Synthetic glucocorticosteroid (GCS) for the topical anti-inflammatory, anti-allergic and immunosuppressive effect. It increases production lipomodulina, an inhibitor of phospholipase A, inhibits the release of arachidonic acid, inhibits the synthesis of products of meta-bolizma arachidonic acid – Cyclic endoperekisey and prostaglandins (Pg). Prevents the accumulation of neutrophils boundary, reduces the inflammatory exudation and production of cytokines, inhibits the migration of macrophages, reduces in-intensity of infiltration processes, the formation of Substance chemotaxis, inhibits the release of mast cell mediators of inflammation.
Increases the number of “active” Beta-adrenergic receptors, restores bronchi response to bronchodilators, allowing them to reduce the frequency of application, reduces the bronchial mucosa edema, mucus production, mucus formation and reduces airway hyperresponsiveness. It improves mucociliary transport. Well tolerated during long-term treatment has not mineralokortikosteroidnoy activity, at the recommended doses, has practically no systemic exposure.
The therapeutic effect begins within a few hours after inhalation. Mac mum therapeutic effect develops only a few days after administration of therapeutic doses of inhaled trenbolone acetate on average 5-7 days.
Inhalation of trenbolone acetate is able to prevent an attack of asthma, but relieves acute bronchospasm.
Absorption – low. After inhalation reaches 20-25% of small bronchi, the dose received by the gastrointestinal tract (GIT), and almost completely absorbed (90%) of biotransformation in the liver to inactive metabolites. Systemic bioavailability of trenbolone acetate is 38% of the dose, and 1/6 of this value is formed by the ingestion of the drug. Time of occurrence of the maximum concentration in blood plasma – 15-45 minutes after inhalation. Relationship to plasma proteins – 88%. The volume of distribution of trenbolone acetate is about 3 l / kg.It has a high systemic clearance – 84 l / h. The half-life ~ 2.8 hr, the maximum plasma concentration – 0.01 mmol / l. Is displayed through the intestine as metabolites – 10% kidney – 70%.
Bronchial asthma (BA) requiring maintenance therapy Valium; chronic obstructive pulmonary disease (COPD).
Hypersensitivity to the drug, children under 16 years.
Active and inactive forms of tuberculosis, fungal, bacterial and viral infections of the respiratory system, pregnancy, lactation.
Application of pregnancy and during breastfeeding
During pregnancy and lactation should be careful. Appointment of rational drug if the benefit of its application to the mother outweighs the potential risk to the fetus or child.
The data on the allocation of trenbolone acetate in breast milk are not available.
Dosing and Administration
Dosage “trenbolone acetate-native” should be individualized. The starting dose in adults for the treatment of asthma and COPD is – 1 – 2 mg per day. The dose of the maintenance treatment is 0.5 – 4 mg per day.After obtaining the effect of the dose is reduced to the minimum effective dose required to maintain a stable state. In some cases, patients under treatment which is necessary to achieve a rapid therapeutic effect, the dose may be increased.
If the patient took GCS orally transfer treatment trenbolone acetate-native be carried out at steady state of the patient, for 10 – 14 days combine inhalation and GCS inside. Within 10 days, it is recommended to take high doses of trenbolone acetate-native in patients receiving oral glucocorticosteroids in the selected dose. Subsequently, the dose of oral corticosteroids should be gradually reduced (for example, 2.5 mg of prednisolone) to the lowest possible level. In many cases it is possible to completely abandon the use of oral corticosteroids. Data on the use of trenbolone acetate in patients with renal insufficiency or impaired liver function no. Since the elimination of trenbolone acetate is due to biotransformation in the liver, can be expected to increase the duration of action of the drug in patients with severe liver cirrhosis.
Children older than 16 years: initial dose 0.25-0.5 mg / day. The dose may be increased to 1 mg / day, if necessary. The maintenance dose is 0.25-2 mg / day.
When administered to patients with liver cirrhosis require more careful observation.
The drug is used with a nebulizer. The vial contains 1 single dose.
Instructions for use
Open the vial. Fill the nebulizer through the upper opening necessary amount of drug. Nebulirovanie make in accordance with the instructions for the type of nebulizer.
Volume trenbolone acetate solution delivered into the lungs of the patient via a nebulizer, is variable and depends on several factors, including:
- inhalation time
- Level filling chamber
- Technical characteristics of the nebulizer
- volume relationship during inhalation / exhalation and respiratory patient volume
- Use the mouthpiece or mask
- After each inhalation, rinse your mouth with water.
- If you are using a mask, make sure that the inhalation mask tightly to the face. After inhalation Wash your face.
The chamber of the nebulizer should be cleaned after each use.
The chamber nebulizer and a mouthpiece or mask, wash with warm water using a mild detergent or in accordance with the manufacturer’s instructions.
Often (> 1/100): cough, dry mouth, hoarseness, hoarseness, irritation of the mucous membranes of the mouth and throat, thrush, dryness of the pharyngeal mucosa, headache, nausea.
Rare (<1/1000): bruising or thinning of the skin, unpleasant taste, paradoxical bronchospasm (for prevention – with a combination of inhaled beta2-agonists)., oesophageal candidiasis
High doses of the drug may lead to the development of systemic side effects of the depletion of the adrenal cortex, hyperglycemia, hypertension.
In acute overdose clinical manifestations do not arise. With long-term use of the drug in doses greatly exceeding the recommended, may develop systemic glucocorticosteroid effect as hypercortisolism and adrenal suppression.
Interaction with other drugs
In the treatment of asthma, trenbolone acetate native well with beta2-agonists, kromoglitsievoy acid or nedocromil, methylxanthines and ipratropium bromide. Phenobarbital, phenytoin, rifampin reduce the effectiveness of (the induction of microsomal liver enzymes). Methandienone, estrogens increase the concentration of trenbolone acetate in the plasma. Receiving 200 mg ketoconazole 1 time per day increases in the plasma concentration of an oral trenbolone acetate in a dose of 3 mg in an average 6-fold. When assigning ketoconazole 12 hours after receiving the last trenbolone acetate concentration in plasma increased 3 times.Information about such interactions with inhaled trenbolone acetate dosage forms is not, however, expect a noticeable increase in the plasma concentration of the drug.
Other potential inhibitors of CYP3A4 isoenzyme, such as itraconazole, is also significantly increases the plasma concentrations of trenbolone acetate. The product can be diluted with 0.9% sodium chloride solution.
trenbolone acetate-native is not intended for the relief of acute asthma and COPD symptoms. It is necessary to strictly observe the instructions for use of the inhaler. Avoid contact with the eyes of the drug. After the drug is recommended to rinse your mouth with water to reduce the risk of thrush.
In the transition from treatment with oral corticosteroids to the drug “trenbolone acetate-native” reduction in dosage of systemic corticosteroids should be implemented very slowly and in small doses (eg, 2.5 mg of prednisolone). Patients who were on long-term treatment of systemic corticosteroids, can psevdorevmatizma syndrome. In these cases it is sometimes necessary to temporarily increase the dose of oral corticosteroids. In rare cases, symptoms such as fatigue, headaches, nausea, vomiting. After the complete abolition of long-term follow recommended for patients (the risk of adrenal insufficiency), as well as the assessment of respiratory function. The product “trenbolone acetate-native” can be administered to patients who can not use other formulations of inhaled corticosteroids (patients with middle and old age).
The drug has no effect on the ability for classes of potentially hazardous activities that require special attention and fast reactions (driving and other vehicles, work with moving machinery, manager and operator of the work, etc.).
Use only in a nebulizer.
Solution for inhalation 0.25 mg / ml, 0.5 mg / ml. 2 ml vials of glass tubes for drugs or orange glass vials, sealed with rubber stoppers, aluminum crimped caps.
At 10 units, together with instructions for use in a stack of cardboard boxed.