Instructions for the use of longidase suppositories in gynecology. Longidase suppositories: instructions for use of rectal and vaginal suppositories Candles with longidase in gynecology

In urology

1 suppository every other day - 10 injections, then after 2-3 days - 10 injections. General course of 20 introductions.

In gynecology

Rectally or intravaginally, 1 suppository after 2 days - 10 injections, then, if necessary, maintenance therapy is prescribed.

In dermatovenereology

1 suppository in 1-2 days - 10-15 injections.

In surgery

1 suppository in 2-3 days - 10 injections.

In pulmonology and phthisiology

1 suppository in 2-4 days - 10-20 administrations.

Overdose

The tool is available in two types of dosage forms, which are prescribed depending on the specific situation. What is the difference between Longidaza candles and injections? According to instructions:

1. Longidase suppositories are usually used when the causes of adhesions are gynecological in nature, they are often prescribed in urology. The course of treatment can be long, up to several months. They are applied vaginally or rectally. Due to the long-term effect, the drug is not used every day, doctors can prescribe it one suppository every two to four days.
2. Longidase powder is used as a solution for intramuscular or subcutaneous injection. Typically, such injections are prescribed locally, injecting the solution directly under the altered scar tissue, but it can also be used intramuscularly. The course is determined by the doctor and may include from 5 to 25 injections. In severe, prolonged illness after the main course, doctors may prescribe additional maintenance therapy lasting 10-14 days. In this case, like candles, the solution can be pricked once every three to five days.

Suppositories and lyophilisate for injection Longidase are prescription drugs. Only a doctor should prescribe them.

During pregnancy and lactation

According to the instructions, the use of Longidaza during pregnancy and breastfeeding is contraindicated. This is due to the fact that there is no clinical experience with the use of the drug when carrying a child and breastfeeding him.

The efficacy and safety of the drug in this group of patients has not been fully studied, so treatment should be refrained from.

The drug Longidaza during pregnancy and breastfeeding is not recommended. If such treatment is necessary, it is necessary to interrupt the lactation process.

The effectiveness of treatment with Longidase

The patient can choose injections active substance intravenously or using suppositories. Each application scheme has its pros and cons.

The use of Longidase injections

Longidaza injections are used for a month. It is desirable that the injection was given by a doctor. This method of therapy is usually prescribed for inpatient treatment after surgery. A month after injection therapy, the substance is excreted from the body, and it is forbidden to take similar drugs.

Suppositories are administered rectally or vaginally. They should be used regularly - every day or every three days, depending on the severity of the inflammation.

The standard course of treatment with Longidasa suppositories is 20 days, but if necessary, it can be increased to 60 days. Repeated therapy is allowed, but only 3 months after the last course.

In most cases, according to practical medical research and feedback from members of the forum, the use of Longidase suppositories and injections has a beneficial effect on restoring lost fertility.

Longidaza in the form of suppositories and injections is used in complex therapy for the treatment and prevention of diseases accompanied by the growth of connective tissue.

Longidase injections and suppositories: use of the drug

drug interaction

Longidaza can be combined with antifungal, antiviral drugs, bronchodilators for inhalation and antibiotics, electrophoresis. Instructions for use highlight types drug interaction:

1. The drug increases the bioavailability and action local anesthetics, antibiotics, diuretics.
2. The enzymatic activity of the agent is lowered by cortisone, salicylates, antihistamines, estrogens.
3. It is forbidden to combine the medicine with Phenytoin, benzodiazepines, Furosemide.

Longidase is compatible with antibiotics.

Longidase for injections is available in the form of a lyophilisate (powder). The vial (ampoule) contains 1500 or 3000 IU (international units) of the active substance. One package contains 5 glass vials (ampoules).

The effectiveness of treatment with Longidaza can be reduced with complex therapy in combination with antihistamines and hormonal drugs. In addition, it is forbidden to simultaneously use the drug in combination with substances such as phenytoin, benzodiazepine, furosemide.

In combination with anesthetics, diuretics and antibiotics, it is possible to enhance the effect of these medicines.

Since Longidase (suppositories and injection solution) is well tolerated, it can be used simultaneously with antibacterial agents, antiallergic, antifungal and drugs with antiviral activity, bronchodilators, cytostatic agents, corticosteroids.

It should be noted that Longidase (solution for injection) helps to increase the bioavailability of other drugs, increases the effectiveness of the analgesics used.

The activity of Longidase decreases with simultaneous treatment with estrogens, salicylates, cortisone, ACTH, antihistamine drugs in high doses. An increase in the bioavailability of the second drug should be taken into account when used simultaneously with Longidase.

Areas of use

The medicine is prescribed for various lesions of the genital organs. These are not only processes that threaten a woman's fertility, but also any other deviations that can result in scarring and inflammation. Indications for the use of the drug:

• recovery period after surgery;
• inflammation of the appendages;
• chronic type endometritis;
• adhesive and cicatricial formations in the genital area;
• infertility caused by adhesions.

The drug Longidaza is prescribed to patients from 12 years of age, with the exception of people with impaired renal function or pulmonary bleeding.

Longidaza suppositories for inflammation of the appendages

In the pelvis, with inflammatory processes in the appendages, the risk of infertility increases. To reduce the likelihood of reduced fertility and the removal of these organs, suppositories are prescribed.

Soft tissues in gynecology are restored due to the introduction of Longidaza and other auxiliary drugs. Suppositories are only part of complex therapy. A month later, the inflammation stops, the condition of the tissues returns to normal.

For chronic endometritis

In the case of diseases accompanied by endometrial hyperplasia, suppositories are prescribed. They reduce swelling of the uterus and appendages, stop inflammation. Patients note positive changes after 1-2 courses of treatment for endometritis, which can also cause infertility.

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An effective remedy for adhesions

In gynecology, the treatment and prevention of the adhesive process is mainly carried out with the help of Longidaza vaginal suppositories. The drug is prescribed because it has all the necessary actions against adhesions:

• destroys interfering formations;
• prevents reappearance;
• gently regenerates surrounding tissues.

You can completely get rid of the adhesive process after several courses of the drug. Then the risk of inflammation of the small pelvis is reduced.

Immunomodulatory action

For inflammatory diseases internal organs it is very important to improve the protection mechanisms. The therapy fully helps only if, after getting rid of adhesions and inflammation, permanent immunity against lesions of the genitourinary system is acquired.

"Longidaza" improves the condition of the soft tissues of the genital organs, thereby increasing protection against infections, inflammations and viral lesions.

How exactly to treat with Longidaza, prescribe suppositories or injections for you is determined by the doctor, depending on the exact diagnosis, severity of the disease, age and other individual characteristics of the patient.

Courses can last from 5 to 25 days, and the interval between doses of the drug is from 2 to 10 days. The dose of the drug is also determined individually.

If necessary, treatment can be repeated, after a break of 2-3 months. Longidaza is able to interact with other drugs, as it:

• Enhances the action of antiseptics, diuretics and antimicrobials.
• Simultaneous administration with estrogens, antihistamines, salicylates, cortisone and adenocorticotropic hormone reduces the activity of hyaluronidase.
• Longidaza can not be used simultaneously with benzodiazepine drugs, furosemide and phenytoin.

Indications

Depending on the form of release of the drug, its indications for use differ. Common for suppositories and lyophilisate, the instruction highlights:

• chronic prostatitis;
• treatment and prevention of adhesions in the pelvic organs after artificial abortions, operations, abdominal organs;
• interstitial cystitis;
• tubal-peritoneal infertility;
• chronic endomyometritis;
• limited scleroderma;
• in dermatology: non-healing wounds;
• fibrosing alveolitis;
• intrauterine synechia;
• cavernous-fibrous, infiltrative tuberculosis, tuberculoma;
• pneumosclerosis.

Candles Longidaza

Instructions for use Longidase differs depending on the form of release of the drug. So, injections are administered subcutaneously at the site of the lesion or under the scar, or intramuscularly in the amount of 3000 IU in a course of 5-25 injections with an interval of 3-10 days.

A second course of injections is possible after 2-3 months. If the diseases are accompanied by a severe chronic process, then maintenance therapy is prescribed with intervals between injections of 10-14 days.

To increase the availability of drugs, injections are made at a dose of 1500 IU 10-15 minutes before the introduction of the main drug. Dilution of the powder: the contents of an ampoule of 3000 IU are diluted in 1-2 ml of 0.25-0.5% procaine, if it is intolerant, in a solution of sodium chloride or water.

To increase the bioavailability of 3000 IU Longidases are diluted in 2 ml of saline, 1500 IU - in 1 ml. The solvent is introduced into the ampoule slowly, aged for 2-3 minutes.

Then the mixture is mixed without shaking (so as not to foam the protein), introduced, not subject to storage. Intravenous administration of Longidaza is prohibited.

Longidaza is indicated for adult patients as part of complex treatment, as well as for the prevention of diseases in which there is hyperplasia of the connective tissue.

• Gynecology: therapy and prevention of adhesions in the pelvic organs in inflammatory diseases (endometritis, infertility, intrauterine synechia).
• Urology: interstitial cystitis, chronic prostatitis.
• Cosmetology, dermatovenereology: keloid, forming, hypertrophic scars, limited scleroderma.
• Surgery: adhesive processes after operations, hypertrophic scars, wounds that do not heal for a long period.
• Pulmonology, phthisiology: pneumosclerosis, tuberculosis, fibrosing alveolitis.
• Orthopedics: arthrosis, joint contracture, ankylosing spondylitis, hematomas.

In addition, Longidase is used to increase bioavailability when using certain antibacterial agents and also to enhance the effect of local anesthetics.

Which is better, injections or suppositories - the doctor determines in each case individually. Before starting therapy, the patient must inform the doctor about the medicines he is taking.

If the patient is prescribed injections of Longidaza 3000, the instruction indicates that the solution should be injected subcutaneously under the tissues altered by scars or near the affected area.

Also, the drug can be administered intramuscularly. Depending on the disease, a course of treatment is prescribed, which includes 5-25 injections.

The interval between injections can be from 3 to 10 days. If there is such a need, re-treatment is prescribed after 2-3 months.

For some diseases, the doctor may prescribe long-term maintenance treatment with Longidaza, in which injections are carried out once every 10-14 days.

Before use, the contents of the ampoule or vial are dissolved in 1-2 ml of procaine solution (0.25 or 0.5%). If the patient is intolerant to procaine, the agent is dissolved in a similar volume of water for injection or sodium chloride solution 0.9%.

If the drug is prescribed to increase the bioavailability of other drugs, the contents of the vial or ampoule of Longidase 3000 should be dissolved in 2 ml of a 0.9% sodium chloride solution, and the contents of the vial or ampoule of Longidase 1500 should be dissolved in 1 ml of the solution.

In this case, the solution should be administered in the same way and in the same place as the main drug, but 10-15 minutes before the main drug is administered.

The solvent is introduced into the ampoule slowly, after which it is kept for 2-3 minutes. Stir gently without shaking vigorously. The solution cannot be stored, it is not administered intravenously.

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Instructions for use of candles Longidase

In case of scars or complications after the introduction of hyaluronate-based fillers, it is recommended to inject the drug subcutaneously directly into the scar or the place requiring correction.

In pulmonology, urology and gynecology, Longidaza injections are administered intramuscularly. The dose of drug administration is 3000 IU, the course of treatment requires the drug to be administered from 5 to 15 times.

The interval between injections of Longidase should be 3-10 days (on average, a week).

For organ diseases respiratory system the medicine is administered intramuscularly in 1 vial (3000 IU) every 3-5 days. The course of treatment requires 10 injections. In the future, it is possible to introduce maintenance doses of the drug (1 vial once a week).

In gynecology, Longidase is also injected into the muscle once a day, 3000-4500 IU every 3 days. The course will require from 5 to 15 injections.

For the treatment of scars, injections are given directly to the place of change every 7 days for five weeks (if necessary, it can be increased to ten).

In orthopedic pathology, the medicine is also administered intramuscularly, one vial per week. The total number of injections is from 5 to 7.

For the treatment of adhesions, it is necessary to inject the medicine into the muscle in a vial 1 time in three days.

In addition to the treatment of gynecological diseases, Longidaza is actively used in other medical fields.

In urology, the drug is used in the treatment of inflammatory processes of the prostate, urethritis and fibrosis, as well as a prophylactic against adhesions during surgical operations on the male genital organs.

Longidase injections 3000 units. are prescribed for subcutaneous injection under the scar tissue or close to the affected area.

The drug in injections can be injected into the muscle, the standard course of treatment with the drug (3000 units) involves the introduction of 5 to 25 injections. To achieve better efficiency, the time interval between injections should be 3-10 days.

The doctor may prescribe a second course of therapeutic therapy with a solution for injection after 2-3 months. A woman can choose: I inject the drug further or take a break.

In a number of diseases, the medicine can be used for a long time, it is prescribed to administer injections once every 10-14 days. How many injections you need to do in a particular case, check with your doctor.

If this drug is prescribed in injections (3000 units), the contents of the vial or ampoule should be diluted before use. For this, a solution of procaine 0.25% or 0.5% is used (the volume should be 1-2 ml).

If the patient has an intolerance to procaine, it can be replaced with the same amount of saline or specially prepared water for injection.

Longidaza from wrinkles is also used, the scheme of application is determined individually.

Longidase to increase the bioavailability of drugs

If the use of a solution to increase the bioavailability of other drugs is prescribed, then a bottle of Longidase (3000 units) is diluted with 2 ml of saline. You will need to administer the drug in the same way as the main drug, but in about 10-15 minutes. before the use of the main drug.

The introduction of the solvent into the ampoule should be done as slowly as possible, after which it will be necessary to withstand the solution for 2-3 minutes. and shake and use immediately as directed.

Features of the use of candles

It is used in the complex therapy of children from 12 years of age and adults with pathologies that occur with connective tissue hyperplasia. It is also prescribed to improve the bioavailability of diagnostic and therapeutic drugs.

Contraindications

The drug is prohibited for use under the age of 12 years. It can have a negative effect on children. Also, you should not use the medicine for:

• renal failure;
• risk of pulmonary hemorrhage.

If there is a risk of these phenomena, you need to consult a doctor about the need to use the medicine.

• individual intolerance to the drug;
• oncological processes in the body;
• pregnancy;
• lactation.

If necessary, you can find analogues of the drug without the listed prohibitions.

• high sensitivity to agents based on hyaluronidase;
• hemoptysis, pulmonary bleeding;
• acute infectious diseases;
• recent hemorrhage in vitreous body;
• malignant tumors;
• kidney failure;
• children and adolescents up to 18 years of age.

Longidaza solution for injections is prescribed for adults and children from 12 years of age with pathology accompanied by connective tissue hyperplasia. The drug can be used only after consultation with your doctor! Indications for use are the following conditions:

• Pulmonology: connective tissue growth in the lungs (pneumofibrosis), fibrosing alveolitis, tuberculoma;
• Urology: non-infectious cystitis, chronic prostatitis, prevention of complications after urethral surgery;
• Gynecology: adhesions in the pelvis, tubal obstruction, chronic inflammation uterus;
• Cosmetology: correction of complications after the introduction of hyaluronic fillers;
• Surgery: scars, adhesions in the abdominal cavity, poorly healing wounds;
• Orthopedics: contractures of the articular apparatus.

• Intolerance to components;
• Oncological diseases;
• Pregnancy and period breastfeeding;
• Age under 12 years old.

Since the drug is excreted by the kidneys, caution should be exercised when prescribing Longidaza to patients with diseases of the organ.

An absolute contraindication to drug therapy with Longidaza is the presence of inflammatory processes and infections in the body, especially during an exacerbation.

You should refrain from taking the drug if you have a history of hemoptysis or bleeding in the lungs. At oncological diseases, elevated body temperature, or kidney disease. Individual intolerance to one of the components of the drug is also a contraindication.

Minor children under the age of 18 are considered separately, since there are no data on reactions to the drug among this group. In the instructions for use, the list of exceptions includes pregnant women and nursing mothers.

However, there are reviews on the use of Longidaza injections in gynecology, not only for those who plan to become pregnant, but also for women in the early stages of pregnancy.

In any case, you need to measure the benefits and harms of the drug and consult a gynecologist.

Longidaza can be indicated for use as monotherapy or as part of a complex treatment of gynecological diseases in:

• inflammatory processes in the pelvic organs for the prevention and elimination of adhesions
• recovery after medical manipulations (abortions, surgical interventions)
• intrauterine synechia
• endometriosis
• chronic endomyometritis
• infertility caused by tubal peritoneal factor
• complications from sexually transmitted infections

Medicines are not used for:

• Susceptibility to components
• The presence of oncoprocesses
• Pregnancy
• Children's age (up to age 12)

• malignant tumors;
• Pregnancy;
• Children's age up to 12 years;
• Hypersensitivity to Longidase and other drugs with hyaluronidase activity.

In case of insufficiency of kidney function and pulmonary bleeding earlier - appoint no more than 1 time per week.

Longidaza price

The price of Longidaza 3000 injections averages 1450-1500 rubles. for 5 pcs. The price of Longidaza candles is 3000 units.

is approximately 1250-1450 rubles. for 10 pcs. You can buy an injection drug in Ukraine at a price of 600 to 700 UAH.

How much candles cost depends on the place of sale. On average, this is 500-600 UAH.

The cost of one package of Longidaza in pharmacies in Moscow is 1800-2100 rubles, and on the Internet you can buy the drug at a price of 1750 rubles.

The drug is produced in two dosage forms: suppositories (method of administration rectally or vaginally) and lyophilizate to obtain a solution for subcutaneous or intramuscular administration.

A drug with proteolytic activity.
Preparation: LONGIDAZA®
The active substance of the drug: non appropriated
ATX encoding: V03AX
CFG: A drug with proteolytic activity
Registration number: LS-000764
Date of registration: 23.09.05
The owner of the reg. Award: NPO PETROVAKS PHARM LLC (Russia)

Longidase release form, drug packaging and composition.

1 amp.

1500 IU

Lyophilizate for the preparation of a solution for i / m and s / c administration in the form of a porous hygroscopic mass of white or white with a yellowish tint.
1 vial
longidase with hyaluronidase activity
1500 IU

Excipients: mannitol (up to 15 mg).

Lyophilizate for the preparation of a solution for i / m and s / c administration in the form of a porous hygroscopic mass of white or white with a yellowish tint.
1 amp.
longidase with hyaluronidase activity
3000 IU

Ampoules (5) - blister packs (1) - cardboard packs.

Lyophilizate for the preparation of a solution for i / m and s / c administration in the form of a porous hygroscopic mass of white or white with a yellowish tint.
1 vial
longidase with hyaluronidase activity
3000 IU

Excipients: mannitol (up to 20 mg).

Vials (5) - blister packs (1) - cardboard packs.

The description of the drug is based on the officially approved instructions for use.

Pharmacological action of Longidase

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

Prolongation of the action of the drug is carried out due to the covalent binding of the enzyme to a physiologically active high-molecular carrier (activated derivative of poly-1.4-ethylenepiperazine N-oxide), which has its own pharmacological activity: it has an immunomodulatory, detoxifying and antioxidant effect.

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 preserved when heated to 37°C for 20 days, while native hyaluronidase loses its activity during the day under the same conditions.

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

Glycosaminoglycans (hyaluronic acid, chondroitin, chondroitin-4-sulfate, chondroitin-6-sulfate), which form the basis of the connective tissue matrix, are a specific substrate for testicular hyaluronidase. As a result of depolymerization (breaking the bond between C1 acetylglycosamine and C4 glucuronic or induronic acids) under the influence of hyaluronidase, glycosaminoglycans 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, and the elasticity of the connective tissue increases. The action of the drug leads to a decrease in tissue swelling, flattening of scars, an increase in the range of motion of the joints, a decrease in contractures and adhesions and the prevention of their formation.

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 mitogenic, polyclonal activity, does not have mutagenic, embryotoxic, teratogenic and carcinogenic effects.

Pharmacokinetics of the drug.

Suction and distribution

When administered s / c or / m, the drug is rapidly absorbed into the systemic circulation from the injection site, while Cmax is reached after 20-25 minutes. It is characterized by a high distribution rate, the half-distribution period is about 30 minutes. It penetrates into all organs and tissues (including through the BBB and the blood-ophthalmic barrier). Does not accumulate.

Metabolism and excretion

In the body, hyaluronidase undergoes hydrolysis and is excreted mainly by the kidneys. The carrier is metabolized to low molecular weight compounds (oligomers), which are excreted by the kidneys. T1 / 2 with different routes of administration ranges from 42 to 84 hours.

Indications for use:

As part of the complex therapy of adults and adolescents over 12 years of age with diseases accompanied by connective tissue hyperplasia.

In pulmonology, urology, gynecology with the development of inflammation of the interstitial type:

Pneumofibrosis, tuberculosis, alveolitis;

Chronic interstitial cystitis;

Adhesive process in the small pelvis;

Tubal-peritoneal infertility.

In orthopedics, surgery, cosmetology:

Keloid, hypertrophic, retracted scars after pyoderma, injuries, burns, operations;

Long-term non-healing wounds;

Joint contractures, arthritis, hematomas;

Adhesive disease.

In dermatovenereology:

Limited scleroderma of various localization.

To increase the bioavailability of medicinal and diagnostic preparations.

Dosage and method of application of the drug.

and the method of administration is set individually, depending on the disease, age and severity of the patient's condition.

Longidaza is injected s / c (near the site of the lesion or under scar tissue) or / m. The course is from 5 to 15 injections with an interval between injections of 3 to 10 days.

In diseases accompanied by a severe chronic productive process in the connective tissue, it is recommended to carry out maintenance therapy with Longidase at a dose of 3000 IU after a standard course with intervals between injections of 10-14 days.

1. In pulmonology, urology, gynecology, dermatovenereology

In case of respiratory diseases, the drug is prescribed intramuscularly at a dose of 3000 IU once every 3-5 days with a total course of 10 injections. Further, long-term therapy is possible (from 3-4 months to 1 year) at a dose of 3000 IU once every 10-14 days.

In diseases of the pelvic organs, the drug is prescribed intramuscularly at a dose of 3000 IU 1 time in 3-5 days with a general course of 5 to 15 injections.

With limited scleroderma of various forms and localization, the drug is administered intramuscularly at a dose of 3000-4500 IU once every 3 days with a course of 5-15 injections. The dose and duration of the course of treatment are selected individually depending on clinical course, stage, localization of the disease.

2. In orthopedics, surgery, cosmetology

With keloid, hypertrophic, retracted scars after pyoderma, burns, operations, the drug is injected into the scar at a dose of 3000 IU in 1-2 ml 1-2 times a week with a course of 5-10 injections and / or intramuscularly 1 time in 3-5 days a total course of up to 10 injections.

For long-term non-healing wounds, the drug is prescribed intramuscularly at a dose of 1500-3000 IU once every 5 days with a course of 5-7 injections.

With contractures of the joints, arthritis, hematomas, Longidase is prescribed intramuscularly at a dose of 3000 IU 1-2 times a week with a course of 7 to 15 injections.

In adhesive disease, the drug is administered intramuscularly 1 time in 3-5 days at a dose of 3000 IU in a general course of 7 to 15 injections.

3. To increase the bioavailability of drugs and diagnostics (antibiotics, chemotherapy drugs, anesthetics), Longidase is administered once every 3 days at a dose of 1500 IU. The course should not exceed 10 injections.

Patients with renal insufficiency should not be given the drug more than once a week.

Solution preparation

For i / m, s / c or / to the introduction of the contents of the vial (ampoules) is dissolved in 1.5-2 ml of 0.25% or 0.5% procaine solution. In case of intolerance to procaine, the drug is dissolved in 0.9% sodium chloride solution or water for injection.

The prepared solution for parenteral administration is not subject to storage.

Side effects of Longidaza:

Local reactions: soreness at the injection site; in some cases, local reactions are manifested in the form of skin hyperemia and swelling at the injection site.

All adverse reactions disappear after 48-72 hours.

Other: rarely - allergic reactions.

Contraindications to the drug:

Malignant neoplasms;

Pregnancy;

Children's age up to 12 years (efficacy and safety have not been studied);

Individual hypersensitivity to the drug.

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

Use during pregnancy and lactation.

The drug is contraindicated for use during pregnancy.

Special instructions for the use of Longidaza.

The drug should not be injected into the area of ​​infection, acute inflammation or tumors.

Drug overdose:

At present, no cases of overdose of Longidaza have been reported.

Interaction of Longidase with other drugs.

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

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

Conditions of sale in pharmacies.

The drug is dispensed by prescription.

Terms of the storage conditions of the drug Longidase.

List B. The drug should be stored in a dry, dark place, out of the reach of children, at a temperature not exceeding 15°C. Shelf life - 2 years.

Longidaza (manufacturer - Petrovax Pharm) - medication, produced in the form of rectal and vaginal suppositories, as well as a lyophilizate to create an injection solution.

One candle contains:

• 3000 IU Longidase substance (azoxymer bromide and hyaluronidase).
• The inactive ingredient is cocoa butter.

Suppositories have an elongated shape, their color is light yellow, the smell is light, characteristic of cocoa butter. One box contains 5 candles.

Pharmacological and pharmacokinetic action

The tool has an enzymatic proteolytic (breaks down the protein to peptides and amino acids) activity and is characterized by a long (prolonged) action.

It also has the following effects on the body:

• chelating - forms complexes by adding metal ions, in other words, binds heavy metals and removes them from the body;
• moderate anti-inflammatory by regulating the synthesis of inflammatory mediators;
• antioxidant;
• antifibrotic;
• immunomodulatory;
• improves joint mobility.

note

No carcinogenic, teratogenic and other negative effects of these suppositories on the developing embryo or human body have been identified.

In the course of experiments in order to establish the patterns of chemical and biological processes occurring in the body of mammals with the introduction of Longidase suppositories, the following was revealed:

• when injected into the rectum, the agent is rapidly distributed in the body;
• well absorbed into the large bloodstream;
• after the introduction of the suppository, the maximum concentration of its active ingredient is reached in the blood in an hour;
• the half-life of Longidaza is 30 minutes;
• blood plasma reaches at least 70% of unchanged drug substance;
• a sharp deterioration in well-being after withdrawal (drug dependence) was not observed;
• the drug is excreted mostly by the kidneys.

Longidaza suppositories, instructions for use rectally:

• Wash your hands thoroughly. Microbes and other bacteria can invade immune system human through the rectum, if given the chance. For this reason, it is recommended to wash your hands even if you wear gloves during the procedure.
• Read the instructions. Follow it and never exceed the recommended dose. If you do not need to take the full dose, cut the suppository in half lengthwise. A longitudinal cut makes insertion much easier than a side cut.
• Put on disposable latex gloves. This is not necessary, but you may feel more comfortable inserting the suppository with gloves on, especially if you have long nails.
• Harden the suppository if it has softened. For example, place it in the refrigerator or freezer for up to 30 minutes, or run it under cool running water for a few minutes.
• Lubricate the area around the anus with petroleum jelly (optional).
• Lie on your left side and stretch your right leg up towards chest. You can also insert the Longidaza suppository in a standing position, in this case, spread your legs apart and sit down slightly. You can also lie on your back with your legs up.
• Insert the suppository into the rectum in a longitudinal direction. It is necessary to push at least 2 cm of the suppository into the rectum.
• Keep your buttocks tightly together for a few seconds after insertion.
• Wait for the medicine to take effect. This may take 15 to 60 minutes and lead to a bowel movement.

Remove gloves and wash your hands thoroughly, use warm water and soap and be sure to rub the soap in for at least 20 seconds and then rinse properly.

Longidaza suppositories, instructions for use vaginally:

• It is best to use these products right before bed.
• Lying on your back with your legs slightly apart will reduce leakage of medication from the vagina that might occur when walking.
• Wash the vaginal area with mild soap and water and dry thoroughly.
• Remove the suppository from the wrapper and gently insert into the vagina.
• Keep using the medicine until your doctor tells you to stop it.

Dosage of the drug for various diseases:

• One suppository with a standard dosage of 3000 IU is administered rectally, that is, into the rectum (after cleansing the intestines with defecation or microclysters) once a day.
• A vaginal suppository is used at night.
• The duration of treatment is from ten to twenty injections (every other day or 2-3 days), it all depends on the duration, severity and stage of the disease.
• For urological diseases, the general course is twenty suppositories. The first ten suppositories are administered one at a time every other day, then every 2-3 days.
• For gynecological diseases, the course is ten suppositories. One candle is administered every two days.
• With dermatovenereological diseases, the course is from ten to fifteen injections (1 suppository every 1-2 days).
• In surgery, the course is ten injections (1 suppository every 2-3 days).
• For problems with the lungs and bronchi, the course is from ten to twenty injections, 1 suppository every 2-4 days.
• If you want to repeat the course of treatment, it is prescribed after 90 days. If long-term maintenance therapy is necessary, the doctor may recommend administering 1 suppository every five to seven days and continuing the course of treatment for up to 4 months.

Candles Longidaza: application and treatment regimens

Longidaza in the form of suppositories and injections is used in complex therapy for the treatment and prevention of diseases accompanied by the growth of connective tissue.

Longidase injections and suppositories: use of the drug

Contraindications:

• Age up to 18 years (no relevant studies have been conducted on the safety of Longidase suppositories. Use in children is less common than in adults).
• Infectious diseases in the acute stage.
• Bleeding from the lungs.
• Malignant tumors.
• Recent vitreous hemorrhage.
• Renal failure.
• Hypersensitivity to hyaluronidase.
• Pregnancy.

Side effects

Rarely there is itching and swelling in the anus or vagina (depending on the method of application of Longidase). Usually these sensations disappear 2-3 days after the introduction of the candle.

note

If the use of suppositories needs to be canceled, this can be done immediately. There is no need to reduce the dose gradually, addiction to Longidase does not occur.

If you forget to use a candle, do so as soon as you remember. No need to use two candles one after the other to compensate for the missed dose.

Possible treatment regimens. You will find out the exact scheme after consulting a doctor.

1. Prevention of compaction of connective tissue and scars after surgery in the pelvis and abdominal cavity: 1 time in three days. There are five candles in total. At the discretion of the doctor, the course can be extended to ten suppositories every five days.
2. Treatment of adhesions in the pelvis: 10-15 suppositories every three to five days.
3. Infertility: at first once every three days, then once every five days. In total - up to 15 candles.
4. Chronic prostatitis: one suppository 1 time in 5 days. In total - up to ten candles.
5. Cystitis: one suppository every 5 days. In total - up to ten candles.
6. Wounds that do not heal for a long time: one candle every five days. In total - up to ten candles.
7. Tuberculosis: one suppository per day, after 5 days. In total - up to twenty-five candles.
8. Pneumosclerosis: one suppository every five days. In total - up to ten candles.
9. Fibrosing alveolitis: one candle every five days. In total - up to fifteen candles.
10. For better bioavailability of other drugs: half a suppository 15 minutes before taking the main drug.
11. For scars and hematomas: they usually do not use suppositories, but intramuscular injections of Longidase, which are done near the affected area, every three days. In total - up to fifteen injections for scars and up to five for hematomas.
12. With arthrosis and other problems with the joints: a candle every three to five days. In total - up to 20 candles.

There are several drugs with active substance hyaluronidase.

Analogues include:

• Ronidase powder (bottles of 5 and 10 grams of the active ingredient).
• Substance and lyophilisate of Lidase (64 units of active substance).
• Lyophilizate Lidaza-M (64 units of active substance).

Due to the reduced amount of the active ingredient, these products are much cheaper than Longidaza - within 300 rubles.

Longidase suppositories for prostatitis, gynecological problems and in surgery

Very often, with prostatitis, against the background of incorrect and late prescribed therapy, scars appear in the tissues of the prostate (scientifically, this is called fibrosis). Because of this, blood circulation suffers and the outflow of secretion is disturbed. In addition, bacteria are very fond of living in scars, which lead to new exacerbations of the disease.

And this is where Longidaza candles come to the rescue. With prostatitis, they are an effective tool that promotes the resorption of scars in the prostate, but you should not expect an instant effect.

It must be at least 3 months before a routine ultrasound or TRUS will show whether the treatment is helping or not.

In the course of a study conducted by Professor V.P. Avdoshin and co-authors in two parallel groups revealed the effect of Longidase suppositories in prostatitis, which is of a long-term nature.

The subjects were divided into two groups, one of which received both standard therapy and Longidase rectally at a standard dosage of 3000 IU, 20 suppositories per course. Initially, patients inserted one suppository every other day, and at 11 suppositories, every two days. The treatment lasted 1.6 months.

The control group was offered standard therapy and placebo (suppositories). The course also lasted forty-nine days. Investigators observed men from both groups for 6 weeks after stopping treatment.

The subjects were asked to complete a questionnaire with a summary assessment of the symptoms of prostatitis. During the study of the questionnaires, it turned out that the clinical index of chronic prostatitis decreased from 27 ± 9 to 13 ± 6 in the Longidaza group, while in the placebo group it decreased from 25 ± 8 to 19 ± 6.

Doctors also noted that in patients from the Longidaza group, scars in the prostate gland decreased, blood flow in the prostate region increased (according to Doppler sonography), and the vascular pattern was enriched.

It can be concluded that Russian suppositories Longidase for prostatitis are an effective and safe remedy for the treatment of bacterial and non-bacterial chronic form of this disease.

In another urological disease - interstitial cystitis - patients complain of severe pain in the area of ​​the ureter, urethra and sacrum, depriving them of the opportunity to normally engage in daily activities. There is also frequent and imperative urination.

• Typically, young and middle-aged women suffer from this type of cystitis.
• When using Longidase suppositories in complex therapy, the intensity decreases pain, the interval between urination increases, in some patients the disappearance of nocturia (frequent nighttime urination) is noted. The therapeutic effect lasted up to six months.

In the first case, the prevention of adhesions is carried out, in the second - direct therapy of the adhesive process.

With long-term non-healing wounds and scars, the use of Longidaza in surgery is justified due to the three effects of this drug. Firstly, it improves the elasticity and trophism of tissues. Secondly, it inhibits the growth of connective tissue in the scar area. Thirdly, it has an anti-inflammatory effect.

In gynecology, Longidaza suppositories are usually used for adhesions that prevent women from becoming pregnant.

What are spikes?

These are scars that occur on the internal membranes of organs as a result of mechanical damage.

If adhesions have arisen in the area of ​​​​thin fallopian tubes, then their (tubes) elasticity and patency are lost. This significantly increases the risk of ectopic pregnancy and infertility. Tubal infertility accounts for up to 40% of all cases of infertility in women.

Scars and adhesions inside the uterus can lead to miscarriage and premature delivery.

Many operations and procedures "on the female side", such as C-section, curettage of the uterus, abortions, cauterization of the cervix are highly likely to cause adhesions. Therefore, many women who are to undergo surgery in the genital area and abdominal cavity are prescribed Longidaza in injections and suppositories. After all, it is easier to prevent the occurrence of adhesions than to treat them.

Also, a gynecologist can prescribe Longidase in order to prevent and cure chronic endometritis and other inflammatory conditions that occur inside the genital organs after surgery.

Most patients leave positive feedback about Longidaza suppositories for prostatitis, infertility, cystitis and other diseases. Ease of use, a long-lasting effect even after discontinuation of the drug, pain relief and a return to normal health - this is what these suppositories are good for.

Many women with infertility due to adhesions report on the Otzovik and iRecommend websites about a successful pregnancy after using Longidaza. However, you should not prescribe these suppositories on your own, since the inability to get pregnant can be explained not only by spikes.

From side effects note nausea, pain in the ovaries, dizziness.

The disadvantages in almost all reviews include the high cost of Longidaza. In various pharmacies, its price ranges from 1670 to 2000 rubles.

Lyophilisate for solution preparation for intramuscular and subcutaneous injection - 1 amp. or fl.:

• active substances: longidase with hyaluronidase activity - 1500 IU - 3000 IU
• excipients: mannitol - up to 15 or 20 mg

In ampoules or vials of neutral glass, in a blister pack 5 ampoules or 5 vials; in a pack of cardboard 1 pack.

Suppositories for vaginal or rectal application- 1 supp.:

• active substances: longidase with hyaluronidase activity - 3000 IU
• excipients: cocoa butter - to obtain a suppository weighing 1.3 g.

In blisters 5 pcs.; in a pack of cardboard 1 or 2 packs.

Description of the dosage form

The lyophilisate for the preparation of a solution for i / m and s / c administration is a porous mass of white or white with a yellowish tint, hygroscopic. Torpedo-shaped suppositories, light yellow in color, with a slight specific smell of cocoa butter, marbling is allowed.

Characteristic

Longidase® is a conjugate of the hyaluronidase enzyme with a water-soluble high molecular weight carrier Polyoxidonium®.

Pharmacokinetics

When administered parenterally, the drug is rapidly absorbed into the systemic circulation and reaches Cmax in the blood after 20-25 minutes, characterized by a high rate of distribution in the body. T1 / 2 (alpha phase) - about 0.5 h, T1 / 2 (beta phase) with different routes of administration - from 42 to 84 hours. It is excreted mainly by the kidneys. In the body, hyaluronidase undergoes hydrolysis, and the carrier breaks down to low molecular weight compounds (oligomers), which are excreted by the kidneys. The drug penetrates into all organs and tissues, incl. passes through the BBB and the blood-ophthalmic barrier. Does not accumulate.

An experimental study of the pharmacokinetics of suppositories with a tritium-labeled enzyme carrier made it possible to establish that, when administered rectally, the drug is characterized by a high distribution rate in the body, is well absorbed into the systemic circulation and reaches Cmax in the blood after 1 hour. The half-life is about 0.5 hours. Bioavailability rectal suppositories Longidaza® - not less than 70%.

Pharmacodynamics

Longidase® has enzymatic proteolytic (hyaluronidase) activity, prolonged action, immunomodulatory, chelating, antioxidant and anti-inflammatory properties. The prolongation of the action of the enzyme is achieved by its covalent binding to a physiologically active high molecular weight carrier (Polyoxidonium®), which has its own pharmacological activity.

Longidase® 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 covalent bond significantly increases the resistance of the enzyme to denaturing influences and the action of inhibitors: the enzymatic activity of Longidase® is preserved when heated to 37 °C for 20 days, while native hyaluronidase loses its activity during the day under the same conditions.

The covalent bond in the Longidase® preparation ensures the simultaneous local presence of a proteolytic enzyme and a carrier capable of binding the released enzyme inhibitors and collagen synthesis stimulators (iron ions, copper ions, heparin, etc.). Due to these properties, Longidase® has not only the ability to depolymerize the connective tissue matrix in fibrous-granulomatous formations, but also to suppress the reverse (regulatory) reaction aimed at the synthesis of connective tissue components.

Glycosaminoglycans (hyaluronic acid, chondroitin, chondroitin-4-sulfate, chondroitin-6-sulfate), which form the basis of the connective tissue matrix, are a specific substrate for testicular hyaluronidase. As a result of depolymerization (breaking the bond between C1 acetylglucosamine and C4 glucuronic or induronic acids), under the influence of hyaluronidase, glycosaminoglycans lose their basic properties: viscosity, the ability to bind water, metal ions, the formation of collagen proteins into fibers becomes more difficult, the permeability of tissue barriers increases, and the movement of fluid into the intercellular space, the elasticity of the connective tissue increases, which manifests itself in a decrease in tissue swelling, flattening of scars, an increase in the range of motion of the joints, a decrease in contractures and the prevention of their formation, and a decrease in the adhesive process. Biochemical, immunological, histological and electron microscopic studies have shown that Longidaza® does not damage normal connective tissue, but causes destruction of the connective tissue changed in composition and structure in the area of ​​fibrosis.

Longidase® does not have mitogenic, polyclonal activity, does not have mutagenic, embryotoxic, teratogenic and carcinogenic effects. The drug is well tolerated by patients, no local and general allergic reactions were noted. The use of Longidase® in therapeutic doses during or after surgical treatment does not cause worsening of the postoperative period or progression of the infectious process; does not slow down the recovery of bone tissue.

Indications for use Longidaza

Adults as part of complex therapy for the treatment and prevention of diseases accompanied by connective tissue hyperplasia.

• in gynecology: treatment and prevention of adhesions in the pelvis in inflammatory diseases of the internal genital organs, incl. tubal-peritoneal infertility, intrauterine synechia, chronic endometritis;
• in urology: treatment of chronic prostatitis, interstitial cystitis;
• in surgery: treatment and prevention of adhesions after surgical interventions on the abdominal organs; hypertrophic scars after injuries, burns, operations, pyoderma; long-term non-healing wounds;
• in dermatovenereology and cosmetology: treatment of localized scleroderma, keloid, hypertrophic, forming scars after pyoderma, injuries, burns, operations;
• in pulmonology and phthisiology: treatment of pneumosclerosis, fibrosing alveolitis, tuberculosis (cavernous-fibrous, infiltrative, tuberculoma);
• in orthopedics: treatment of joint contractures, arthrosis, ankylosing spondylitis, hematomas;
• to increase bioavailability: when administered together antibacterial drugs in urology, gynecology, surgery, dermatovenereology, pulmonology, to enhance the action of local anesthetics.

Contraindications to the use of Longidaza

• hypersensitivity to drugs based on hyaluronidase;
• acute infectious diseases;
• pulmonary bleeding and hemoptysis;
• fresh hemorrhage in the vitreous body;
• malignant neoplasms;
• kidney failure;
• age up to 18 years (results clinical research absent).

With caution: do not inject the drug into the area of ​​​​acute infectious inflammation (due to the risk of spreading a localized infection); chronic renal failure (used no more than 1 time per week); development of an allergic reaction (should interrupt the use of the drug).

Before starting treatment, it is necessary to inform the doctor about all drugs taken by the patient.

Longidaza Use in pregnancy and children

Longidase ® should not be used by pregnant women and women during breastfeeding.

Longidaza side effects

Often (>1/100,<1/10) - болезненность в месте введения; иногда (>1/1000, <1/100) - возможны реакции в месте инъекции в виде покраснения кожи, зуда и отека. Все местные реакции угасают через 48–72 ч. Очень редко (<1/10000) - аллергические реакции.

drug interaction

For a lyophilisate for preparing a solution for intramuscular and s / c administration: Longidaza® can be combined with antibiotics, antiviral, antifungal and antihistamines, corticosteroids, bronchodilators, cytostatics. For suppositories: when using Longidase® in patients receiving high doses of salicylates, cortisone, ACTH, estrogens or antihistamines, the effectiveness of the hyaluronidase enzyme may be reduced. When administered in combination with other drugs, the possibility of increasing their absorption (bioavailability) and enhancing systemic action should be considered.

Dosage of Longidase

S / c (near the site of the lesion or under scar tissue) or / m at a dose of 3000 IU, a course of 5 to 25 injections (depending on the severity of the disease) with an interval between injections 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.

In the case of treatment of diseases accompanied by a severe chronic productive process in the connective tissue, long-term maintenance therapy with Longidaza® 3000 IU is recommended after a standard course with intervals between injections of 10–14 days.

To increase the bioavailability of drugs, a dose of 1500 IU is recommended with preliminary (10-15 minutes) intramuscular or s / c administration at the same place as the main drug.

Breeding

1. The contents of an ampoule or vial of Longidase ® 3000 IU are dissolved in 1-2 ml of procaine solution (0.25 or 0.5%). In case of intolerance to procaine, Longidaza ® is dissolved in the same volume of sodium chloride solution 0.9% for injection or water for injection.
2. When used to increase bioavailability, the contents of an ampoule or vial of Longidase ® 3000 IU are dissolved in 2 ml, and with a dosage of 1500 IU in 1 ml of a 0.9% sodium chloride solution for injection.

The solvent must be introduced into the vial or ampoule slowly, hold for 2-3 minutes, mix gently without shaking so as not to foam the protein.

The prepared solution for parenteral administration is not subject to storage. Do not administer intravenously!

For the prevention of adhesive disease and gross scarring after surgical interventions on the organs of the abdominal cavity and small pelvis - intramuscularly at a dosage of 3000 IU 1 time in 3 days, a course of 5 injections. If necessary, the use of the drug Longidase ® 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 small pelvis with inflammatory diseases of the internal genital organs - intramuscularly at 3000 IU 1 time in 3–5 days, the course is 10–15 injections;
• tubal-peritoneal infertility - intramuscularly at 3000 IU with a total 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 - IM 3000 IU 1 time in 5 days, course - 10-15 injections;
• interstitial cystitis - IM 3000 IU 1 time in 5 days, course - up to 10 injections;

In surgery:

• adhesive disease after surgical interventions on the abdominal organs - intramuscularly at a dosage of 3000 IU 1 time in 3–5 days, a course of 10 to 15 injections;
• long-term non-healing wounds - intramuscularly at a dosage of 3000 IU 1 time in 5 days, a course of 5-10 injections;

In dermatovenereology, cosmetology:

• limited scleroderma - IM 3000-4500 IU 1 time in 3-5 days, course - up to 20 injections. The dosage and course are selected individually, depending on the clinical course, stage, localization of the disease and the individual characteristics of the patient;
• keloid, hypertrophic and forming scars after pyoderma, burns, operations, injuries - intra-scar or s / c (near the site of the lesion) administration at a dosage of 3000–4500 IU, 1 time in 3 days, a course of up to 15 injections. The volume of dilution of 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 ​​the skin lesion, the duration of scar formation, it is possible to alternate s / c and / m injections 1 time in 5 days at a dosage of 3000 IU, a course of up to 20 injections.

In pulmonology and phthisiology:

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

In orthopedics:

• joint contracture - s / c near the site of the lesion at a dosage of 3000 IU 1 time in 3 days, the course - from 5 to 15 injections;
• arthrosis, ankylosing spondylitis - s / c near the site of the lesion at a dosage of 3000 IU 1 time in 3 days, a course of up to 15 injections, if necessary, treatment can be continued with injections 1 time in 5 days. The duration of maintenance therapy is chosen by the doctor depending on the severity of the disease;
• hematomas - s / c near the site of the lesion at a dosage of 3000 IU 1 time in 3 days with a course of up to 5 injections;

To increase bioavailability: when administered jointly subcutaneously or intramuscularly with diagnostic or medicinal products (including antibiotics, chemotherapy drugs, anesthetics). Longidase ® is administered 10–15 minutes beforehand at a dosage of 1500 IU in the same way and at the same place as the main drug.