Soluboston 20 Boston effervescent tablets for reduced inflammation, allergies (2 blisters x 10 tablets)
Dosage form Box of 2 blisters x 10 tablets
Specifications Prednisolone
Ingredient
| Composition information | Content |
| Prednisolone | 20mg |
Uses
indications
Soluboston drug is indicated for treatment to reduce inflammation and allergies in the following cases:
collagen - connective tissue
joint
ATC code: H02AB06
Mechanism of action
corticosteroids act on specific intracellular receptors of the group of proteins that are capable of connecting with DNA and regulating gene activity. When stimulating receptors will lead to protein synthesis that acts as enzymes that change the protection activity.
Prednisolon is a synthetic adrenal steroid that has the characteristics of corticosteroids used mainly for anti -inflammatory and immunosuppressive inhibition at pharmacological doses.
Prednisolon inhibits inflammation (edema, fibrin deposits, capillary dilatation, white blood cell movement and macronal cavity into the inflammatory foci) and the later stage of healing wound scars (capillary proliferation, collagen deposition, scar formation). Anti -inflammatory mechanism: Stabilizing lysosom membrane, leukemia, preventing the release of acid hydrolase destroyed from leukocytes, inhibiting the concentration of macrophages at the inflammatory drive, reducing the white blood cell adhesion to the capillary endothelium, reducing the vascular wall and formation of edema, reducing the component of the component, opposing the activity of histamine and releasing kinine, reducing the fiber -producing and post -fiber -producing and reducing acidosis by the muscles and the scarring of the fiber, the fibrosis and the scarring of the fiber to the stage of the fiber Other unknown.
Prednisolon inhibits the immune system due to reducing the activity and volume of the lymphatic system, reducing lymphocytes, immune globulin reduction and complementary concentration, reducing immune complex through membrane and can be by reducing tissue reactions to antigen -antibody interaction.
Effective metabolism and salt retention of synthetic corticosteroids is lower than hydrocortison, increasing sodium retention and causing potassium loss in cells, which can lead to sodium stagnation and hypertension.
Dynamic pharmacokinetics
absorption
Prednisolon is easily absorbed from the gastrointestinal tract. Peak concentration in plasma is achieved from 5 hours after drinking.
The initial absorption of Prednisolon is affected by food. Prednisolon has many hours of biological emissions so it is suitable for Japanese treatment regimens.
distribution
Prednisolon binds to protein about 65 - 91%, reduced in the elderly. The distribution of the drug is 0.22 - 0.7 liters/kg. The pharmacokinetics of Prednisolon depend on the dose. When increasing the dose will lead to increased distribution and plasma clearance. The degree of plasma protein binding affects the distribution and clearance of pharmaceutical substances, so the dose should be reduced for patients to reduce the sample albumin.
transformation
Prednisolon is metabolized mainly through the liver and is also transformed in most tissues, into an inactive form. The liver diseases extend Prednisolon's waste time, then, if the patient is accompanied by a lack of blood albumin, it will lead to an increase in the ratio of pharmaceuticals in a free state and can increase unwanted effects.
Elimination
Prednisolon is eliminated by urine in the form of free metabolites, sulfate or glucuronid and a constant small amount of prednisolon. Selling time from 2.5 to 3.5 hours. Effect time is 18 - 36 hours.
Before taking Soluboston 20 Boston effervescent tablets for reduced inflammation, allergies (2 blisters x 10 tablets)
How to use
Soluboston tablet tablets for oral tablets. Put the effervescent tablet dissolved in water and drink at meals.
Dosage
Products suitable for treatment of attack or short -term treatment with average/high dose requirements in adults or children over 10kg.
In case of maintenance treatment and for maintenance dose lower than 20 mg/day, using other products more appropriate.
Adults
Dosage depends on the diagnosis, severity, prognosis, ability to respond and tolerate medication of the patient. Use the lowest dose effectively in a short time to minimize unwanted effects.
attack treatment: 0.35 - 1.2 mg/kg/day. In severe cases of inflammation: 0.75 - 1.2 mg/kg/day.
For other special cases, it may require higher doses.
Children
Children over 10kg:
Dosage depends on the condition and weight of children.
attack treatment: 0.5 - 2 mg/kg/day.
Japanese corticosteroid therapy (one day without corticosteroids and the next day is used double the daily dose specified) used in children to limit rickets. Japanese insertion is considered to be used only when inflammation is controlled with high doses of corticosteroids and during treatment does not recur.
Children do not exceed 10kg: Use low -dose products more appropriate.
Continue to use the offensive dose until the condition is well controlled. In the case of prolonged use, the dose reduction must be done slowly. Sometimes, if necessary, continue to use in maintenance dose (minimum doses effectively).
For long -dose use, the first dose may be divided into 2 times a day. After that, you can use a single dose every day.
In patients who receive corticosteroid doses higher than physiological doses (approximately 7.5 mg of Prednisolon) for more than 3 weeks, do not stop the drug suddenly. The speed of stopping the drug depends mainly on the time of treatment, the starting dose and the disease needs treatment.
The treatment with corticosteroids reduces hormones such as ACTH and cortisol, prolonged that can impair adrenal gland function. It is necessary to stop the drug slowly to ensure the recovery of the HPA axis and avoid the risk of disease recurrence: an average of 10% decrease every 8-15 days.
For a shorter 10 -day treatment: There may be no need to reduce the dose slowly.
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 are like unwanted effects.
How to handle
No specific antidote.
Extremely overdose treatment: gastric lavage or instant vomiting then symptomatic treatment and support.
Treatment of chronic overdose in patients with severe illnesses should continue to use corticosteroids that can reduce the dose of Prednisolon temporarily or rotate the day.
In an emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.
Side Effects
A series of mental reactions, including: emotional disorders (such as irritation, excitement, depression, unstable mood, suicide thought), psychotic reactions (including manic, paranoia, hallucinations, severe schizophrenia), behavioral disorders, discomfort, anxiety, sleep disorders, and cognitive disorders including confusion and memory loss. These effects are very popular and can occur in both adults and children. In adults, the frequency of reactions weighs about 5-6%.
Mental influence has been reported when stopping corticosteroids; Frequency: unknown.
Unexpected effect rate can be predicted, including reducing the function of pituitary - underlying - adrenal (HPA) (HPA) correlated with the effectiveness of the drug, dosage, time of drug use and treatment time.
Unwanted effects are classified according to the following frequency: Very common (≥1/10), common (≥1/100 to
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Soluboston drug contraindicated in the following cases:
Be cautious when used
Before starting treatment with corticosteroids for a long time, the electrocardiogram, blood pressure, pulmonary and spine X -ray, test glucose tolerance and evaluate the axial function under the adrenal pituitary (HPA) for all patients.
Need to provide a manual for patients for this product. It is advisable to clearly record preventive measures to minimize risks and provide detailed information such as prescriptions, drugs, dose, treatment time.
Effects of immunosuppressive effects, infections
Inhibiting effects causing inflammation and immune function of corticosteroids may increase sensitivity to cases of infections, fungal infections, viral infections. Clinical symptoms may be covered and not typical, affecting diagnostic results. For example, in children or adults who are using corticosteroids when suffering from chickenpox and measles may be worse, even death.
If there is no history of chickenpox patients, patients should avoid direct contact with people with chickenpox or people infected with herpes zoster. Patients should also avoid contact with measles. In case of exposure, go to the medical center for timely support. Passive immunity with chickenpox antibodies (VZIG) is necessary in non -immune patients, using systemic corticosteroids or those who used corticosteroids within 3 months ago; This must be done within 10 days from the date of exposure to chicken pox. Corticosteroids should not be stopped but can increase the dose.
Do not use inactivating vaccines or vaccines to reduce poison for patients taking corticosteroids with immunosuppressive doses because antibody reactions to these vaccines can be reduced, and immune -loss patients are often at high risk of developing the disease because they are inability to inhibit the multiplication of viruses that reduce toxic viruses, causing severe complications.
The use of corticosteroids in labor should only be limited in the case of working tuberculosis to control the disease and must be combined with appropriate tuberculosis regimen. When corticosteroids are indicated for potential tuberculosis patients, reacting with tuberculin, those with tuberculosis or X-ray have typical changes of tuberculosis, should be closely observed because the disease may recur. If used for prolonged corticosteroids, these patients need to use preventive measures and anti -tuberculosis drugs.
hypersensitivity
A few cases of skin reactions occur and anaphylactic/anaphylactic reaction when using corticosteroids. Therefore, it is necessary to take appropriate preventive measures before taking the drug, especially for patients with a history of allergies to any drugs.
Effects on endocrine systems
Prednisolon can cause adrenal energy, adrenal atrophy or HPA axis inhibitors, especially in children and patients taking high doses for a long time. When stopping the drug must be cautious and slowly reduced. Closely monitor patients who are using body corticosteroids to inhales because they can cause hormone deficiency or when stopping the drug, including increased allergic symptoms, especially those who are taking prednisolon> 20 mg/day.
Adrenal insufficiency may occur when the drug is discontinued suddenly after a long time of treatment, or stress. Patients who are about to have surgery may have to use corticosteroids because they respond normally with stress reduced due to the inhibition of HPA axis.
The following patients need to reduce the dose slowly whether the treatment time is more or less than 3 weeks:
During the prolonged treatment process, any other attached diseases, trauma or surgery will require temporary dosage increase; If corticosteroids have been stopped after prolonged treatment, may need temporary use.
Because corticosteroids can cause or worsen the Cushing syndrome, corticosteroids do not use cushing patients.
Need to be cautious and monitor regularly when using body corticosteroids for patients with thyroid failure.
Scramps are associated with adrenal marrow, even leading to deaths after using corticosteroids. Need to evaluate benefits - the risk of using corticosteroids for patients suspected or have adrenal medulla
Mental effect
Patients or family members should be warned of unwanted mental effects that may occur. Symptoms usually appear within a few days or weeks after the beginning of treatment. Although the time of onset, classification, severity or prolonged time is often unpredictable through the dosage, the risk of this unwanted effect is higher when using high doses, systemic effects (pharmacokinetic interactions can increase unwanted effects). Most will recover after reducing the dose or stop use but specific treatment is also essential.
Patients/family members should be encouraged to see a doctor if they see mental symptoms, especially if there are signs of depression or suspicion of suicide. Patients/family members also need to be warned of mental disorders that may occur during or after reducing the dose or stopping the drug suddenly even though these reactions occur irregularly.
It is important to pay special attention when considering using corticosteroids for systemic effects in patients who are or have shown signs of serious emotional disorders (depression, depression or mental disorders due to the previous steroid), or the family with a history of emotional disorders.
diabetes
Corticosteroids including prednisolon may increase blood glucose, worsen predicated diabetes and can lead to diabetes when used for a long time. Be careful when using drugs for people with diabetes (or have a family history of diabetes).
nervous system
Be careful when using corticosteroids for epilepsy patients.
Eyes
Be cautious when using corticosteroids in patients with glaucoma (or families with a history of glaucoma), patients with herpes simplex in the eye because they can cause corneal perforation. Using corticosteroids for a long time can cause cataracts under the back and central cataracts (in children), convex eyes or intraocular pressure can lead to glaucoma accompanied by visual destruction. Corticosteroids may increase the risk of fungal or secondary viruses in the eye, which can be associated with the central retinopathy and can lead to retina. If the patient has symptoms such as blurred vision or other visual disorders, see a doctor immediately to be assessed the cause.
heart and blood vessels
Corticosteroid adverse effects on the cardiovascular system such as blood lipid disorders and hypertension, which can increase cardiovascular risks for patients, if treated with high and prolonged doses. Therefore, it is necessary to use corticosteroids cautiously in these patients and pay attention to the implementation of risk reduction and heart monitoring if necessary. Low doses and Japanese treatment can reduce the incidence of complications in corticosteroid therapy.
Only use corticosteroids for patients with congestive heart failure or myocardial infarction when really necessary. Must be cautious and monitor regularly when using whole corticosteroids for this patient.
Be careful when used for patients who are using anti -arrhyths such as digoxin.
corticosteroid has been reported to increase blood clotting and precipitate thrombosis in the vessel, thrombosis, venous thrombosis (although very rare), should be used with corticosteroids carefully in patients at risk of thrombosis.
digestive system
Be careful when using corticosteroids for patients with stomach ulcers. Combined with nonsteroidal anti-inflammatory drugs that increase the risk of stomach ulcers. In case of a history of ulcer, corticosteroid therapy may be prescribed in combination with clinical monitoring, or ulcerative endoscopy if necessary.
liver failure
Be careful when using corticosteroids for patients with liver or cirrhosis. The effect of corticosteroids can be enhanced in patients with chronic liver disease with liver function impairment.
skeletal muscle
Acute muscle disease when using high doses of corticosteroids has been reported, often occurring in patients with muscular disorders (such as muscle weakness) or on patients taking anti -cholinergic drugs such as neuromeric inhibitors (pancuronium). The disease often spreads, to both eye muscles, respiratory muscles and can lead to limb paralysis. Creatinin kinase should be monitored.
Be cautious when using corticosteroids in osteoporosis patients (especially women after menopause) and monitor patients regularly. Oral or injection corticosteroids may increase the risk of tendon diseases even tendons in those who are using fluoroquinolon, dialysis, secondary hyperthyroidism, or kidney transplant.
kidney disease
Be careful when using corticosteroids for patients with renal impairment and monitor patients regularly.
Kidney disease caused by sclerosis (can be fatal) with hypertension, the amount of urine is observed with daily dose of 15 mg of prednisolon or higher in systemic sclerosis patients. Therefore, it is advisable to regularly check blood pressure and kidney function (serum creatinine) in these patients, if there is suspicion of kidney disease, need to strictly control the patient's blood pressure.
Special subjects
Children:
corticosteroids cause retardation in newborns, young children and adolescents, may not recover, so it is advisable to avoid prolonged pharmacological doses. If required for prolonged treatment, the limit should be used to minimize the inhibition of HPA axis and growth in children. The growth and development of infants and children should be closely monitored. Should use Japanese insulation for children.
Elderly:
It is advisable to note the consequences of unwanted effects when using prolonged corticosteroids in the elderly, especially osteoporosis, diabetes, high blood pressure, hypokalemia, sensitive to infections and thinning the skin. Precautions must be used with the lowest doses, in the shortest time, strict clinical monitoring to avoid life -threatening reactions.
Note in the case of prolonged use of corticosteroids
During treatment can increase blood sugar and disorders of protein metabolism with negative nitrogen balance, so the diet is rich in protein, less sugar absorption.
To ensure blood pressure, the amount of salt will be reduced in the diet when the treatment dose is higher than 15 - 20mg Prednisolon/day and keeps the average amount of salt in prolonged treatment at low doses.
Potassium supplements in the case of prolonged treatment with high doses of corticosteroids, or combine the treatment of hypokalemia when there is a risk of arrhythmia.
Patients should also be supplemented with calcium and vitamin D.
It should be noted for athletes, this active ingredient can cause false positive for the Dopping test.
Drug interaction
mannitol
Products containing mannitol, which can cause light laxative effects.
Sodium benzoat
The product containing sodium benzoate must be used very carefully for babies, because benzoic acid (of benzoat) is a metabolic substance of benzyl alcohol and a large amount of Benzyl alcohol (≥ 99 mg/kg/day) has been related to death poisoning (fish yawning syndrome (Gapsing syndrome) in babies.
Medication interactions can affect the activity of the drug or cause side effects.
Patients should notify the doctor or pharmacist a list of the drugs and functional foods you are using. Do not use or increase or decrease the dose of the drug without the guidance of a doctor.
Storage
Leave a cool place, avoid light, temperature below 30⁰C.
To be out of reach of children.
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