Ointments from leg swelling

Pathologies in which the ointment from leg edema helps to reduce the severity of such a symptom as a fluid retention in soft tissues, a lot: extra pounds, a violation of lymphatic drainage (lymphostasis), varicose veins or thrombophlebitis of the lower extremities.

Of course, with puffiness associated with a low level of protein in the blood, problems with the heart, kidneys or thyroid gland, use systemic drugs, but in some cases it is recommended a decongestant for topical application, that is, a properly selected ointment from swelling of the legs.

[1], [2], [3], [4], [5]

Release form

Many modern ointments are not produced on fat basis, but on gel, hydrophilic properties of which promote better penetration into the skin of pharmacologically active components and increase their bioavailability. Therefore, almost all the names of ointments from edema of the legs included in this review are gel preparations, and their form of release is a gel of different concentrations (in tubes).

The heparin ointment (other trade names - Gepatrombin, Gepalpan, Trombles, Trombophobia, Lyoton, Venobene, Viatrom), according to the official instructions, has the following indications for use: thrombophlebitis of the veins of the lower extremities, phlebitis and periphlebitis, external hemorrhoids, trophic skin and subcutaneous skin manifestations shin tissue, hematoma and swelling of the extremities.

• Ointment from edema of legs with varicose veins: Troxevasin (synonyms: Troxerutin, Venorutinol, Venoruton), Heparin ointment, Venohepanol (Venolife), Venitant (Eszin, Essaven, Venastat, Venen, Cyclovene forte).
• Ointment for legs from swelling and fatigue: Girudoven (analogues, also containing leech extract - Venozol, gel-balm 911+).
• Ointments for pain and swelling of the foot: Heparin ointment, Ginkor, Dolobene, Indovazin.
• Ointment from swelling of the legs after a fracture: Heparin ointment, Dolobene, Indovazin.
• Ointment from swelling of the feet during pregnancy: Venitane, Venohepanol, Ginkor Gel.
• Ointments from leg edemas in the elderly: Heparin ointment, Venohepanol, Venitaine, Herbionus esculus.

These remedies can help with various injuries, accompanied by pain and edema formation.

[6], [7]

Pharmacodynamics

Heparin ointment acts at the expense of reducing blood clotting (increased activity of its plasma factors - AT III, KFG II and thrombin), and this drug is attributed to direct anticoagulants, which prevent the formation of fibrin from fibrinogen. Endogenous heparin is a naturally sulphated glycosaminoglycan, a biopolymer that is synthesized by basophils and mast cells and enters the bloodstream at sites of vascular and tissue damage. The heparin sodium that is part of this ointment also inhibits blood coagulation factors. Negatively charged heparin molecules bind positively charged molecules of the interstitial (intercellular) fluid, so that the heparin ointment from the edema of the feet of any etiology is an effective antiexcudative.

The benzonicotinic acid included in the Heparin Ointment, expanding the vessels, facilitates the access of heparin to the tissues, and the local analgesic benzocaine (anestezin) relieves pain.

Pharmacodynamics ointment Dolobene is provided with heparin sodium, dimexide and dexpanthenol. How Heparin works is already clear; anti-inflammatory and anti-edematous action of dimexide is associated with the suppression of hydroxide radical activity at the site of inflammation and absorption of excess fluid; dexpanthenol is converted to pantothenic acid, which contributes to the normalization of metabolism in cells.

Ointment from leg edema in varicose troxevasin contains hydroxyethylrutoside (troxerutin) - flavonol, a semi-synthetic derivative of the quercherin glycoside routine (rutozide), which is part of the vitamin P group, that is, it helps to strengthen the vascular walls of the vessels, reducing the permeability of small vessels. Also, troxerutin is an antioxidant, as it blocks the activity of lipoxygenase catalyzing the processes of peroxidation of polyunsaturated fatty acids; inhibits the synthesis of anti-inflammatory glycosaminoglycans and blocks the release of histamine from mast cells, helping to reduce inflammation.

In addition to troxerutin, in the ointment for pain and edema of the foot of Indovazin, there is a non-steroidal anti-inflammatory drug indomethacin that relieves inflammation, pain and swelling of tissues by suppressing platelet aggregation and improving trophism of tissues - due to the inhibition of the synthesis of inflammatory mediators (COX-1 and COX-2 ).

Farmakodinamka combined ointment Venohepanol is based on three components - heparin, venutinolle (analogue trokserutina) and dexpantheneol (see above).

As part of the remedy for edema in varicose veins and thrombophlebitis, Ginkor Gel is not only trokserutin, but also an extract of ginkgo biloba, which is a powerful antioxidant, inhibits the phospholipid mediator of inflammation of the FAT, reduces vascular tone and promotes vascular strengthening.

Effective angioprotective preparations include Venitan ointment - based on the extract of horse chestnut (Aesculus), which contains saponin escin (reducing blood viscosity, increasing elasticity and strength of blood vessels) and glycoside esculin (reducing capillary wall permeability and improving blood circulation in them).

The Herbionus Esculium ointment also includes substances of vegetable origin: liquid extracts of horse chestnut fruit and medicinal melon grass (Melilotus officinalis), which enhance the tone of the venous vessels and reduce the activity of blood coagulation (including due to the anticoagulant properties of the dicumarol in the dolcin).

The mechanism of ointment for feet from swelling and fatigue, as well as from the severity and pain in the legs - Girudoven - is due to the improvement of microcirculation in the vessels of the lower limbs, which is promoted by horse chestnut extract (see earlier), medicinal leech extract (Hirudo medicinalis), camphor and menthol. The extract of leech contains anticoagulant peptide of its salivary glands - hirudin, suppressing the activity of coagulation factors. Activated local circulation of menthol and camphor - due to irritation of skin receptors and reflex response of vessels of the skin and subcutaneous tissue.

[8], [9], [10], [11], [12], [13], [14], [15],

Pharmacokinetics

The pharmacokinetics of the ointments listed above from edema of the legs are not represented in the official instructions to the preparations.

[16], [17], [18], [19], [20]

Dosing and administration

Any ointment from edema is applied topically and is applied in a thin layer:

• Heparin ointment, Venohepanol - no more than three times a day, after application the drug is rubbed into the skin;
• Troxevasin, Venitant - twice a day (morning and evening) gently rub into the skin (until the ointment is completely absorbed); it is possible to apply a bandage or apply under an elastic bandage;
• Dolobene and Indovazin - twice a day (not longer than a week).
• Ginkor Gel - two or three times during the day (it is impossible to get sun rays on the skin treated with ointment);
• ointment Herbionus Esculus - applied up to four times a day (can not be rubbed);
• ointment for feet from edema and fatigue Girudoven can be applied three to five times during the day.

[26], [27], [28]

Use of the ointments from swelling of the feet during pregnancy

To appoint Venohepanol or Heparin ointment from edema of legs during pregnancy should be the attending physician - after the study of blood on the level of platelets.

Troxevasin is contraindicated in the first trimester of pregnancy; in the second and third trimesters, the drug can be prescribed if the expected benefit for the mother is higher than the risk for normal fetal development.

Ointments Venitane and Ginkor Gel are allowed to use during the period of gestation and breastfeeding of the child.

Herbion Esculus, according to the instructions, during pregnancy and lactation can be used (due to the lack of systemic action on the body). However, it should be noted that clover in pregnancy is contraindicated because of the presence of coumarin and dicoumarol in it.

Mazi Dolobene, Indovazin and Girudoven are forbidden to pregnant women.

Contraindications

General contraindications to use for all included in the review: the presence of damage or any pathological changes in the skin at the site of ointment, as well as individual hypersensitivity to a particular drug or some of its components.

Heparin ointment from edema and Girudoven is not used for poor blood coagulability.

Dolobene ointment is not used in the case of bronchial asthma and kidney failure, as well as children under five. Venohepanol is prohibited for children under 12 years of age, and Ginkor Gel is not used for children at all.

Troxevasin is contraindicated in exacerbation of chronic gastritis, ulcer of the stomach and duodenum; Indovazin - with a tendency to bleeding; Venitant - with an elevated level of platelets in the blood.

[21], [22], [23], [24], [25]

Side effects of the ointments from swelling of the feet

In the instructions, the following side effects of ointments from leg edema are noted:

Heparin ointment, Troxevasin, Indovazin, Venohepanol, Venitant, Ginkor, Girudoven - skin hyperemia, rashes, itching;

Dolobene - redness of the skin, burning or itching, smell of garlic from the mouth (which can give dimexide);

Herbion escus is skin irritation and excessive dryness.

Overdose

Overdose of these external agents in the instructions is not described because of the lack of data on the excess doses.

[29], [30]

Interactions with other drugs

General recommendation regarding these drugs: to avoid external interaction with other drugs, never simultaneously apply different ointments.

Do not use Heparin ointment when treated with antibiotics, NSAIDs or antihistamines; ointment Dolobene is incompatible with oral intake of drugs containing acetylsalicylic acid.

Storage conditions

Ointments from swelling of the legs Indovazin and Venohepanol, Heparin ointment is stored at a temperature not exceeding + 18 ° C (in addition, Heparin ointment and all ointments with heparin should be kept in a dark place); ointments Troxevasin, Dolobien, Venitan and Herbionus Esculius - at a temperature not exceeding + 25 ° C; Ginkor Gel and Girudoven - at a temperature of + 10-20 ° C.

[31], [32], [33]

Shelf life

The shelf life of the ointments Dolobene, Troxevasin, Heparin ointment and Ginkor Gel is three years; Indovazin, Venohepanol, Venitan, Herbion Esculus and Girudoven are suitable for use for two years from the date of release (indicated on the packaging).

[34]

In conclusion, it should be recalled that - no matter how effective and simple in use, this or that ointment from edema of the legs - the causes of edema are different, therefore it is necessary to undergo a medical examination in order to reveal the etiology of fluid stagnation in the lower extremities and to direct the treatment not on a symptom, but on the disease itself.