Longidaza: accelerates wound healing, reduces inflammation

Indications As part of complex therapy for adults and adolescents over 12 years of age for 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;
• adhesions in the pelvis;
• tubo-peritoneal infertility.

In orthopedics, surgery, cosmetology:

• keloid, hypertrophic, retracted scars after pyoderma, trauma, burns, operations;
• long-term non-healing wounds;
• joint contractures, arthritis, hematomas;
• adhesive disease.

In dermatovenerology:

• limited scleroderma of various localizations.

To increase the bioavailability of medicinal and diagnostic drugs.

pharmachologic effect

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

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 (an 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 enzyme's resistance to denaturing influences and the influence of inhibitors. The enzymatic activity of Longidase is maintained when heated to 37°C for 20 days, while native hyaluronidase loses its activity within 24 hours under the same conditions.

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, and does not have mutagenic, embryotoxic, teratogenic or carcinogenic effects.

What is Longidaza

Combined pharmaceutical preparation for local use and parenteral administration. It has an immunomodulatory and anti-inflammatory effect. The product contains several active compounds: azoximer bromide and the enzyme hyaluronidase.

The medicine is produced in the form of:

• lyophilisate: porous white substrate for injection, available in ampoules, 15 mg of the drug contains 1500 active IU and stabilizers;
• fat-based suppositories that are administered rectally or intravaginally: in cell blisters of 5 or 10 copies.

Pharmacokinetics

An experimental study of the pharmacokinetics of suppositories with an enzyme carrier labeled with tritium made it possible to establish that when administered rectally, the drug is characterized by a high rate of distribution in the body, is well absorbed into the systemic circulation and reaches Cmax in the blood after 1 hour. The half-life of distribution is about 0.5 hours, period elimination half-life is from 42 to 84 hours. It is excreted mainly by the kidneys.

The drug penetrates into all organs and tissues, incl. passes through the BBB and the blood-ophthalmic barrier. The absence of tissue cumulation was established.

The bioavailability of Longidase® rectal suppositories is at least 70%.

How does Longidaza work?

The active components of the drug promote the resorption of edema and hematomas, increase the permeability of soft tissues, reduce the concentration of fibrin in areas of damage, slow down scarring, help maintain the elasticity of connective fibers, and accelerate the production of collagen.

Longidaza strengthens the body's defenses, inhibits inflammatory reactions, and prevents the growth of adhesive structures. In complex treatment, the drug increases the effectiveness of other medications, including painkillers. The product is not toxic and does not accumulate or be deposited in the body. After administration, Longidaza is distributed in tissues, gradually undergoes hydrolysis, and is completely eliminated from the body within 5 days.

Pharmacodynamics

Longidase® has hyaluronidase (enzymatic proteolytic) activity of prolonged action, chelating, antioxidant, immunomodulatory and moderate anti-inflammatory properties.

Prolongation of the action of the enzyme is achieved by covalent binding of it to a physiologically active high-molecular carrier (activated derivative of poly-1,4-ethylenepiperazine N-oxide, an analogue of the drug 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 pronounced antifibrotic properties of Longidase® are ensured by the conjugation of hyaluronidase with a carrier, which significantly increases the resistance of the enzyme to denaturing influences and the action of inhibitors: the enzymatic activity of Longidase® is maintained when heated to 37 °C for 20 days, while native hyaluronidase loses under the same conditions your activity during the day. The Longidaza® preparation ensures the simultaneous local presence of the proteolytic enzyme hyaluronidase and a carrier capable of binding matrix components released during hydrolysis, enzyme inhibitors and stimulators of collagen synthesis (including iron, copper ions, heparin). Thanks to these properties, Longidaza® has not only the ability to depolymerize the connective tissue matrix in fibrogranulomatous formations, but also suppress the reverse regulatory reaction aimed at the synthesis of connective tissue components.

The specific substrate of testicular hyaluronidase is glycosaminoglycans (hyaluronic acid, chondroitin, chondroitin-4-sulfate, chondroitin-6-sulfate), which form the basis of the connective tissue matrix. As a result of depolymerization (breaking the bond between C1 acetylglucosamine and C4 glucuronic or induronic acids), glycosaminoglycans change their basic properties: viscosity decreases, the ability to bind water and metal ions decreases, the permeability of tissue barriers temporarily increases, fluid movement in the intercellular space is facilitated, and the elasticity of connective tissue increases. , which manifests itself in a decrease in tissue swelling, flattening of scars, an increase in the range of motion of joints, a decrease in contractures and prevention of their formation, and a decrease in adhesions.

Biochemical, immunological, histological and electron microscopic studies have proven that Longidaza® does not damage normal connective tissue, but causes destruction of connective tissue altered in composition and structure in the area of ​​fibrosis.

Longidaza® does not have mutagenic, embryotoxic, teratogenic or carcinogenic effects.

The drug was well tolerated by patients; no local or 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 bone tissue recovery.

For what pathologies is Longidaza necessary?

The medication is prescribed to prevent or eliminate hyperplasia of connective tissue areas:

• when adhesions form in the pelvic area;
• endometritis;
• infertility;
• with interstitial type of cystitis;
• with prostatitis;
• to slow down the formation of keloid scars, prevent tissue hypertrophy after mechanical damage;
• with limited scleroderma;
• for healing old wounds and fistulas;
• for pneumosclerosis, alveolitis with a risk of developing pulmonary fibrosis;
• for impaired joint mobility, arthritis and spondyloarthritis;
• severe hematomas.

Indications for Longidaza®

Adults and children over 12 years of age in the form of monotherapy and as part of complex therapy for diseases accompanied by connective tissue hyperplasia, incl. and against the background of the inflammatory process:

in urology: chronic prostatitis, interstitial cystitis, strictures of the urethra and ureters, Peyronie's disease, the initial stage of benign prostatic hyperplasia, prevention of scar formation and strictures after surgical interventions on the urethra, bladder, ureters;

in gynecology: adhesions (prevention and treatment) in the pelvis in chronic inflammatory diseases of the internal genital organs after gynecological manipulations, incl. induced abortions, previous surgical interventions on the pelvic organs: intrauterine synechiae, tubo-peritoneal infertility, chronic endomyometritis;

in dermatovenerology: limited scleroderma, prevention of fibrotic complications of sexually transmitted infections;

in surgery: prevention and treatment of adhesions after surgical interventions on the abdominal organs, long-term non-healing wounds;

in pulmonology and phthisiology: pneumofibrosis, siderosis, tuberculosis (cavernous fibrous, infiltrative, tuberculoma), interstitial pneumonia, fibrosing alveolitis, pleurisy;

to increase the bioavailability of antibacterial therapy in urology, gynecology, dermatovenereology, surgery, pulmonology.

When is Longidaza contraindicated?

The use of the drug is prohibited:

• in case of individual intolerance to components;
• internal bleeding;
• blood impurities in mucous sputum;
• in acute infectious processes;
• severe renal impairment;
• recent hemorrhages in the eyeball area;
• after hemorrhagic stroke.

Patients under 18 years of age should avoid using Longidase.

Literature

1. Injection methods in cosmetology / ed. B. Asher; lane from English; Ed. N.P. Mikhailova - M: MEDpress-inform, 2021. - 584 p.
2. Ilsheva T.V. Complications of injection methods of correction in aesthetic medicine // Metamorphoses. – 2013. – No. 2. – P. 48–52.
3. Ozerskaya O.S. Skin scars and their dermatocosmetological correction. – St. Petersburg: OJSC “Art of Russia”, 2007. – 224 p.
4. Butov S.N., Akhtyamov Yu.S. Practical dermatocosmetology. - M.: Medicine, 2003. - 397 p.
5. Privalova E.G., Gubanova E.I., Vasiliev A.Yu., Davydov D.V. The role of high-resolution ultrasound in the diagnosis of complications of facial contouring // Metamorphoses. - 2021. - No. 17.
6. Karpyuk V.B. The state of nitrooxydergic vasorelaxation in subarachnoid hemorrhage (clinical and pathogenetic aspects of cerebral vasospasm): abstract. dis. ...cand. honey. Sci. – M., 2001. – 29 p.
7. Bondarenko I.N. Clinical, pathogenetic and prognostic significance of nitric oxide in leptospirosis: dis. ...cand. honey. Sci. – Krasnodar, 2008. – 129 p.
8. Karpova E.I. Compression-ischemic syndrome in the practice of a cosmetologist // Metamorphoses. -2014. - No. 5 - P. 54-58.
9. Mingazova L.R., Karpova E.I., Orlova O.R., Kotenko K.V., Kruglova L.S. Complications in the form of neuropathic disorders in the facial area after contour injection plastic surgery // Russian Journal of Skin and Venereal Diseases. – 2014. – No. 3 – P. 52-55.
10. Korenevskaya I.Ya., Shirshakova M.A. Where do the Fillers go? Visual diagnostics of tissue fillers // Metamorphoses. - 2017. - No. 17.

How to give Longidaza injections

Before placing the suppository into the intestines, you must go to the toilet, and if necessary, do an enema. The drug is administered in a lying position, 6–10 cm deep into the rectum. The optimal time is before a night's rest.

Vaginal administration is carried out in the same way: after hygienic procedures, in a lying position. Within 1.5–2 hours after placing the medicine inside, vigorous activity and vertical body position are not recommended. It is advisable to use candles while relaxing or before bed.

The course of therapy with suppositories depends on the type of disease:

• for gynecological pathologies: 1 suppository every three days, a total of 10 procedures;
• for skin inflammations or wounds: rectally, a suppository every 2 days, 15 pieces in total;
• for surgical lesions: every 4 days rectally, 10 procedures per course;
• in pulmonology: rectally every 3 or 5 days, course duration - from 10 to 20 suppositories.

The drug is used with caution in cases of kidney dysfunction. In this case, a longer interval between administrations of suppositories is required - about 7 days.

The doctor may suggest a treatment regimen that differs from that recommended in the instructions.

Directions for use and doses

Longidaza is applied subcutaneously (near the site of the lesion or under scar tissue) or intramuscularly at a dose of 3000 IU in a course of 5 to 25 injections (depending on the disease) with an interval between injections of 3 to 10 days.

Methods of application are selected by the doctor depending on the diagnosis, severity of the disease, clinical course, and age of the patient. If necessary, a repeat course is recommended after 2-3 months.

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

To increase the bioavailability of drugs and diagnostic agents, a dose of 1500 IU is recommended with a preliminary 10-15 minute intramuscular or subcutaneous injection into the same place as the main drug.

Breeding

1. The contents of the ampoule or bottle of Longidaza® 3000 IU are dissolved in 1-2 ml of procaine solution (0.25% or 0.5%). In case of intolerance to procaine, the drug is dissolved in the same volume of 0.9% sodium chloride solution for injection or water for injection.

2. When used to increase bioavailability, the contents of the ampoule or vial of Longidaza® 3000 ME are dissolved in 2 ml, and with a dose of 1500 ME - in 1 ml of 0.9% sodium chloride solution for injection.

The solvent must be introduced into the vial or ampoule slowly, wait for 2-3 minutes, and carefully mix without shaking so as not to foam the protein. The prepared solution for parenteral administration cannot be stored. Do not administer IV!

Contraindications

• malignant neoplasms;
• pregnancy;
• children under 12 years of age (efficacy and safety have not been studied);
• individual hypersensitivity to the drug.

special instructions

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

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

When used together, it increases the bioavailability of drugs and accelerates the onset of analgesia when local anesthetics are administered.