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The instruction for medical use of Zoviraks® medicine the Duo Trade name of Zoviraks® the Duo International unlicensed name Is not present the Dosage form external use Cream Structure 100 g of cream contain active agents: acyclovir of 5 g hydrocortisone of 1 g excipients: liquid paraffin (liquid paraffin), paraffin white soft (vaseline white), isopropyl myristate, sodium lauryl sulfate, cetostearyl alcohol, half-oxameasures 188, propylene glycol, citric acid monohydrate, sodium hydroxide, Acidum hydrochloricum, water purified. Description Uniform cream of color, white or white with yellowish shade. Pharmacotherapeutic group Dermatological means. Antibiotics and chemotherapeutic drugs for use in dermatology. Chemotherapeutic drugs for topical administration. Antiviral drugs. Acyclovir in a combination with other drugs. ATH code: D06BB53 Pharmacological Pharmacokinetics At properties topical administration of drug system absorption of acyclovir minimum. Glucocorticoids can get into a corneal layer of epidermis, reaching its sublayers. It is normal absorbed in insignificant quantity and does not affect hormonal balance. Systemic action of glucocorticoids can be shown in case of increase in absorption (when putting drug on big sites of skin or on skin which corneal layer of epidermis, is damaged). Okklyuziruyushchy bandages increase absorption of a hydrocortisone. The pharmacodynamics the Combined drug, contains acyclovir and a hydrocortisone. Acyclovir is antiviral medicine. In pilot studies of in vitro shows activity concerning a virus of a herpes simplex (Herpes simplex) 1 and 2 of types. At hit in the cells infected with a herpes virus, acyclovir it is phosphorylated and will be transformed to an active form – acyclovir triphosphate. The first stage of this process depends on existence of the HSV coded thymidinekinase. Acyclovir triphosphate works as inhibitor and substrate for herpes – specific DNA of a polymerase, preventing further synthesis of virus DNA, not influencing usual cellular processes. The hydrocortisone is a slaboaktivny corticosteroid. At external and topical administration the therapeutic activity is caused by anti-inflammatory action. As a result of a combination of the antiviral effect which had by acyclovir and the anti-inflammatory effect which had by a hydrocortisone, the drug Zoviraks® Duo prevents formation of elements of vesicular rash on affected areas of skin. The mechanism of action is caused by blocking of replication of a virus and slowing down of development of inflammatory reaction on an affected area of skin that leads to reduction of expressiveness of symptoms of an infection. Indications of Zoviraks® Duo it is intended for treatment of early symptoms of recurrent herpes of lips for the purpose of decrease in progressing of the diseases caused by a virus of a herpes simplex (Herpes Simplex), and development of cankers of skin in adults and children is more senior than 12 years. The route of administration and doses Drug is intended only for external use. Adults and children are more senior than 12 years Drug it is necessary to put 5 times a day (approximately each 3-4 hours, except for night time). Necessary amount of cream apply skin to the sites struck and adjoining on them. For achievement of the maximum therapeutic effect it is necessary to use drug already at the first symptoms of a disease (for example, pricking, a skin itching). If you missed putting cream, according to the recommended dosing mode, use it as soon as possible and continue as earlier. Duration of treatment is not less than 5 days. In case of preservation of symptoms of a disease more than 10 days or aggravation of symptoms, it is necessary to see a doctor. Not to allow aggravation of symptoms and to prevent transmission of infection, it is necessary to wash hands before putting drug, not to rub and not to touch affected areas of skin with a towel. Use for children. Due to the lack of data on safety and efficiency of drug at children up to 12 years it is not recommended. Side effects Side effects are classified by the systems of bodies and frequency. Frequency of side effects is determined as follows: very often ≥ 1/10, it is frequent ≥ 1/100 and & lt, 1/10, infrequently ≥ 1/1000 and & lt, 1/100, is rare ≥ 1/10,000 and & lt, 1/1000, also lt, 1/10,000 is very rare. Disturbances from skin and hypodermic fabrics: Often – dryness or peeling of skin, Infrequently – the taking place burning or pricking on sites of putting drug, an itching, is rare – an erythema (reddening), discoloration of skin, – the contact (allergic) dermatitis more often connected with reaction to a hydrocortisone or excipients of cream – reactions in the site of application of cream, including symptoms of inflammatory reaction (pain, hypostasis, reddening, local temperature increase). Disturbances from the immune system: Very seldom – hypersensitivity reactions of immediate type, including a Quincke’s disease. At emergence of any of the listed side effects, stop use of drug and immediately see a doctor. Contraindications – hypersensitivity to acyclovir, a valatsiklovir, a hydrocortisone, propylene glycol or other components of drug, – the damages of skin caused by other viruses and also fungal, bacterial, parasitic infections of skin, – children’s age up to 12 years. Medicinal interactions At external use of interaction with other medicines it is not revealed. Before use of the drug Zoviraks® Duo it is necessary to consult with the doctor if you accept any medicines on a regular basis or it is episodic. The special instructions Cream can be applied only in herpes of skin of lips and persons. It is not recommended to apply drug on mucous membranes (for example, oral cavities, an eye, a nose, genitals). Not to apply cream for treatment of genital herpes. To avoid hit of cream in eyes. At accidental hit of cream in eyes, it is necessary to wash carefully them with warm water and if necessary to see a doctor. At the significant manifestations of herpes of lips whether and also in case of doubts the arisen damage of skin is caused by a herpes virus, it is recommended to consult with the doctor. It is not necessary to apply occlusive bandages and also plasters or the special anti-herpetic masking plasters to the site of application of cream. The drug Zoviraks® Duo is not recommended to be taken to patients with the weakened immunity (for example, after bone marrow transplantation or presence of HIV infection) in connection with possible presence of opportunistic infections or existence of atsiklovirastvorezistentny strains. Patients with immunodeficiency at treatment of any infectious diseases have to follow the recommendations of the doctor. To the persons having herpes on lips (especially in the presence of open defeats), it is necessary to wash hands before putting cream not to allow infection of other people. It is necessary to exclude long use of drug and also use on big sites of skin. Not to use drug more than 5 days. Drug contains cetostearyl alcohol which can cause local skin reactions, such as contact dermatitis. Propylene glycol can cause irritation of skin. Pregnancy and the period of a lactation Use is shown only when the expected advantage for mother exceeds potential risk for a fruit. However, system influence of acyclovir and a hydrocortisone, at external use of cream, very insignificant. Acyclovir and a hydrocortisone get into breast milk as a result of system use. However the dose received by the baby as a result of use of acyclovir and a hydrocortisone by mother will be insignificant. Features of influence of medicine on ability to run the vehicle or potentially dangerous mechanisms the Drug Zoviraks® Duo does not affect performance of potentially dangerous types of activity requiring special attention and speed of reaction (driving and other vehicles, work with moving mechanisms, etc.). Overdose At accidental ingestion or topical administration of all contents of packing of Zoviraks® cream of Duo adverse action it was not revealed. At suspicion on overdose it is necessary to ask for medical assistance. Release form external use Cream. On 2 g of drug place in a tuba aluminum with the screw-on cap. On 1 tuba together with the instruction for medical use in the state and Russian languages place in a cardboard pack. Expiration date 2 years. An expiration date after the first opening of a tuba – 3 months. To Store storage conditions at a temperature not above 25 °C. Not to store in the fridge and not to freeze. To store out of children’s reach! Prescription status Without prescription the Name and the country of the Glakso Vellkom Opereyshns manufacturing organization, Great Britain Harmire Road, Barnard Castle, Co Durham, DL 12 8DT, the UK Name and the country of the owner of the registration certificate of Bichem Group of PLS, Great Britain the Address of the organization accepting in the territory of the Republic of Kazakhstan claims from consumers on quality of products (goods) of the GlaksoSmitKlyayn Export Ltd personal computer, Almaty, Furmanov St., 273.