Shingles pills

Such an infectious dermatological disease as lichen includes diseases caused by different pathogens. And there are papular-exfoliative pathologies, the true cause of which is still unknown. When prescribing systemic therapy, doctors necessarily take this factor into account when recommending taking certain tablets for lichen.

Indications shingles pills

Indications for the use of tablets for lichen include such diagnosed skin lesions as:

• pityriasis versicolor or lichen versicolor is a fungal skin disease caused by yeast-like fungi Pityrosporum orbiculare, Pityrosporum ovale and Malassezia furfur;
• shingles - herpes zoster, which occurs when infected with the Varicella-zoster virus (HHV 3);
• ringworm - trichophytosis and dermatophytosis, the causative agents of which are the onygenous anthropophilic fungi Trichophyton and Microsporum;
• Pink lichen - pityriasis rosea or Gibert's lichen, the etiology of which is not precisely determined.

It should be borne in mind that systemic etiological therapy of papulosquamous infections, when tablets for lichen are taken orally, is carried out only with an accurate determination of the pathogen and only in cases where local treatment does not give the desired effect.

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Release form

Tablets for pityriasis versicolor (tinea versicolor): Terbinafine (Binafin, Terbizil, Termicon, etc.; Lamisil cream and spray are produced with this fungistatic substance), Fluconazole (Diflucan, Fluzon, Medoflucon), Ketoconazole (Nizoral, Mikozoral, Oronazole, etc.).

Tablets for shingles: Acyclovir (other trade names: Acyclostad, Vivorax, Zovirax, Gervirax, Lizavir, Provirsan, Cyclovir, etc.), Valavir (Valacyclovir, Valtrex, Valtrovir, Gerpeval).

Tablets for ringworm: Griseofulvin (other trade names: Grifulin, Grifulvin, Fulcin, Fulvicin, Neo-Fulcin, etc.), Ketoconazole.

Tablets for pink lichen, given its non-infectious origin, include antihistamines that help reduce the intensity of itching, for example, Loratadine (Claritin, Lotaren, Lorisan and other trade names).

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Pharmacodynamics

The active substance of the drug Terbinafine is the methylnaphthalene derivative terbinafine hydrochloride, which has a fungicidal effect by blocking squalene epoxidase, an enzyme in the cell wall of fungi that ensures the process of producing the sterols necessary for their formation (in particular, ergosterol). As a result, the fungi lose viability and die.

The pharmacodynamics of Fluconazole and Ketoconazole, which are part of the group of azole derivatives (triazole and imidazole), are similar. Only these tablets for pityriasis versicolor (tinea versicolor) act on another enzyme of the fungal cell membrane – sterol-14-demethylase.

Tablets for shingles Acyclovir and Valavir are also similar in the mechanism of their action on the herpes virus. Since viruses do not have cells, Acyclovir and Valavir, being analogs of nitrogenous glycosylamines of viral deoxyribose, come into contact with viral enzymes and stop the process of DNA replication, that is, the reproduction of viruses. In this case, the component of the drug Valavir (L-valyl ester of acyclovir in the form of a salt) is first converted into active acyclovir.

The action of Griseofulvin tablets against fungi (Trichophyton, Microsporum, Epidermophyton) in ringworm and dermatomycosis is provided by the antibiotic substance included in its composition, which is synthesized by Penicillium griseofulvum (a type of mold fungi). The drug disrupts the synthesis of proteins of the cell membrane of pathogenic fungi, suppressing mitosis of their cells.

Loratadine tablets, used to reduce skin itching, like all antihistamines, prevent the action of histamine on histamine receptors of the H1 type, and also inhibit the release of mediators of inflammatory-allergic reactions from T cells.

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Pharmacokinetics

Terbinafine, prescribed for pityriasis versicolor, is freely adsorbed into the blood from the gastrointestinal tract and almost completely binds to plasma proteins and enters many tissues, penetrating the skin, nails and hair follicles. The highest concentration of the drug is noted 100-120 minutes after taking one dose. Terbinafine hydrochloride is transformed in the liver, metabolites are excreted from the body through the kidneys.

Tablets for lichen Fluconazole and Ketoconazole are absorbed quickly, but bind to blood proteins differently: Ketoconazole - more than 98%, Fluconazole - only a little more than 10% (but remains in it for quite a long time). Both drugs are metabolized in the liver, excreted through the intestines and kidneys.

The pharmacokinetics of the drug Acyclovir is characterized by an insignificant level of absorption - no more than 20% of the dose taken; for Valavir tablets this figure is twice as high. And the half-life of the active substance is almost the same, however, it can increase from the usual 3 hours by 5-6 times in the presence of kidney problems.

Griseofulvin binds to plasma proteins by 80%, penetrates many tissues of the body and overcomes the HPB; the maximum concentration in the blood is noted, on average, 4.5 hours after administration. This drug is 60% broken down by the liver, half of the drug and its metabolites are excreted within 24 hours - with urine and feces.

Loratadine is 100% absorbed in the gastrointestinal tract and 97% bound to plasma proteins, reaching its highest level 1.5-2.5 hours after taking a standard dose of the drug. Biochemical transformation occurs in the liver (a pharmacologically active substance is formed). The average half-life of Loratadine in urine and bile is about 18 hours.

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Dosing and administration

All of the above tablets for lichen are taken orally:

Terbinafine – one tablet (0.25 g) once a day (after meals).

Fluconazole – 50-100 mg once a day.

Ketoconazole – 0.2-0.4 g per day (during meals); the daily dose for adults should not exceed 1 g. Taking the drug requires regular monitoring of blood counts and liver enzyme levels.

Tablets for shingles Acyclovir - five times a day at 800 mg (4 tablets of 200 mg); children under 2 years - ½ of the adult dose. The course of treatment lasts one week.

Valavir – 1 g three times a day (the drug is also taken for 7 days).

Griseofulvin (125 mg tablets) – 2-4 tablets twice a day (for children, the dose is calculated based on body weight – 22 mg/kg). Tablets are taken during or immediately after meals, always with a spoonful of vegetable oil. It is also necessary to monitor the blood condition (take tests) once every two weeks.

Loratadine should be taken once a day at 0.01 g (i.e. one tablet), for children – half as much.

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Use shingles pills during pregnancy

During pregnancy and lactation, tablets for lichen Griseofulvin, Terbinafine and Ketoconazole, tablets for pityriasis versicolor Fluconazole, as well as tablets for shingles Acyclovir and Valavir are not used.

The drug Loratadine can be used by pregnant and lactating women only in cases of extreme necessity - under the supervision of a doctor.

Contraindications

The tablets for lichen listed in the review have the following contraindications for use:

Terbinafine - renal failure, oncology of any localization and stage, serious metabolic and vascular pathologies, children under two years of age;

Fluconazole - age under 16 years;

Ketoconazole - liver pathologies in the acute stage;

Acyclovir and Valavir – individual hypersensitivity or intolerance to the drugs.

Griseofulvin tablets are not used in patients with systemic blood diseases, SLE, cerebral circulation disorders, functional liver and kidney failure. The drug is not used to treat children under two years of age.

The antihistamine Loratadine is also contraindicated for use in children under two years of age.

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Side effects shingles pills

When used in systemic therapy for lichen, Terbinafine tablets may cause side effects such as nausea, diarrhea, abdominal pain, cholestatic syndrome, neutropenia or thrombocytopenia.

Fluconazole and Ketoconazole can cause skin rashes, nausea, loss of appetite, diarrhea, flatulence. In addition, the use of Ketoconazole can lead to increased drowsiness, jaundice and hepatitis (in case of long-term use), joint pain, menstrual irregularities and erectile dysfunction.

The list of undesirable but possible side effects of the antiherpes drugs Acyclovir and Valavir includes dyspeptic symptoms, headaches, urticaria, and general weakness.

The most serious side effects of Griseofulvin tablets include impaired coordination of movements and sleep, confusion, liver inflammation, changes in the functioning of the hematopoietic organs, as well as skin manifestations in the form of exudative erythema and toxic epidermal necrolysis.

Side effects of Loratadine include nausea, skin rashes, hair loss, increased drowsiness and fatigue.

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Overdose

Overdose of any of the above medications leads to an increase in their side effects. To treat an overdose, it is recommended to wash out the stomach and take a sorbent.

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Interactions with other drugs

When used simultaneously with antihistamines, terbinafine slows down their metabolism, reduces the contraceptive effect of oral contraceptives, and inhibits the elimination of antibiotics.

Tablets for pityriasis versicolor Ketoconazole are incompatible with drugs containing corticosteroids. And Fluconazole potentiates the action of diuretics, indirect anticoagulants and drugs to reduce blood sugar levels in diabetes.

Griseofulvin reduces the pharmacological effects of anticoagulant drugs and hormonal contraceptives.

When using Loratadine tablets, you should not take Ketoconazole or macrolide antibiotics.

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Storage conditions

Tablets for lichen should be taken at normal room temperature.

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Shelf life

The shelf life of Ketoconazole is 5 years; Griseofulvin and Terbinafine – 3 years; Fluconazole, Acyclovir and Valavir – 2 years.

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