Longidaze

1 suppository contains:

Active substance:

hyaluronidase conjugate with an oxide copolymer,

1,4-ethylene piperazine and (N-carboxymethyl) 1,4-ethylene piperazine bromide 3000 IU;

Excipient :

cocoa butter - to obtain a suppository weighing 1.3 g.

Longidase - enzymatic, proteolytic.

Pharmacodynamics

Longidase® has a long-acting hyaluronidase (enzymatic proteolytic) activity, chelating, antioxidant, immunomodulating and moderately pronounced anti-inflammatory properties.

The prolongation of the action of the enzyme is achieved by covalently binding it to a physiologically active high molecular weight carrier (an activated derivative of N-oxide poly-1,4-ethylene piperazine, an analog of polyoxidonium), which has its own pharmacological activity. Longidaza® exhibits antifibrotic properties, weakens the course of the acute phase of inflammation, regulates (increases or decreases, depending on the initial level) the synthesis of inflammatory mediators (IL-1 and tumor necrosis factor-alpha), increases the humoral immune response and the body's resistance to infection.

The pronounced antifibrotic properties of Longidase® are provided by conjugation of hyaluronidase with a carrier, which significantly increases the enzyme's resistance to denaturing effects and inhibitors: the enzymatic activity of Longidase® is preserved by heating to 37 ° C for 20 days, while native hyaluronidase loses under the same conditions its activity during the day. In the Longidaza® preparation, the simultaneous local presence of the proteolytic enzyme hyaluronidase and a carrier capable of binding the inhibitors of the enzyme and collagen synthesis stimulators (iron, copper ions, heparin, etc.) released upon hydrolysis of the matrix components is ensured. Due to these properties, Longidaza® has not only the ability to depolymerize the connective tissue matrix in fibro-granulomatous formations,

A specific substrate of testicular hyaluronidase is glycosaminoglycans (hyaluronic acid, chondroitin, chondroitin-4-sulfate, chondroitin-6-sulfate), which form the basis of the matrix of connective tissue. As a result of depolymerization (breaking the bond between C1-acetylglucosamine and C4 glucuronic or inductronic acids), glycosaminoglycans change their basic properties: viscosity decreases, the ability to bind water, metal ions decreases, the permeability of tissue barriers temporarily increases, fluid movement in the intercellular space is facilitated, the elasticity of connective tissue is increased, which is manifested in a decrease in swelling of the tissue, flattening of scars, an increase in the volume of movement of the joints, a decrease in contractures and the prevention of their formation, a decrease in the adhesion process.

Biochemical, immunological, histological and electron microscopic studies have proved that Longidaza® does not damage normal connective tissue, but causes destruction of the connective tissue, which has been changed in composition and structure, in the area of ​​fibrosis.

Longidase® does not have mutagenic, embryotoxic, teratogenic and carcinogenic effects.

The drug is well tolerated by patients, there are no local and general allergic reactions.

The use of Longidase® in therapeutic doses during or after surgical treatment does not cause a deterioration in the course of the postoperative period or the progression of the infectious process; Does not slow down bone repair.

• in urology: chronic prostatitis, interstitial cystitis, strictures of the urethra and ureters, Peyronie's disease, the initial stage of benign prostatic hyperplasia, prevention of scarring and strictures after surgical interventions on the urethra, bladder, and ureters;
• in gynecology: adhesions (prophylaxis and treatment) in the pelvis for chronic inflammatory diseases of the internal genital organs after gynecological manipulations, including artificial abortions, previous surgical interventions on the pelvic organs: intrauterine synechia, tubal-peritoneal infertility, chronic endomyometritis;
• in dermatovenerology: limited scleroderma, prevention of fibrotic complications of sexually transmitted infections;
• in surgery: prevention and treatment of adhesions after surgical interventions on the abdominal organs, long-term non-healing wounds;
• in pulmonology and phthisiology: pneumofibrosis, siderosis, tuberculosis (cavernous fibrous, infiltrative, tuberculoma), interstitial pneumonia, fibrosing alveolitis, pleurisy;
• to increase the bioavailability of antibiotic therapy in urology, gynecology, dermatovenerology, surgery, pulmonology.

The drug is contraindicated in pregnancy.

Data on the safety of the drug during lactation are not provided.

Longidase has no embryotoxic and teratogenic effects.

• increased individual sensitivity to drugs with hyaluronidase activity, Longidase®;
• malignant neoplasms;
• pregnancy (no clinical experience);
• children under 12 years of age (efficacy and safety have not been studied).

With caution (apply no more than 1 time per week): renal failure; a history of pulmonary hemorrhage.

Rarely, allergic reactions with increased individual sensitivity.

When using Longidase in patients receiving salicylates, cortisone, ACTH, estrogens or antihistamines in high doses, the effectiveness of the action of the enzyme hyaluronidase can be reduced.

When prescribed in combination with other drugs, the possibility of increasing their absorption (bioavailability) and enhancing systemic effects should be considered.

Rectally, 1 suppository 1 time per day after bowel cleansing.

Vaginally, 1 time per day (at night) 1 suppository is introduced into the vagina in the supine position.

Longidaza® Suppositories 3000 ME is recommended in a course of 10 to 20 injections.

The administration schedule is adjusted depending on the severity, stage and duration of the disease: Longidaza® is prescribed every other day or with interruptions of 2-3 days.

Recommended regimens and doses:

• in urology: 1 suppository every other day - 10 injections, then after 2–3 days - 10 injections, a total of 20 suppositories .;
• in gynecology: rectally or vaginally, 1 suppository after 2 days - 10 injections, then, if necessary, maintenance therapy is prescribed;
• in dermatovenerology: for a suppository in 1-2 days - 10-15 introductions;
• in surgery: by suppository in 2-3 days - 10 injections;
• in pulmonology and phthisiology: for a suppository in 2–4 days - 10–20 injections.

If necessary, a repeated course of Longidase® is recommended no earlier than 3 months or long-term maintenance therapy - 1 suppository once every 5–7 days for 3-4 months.

When used against the background of exacerbation of foci of infection, to prevent the spread of infection, prescribe under the cover of antimicrobial agents.

With the development of an allergic reaction, the use of Longidase should be immediately discontinued.

Longidase does not have a mutagenic and carcinogenic effect.

Use with caution and not more than 1 time per week in patients with renal failure.

Suppositories for vaginal or rectal use