Longidaza (Bovhyaluronidase azoximer) 5 vials

1 fl. contains longidase with hyaluronidase activity of 3000 IU

excipient:

mannitol - up to 20 mg

A drug with proteolytic activity. It has enzymatic proteolytic (hyaluronidase) activity of prolonged action, immunomodulating, chelating, antioxidant and anti-inflammatory effects.

The drug is prolonged due to covalent binding of the enzyme to a physiologically active high molecular weight carrier (activated derivative of N-oxide poly-1.4-ethylene piperazine), which has its own pharmacological activity: it has immunomodulating, detoxifying and antioxidant effects.

The presence of a covalent bond significantly increases the resistance of the enzyme to denaturing effects and the influence of inhibitors. The enzymatic activity of Longidase is maintained when heated to 37 ° C for 20 days, while native hyaluronidase under the same conditions loses its activity during the day.

The covalent bond provides the simultaneous local presence of a hydrolytic enzyme and a carrier capable of binding the released enzyme inhibitors and collagen synthesis stimulants (iron, copper, heparin ions). Due to these properties, Longidaza possesses not only the ability to depolymerize the matrix of connective tissue in fibro-granulomatous formations, but also suppress the reverse regulatory reaction aimed at the synthesis of components of connective tissue.

A specific substrate for testicular hyaluronidase is glucosaminoglycans (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 C 1 acetylglucosamine and C 4 glucuronic or inductronic acids) under the influence of hyaluronidase, glucosaminoglycans lose their basic properties (viscosity, ability to bind water, metal ions). The formation of collagen proteins into fibers is also difficult, the permeability of tissue barriers increases, the movement of fluid in the intercellular space is facilitated, the elasticity of the connective tissue increases. The action of the drug leads to a decrease in swelling of the tissue, flattening of scars, an increase in the volume of movement of the joints,

The drug reduces the manifestations of the acute phase of the inflammatory process, regulates (increases or decreases, depending on the initial level) the synthesis of inflammatory mediators (interleukin-1 and tumor necrosis factor), increases the body's resistance to infection and the humoral immune response.

Longidase does not have antigenic properties, mitogenic, polyclonal activity, does not have allergenic, mutagenic, embryotoxic, teratogenic and carcinogenic effects.

The drug is prescribed for adults as part of complex therapy for the treatment and prevention of diseases accompanied by connective tissue hyperplasia.

In gynecology:

• treatment and prevention of the adhesion process in the pelvis with inflammatory diseases of the internal genital organs, including tubal-peritoneal infertility, intrauterine synechia, chronic endometritis.

In urology:

• treatment of chronic prostatitis;
• treatment of interstitial cystitis.

In surgery:

• treatment and prevention of the adhesive process after surgical interventions on the abdominal organs;
• hypertrophic scars after injuries, burns, operations, pyoderma;
• long non-healing wounds.

In dermatology and cosmetology:

• treatment of limited scleroderma;
• treatment of keloid, hypertrophic, forming scars after pyoderma, injuries, burns, operations.

In pulmonology and phthisiology:

1. treatment of pneumosclerosis, fibrosing alveolitis;
2. treatment of tuberculosis (cavernous fibrous, infiltrative, tuberculoma).

In orthopedics:

• treatment of joint contracture, arthrosis, ankylosing spondylitis, hematomas.

To increase bioavailability:

• with the joint introduction of antibacterial drugs in urology, gynecology, surgery, dermatovenereology, pulmonology, to enhance the action of local anesthetics.

• Longidaza is contraindicated during pregnancy
• in children under 12 years of age (efficacy and safety have not been studied).

• increased individual sensitivity to enzymes with hyaluronidase activity
• malignant neoplasms

With caution, the drug is prescribed for acute renal failure, pulmonary hemorrhage.

Local reactions: pain at the injection site; in some cases, hyperemia of the skin and swelling of the tissues at the injection site.

Other: rarely - allergic reactions.

All adverse reactions pass through 48-72 hours.

Longidase is compatible with antibiotics, antiviral, antifungal and antihistamines, bronchodilators, cytostatics, GCS.

When combined, it increases the bioavailability of drugs, accelerates the onset of analgesia with the introduction of local anesthetics.

Longidase is used subcutaneously (near the lesion site or under scar-altered tissues) or IM at a dose of 3000 IU with a course of 5 to 25 injections (depending on the disease) with an interval between administrations of 3 to 10 days.

Methods of application are chosen by the doctor depending on the diagnosis, severity of the disease, clinical course, age of the patient. If necessary, a second course is recommended after 2-3 months.

In the case of treatment of diseases accompanied by a severe chronic productive process in the connective tissue, after a standard course, long-term maintenance therapy with Longidaza is recommended with intervals between injections of 10-14 days.

To increase the bioavailability of drugs and diagnostics, a dose of 1,500 IU is recommended with a 10-15 minute preliminary intramuscular or subcutaneous administration at the same place as the main drug.

Breeding

• The contents of the ampoule or vial of the drug Longidaza is dissolved in 1-2 ml of procaine solution (0.25% or 0.5%). In case of procaine intolerance, the drug is dissolved in the same volume of 0.9% sodium chloride solution for injection or water for injection.
• When used to increase bioavailability, the contents of the ampoule or vial of the drug Longidaza are dissolved in 2 ml, and with a dose of 1500 ME in 1 ml of 0.9% sodium chloride solution for injection.

The solvent in the vial or ampoule must be entered slowly, withstand 2-3 minutes, mix gently, without shaking, so as not to froth the protein. The prepared solution for parenteral administration is not subject to storage. Do not inject I / O!

Recommended prevention and treatment regimens

For the prevention of adhesive disease and gross scarring after surgical interventions on the organs of the abdominal cavity and small pelvis / m in a dose of 3000 ME once every 3 days with a course of 5 injections. If necessary, the use of the drug can be continued with a general course of up to 10 injections with the introduction of 1 time in 5 days.

For treatment

in gynecology:

• adhesive process in the pelvis with inflammatory diseases of the internal genital organs - i / m once every 3-5 days with a course of 10-15 injections;
• tubal-peritoneal infertility - i / m general course of up to 15 injections: the first 5 injections 1 time in 3 days, then - 1 time in 5 days.

in urology:

• chronic prostatitis - in / m 1 time in 5 days, a course of 10-15 injections;
• interstitial cystitis - in / m 1 time in 5 days, a course of up to 10 injections.

in surgery:

• adhesive disease after surgical interventions on the organs of the abdominal cavity - i / m once every 3-5 days with a course of 10 to 15 injections;
• long non-healing wounds - i / m once every 5 days with a course of 5-10 injections.

in dermatology, cosmetology:

• limited scleroderma - IM once every 3-5 days with a course of up to 20 injections. The dose and course are selected individually depending on the clinical course, stage, localization of the disease and individual characteristics of the patient;
• keloid, hypertrophic and forming scars after pyoderma, burns, surgeries, injuries - intra-cicatricial or subcutaneous injection near the lesion site once every 3 days, with a course of up to 15 injections at a dosage of 3000-4500 ME. The dilution volume of the drug Longidaza is chosen by the doctor depending on the number of injection points. If necessary, the course can be continued according to the scheme 1 time in 5 days up to 25 injections. Depending on the area of ​​skin lesion, the age of scar formation, alternating sc and i / m administration is possible once every 5 days at a dose of 3000 ME, with a course of up to 20 injections.

in pulmonology and phthisiology:

• pneumosclerosis - i / m once every 5 days with a course of 10 injections;
• fibrosing alveolitis - i / m 1 time in 5 days with a course of 15 injections, then - maintenance therapy 1 time in 10 days with a general course of up to 25 injections;
• tuberculosis - i / m once every 5 days with a course of up to 25 injections; depending on the clinical picture and severity of the course of the disease, long-term therapy is possible (from 6 months to 1 year at a dose of 3000 ME once every 10 days).

in orthopedics:

• joint contracture - sc in the vicinity of the lesion at a dose of 3000 ME once every 3 days with a course of 5 to 15 injections;
• arthrosis, ankylosing spondylitis - sc in the vicinity of the lesion at a dose of 3000 ME once every 3 days with a course of up to 15 injections, if necessary, treatment can be continued by injection once every 5 days. The duration of maintenance therapy is chosen by the doctor depending on the severity of the disease;
• hematoma - sc in the vicinity of the lesion in a dose of 3000 ME once every 3 days with a course of up to 5 injections.

To increase bioavailability: when administered jointly with a / c or intramuscular injection with diagnostic or medicinal products (antibiotics, chemotherapy drugs, anesthetics, etc.), Longidaza is administered preliminarily for 10-15 minutes at a dose of 1500 ME in the same way and at the same place as the main drug.

Currently, cases of overdose of the drug Longidaza were not reported.

The drug should not be injected into the zone of infectious lesion, acute inflammation or tumor.

Lyophilisate for solution for i / m and s / c administration