Ointments to relieve inflammation

In the complex therapy of inflammatory processes that develop in various diseases of the skin and subcutaneous tissue, joints and muscles, nerve endings, individual ENT organs, one or another ointment that relieves inflammation is often used.

According to their pharmacological effect, all external anti-inflammatory drugs are divided into etiotropic (that is, those that specifically act on the cause of inflammation) and pathogenetic, the purpose of which is to relieve inflammatory symptoms by disrupting their biochemical mechanism.

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Indications an ointment that relieves inflammation

An ointment that relieves inflammation by affecting its etiology must contain antibacterial (antiviral or fungicidal) substances. Thus, indications for the use of ointments with antibiotics active against gram-positive and gram-negative aerobic and anaerobic bacteria include: infected wounds and burns; trophic ulcers and pyoderma (pustular lesions of the skin); erysipelas and streptococcal lesions of the epidermis (ecthyma); ophthalmologic infections with blepharitis or conjunctivitis, as well as inflammations localized in the nasal cavity or auricles.

Indications for the use of ointments that relieve inflammation by pathogenetic action - non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticosteroids (GCS) - extend to an extremely wide range of diseases. Non-steroidal ointments help to cope with inflammation and pain in rheumatoid and deforming arthrosis, osteoarthrosis and osteoarthritis, osteochondrosis and gout; in inflammation of muscles (myositis) and peripheral nerves (neuritis).

And ointments containing GCS, which relieve skin inflammation, are prescribed for common, contact and atopic dermatitis, eczema, psoriasis, vulgar pemphigus, exudative erythema and other dermatological diseases.

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Release form

We will list some names of ointments that relieve inflammation, dividing the list into groups according to the recommendations for their use.

Ointment for purulent inflammations in wounds, burns, folliculitis, phlegmon, etc.: Baneocin, Levomekol, Vishnevsky ointment, Inflarax, Oflokain; with furuncles and hidradenitis (inflammation of the sweat glands) at the stage of abscess, ichthyol ointment is well treated, and after the abscess has broken through - erythromycin or tetracycline ointment.

Ointments that relieve skin inflammation: Fluorocort (Triamcinolone, Triacort, Polcortolone, Cinacort and other trade names), Celestoderm-B, Cortomycetin, Gioxizone, etc.

An effective ointment for erysipelas is Baneocin and erythromycin ointment.

Ointment that relieves joint inflammation and muscle inflammation (myositis): Diclofenac (Diclofenacol, Dicloran, Voltaren), Indomethacin, Ibuprofen (Dolgit, Deep Relief and other trade names), Ketoprofen (Ketonal, Bystrumgel), Piroxicam, etc. Read more about how these ointments work, what contraindications and side effects they have in the article - Ointment for joint pain, as well as in the publication - Treatment of muscle pain

Ointment that relieves swelling and inflammation: drugs from the NSAID group, as well as heparin ointment.

The ointment prescribed by neurologists for nerve inflammation most often also refers to non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, etc.).

The most recommended ointment by ophthalmologists for inflammation of the eyelids (blepharitis or meibomitis) is Sodium Sulfacyl ointment (10%), ditetracycline eye ointment, erythromycin eye ointment (0.5%) or Dexa-Gentamicin.

In the complex treatment of external otitis and inflammations localized in the external auditory canal (for example, furuncle), as well as uncomplicated perichondritis of the auricle or mastoiditis (inflammation of the mastoid process), specialists use an ear ointment for ear inflammation with an antibiotic: Bactroban (Mupirocin), Levomekol, tetracycline ointment or Oflokain. And for dermatitis of the external auditory canal - the above-mentioned ointments with corticosteroids.

Ointment for inflammation in the nose (for example, caused by a boil) - these are the same ointments containing antibiotics.

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Pharmacodynamics

Let's start with the fact that Baneocin, Levomekol, Bactroban (Mupirocin), Inflarax, Oflokain, Sulfacyl sodium ointment, erythromycin and tetracycline ointments are antibacterial drugs. Baneocin contains the antibiotics neomycin and bacitracin; Levomekol ointment contains chloramphenicol, Bactroban contains mupirocin, Inflarax contains amikacin, and Oflokain contains the fluoroquinolone antibiotic ofloxacin.

The pharmacodynamics of bactericidal and bacteriostatic antimicrobial drugs is based on their ability to penetrate bacterial cell membranes and bind to ribosomes, which results in the cessation (or significant slowdown) of protein synthesis in the cells of microorganisms.

In addition, Levomekol ointment contains methyluracil, a substance with regenerative properties that helps improve the trophism of inflamed tissues.

The multi-component ointment for purulent inflammations Inflarax also contains the antiseptic benzalkonium chloride, the NSAID of the sulfonanilide group nimesulide (suppressing the production of prostaglandin inflammatory reaction mediators and reducing the permeability of the walls of blood and lymphatic vessels) and the local anesthetic lidocaine hydrochloride. In addition to the antibiotic, the Oflokain ointment also contains lidocaine, which has an additional analgesic effect due to the suppression of the transmission of pain impulses.

Erythromycin ointment for erysipelas is an antibiotic of the macrolide group erythromycin, which is active against many bacteria, including group A beta-hemolytic streptococcus, which causes erysipelas of the skin.

Dexa-Gentamicin ointment for eyelid inflammation is a drug with combined pharmacological action, containing the aminoglycoside antibiotic gentamicin and the synthetic corticosteroid dexamethasone. Sulfacyl sodium ointment belongs to sulfonamides, and its action is based on disruption of the cycle of production of folic acid and its derivatives by bacteria, without which the formation of nucleic acids in the cells of microorganisms is impossible.

Ointments that relieve skin inflammation and itching - Fluorocort, Cortomycetin, Gioxizone, etc. - are hormonal, since their action is provided by glucocorticosteroids: in Fluorocort ointment it is fluorinated GCS triamcinolone, in Cortomycetin and Gioxizone - hydrocortisone. Steroids activate the synthesis of lipomodulin and inhibit the enzyme phospholipase, which prevents the production of the same inflammatory mediators in mast cells of damaged tissues.

At the same time, the ointments Cortomycetin and Gioxizone are combined agents: the first contains the antibiotic levomycetin, and the second contains oxytetracycline. This is what allows them to be used if the inflammation of the epidermis in dermatitis or eczema becomes infected.

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Pharmacokinetics

Pharmacokinetics of Baneocin, Levomekol, Inflarax, Sulfacyl sodium, erythromycin and tetracycline ointments, as well as Cortomycetin and Gioxizone

The instructions for the drugs do not explain this.

The ingredients of Bactroban can penetrate into the bloodstream only through damaged epidermis and are then transformed and excreted from the body with urine. Oflokain ointment for purulent inflammation has similar pharmacokinetics.

Dexa-Gentamicin, or more precisely the antibiotic gentamicin sulfate included in the drug, does not penetrate into the blood, provided that the tissues to which this ointment for eyelid inflammation is applied are intact.

The active substance of the ointment Fluorocort triamcinolone is absorbed by skin cells and enters the systemic bloodstream; triamcinolone is metabolized in the liver, and metabolites are eliminated by the kidneys.

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Dosing and administration

It is recommended to apply Baneocin and Bactroban ointments two to three times a day; the duration of treatment is one week.

Levomekol and erythromycon ointment are used up to 4-5 times a day (for a maximum of 10 days).

Inflarax is applied twice a day (three times a week for burns), a gauze napkin with ointment can be applied to the inflamed area. The standard course of treatment is 5-7 days.

Oflokain ointment for purulent inflammation should be applied once a day (for ulcers and wounds) - with the application of a sterile bandage; when treating burn injuries - every other day.

Tetracycline ointment and Cortomycetin are applied no more than twice a day, possibly under a bandage (with its change every 12 hours).

Dexa-Gentamicin is used up to three times a day; the duration of use of this drug should not exceed three weeks.

Fluorocort should be used no more than three times a day; the maximum permissible dose is 15 g per day (for adult patients), and when applying a bandage - 10 g. For children and the elderly, the ointment should not be applied under a bandage, and the duration of treatment should not exceed five days.

It is recommended to apply Gioxizone ointment to the affected area one to three times during the day.

The instructions for the described drugs indicate that their overdose is unlikely or that there is no data on drug overdose.

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Use an ointment that relieves inflammation during pregnancy

Among the ointments presented in the review, only Levomekol is allowed to be used during pregnancy.

Bactroban ointment is used during pregnancy only when the expected benefit to the mother is much higher than the probable threat to the fetus. Dexa-Gentamicin is prohibited for use in the first trimester of pregnancy, and at later stages this ointment can be prescribed by an ophthalmologist only after assessing the benefit-harm ratio.

Baneocin, Inflarax, Oflokain and tetracycline ointments are not used to treat pregnant and lactating women.

When used by pregnant women, any steroid ointment that relieves inflammation – including Fluorocort, Cortomycetin and Gioxizone – can cause systemic side effects, so GCS are not prescribed to such patients.

Contraindications

It is necessary to take into account what contraindications for use a specific anti-inflammatory ointment has.

Baneocin is contraindicated in case of hypersensitivity to aminoglycoside antibiotics, poor kidney function, allergies, and open injuries to the external auditory canal;

Tetracycline ointment is not used for fungal infections, as well as for patients under 10 years of age;

Inflarax ointment is contraindicated in the presence of mycosis, eczema, neurodermatitis and for children under two years of age;

Dexa-Gentamicin ointment for eyelid inflammation is contraindicated in herpes virus and

Fungal eye infections, acute purulent diseases with corneal lesions, increased intraocular pressure (glaucoma) and patients under 18 years of age.

Hormonal ointments that relieve skin inflammation and itching (Fluorocort, Celestoderm-B, etc.) are not used for bacterial, viral and fungal skin lesions, tuberculosis of the skin, syphilis and the presence of oncological diseases.

Among the contraindications for the combined drugs Cortomycetin and Gioxizone are also viral and fungal dermatological diseases and cutaneous tuberculosis.

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Side effects an ointment that relieves inflammation

The most common side effects of Levomekol, Bactroban, Inflarax, Oflokain, erythromycin and tetracycline ointments are allergic reactions in the form of rash, itching and peeling of the skin at the site of application of the drugs.

When applying Baneocin ointment to large areas of skin, systemic side effects may occur, in particular, hearing impairment, muscle innervation, and the development of superinfection.

The use of ointments for eyelid inflammation Dexa-Gentamicin and Sulfacyl sodium can also cause burning, and Dexa-Gentamicin can cause secondary glaucoma and steroid cataracts.

Fluorocort, Cortomycetin, Gioxizone and all local agents with GCS have the same type of side effects: redness and itching of the skin, skin atrophy at the site of application; long-term use of these agents can provoke a decrease in the functions of the hypothalamic-pituitary-adrenal system, osteoporosis, metabolic disorders, including glucose and fats.

Interactions with other drugs

There are no reports of interactions between Levomekol, Bactroban (Mupirocin), Baneocin, Oflokain, erythromycin and tetracycline ointments, as well as corticosteroid ointments with other drugs.

Inflarax ointment for purulent inflammations, containing amikacin, can enhance the effect of other antibacterial agents for external use, especially with benzylpenicillin and cephalosporin antibiotics; nimesulide potentiates the effect of sulfonamides and anticoagulants, and lidocaine potentiates the effect of other local anesthetics.

Dexa-Gentamicin ointment is incompatible with atropine, heparin and sulfonamides.

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Storage conditions

Store Baneocin, Levomekol, Bactroban, erythromycin ointment, Inflarax, Oflokain ointments at a temperature of < +25°C; tetracycline ointment, Dexa-Gentamicin, Sulfacyl sodium – at a temperature of +18-20°C; Fluorocort, Cortomycetin and Gioxizone – at a temperature of +8-15°C.

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Shelf life

The shelf life of tetracycline and erythromycin ointments, Levomekol, Sodium sulfacyl is 3 years; the ointments Baneocin, Bactroban, Inflarax, Oflokain, Dexa-Gentamicin, Fluorocort, Cortomycetin, Gioxizone - 24 months.

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