NEFLUAN ® Neomycin + Fluocinolone acetonide + Lidocaine

NEFLUAN ® is a drug based on Neomycin sulfate + Fluocinolone acetonide + Lidocaine

THERAPEUTIC GROUP: Local anesthetics

Indications NEFLUAN ® Neomycin + Fluocinolone acetonide + Lidocaine

NEFLUAN ® is clinically used in all endoscopic and instrumental urological maneuvers, in which it has proved effective in reducing pain associated with the examination, inflammation of the mucous membranes involved and all possible infectious sequelae.

Mechanism of action NEFLUAN ® Neomycin + Fluocinolone acetonide + Lidocaine

The use of NEFLUAN ® in the clinical setting is due to the different therapeutic activities carried out by its active ingredients, which make this medicine an excellent local anesthetic with high inflammatory and antibiotic capacities.
More precisely, the aforementioned activities are attributable to the presence of:

• Neomycin: aminoglycoside with a strong direct antibiotic activity against both Gram positive and Gram negative bacteria, guaranteed by the ability of the active ingredient to bind and inhibit the 30S ribosomal subunit, leading to the formation of aberrant proteins capable of compromising both normal metabolic activities of the microorganism both the structural characteristics and in particular the membrane integrity.
• Lidocaine: local anesthetic widely used topically, able to counteract the depolarization of neurons involved in nociceptive transmission, thus exerting an important pain-relieving effect useful in minor surgery maneuvers.
• Fluocinolone acetonide: synthetic corticosteroid derived from hydrocortisone widely used in dermatology, capable of inhibiting the synthesis of inflammatory mediators thus reducing damage to the mucosa involved.

Following the topical application of NEFLUAN ®, a greater concentration of the active ingredients is observed mainly in the site, thus guaranteeing a particularly effective local therapeutic action.
However, it should be remembered that lidocaine can be absorbed systemically, metabolized in the liver and subsequently excreted mainly in the form of inactive catabolites.

Studies carried out and clinical efficacy

1. NEOMYCIN PROMOTES THE STABILITY OF THE HEART VALVES
J Biomed Mater Res B Appl Biomater. .

Neomycin enhances extracellular matrix stability of glutaraldehyde crosslinked bioprosthetic heart valves.

Friebe VM, Mikulis B, Kole S, Ruffing CS, Sacks MS, Vyavahare NR.

Interesting study that demonstrates how the use of neomycin can improve the stability of the extracellular matrix of heart valves, improving the formation of cross-links between glutaraldehyde molecules, responsible for the structural properties of the tissue.

2 . NEOMYCIN IN THE PROPHYLAXIS OF INTESTINAL SURGERY
Br J Surg. 2007 May; 94: 546-54.

Randomized clinical trial of effect of synbiotics, neomycin and mechanical bowel preparation on intestinal barrier function in patients undergoing colectomy.

Reddy BS, Macfie J, Gatt M, Larsen CN, Jensen SS, Leser TD.

Work that demonstrates how the administration of neomycin in combination with symbionts before invasive intestinal maneuvers can prevent bacterial translocation and colonization by Enterobacteriaceae.

3. HYPERSENSITIVITY TO NEOMYCIN
Therapeutique. 1973 Nov; 49: 609-13.

Dermatological study of a new topical compound of fluocinonide and neomycinsulfate.

Privat Y.

Very dated study evaluating for the first time the efficacy and safety of the combined topical administration of neomycin and flucinolone acetonide for dermatological diseases.

Method of use and dosage

NEFLUAN ®
Water-soluble gel containing 2.5 g of lidocaine hydrochloride, 0.5 g of neomycin sulfate and 0.025 g of flucinolone acetonide.
Since the use of NEFLUAN ® is limited to healthcare personnel, the application of this gel should take place a few minutes before the instrumental evaluation by the physician or healthcare staff.

Warnings NEFLUAN ® Neomycin + Fluocinolone acetonide + Lidocaine

The application of NEFLUAN ® should be carried out by healthcare personnel in the appropriate outpatient facilities.
It is recommended to avoid the application of the gel on severely damaged mucous membranes given the possible risk of systemic absorption of the active ingredients taken.
Prolonged and inappropriate use of the product could facilitate the formation of strains resistant to common antibiotic therapy, aggravating the patient's clinical picture and exposing him to possible sensitization reactions.

PREGNANCY AND BREASTFEEDING

The use of NEFLUAN ® is generally not recommended during pregnancy and in the subsequent period of breastfeeding, given the absence of clinical trials capable of characterizing the safety profile of the drug on the fetus exposed to the drug.

Interactions

All possible drug interactions capable of varying the pharmacokinetic and pharmacodynamic characteristics of NEFLUAN ® are due to the presence of lidocaine, whose plasma half-life could be increased by the simultaneous administration of propanolol.

Contraindications NEFLUAN ® Neomycin + Fluocinolone acetonide + Lidocaine

The use of NEFLUAN ® is contraindicated in case of hypersensitivity to the active ingredients and to the relative excipients.

Undesirable Effects - Side Effects

Although the use of NEFLUAN ® is generally safe and free from clinically relevant side effects, the presence of lidocaine could determine the appearance of side effects linked above all to possible adverse reactions to the active ingredient.
The presence of neomycin could instead cause local hypersensitivity reactions characterized mainly by itching, redness and swelling.

Note

NEFLUAN ® is a prescription drug

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