Advantan ointment (Bayer AG, Germany) is applied once a day in a thin layer for no more than 1 month for children and up to 12 weeks for adults. Contains a local hormone, has anti-inflammatory, anti-edematous, antipruritic, anti-allergic effects. It has strong healing properties and low penetration into the blood.
This allows you to use the ointment for a minimal course, on large areas of the skin, for children, pregnant and lactating women. The latter categories of patients are prescribed with caution and under the supervision of a physician. Contraindicated in case of infection, vaccination, acne; not applied to the skin form of syphilis and tuberculosis.
Pharmacological properties of the drug Advantan
Advantan - methylprednisolone aceponate, when applied topically, reduces inflammatory and allergic skin reactions, as well as reactions associated with cell hyperproliferation, which leads to the elimination of both objective symptoms (erythema, edema, infiltration, lichenification) and subjective complaints (itching, burning, pain ). When methylprednisolone aceponate is applied at a dose that is effective for topical use, the systemic effect is minimal. When applied to large areas of skin in patients with skin diseases, the level of cortisol in the blood plasma remains within normal limits, and its circadian rhythm does not change. There was also no decrease in cortisol concentration in daily urine. As with other corticosteroids, the mechanism of action of methylprednisolone aceponate has not been fully elucidated. It is known to bind directly to intracellular glucocorticoid receptors. This is especially true for the main metabolite of methylprednisolone aceponate, 6α-methylprednisolone-17-propionate, which is formed in the skin as a result of metabolism. The binding of the receptor-steroid complex to a specific region of the DNA molecule initiates a number of biological effects. The mechanism of anti-inflammatory action has been clarified more precisely. Binding of the receptor-steroid complex leads to the induction of macrocortin synthesis. Macrocortin inhibits the release of arachidonic acid and reduces the formation of inflammatory mediators such as prostaglandins and leukotrienes. The immunosuppressive effect of GCS can be explained by inhibition of cytokinin synthesis and an antimitotic effect, which has not yet been sufficiently studied. Inhibition of the synthesis of vasodilatory prostaglandins or potentiation of the vasoconstrictor effect of adrenaline ultimately determines the vasoconstrictor activity of GCS. Methylprednisolone aceponate (MPA) penetrates into the skin from any form of the drug (cream, ointment, greasy ointment). Its concentration in the stratum corneum and skin decreases in the direction from the surface to the middle. MPA is hydrolyzed in the epidermis and dermis. The main metabolite, 6α-methylprednisolone-17-propionate, binds more strongly to corticoid receptors, which indicates the process of bioactivation in the skin. The degree of subcutaneous absorption depends on the condition of the skin, the medicinal form and the type of application (open or under an occlusive dressing). The results of a study of the absorption of MPA when applied openly to affected areas of the skin in adolescents and adults with neurodermatitis or psoriasis showed that the absorption of the drug was only slightly greater (no more than 2.5%) than absorption through intact skin in healthy volunteers (0.05– 1.5%). If the stratum corneum is removed before application to the skin surface, the level of corticosteroid in the skin is approximately three times higher than after application without removing the stratum corneum. Once in the systemic circulation, the main product of MPA hydrolysis, 6α-methylprednisolone-17-propionate, quickly conjugates with glucuronic acid and, as a result of this process, is inactivated. Metabolites of MPA (main metabolite: 6α-methylprednisolone-17-propionate-21-glucuronide) are excreted mainly by the kidneys with a half-life of about 16 hours. The compound and its metabolites do not accumulate in the body.
Release form
In accordance with the instructions, Advantan is produced in the form of a white or yellowish, opaque 0.1% cream, applied externally, in aluminum tubes of 5, 10, 15, 20, 25, 30 and 50 g in cardboard packs. One gram of cream contains 1 mg of methylprednisolone aceponate, as well as such excipients as:
- 1 mg disodium edetate;
- 10 mg benzyl alcohol;
- 25 mg each of cetostearyl alcohol and solid fat;
- 50 mg glycerol 85%;
- 30 mg macrogol stearate;
- 60 mcg butylated hydroxytoluene;
- 75 mg softizan;
- 85 mg glyceryl monostearate 40-55%;
- 100 mg decyl oleate;
- 597.94 mg purified water.
Also, according to the instructions, Advantan is produced in the form of a homogeneous, slightly yellow or white 0.1% opaque ointment, or a non-homogeneous, translucent fatty ointment, intended for external use, in aluminum tubes of various volumes (from 5 to 50 g). One gram of Advantan ointment contains 1 mg of methylprednisolone aceponate, 300 mg of purified water, 350 mg of white soft paraffin, 40 mg of white beeswax, 239 mg of liquid paraffin and 70 mg of the emulsifier Dehimuls E. One gram of Advantan fatty ointment contains:
- 1 mg methylprednisolone aceponate;
- 30 mg hydrogenated castor oil;
- 150 mg microcrystalline wax;
- 394 mg liquid paraffin;
- 425 mg white soft paraffin.
Advantan is also produced in the form of an opaque white 0.1% emulsion in aluminum tubes of 20 and 50 g in cardboard packages. 1 g of emulsion contains:
- 1 mg methylprednisolone aceponate;
- 10 mg disodium edetate;
- 12.5 mg benzyl alcohol;
- 30 mg glycerol 85%;
- 40 mg each of polyoxyethylene-2-stearyl and polyoxyethylene-21-stearyl alcohol;
- 50 mg softizan 378;
- 150 mg medium chain triglyceride;
- 675.5 mg purified water.
Indications for use of the drug Advantan
Cream, ointment, fatty ointment: atopic dermatitis, neurodermatitis, eczema, contact dermatitis, allergic dermatitis, degenerative eczema, dyshidrotic eczema, eczema in children; Emulsion: acute inflammatory skin diseases - contact dermatitis, true eczema, seborrheic eczema, microbial eczema, dyshidrotic eczema, degenerative eczema, atopic dermatitis, neurodermatitis, acute eczema in children (from 4 months of age), solar dermatitis (severe sunburn) .
Reviews
Alexey, 33 years old:
My son was prescribed Advantan ointment at the initial stage of atopic dermatitis. The red itchy spots were applied for three days, after which the acute stage of the disease subsided.
I have no doubt about the effectiveness of the product, the only thing that confuses me is the fact that it is hormonal. The doctor dispelled fears and said that the composition is absolutely safe for children if used according to the regimen described in the instructions.
Tamara Nikolaevna, 54 years old:
In recent years, every spring, strange spots appear on the elbows, which either grow, then peel, or disappear spontaneously. At first I thought that the problem was a lack of vitamins, but a neighbor said that the lesions looked more like dermatitis. On her advice, I used Advantan ointment.
After 4 days, not a trace remained of the coarsened formation.
Svetlana, 27 years old:
The recent reaction to eating an exotic product for the first time exceeded all fears - my face and neck were completely covered with small itchy pimples. The doctor advised me to take Telfast tablets and Advantan emulsion for external treatment of the focal area.
It took 6 days to eliminate the allergic manifestation, but the alarming signs of dermatitis disappeared after three days of treatment. The drug really works, I recommend it!
Use of the drug Advantan
If the affected skin is very dry, it requires an anhydrous medicinal base with a high fat content (Advantan fatty ointment). If the damaged skin is not wet and not very dry, it requires a dosage form with a balanced content of fat and water - Advantan ointment. Advantan cream with a low fat content and high water content is suitable for the treatment of acute inflammatory processes and weeping eczema. Advantan emulsion is used for sunburn 1-2 times a day (no more). The drug Advantan is applied to the affected areas of the skin once a day in a thin layer. The duration of use usually does not exceed 12 weeks for adults, and 4 weeks for children.
Compound
All dosage forms contain the same active ingredient - methylprednisolone, but they differ in auxiliary components:
- ointment – paraffin, wax, emulsifier;
- greasy ointment - paraffin, wax, castor oil;
- cream – glyceryl, glycerol, organic alcohols, fat;
- emulsion – triglycerides, softisan, glycerol, organic alcohols.
Side effects of the drug Advantan
In some cases, the use of Advantan may be accompanied by local reactions, such as itching, burning, erythema or the appearance of vesicles. With long-term therapy with GCS, local manifestations such as skin atrophy, telangiectasia, the appearance of stretch marks or acne-like rashes on the skin cannot be excluded. As a result of clinical studies of the drug Advantan, which was used in adults for 12 weeks, and in children for up to 4 weeks, no such side effects were established. In isolated cases, during treatment with Advantan, side effects characteristic of topical use of corticosteroids may occur: folliculitis, hypertrichosis, perioral dermatitis, allergic skin reactions to any of the components of the drug.
Price
You can buy Advantan in almost any pharmacy or online store without presenting a prescription.
There is no significant difference in the cost of the medicine in different forms of release.
The average price for the drug is in the range of 530-650 rubles .
Special instructions for the use of the drug Advantan
In case of bacterial infectious processes of the skin and/or in case of fungal infection, additional special treatment is required. When using Advantan on the face, avoid contact of the drug with the eyes. If you have rosacea or perioral dermatitis, it is not recommended to apply Advantan to your face. When Advantan was applied to large areas of skin (40–60% of the skin surface) or when occlusive dressings were used, neither adults nor children experienced dysfunction of the adrenal cortex. During pregnancy and breastfeeding. It is necessary to carefully study the clinical indications for treatment with Advantan during pregnancy and lactation and carefully weigh the expected benefits of use against the risk to the fetus and child. You should avoid using the drug on large areas of skin or for a long time.
What analogues are there?
There are several analogues of the drug. All of them are used locally.
| Analogs | Active substance | Price |
| Beloderm | betamethasone | 370 RUR |
| Cutivate | fluticasone propionate | 300-320 RUR |
| Momat | mometasone | 198-230 RUR |
| Akriderm | betamethasone dipropionate | from 88 RUR |
All medications consist of they belong to a single pharmacological group. There are no exact analogs of the medicine.
Effect on the fetus
The problem of lack of weight is common. There are cases when, after taking this drug, a baby was born with severe deviations, for example, 1.5 kilograms at normal term. In addition, some doctors suspect that the drug increases the risk of stillbirths.
There may be disruptions in the endocrine system of the fetus, followed by problems with the thyroid gland and immune system. This remedy is especially negative for boys, since it suppresses male hormones in the mother’s body, which prevents the child from developing normally. Therefore, experts recommend that after receiving information about the baby’s gender, look for a replacement for such medication.[18]
Contraindications
- Diabetes;
- mental illness;
- epilepsy;
- allergy to components;
- viral skin diseases (chickenpox, shingles);
- age up to 4 months;
- skin manifestations of tuberculosis and syphilis;
- perioral dermatitis in the area of application;
- severe heart failure.
In emergency situations, glucocorticoids are administered without taking into account contraindications.
Notes
- ↑ 1 2 3 4
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Overdose
Clinical trials at all levels of evidence did not reveal high toxicity of the drug, as well as cases of overdose. If the drug is used excessively often or for a long time, only pronounced side effects are observed. In such a situation, discontinuation of the drug is necessary.
If accidentally ingested, nausea may occur, which is largely due to the excipients.
Clinical trials on interactions with other drugs have not been conducted.
