to 30 ml of this drug. This dose is administered in two steps with a short interval. The urethra is compressed for a short time.

Also used in cosmetology "Lidocaine" (ointment) - for epilation of bikini and other sensitive areas of the body.

After intramuscular administration of the drug, it is absorbed almost completely. Distributes quickly. Its interaction with proteins is affected by the concentration of the active ingredient in the blood, which is 60-80%. The drug is metabolized mainly in the liver, while it provokes the appearance of active metabolites that affect the therapeutic and toxic effects, especially after infusion (for a day or more).

The half-life of the drug tends to be biphasic with a distribution phase of 7-9 minutes. It depends on the dose of administration and is equal to 1-2 hours, gradually increasing to three hours or more during prolonged intravenous infusions (more than 24 hours). It is excreted by the kidneys in the form of metabolites, only 10% is excreted unchanged.

In order for the depilation process to be painless and the desired effect to be achieved, it is necessary to adhere to certain rules:

1. An anesthetic gel is first applied to the elbow area for 30 minutes. If after this period of time no irritation has appeared on the skin (redness, burning, itching), then epilation can be carried out.
2. Depilation is carried out in the first week after the end of the menstrual cycle.
3. The procedure for removing unwanted hair will be less painful if carried out in the morning.
4. On the day of epilation, do not wear trousers to avoid mechanical friction on the skin; Epilation will lead to irritation, and in the following days the pain will intensify.
5. At the end of the procedure, apply ice to the area that has undergone depilation - this is a way to temporarily relieve pain, moisturize and soothe the skin.
6. Before the session, do not use creams and cosmetics containing alcohol, as alcohol remaining on the skin can cause pain or neutralize the effect of the anesthetic cream.
7. With a significant length of hair in the bikini area, their preliminary removal with scissors is carried out, after which the procedure will not be so painful.
8. Wipe the hair removal area after depilation with any antiseptic or hydrogen peroxide 3%.
9. After the procedure, within 2 days after the procedure, do not take a hot bath, only a warm shower. This will allow once again not to irritate the treated area of ​​\u200b\u200bthe skin.

   The most important advice: you need to use a good anesthetic gel for epilation of the delicate bikini area. The least painful sugaring procedure.

The most important advice given by cosmetologists is to use a good anesthetic gel for hair removal of such a delicate bikini zone, and also not to trust little-known advertised brands and products made in Asian countries.

In addition, painkillers must be bought at a pharmacy, but in no case from merchants distributing cosmetics on the streets of the city.

Overdose

If an overdose is noted, the first signs of intoxication in a patient may be nausea, dizziness, vomiting, a feeling of euphoria, asthenia, and a decrease in blood pressure. Later, spasms of mimic muscles develop, turning into spasms of skeletal muscles. The patient also has bradycardia, psychomotor agitation, collapse, asystole. If an overdose occurs during childbirth, the newborn may develop bradycardia, apnea, depression of the respiratory center.

In case of an overdose, it is necessary to stop the administration of the drug, carry out inhalation with oxygen. This is followed by symptomatic breathing. With the development of seizures, 10 mg of diazepam should be administered. In the case of bradycardia, the introduction of m-anticholinergics (atropine), vasoconstrictors is practiced. Hemodialysis will be ineffective.

Ointment Lidocaine

This tool refers to both local anesthetics and drugs that can relieve the excitability of nerve endings, and antiarrhythmic drugs.

Release form

Ointment for topical use is available in packages of 15, 20 and 30 grams. The medicine comes in different concentrations - the content of the active active substance is 2% and 5%.

Compound

• Lidocaine hydrochloride 2 grams
• Gietellose - 1.5 g
• Glycerol - 20 g
• Chlorhyxidine dihydrochloride 0.5 mg
• Water for injection - up to 100 g

pharmachologic effect

Pharmacodynamics
Local anesthetic. When applied, it is absorbed and enters the systemic circulation and stabilizes the permeability of the neuronal membrane for sodium ions. The threshold of excitability of neurons, as a result, becomes higher, and the conduction of the nerve impulse is blocked. Pharmacokinetics
Metabolized in the liver by 90%. Metabolites are monoethylglycinexylidide and glycinexylidide. Their half-life is 2 and 10 hours, respectively.

Indications

Ointment with Lidocaine is used as a local anesthetic of the skin and mucous membranes of the oral cavity and perianal region.

Contraindications

• Injury to the skin or mucous membrane
• Hypersensitivity to the drug
• Children's age up to 2 years

Side effects

Side effects that may occur after applying the ointment are identical to the side effect of injections with this anesthetic.

Instructions for use

Instructions for using Lidocaine ointment are as follows:

1. An anesthetic ointment can be applied on average 3-4 times a day to the desired area of ​​​​the skin or mucous
2. For endoscopic studies, the drug is applied directly to the surface of the device.
3. In order to anesthetize the oral mucosa, the ointment is applied with a cotton swab, the volume is 0.5-2 grams. Very often, anesthetic ointment is used in dentistry to anesthetize the area where the injection is planned with the main anesthesia.