Fellaini Medisun treatment psoriasis and skin diseases (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Acitretin

Ingredient

Composition information	Content
Acitretin	25mg

Uses

indications

Fellaini drugs are indicated in the following cases:

Severe psoriasis on a large scale, not supported after taking other therapies. A retinoid and a metabolic substance of Etretinat. The exact mechanism of action of the drug is not known.

For psoriasis, studies suggest that acitretin affects immune response, epidermal cell proliferation and skin glycoprotein synthesis. In particular, acitretin helps to normalize the process of cell specialization, thinning the horny layer in the epidermis due to reducing the growth of horn cells.

Pharmacokinetics

absorption

After drinking, the maximum drug concentration in the blood is achieved after 1-5 hours. Born is 60 - 70%, but changes among individuals (36 - 95%), the bioavailability of acitretin increases when drinking with meals (72%). After daily taken for 2 months at a dose of 50 mg/day, the stable state is achieved within 7 days for acitretin and 10 days for direct metabolites, Isome 13 - CIS - Acitretin.

Distribution

Acitretin is very fatty and easy to enter the tissues. Acitretin attaches to plasma proteins over 99%, mainly on albumin, a low ratio in lipoprotein. Acitretin through the placenta and breast milk.

Metabolism

Metabolic drugs into active substances are 13 - CIS - acitretin and a few are Etretinat, but Etretinat is only discovered in the serum of some patients using acitretin. Drinking alcohol will increase the rate of metabolism of acitretin into eryretinat, even after the patient has stopped the drug.

Elimination

Acitretin's waste time is about 49 hours, of 13 - CIS - Acitretin is 63 hours, Etretinat has a 120 -day sale time, which can be reserved in fat cells for months and for several years. Both acitretin and metabolites 13 - CIS - acitretin eliminate through bile and urine in the form of combined.

Before taking Fellaini Medisun treatment psoriasis and skin diseases (3 blisters x 10 tablets)

How to use

Drugs are taken for meals or drinks with milk.

Dosage

adults

Severe psoriasis

Normal starting dose 1 capsule 1 time/day (can allow up to 2 capsules/time/day), used for 2-4 weeks. The daily dose is then adjusted depending on the clinical response of the patient and the unwanted effect. The optimal results are usually achieved at a dose of 1-2 tablets/day, for 6-8 weeks. Some patients need to increase to up to 3 tablets/day.

Darier disease and fish scales

Take 1-2 tablets/day (not exceeding 2 tablets/day). The treatment lasts more than 3 months.

with any indications, do not take the drug lasting more than 6 months. In case of recurrence, treatment as originally.

Children

Do not use acitretin for children. However, in case it is necessary to use acitretin but must be closely monitored by the physician.

From 12 years old - 18 years old

Starting dose 1 tablet/time/day, for 2-4 weeks, then adjust the dose depending on the response of the patient, the next dose is usually 1-2 tablets/day, up to 3 capsules/day in a short time when treating psoriasis or fish scales.

Children under 12 years old

Following the instructions of the physician.

Elderly

The usual dose of adults or as directed by the physician.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

Like vitamin A poisoning such as sleeping, increased intracranial pressure (prolonged severe headache, nausea, vomiting), irritation, itching.

Handling

Use conventional measures to remove the unexplained drug part in the digestive tube within 2 hours after the patient takes the medication in case of an acute overdose. Stop drugs in patients who are taking the drug in treatment but have symptoms of overdose. Monitoring of increased cranial pressure.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Fellaini, you may experience unwanted effects (ADR).

In clinical studies with acitretin, the proportion of patients encountered adverse effects is 98%.

Very common, ADR> 1/100

Central nerve: Increase sensation.

Skin: lip inflammation, hair loss, peeling skin, dry skin, nail disorders, itching, redness, skin atrophy, sticky skin, inflammation around the nail.

Endocrine and metabolism: Hyper cholesterol, hyper triglycerides, HDL decrease, phosphor hyperkemen, hyperkalemia, hyperkemia, hyperka, hyperglycemia, hyperlemy glucose serum, decrease in serum glucose.

digestive: dry mouth.

Hematology: Hematocrit red blood cells, hemoglobin decrease, hypernthenia, haptoglobin, neutropen growth.

liver: Increased liver function tests, alkaline phosphatase, increased bilirubin.

Neuropathy - bone: Perseverance, joint pain, shiver, increase creatin phosphokinase, thicken the backbone.

Eyes: dry eyes.

kidney: increased uric acid, aceton urine, urinary blood, urinary red blood cells.

Respiratory: rhinitis, nosebleeds.

Common, 1/100

Cardiovascular: blush, edema.

endocrine and metabolism: reduced potassium, phosphor, sodium; Increase/decrease in calcium, chloride. Peripheral joints, bell paralysis. Urinary.

Respiratory: Sinusitis.

Axious, increased bleeding time, chest pain, cirrhosis, conjunctival bleeding, purple blue, deafness, double -dizziness, dizziness, urination, eczema, esophagitis, fever, gastritis, gastritis, teeth hypertrophy, hair discoloration, liver dysfunction, bleeding, hepatitis, horny hyperkemop, feathering, reducing sensation Sutta, pancreatitis, peripheral ischemia, sensitive to light, fake brain tumors, skin hardness, thin skin, thick spine, stroke, loss of taste, blood thrombosis.

Instructions on how to handle ADR

The common ADR due to the wide and recovery effect of the drug to the epithelium (such as dry lips, chapped edges ...) often all over.

Must test the patient's liver function weekly if the results are abnormal. Stop the drug if the condition becomes worse. Fat diet, no alcohol, weight loss can help solve the increase in lipid and HDL blood. Stop the drug if the lipid or lipoprotein concentration is prolonged.

Need to use medication and eye exams if the patient has vision loss. If the patient appears early symptoms of brain tumors (prolonged severe headache, vomiting and nausea, blurred vision, vision loss) should stop immediately and check in neuropathy.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Fellaini drugs contraindicated in the following cases:

hypersensitivity to acitretin or other retinoid derivatives.

Hepatic failure or severe renal failure.

hyperlipidemia.

Pregnant or lactating women.

Women of reproductive age without using effective contraception.

Take alcohol during medication and 2 months after stopping the drug: This is applied to women of reproductive age due to the risk of malformations for the fetus.

Do not coordinate with tetracycline and methotrexate.

Be cautious when using

acitretin causes strong teratosis. For women of reproductive age, acitretin prescription can only be set if the patient has the following conditions:

Severe illness and necessarily use acitretin.

Has the ability to perceive the importance of the risk of teratogenicity of the drug and adhere to the caution in the use of the drug.

There is a negative pregnancy result within 1 week before the beginning of treatment, starting treatment on the 2nd or 3rd day of the next menstrual cycle. Monthly a pregnancy test.

Use an effective method of effective contraception for at least 1 month before starting, while treatment and 3 years after stopping treatment with acitretin.

Do not drink alcohol during medication and 2 months after stopping the drug.

Symptoms of psoriasis can sometimes worsen at the beginning of treatment. It may take 2-3 months to use the drug to maximize the maximum effect.

Consider benefits/ risk when using acitretin for people with diabetes, patients with a history of pancreatitis, patients with kidney failure or severe liver failure.

Patients must not donate blood during treatment and 3 years after stopping treatment with acitretin, especially for pregnant women and women of reproductive age because of the risk of teratogenicity.

Need to monitor liver function before starting treatment, every 2-4 weeks in the first 2 months, then 3 months. If the result is 2 times higher than normal, it is necessary to check the transaminase after 8 days. If the results of the liver function test still do not return to normal, it is necessary to stop acitretin to find the cause and monitor the liver function for 3 months.

Need to monitor all the total cholesterol and triglycerides when treated for a long time and people are at high risk (alcoholism, obesity, diabetes, fat metabolism disorders). For people who are being treated with acitretin, every 1-2 weeks for the first 2 months, then every 3 months monitor plasma lipid concentration. If these indicators increase, the diet should be adjusted, taking hypoglycemic drugs and reducing acitretin dose.

The drug affects the ability to tolerate glucose (good or bad tolerance of glucose) so it is necessary to periodically check the patient's blood glucose, especially in people with diabetes using sulfamid to lower blood glucose.

If prolonged treatment with acitretin, periodic monitoring should be monitored.

The drug can cause early bone head, so children do not recommend using acitretin, only for children when other drugs are ineffective and must periodically check bone X -ray, including knees.

Avoid in the sun and avoid using strong lights while using acitretin because retinoid derivatives increase the effect of ultraviolet rays.

Avoid simultaneously with cyclin antibiotics, high doses of vitamin A (over 4000 - 5000 units per day) and horns.

Acitretin is only used as a final treatment, when other drugs do not work.

The ability to drive and operate machinery

The drug reduces the ability to drive and operate machinery due to being able to cause dizziness, reducing the ability to see especially in the evening.

Pregnancy

acitretin causes teratogenicity in humans, so it is an absolute contrary drug for pregnant women. It is necessary to make sure the patient is not pregnant before starting with acitretin treatment (pregnant tests within 1 week before taking the medication and periodically every month during treatment. Women treated with acitretin (including people with a history of infertility) need to avoid pregnancy at least 1 month before treatment, while treatment and 3 years after stopping the drug.

The period of breastfeeding

Because the drug can be breastfed, acitretin is not recommended in nursing women. Do not breastfeed for at least 3 years after stopping the drug because acitretin can cause adverse effects in breastfeeding.

Drug interaction

Ethanol -containing beverages: Increases the rate of metabolism of acitretin into eryretinat is an active, accumulating substance that lasts in the body, increasing the risk of monitoring in women using acitretin.

Cyclosporin: Etretinat reduces cyclosporin metabolism and metabolites of this drug through the cytochrom P450 system, acitretin may have the same effect so may need to reduce the dosage of cyclosporin.

glyburid: Acitretin may increase glucose excretion, which may need to adjust the dose of glyburid.

Poisoning drugs with the liver, especially methotrexat: increase the toxicity of the liver, not simultaneously.

Hytantoin: Acitretin can push Hytantoin from plasma protein bonds that increase the percentage of drugs in the form of free, need to calibrate HytanToin dose.

Oral contraceptives containing progestin alone: Acitretin reduces contraceptive effect.

Other retinoid conductors use systemic sugar (ery Etretinat, isotretinoin, tretinoin) or in the skin (adapalen, tretinoin), vitamin A: Causes symptoms of overdose of vitamin A.

Tetracyclin is taken orally: Increased intracranial pressure. Contraindicated simultaneously.

Storage

In a dry place, temperatures below 30 ° C, avoid light.

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