Cycloferon. Solution for intravenous/intramuscular administration

Registration number: P N001049/03 Trade name: CYCLOFERON® Group name: Meglumina acridone acetate Dosage form: solution for intravenous and intramuscular administration

Composition of the drug Pharmacological properties Indications for use Contraindications

Directions for use and dosage Side effects Interaction with other drugs

Pharmacological properties

Pharmacodynamics
CYCLOFERON® is a low-molecular-weight interferon inducer, which determines a wide range of its biological activity (antiviral, immunomodulatory, anti-inflammatory, etc.).
The main interferon-producing cells after administration of the drug CYCLOFERON® are macrophages, T- and B-lymphocytes. Depending on the type of infection, the activity of one or another part of the immune system predominates. The drug induces high interferon titers in organs and tissues containing lymphoid elements (spleen, liver, lungs), activates bone marrow stem cells, stimulating the formation of granulocytes. CYCLOFERON® activates T-lymphocytes and natural killer cells, normalizes the balance between subpopulations of T-helpers and T-suppressors. Enhances the activity of α-interferons. CYCLOFERON® demonstrates antiviral activity against pathogens of tick-borne encephalitis, influenza, herpes, cytomegalovirus, papilloma virus and other viruses. Preclinical studies have shown that the use of Cycloferon in the early stages of the infectious process leads to a decrease in the viral load (virus titer) in lung tissue. Increases the body's nonspecific resistance to viral and bacterial infections. The drug has been found to be highly effective in complex therapy of acute and chronic bacterial infections (neuroinfections, chlamydia) as a component of immunotherapy. Pharmacokinetics
When the maximum permissible dose is administered, the maximum concentration in the blood is reached after 1–2 hours; after 24 hours the drug is detected in trace amounts. Crosses the blood-brain barrier. The half-life is 4–5 hours. CYCLOFERON® does not have cumulative properties. Does not accumulate in tissues with prolonged use.

Experience with the use of cycloferon in the treatment of human papillomavirus infection

Isakov V.A., Ermolenko D.K., Goncharov S.B., Ermolenko K.D.

Lesions of the skin and mucous membranes caused by human papillomaviruses (HPV) have been known to mankind for a long time. More than 130 types of HPV are distinguished based on the nucleotide sequence and antigenic properties of capsids. The HPV genome contains DNA. HPVs are species and tissue specific. They are capable of infecting squamous epithelial cells and exhibiting replicative activity within them; they are found on the skin, mucous membranes of the oral cavity, conjunctiva, esophagus, bronchi, larynx, rectum, and genitals [14].

At the end of the twentieth century. An unprecedented spread of HPV infection has been noted: it is believed that approximately three quarters of sexually active adults worldwide are infected with HPV at different stages of their lives. In general, at the moment, HPV infection in people of biologically active age is 20–60% [14]. The infection is transmitted primarily through sexual contact, during medical procedures (infection of medical personnel is possible), vertically, during pregnancy and childbirth. The incubation period is 1–6 months, the maximum content of the virus in the affected tissues is detected in the 6th month. Often the result of infection is diseases of the anogenital area: cancer of the cervix, vulva, vagina, perianal area and genital warts. Cervical cancer is the second most common malignant disease in women: more than 500 thousand cases are registered annually in the world. According to WHO forecasts, the number of deaths from cervical cancer will increase to 320 thousand in 2015 and to 435 thousand in 2030 [12]. The average age of patients with carcinoma in situ is 29 years, i.e. It takes approximately 10 years from the time of initial infection to the appearance of severe neoplasia. Invasive cancer is registered at the age of 49 years, when additional changes in immunity occur, leading to invasion and metastasis [14,15]. Papillomaviruses are the only group of viruses that have been proven to induce tumor formation in humans under natural conditions. The combined persistence of HPV with herpes simplex virus-2, cytomegalovirus, Epstein-Barr virus, human immunodeficiency virus, chlamydia and mycoplasma is unfavorable.

Up to 20 million American citizens suffer from genital warts, and HPV is 3 times more common than genital herpes and no less common than gonorrhea [5]. According to the Ministry of Health of the Russian Federation (2001), the frequency of the most common clinical form of HPV - genital warts - is 26 per 100 thousand population, in the USA - 100 per 100 thousand population.

An essential feature of HPV is its ability to switch from a non-productive type of infection to a productive type of infection and vice versa. In the first case, the virus replicates synchronously with the cell and does not harm it. In the second case, it quickly multiplies and lyses the cell, releasing a mass of new virions that can infect other cells [14]. It has been shown that HPV can have different effects on the mucosa. Thus, the manifestation of a productive effect is papillomas and condylomas, and the result of a transforming effect can be intraepithelial lesions (dysplasia, invasive cancer). Thus, the conditions for the formation of irreversible neoplasia are [9]: active expression of the E6 and E7 HPV genes; induction of metabolic mechanisms for the conversion of estradiol into 16a-hydroxysterone, which belongs to the category of “aggressive hormones” that cause a long-term effect; induction of multiple chromosomal DNA damage in the infected cell, which completes the process of degeneration.

HPV-1 – HPV-4 types were isolated from stratified squamous epithelium. They are associated with the development of vulgar and flat warts of the hands, as well as plantar warts. In most cases, HPV types 6, 11, 13, and 30 are associated with the development of verrucous laryngitis (juvenile laryngeal papillomatosis). The disease is diagnosed more often in children under 5 years of age who are infected perinatally, and is characterized by the appearance of papillomatous growths on the vocal cords, which leads to speech difficulties and air circulation problems in the upper respiratory tract. HPVs have also been isolated from the mucous membranes of the oral cavity. Cases of laryngeal papillomatosis have been described in children born by cesarean section, so cesarean section should not be performed for the sole purpose of preventing HPV infection of the newborn.

As shown above, HPV-6, 11 can cause cancer of the larynx and pharynx, while the role of other types of HPV in malignant degeneration of the oral mucosa has not been sufficiently studied. Rare cases of the development of oropharyngeal warts caused by “genital” serotypes HPV-16, 18 have been noted. The presence of the same types of viruses in different localizations of mucosal lesions suggests a single source of infection and the ability of viruses to interact with various receptors on the epithelium of the oral cavity and urogenital tract.

We examined 40 women of childbearing age practicing commercial oral-genital sex. Material was collected (scrapings from altered areas of the mucous membranes) from patients with clinical manifestations of HPV infection. Subsequently, all samples were subjected to genetic analysis using polymerase chain reaction (PCR) with primers aimed at identifying the following types of HPV: 16, 18, 31, 33, 50, 59 [3]. HPV-16 was isolated in 52.5%, and HPV-18 – in 27.5% of cases. HPV-31, 50, 59 were detected much less frequently (7.5%) in the samples. HPV-33 was detected in only two women. It should be noted that in 6 patients several serotypes of the virus were recorded simultaneously. Thus, in 2 samples HPV-16 and 18 were isolated, in 3 samples - HPV-16 and 50, in 1 sample - HPV-16, 31 and 39. The studies conducted indicate the significant role of oral-genital contacts in the spread of human papillomavirus infection, including viruses of high oncogenic risk, and may also indirectly indicate an increased risk of developing malignant diseases of the oral cavity and larynx in women who use oral-genital contact [3].

According to Kozlova V.I. et al. (2003) [10], the urogenital tract is most often affected by HPV-6, 11, 16, 18, 31, 35. Based on the ability of HPV to induce neoplastic processes, they are usually divided into low-grade types (types 3, 6, 11, 13, 32 , 34, 40, 41, 42, 43, 44, 51, 61, 72, 73), medium (30, 35, 45, 52, 53, 56, 58) and high (16, 18, 31, 33, 39 , 50, 59, 64, 68, 70) cancer risk [9,10]. Recently, about 20 types of HPV have been associated with cervical cancer (95%). Among them, HPV-16 (50%) and HPV-18 (10%) are most often detected, and therefore women with confirmed HPV infection should undergo an annual examination by a gynecologist with colposcopy, cytological examination of cervical smears, virological and immunological examination. It is believed that in 50% of cases of human papillomavirus infection (PVI), the virus is cleared from a woman’s body within 1 year, and in 85% of cases – within 4 years. In St. Petersburg from 1999 to 2004, from 28 to 34% of the female population aged 20 to 60 years were infected with HPV and high-risk (HPV types 16 and 18) cancer [11]. HPV contributes to the development of cervical cancer in 99.7%, cancer of the vulva, vagina, penis, prostate, testicle - in 10-30%, cancer of the larynx and oral cavity - in 10-30% of cases.

In addition to HPV, a number of concomitant factors play a decisive role in the development of oncogenic transformation. First of all, it is necessary to highlight concomitant infectious diseases of the anogenital area, the causative agents of which are often isolated in patients with HPV infection: chlamydia - 62.1%, gonococci - 23.3%, ureaplasma - 16.2%, herpes viruses - 16%, trichomonas - 14.8%. The combination of HPV infection with two infections was detected in 23.3%, with three – in 16.2%, with four – in 8.1% of cases [2,8]. Of great importance in the development of cancer against the background of PVI are social status and living conditions, hormonal levels corresponding to age, gynecological history (risk factors: early onset of sexual activity, frequent change of sexual partners, cervical canal injuries, number of pregnancies and births, anogenital contacts). An important feature of HPV infection is polymorphism, multifocality of damage to the skin and mucous membranes of the genital tract in the form of clinical, subclinical and latent forms [2,6,7].

In St. Petersburg, a system of preventive measures has been proposed aimed at reducing the incidence of virus-related malignant neoplasms in the population. A comprehensive examination program includes cytological methods, testing for viruses (HPV, CMV, EBV, viral hepatitis B and C). Detection of high cancer risk viruses (HPV-16, 18 types) requires the examination to be supplemented with clarifying diagnostic methods: determination of the level of prolactin, prolactin/TSH in the blood, HPV gene testing (ratio of E2-E6 genes), drawing up a patient’s genetic risk map, which will allow us to offer an individual model of strategy and tactics for treatment and monitoring of the patient, as well as to form risk groups for virus-related tumors [11].

Principles of complex treatment of HPV infection. With PVI, as with other chronic diseases with long-term persistence of the virus, immunodeficiency states (IDS) develop due to insufficiency of various parts of the immune system: there is a decrease in T-cell immunity, immunoregulatory index (CD4/CD8), the number of Langerhans cells and immune response of cervical lymphocytes. The functional activity of natural killer (NK) cells and the level of basic serum immunoglobulins are reduced. The content of CEC in the peripheral blood is increased, which correlates with the prevalence and severity of the process [7,12,13].

Due to the imbalance of the immune system, for more successful treatment in the regimen of infection caused by HPV, it is necessary to include, in addition to antiviral (systemic and local), immunocorrective drugs, as well as pathogenetic agents (systemic enzyme therapy, antioxidants, pro- and prebiotics), which alleviate the patient's condition and contribute to more effective use of the drugs used. When PVI is combined with other pathogens, complex treatment is carried out using etiotropic drugs against specific pathogens in standard dosages. It has been shown that modern treatment does not avoid recurrence of PVI in 20–30% of cases [1,2].

It is assumed that the sensitivity of HPV to certain chemotherapy drugs is primarily due to genetically programmed features of the immune response in this pathology. In the process of evolution, a mechanism has emerged in which a viral infection is protected at the molecular level from the systemic effects of the host immunity. In some cases, the reason for the failure of therapy for infection caused by HPV is the use of interferon drugs (IFN), since the E7 oncoprotein causes resistance of infected cells to IFN drugs during treatment [1,12].

Thus, the treatment of PVI remains a rather difficult task, despite a significant arsenal of drugs and treatment methods. Since complete cure is currently impossible to achieve, it is believed that the goal of the treatment procedures should not be to eliminate the pathogen, but to transfer the infection to a stage of stable remission (clinical recovery). In this regard, the following tactics for managing patients with HPV infection are proposed: 1) destruction of papillomatous foci; 2) stimulation of antiviral immunity, i.e. correction of general and local immunity; 3) a combination of these approaches, eliminating factors contributing to relapse of the disease [7,12,13].

Local destruction of foci during the clinical and subclinical course of HPV infection (aimed at removing the surface layer of the epidermis without sanitizing the cells of the basal layer) makes it possible to cure only the area of the epithelium where the infection manifested itself. In the surrounding tissues, a reservoir of HPV remains in an inactive state or an undiagnosed subclinical form, which can cause relapses of the disease. During a five-year observation of patients with cervical infections caused by HPV, progression of the latent stage of papillomavirus infection into a clinical or subclinical form was noted in 21.4% of cases. Moreover, the clinical manifestation of infection occurs in women with persistent HPV against the background of an imbalance in immunity parameters. Adequate immunotherapy helps suppress the activity of HPV and its complete elimination, reducing the frequency of relapses and the risk of developing precancerous diseases and cervical cancer in patients with latent HPV infection [4,6,12]. For genital warts, both sexual partners are treated. It is recommended to abstain from sexual intercourse while taking medications and use barrier contraception for 6 months. after completion of therapy.

Experience with the use of Cycloferon in the treatment of HPV infection. Currently, in the treatment of patients with HPV infection, an alternative approach to the treatment of PVI is very promising. With this technique, IFNs have a protective effect, i.e. Interferon inducers (II) are used, among which the domestic drug Cycloferon deserves special attention (NTTF POLYSAN LLC, St. Petersburg). Cycloferon belongs to low-molecular interferon inducers, the acridone class. When Cycloferon is administered, endogenous IFN is formed, which is not antigenic or pyrogenic; the activity of induced IFN is controlled by special regulatory mechanisms, which ensures the absence of side effects inherent in recombinant IFN drugs as a result of their cumulation; Cycloferon also does not have mutagenic, teratogenic, embryotoxic, or carcinogenic effects; Cycloferon does not induce autoimmune processes. The drug has no described side effects, it goes well with traditional therapeutic treatments (antibiotics, vitamins, immunotropic drugs, etc.).

Advantages of using Cycloferon: rapid penetration into the blood, low level of binding to serum proteins, high bioavailability in organs, tissues, biological fluids of the body; the predominant method of elimination from the body is through the kidneys (99% of the administered drug) unchanged, within 24 hours [4,5]. After the administration of Cycloferon, a high level of synthesis of IFN-a in tissues and organs containing lymphoid elements is observed for at least 72 hours, while in the blood serum of a normal person, high levels of IFN remain for 48 hours.

Mechanisms of action of Cycloferon. One of the key parameters when introducing interferon-inducing drugs into the body, which determine the effectiveness of the immune response, is the profile of cytokines - factors that activate the proliferation and differentiation of body cells, controlling the processes of regeneration, angiogenesis and metabolism. The existence of different cytokine profiles provided by Th cells has been established, with the Th1 type of immune response associated with the production of IFN-g, IL-2 and TNF; the Th2 type is characterized by increased production of IL-4,5,6,10 and leads to increased humoral and suppression of cellular immunity [4,5]. Currently, the direct and indirect immunotropic effects of CP are well described.

The influence of Cycloferon on nonspecific immune cells: Cycloferon increases the formation of reactive oxygen species by phagocytes, which promotes completed phagocytosis with the elimination of captured pathogens; causes an increase in the level of NK cells in the peripheral blood.

The influence of Cycloferon on specific immune cells: 1) an increase in the level of CD4+ and a decrease in CD8+ T-lymphocytes, normalization of the immunoregulatory index even with a single use of Cycloferon; 2) the use of Cycloferon leads to a decrease in the level of B-lymphocytes in the peripheral blood and to an increase in the production of high-affinity antibodies, which reflects its effect on switching the synthesis of immunoglobulin classes in B-cells; induces the synthesis of IFN-α in B cells, macrophages and neutrophils. These secondary effects of Cycloferon can be partially explained by the induction of the synthesis of interleukins (IL-2, IL-1), IFN-α, IFN-γ by various cells of the immune and other body systems, as well as the suppression of the synthesis of IL-8, TNF-a ( shown using ELISA, RT–PCR). Other immunocorrective effects of Cycloferon include experimentally discovered radioprotective and anti-inflammatory effects, stimulation of reparative osteogenesis (in the area of a long bone fracture in animals).

In addition, the direct antiviral effect of Cycloferon has been shown, which manifests itself at the stage of virus assembly, leading to the formation of defect-interfering particles (DI-particles), which are a kind of autovaccine in the body. DI particles interfere with the normal replication of viruses, which leads to the suppression of their cytocidal effect. At the same time, DI particles retain their IFN-inducing properties, stimulating nonspecific immunity.

Thus, Cycloferon, as an IFN inducer, has a bifunctional effect - it is able to suppress the reproduction of a wide range of viruses (orthamyxoviruses, paramyxoviruses, adenoviruses, coronaviruses, herpes viruses, HPV, HIV, etc.) and at the same time has a pronounced immunocorrective effect, normalizing disorders immune systems (secondary immunodeficiencies), so characteristic of viral infections. A dose- and interval-dependent effect of the drug has been established, which must be taken into account when using Cycloferon [4,5,13].

Release forms of Cycloferon. The drug is available in the form of a solution for intramuscular and intravenous administration of 125 mg/ml in ampoules of 2 ml; tablets of 0.15 g, enteric-coated and liniment 5% for external use in tubes of 5 and 30 ml. Liniment Cycloferon 5% 30 ml contains in one package five disposable applicators for intravaginal administration of liniment, which allows patients to use the drug at home.

Clinical effectiveness of Cycloferon drugs. Taking into account the antiviral, interferon-inducing and immunomodulatory effects of Cycloferon, it is actively used for systemic and local use in the treatment of viral infections, incl. papillomavirus diseases of the skin and mucous membranes [2,4,7,13]. Cycloferon is effective against cytomegalovirus, HIV-1, HSV, human papillomavirus and other viruses. Cycloferon is used as monotherapy or in combination with other antiviral and immunotropic drugs. Thus, patients with filamentous warts were prescribed bemitil 1 tablet 4 times a day. for 14 days followed by electrocoagulation. Intramuscular injections of Cycloferon solution 125 mg/ml, 1 ampoule every other day, were additionally prescribed to patients in case of a large number of warts or in the development of relapses after local destructive treatment. The course of treatment with Cycloferon was repeated after 10 days. Cycloferon liniment (lCF) was prescribed for vulgar warts, alternating with tebrofen ointment for 4–6 weeks (with pre-treatment with keratolytic agents). If there was no effect, local destructive treatment was performed.

PVI is often combined with urogenital chlamydia. When examining such patients, we identified dysbiosis of the vagina and intestines. Appropriate comprehensive treatment was carried out. Often small papillomas decrease in size and HPV activity decreases. If the clinical picture of HPV infection remained unchanged, then destructive treatment of the main condylomas was carried out and a course of Cycloferon was prescribed intramuscularly: 10 injections of 2 ml according to the basic regimen. Applications of 5% lCF were used locally, as a result of which normalization of local immunity parameters and restoration of vaginal endoecology were observed. Normalization of vaginal microbiocenosis from the point of view of eliminating the infectious agent (antibacterial, antiviral, antifungicidal effects) is based primarily on the distinct immunocorrective effect of lCF. This effect consists of an impact on the local immunity of the mucous membranes of the lower part of the female genital area and consists of increasing the permeability of the vaginal histohematic barrier (VHB) and compensation for the initially reduced local synthesis of IgG, at the beginning of therapy - due to increased diffusion of immunoglobulins from the bloodstream, and subsequently by normalizing and increasing the degree of local synthesis of immunoglobulins.

It is known that high doses of Cycloferon (500 mg) promote the active synthesis of IFN-γ, which has immunoregulatory and antiproliferative properties, and also ensures the induction of a Th1-type immune response.

Cycloferon in the treatment of PVI of the anogenital area. We observed 100 patients of both sexes with PVI of the anogenital area aged from 19 to 50 years. Diagnosis was carried out on the basis of characteristic clinical manifestations of the disease, cytological examination of smears and PCR. In 20 patients, HPV was not detected or not identified. In 80 patients, when determining the HPV type, the following results were obtained: 40% (32 people) – HPV-11, 7% (6 people) – HPV-16, 4% (3 people) – HPV-6, 4% ( 3 people) – HPV-18. 45% (36 people) – HPV-2, 7, 31 and 33 were identified. Clinically, forms of PVI were more often recorded – genital warts, papillomas and flat warts. Laboratory examination: immunogram (CD4+ and NK cells, interferon status, transferrin (TF), ceruloplasmin (CP). To assess non-enzymatic antioxidant activity, the coefficient K was determined, obtained as the quotient of dividing the values of TF to CP (TF/CP).

PVI therapy regimen. Treatment was carried out in 2 stages. First, papillomatous elements were removed using chemical destructive therapy: Solcoderm 2 sessions, with an interval of 4–5 days. The second stage was an anti-relapse course with Cycloferon (systemic and local) in 50 patients (36 women and 14 men). Cycloferon solution 125 mg/ml was prescribed intramuscularly according to the following regimen: 2 ml on the first and second days, and from the third day, 2 ml every 48 hours, course of 8–10 injections. At the same time, 5% lCF was applied to the sites of former lesions daily for 10 days. 50 patients in the control group (35 women and 15 men) were prescribed rectal suppositories of recombinant a2-interferon (3 million IU) according to the standard regimen: 1 st. 2 times/day. – 10 days, then every other day No. 10.

During therapy with Cycloferon, positive clinical dynamics were observed faster (resolution of elements of HPV infection, etc.), and indicators of nonspecific resistance of the body (level of CD4+, NK–cells, transferrin, synthesis of endogenous IFN) significantly increased. HPV was detected significantly less frequently by PCR after completion of the course of treatment (Table 1). The use of Cycloferon in the complex therapy of PVI made it possible to reduce the recurrence rate of PVI from 48 to 15% within 6 months. after a course of therapy.

It has been shown that the use of liquid 5% lCF for local treatment of diseases of the urogenital tract can solve many problems that arise in the treatment of STIs. A pronounced antiviral, antibacterial and antichlamydial effect of the drug due to activation of the immune system, as well as anti-inflammatory and antiproliferative effects of CP, have been established. The effectiveness of lCF in the complex treatment of acute and chronic bacterial and viral infections (chlamydia, bacterial and fungal infections of the genitourinary tract, genital herpes, human papillomavirus infection) has been shown.

It is believed that HPV-5, HPV-6 and HPV-11 types cause the development of genital warts (AC). 28 adult patients with OK received two-stage treatment. First, the OC was removed by cryodestruction with liquid nitrogen, then 17 patients were prescribed intravaginal and intraurethral instillations of 5% lCF once a day. No. 10 every other day to prevent relapse of the disease. 11 patients in the control group were treated only by cryodestruction. Within 10–24 hours, swelling and hyperemia developed at the cryoapplication site, followed by the formation of blisters and erosions. Bubbles and erosions were treated with a fucorcin solution, the affected area was washed with a solution of chlorhexidine bigluconate for 2 weeks (to prevent secondary infection). Complete rejection of neoplasms and epithelization were observed on days 10–14 [13]. As a result of treatment in patients of the main and control groups, relapses in the first days after cryodestruction were observed in 3 (17.6%) and 2 (18%) patients, respectively. During the first month after surgery, relapses of OK were observed in 4 (23.5%) patients of the main and 3 (27.2%) control groups. During the second month, relapses were observed in 1 (5.8%) and 3 (27.7%) patients, respectively. Assessing the results obtained, it should be noted the effectiveness of local application of lCF. Thus, already during the second month after cryodestruction, the frequency of OK relapses was significantly higher in the control group compared to the main group of patients (27.2 and 5.8%, respectively, p <0.05). The final examination showed that combined OC therapy using cryodestruction and instillation of 5% lCF significantly reduced the incidence of disease recurrence in the first 3 months. after surgery: 49.9% in the main group and 72.7% in the control group (p<0.05).

lCF has no side effects that limit its use during intravaginal/intraurethral administration and is recommended in the complex treatment of urogenital infections, including those caused by HPV. The use of lCF is effective in women both as monotherapy for urogenital infections and as a combination treatment. The drug combines well with various official intravaginal drugs (vaginal tablets, suppositories) and with medicinal mixtures prepared ex tempore. The effectiveness of lCF in women has also been proven for the following types of pathologies: nonspecific bacterial vaginitis, bacterial vaginosis, candidal vaginitis, nonspecific urethritis.

Regimen for the treatment of lCF urogenital infections can be variable depending on the severity of the disease, its nosological form and the nature of local changes.

Schemes for using Cycloferon liniment

For genital herpes, recurrent genital warts - intravaginal (intraurethral) instillations 1 time per day. 5 ml daily, 10–15 days. It is possible to combine lCF with other antiviral agents (both systemic and local) in the form of ointment (gel) applications to the lesion. When treating candidal vaginitis, nonspecific vaginitis (endocervicitis) and bacterial vaginosis, the drug can be used both as monotherapy and as part of complex treatment. Use intravaginal instillations of the drug, 5–10 ml daily for 10–15 days. To prevent free evacuation of the drug, the entrance to the vagina is tamponed with a small cotton swab for 2–3 hours. In parallel, in the case of combined damage to the mucous membranes of the vagina and urethra (human papillomavirus infection, etc.), it is advisable to use a combination of intravaginal and intraurethral instillations (in a volume of 5 ml daily, 10– 14 days). Considering the wide range of effects of 5% lCF, we can say that it has not only taken its place in the treatment of urogenital infections, but has also supplanted traditional drugs used in the treatment of STIs.

Thus, the safety and high clinical effectiveness of the use of Cycloferon in the treatment of patients with recurrent HPV infection has been demonstrated. Cycloferon has antiviral and immunomodulatory effects, is combined with basic dosage forms, is well tolerated by patients, is highly effective when used locally and systemically as monotherapy and in combination with antiviral chemotherapy drugs, enhancing and prolonging the therapeutic effect.

Literature

1. Van Krogh D., Lacey S.D., Gross D., Baracco R., Schneider A. European guidelines for anogenital warts // STI. 2002. No. 3. P.29–37.

2. Dmitriev G.A., Bitkina O.A. Human papillomavirus infection. M.: Medical book, 2006. 76 p.

3. Ermolenko D.K., Ermolenko K.D., Isakov V.A. Frequency of occurrence of human papillomaviruses of high oncogenic risk in the oral cavity in women practicing commercial oral-genital sex / 3rd Interregional Scientific and Practical. conf. "Benign neoplasms and infections in urology and gynecology." St. Petersburg, 2008. pp. 20–21.

4. Ershov F.I., Kiselev O.I. Interferons and their inducers (from molecules to drugs). M.: GEOTAR-Media, 2005.

5. Ershov F.I., Romantsov M.G. Medicines used for viral diseases. Guide for doctors. M.: GEOTAR-Media, 2007.

6. Ershov V.A., Narvskaya O.V. Background processes and neoplasia of the cervical epithelium. St. Petersburg: Chelovek, 2007. 79 p.

7. Isakov V.A., Ermolenko D.K., Ermolenko E.I. Herpesvirus and human papillomavirus infections. / Chapter in the book: “Sexually transmitted infections.” / Ed. V.A. Akovbyana, V.I. Prokhorenkova, E.V. Sokolovsky. A textbook for the system of postgraduate professional education of doctors. M.: Media Sphere, 2007. pp. 448–513.

8. Isakov V.A., Ermolenko D.K., Kutueva F.R., Ermolenko E.I., Moskvin I.I. The use of cycloferon in the treatment of human papillomavirus infection. Recommendations for doctors. St. Petersburg–V.Novgorod: Taktik–Studio, 2007. 64 p.

9. Kiselev V.I. Human papillomaviruses in the development of cervical cancer. M.: Dimitrade Graphic Group Company, 2004. 180 p.

10. Kozlova V.I., Puhner A.F. Viral, chlamydial and mycoplasma diseases of the genitals. A guide for doctors. M.: Publishing house “Triada-X”, 2003. 439 p.

11. Safronnikova N.R. Preventive gynecological oncology. SPb.: COSTA, 2007. 207 p.

12. Semenov D.M., Zanko S.N., Dmitrachenko T.I. Human papillomavirus infection (clinical and pathogenetic features, treatment, prevention). Educational and methodological manual. St. Petersburg: Dialect, 2008. 83 p.

13. Fedotov V.P., Rybalkin S.B., Romantsov M.G. Essays on immunocorrection in dermatovenerology. A manual for doctors. St. Petersburg, 2005.

14. Ludicke F., Stalberg A., Vassilokos P. et al. High and intermediate risk human papillomavirus infection in sexually active adolescent females. //J. Pediatr. Adolesc. Gynecol.–2001. Vol. 14. N4. P.171–174.

Directions for use and doses

In adults

CYCLOFERON® is used intravenously or intramuscularly. For herpes and cytomegalovirus infection, the course of treatment consists of 10 injections of the drug, 250 mg each, with an interval between injections of 48 hours (every other day). A single dose is 250 mg (1 ampoule). The course dose is 2.5 g. Treatment is most effective at the beginning of an exacerbation of the disease.

For neuroinfections, the course of treatment consists of 12 injections of the drug, 250–500 mg each, with an interval between injections of 48 hours (every other day) in combination with etiotropic therapy. A single dose is 250–500 mg (1–2 ampoules). The course dose is 3.0–6.0 g. Repeated courses are carried out as needed. For immunodeficiency conditions, the course of treatment consists of 10 intramuscular injections of the drug, 250 mg each, with an interval between injections of 48 hours (every other day). A single dose is 250 mg (1 ampoule). The course dose is 2.5 g. A repeat course is carried out after 6–12 months.

For chlamydial infection, the course of treatment consists of 10 injections of the drug, 250 mg each, with an interval between injections of 48 hours (every other day). A single dose is 250 mg (1 ampoule). The course dose is 2.5 g. A second course of treatment is carried out after 10–14 days. It is advisable to combine the drug CYCLOFERON® with antibiotics.

In children over 4 years old

CYCLOFERON® is used intramuscularly or intravenously. A single dose is 6–10 mg per 1 kg of body weight.

For herpes infection, the course of treatment consists of 10 injections of the drug with an interval between injections of 48 hours (every other day). If the replicative activity of the virus is maintained, the course of treatment is continued according to the maintenance regimen - administration of the drug once every three days for four weeks.

Instructions for use of Cycloferon tablets

The medication is indicated for use orally. You should take the tablets half an hour before meals. The tablet form should not be chewed, as it has a protective coating that does not allow the active substance to be destroyed by gastric juice. The tablet shell dissolves only in the intestinal cavity, which increases the effectiveness of the drug.

Take the tablet with 50 ml of water. Depending on age, different dosages are used:

adults - single dose 450-600 mg;
7-11 years of age - single dosage 300-450 mg;
4-6 years - single dose 150 mg.

Repeated course therapy is carried out 14-21 days after the end of the first course.

Side effect

According to the World Health Organization, undesirable effects are classified according to the frequency of their development as follows: – very common (≥ 1/10); – common (≥ 1/100 – – uncommon (≥ 1/1000 – – rare (≥ 1/10000 – – very rare ( – frequency unknown (cannot be determined from available data). General disorders and administration site conditions: very rarely - chills, fever, pain and redness at the injection site Disorders of the skin and subcutaneous tissues: very rarely - rash, urticaria If any of the undesirable effects indicated in the instructions worsen or you notice any other undesirable effects not listed in the instructions, tell your doctor about this.

Using liniment

Liniment is used topically. Rules of use for various conditions:

herpes - applied to damaged skin 1-2 times a day for 5 days; for herpetic lesions of the genital organs, it is recommended to apply to the vaginal mucosa once for 5 days.
bacterial or nonspecific vaginosis - intravaginally 5-10 ml 1-2 times a day; course therapy is 10-15 days; it is allowed to soak a tampon with liniment and then insert it into the vagina; The medication can be used with other local remedies (vaginal tablets and suppositories).

To introduce liniment intravaginally, you need to open the tube and pierce the tube membrane. Next, you should take a disposable syringe with a needle, draw up 5-10 ml of medicine, and remove the needle. Next, it is recommended to lie on your back and insert the medication into the vagina by pressing on the syringe plunger. To ensure that the medicine remains in the vaginal cavity, a cotton swab should be placed for 2-3 hours. Course therapy can last up to 15 days. If necessary, treatment is repeated after 2 weeks.

The external preparation can be used for periodontitis. Before applying the antiviral liniment, it is recommended to rinse the periodontal pockets. Next, liniment is applied using a cotton swab. Dose calculation: 1.5 ml per 1 gum. Rubbing the drug in is not recommended. It is advisable to apply the medicine 1-2 times a day. The intervals between uses are 10-12 hours. The duration of treatment is up to 2 weeks. A second course of therapy is carried out after 2 weeks.

Release form

Solution for intravenous and intramuscular administration 125 mg/ml. 2 ml in brown glass ampoules. A self-adhesive label is placed on the ampoule. 5 ampoules are placed in a blister pack made of polymer film. The contour blister packaging is heat-sealed with a cover film or left open. 1 blister pack together with instructions for medical use are placed in a cardboard box. To control the first opening, the side flaps of the package can be sealed with labels.

Cycloferon: dosage regimen for adults

For respiratory pathologies, it is recommended to take the medicine in a single dose on the 1st, 2nd, 4th, 6th, 8th day (20 tablet forms are required). Therapy should be started when the first signs of the disease appear. This will increase the effectiveness of treatment. If the disease is severe, you need to drink 900 mg on the first day of therapy, and then take a standard single dose on the remaining days. To alleviate the condition, it is recommended to use cough and fever medications along with Cycloferon.

Herpetic infection is treated according to the following scheme: single dosage on days 1, 2, 4, 6, 8, 11, 14, 17, 20, 23. For therapy you will need 40 tablet forms.

Adults can use Cycloferon to prevent respiratory diseases. It is better to check the treatment regimen with your doctor.

Cycloferon, 150 mg, enteric-coated tablets, 20 pcs.

Polisan, Russia

Price from 389₽

Cycloferon, 150 mg, enteric-coated tablets, 10 pcs.

Polisan, Russia

Price from 175₽

Cycloferon, 5%, liniment, 5 ml, 1 pc.

Polisan, Russia

Price from 174₽

There are contraindications. Specialist consultation is required.

How to take Cycloferon for HPV

The causative agent of HPV can have low or high oncogenicity (the ability to cause cancer). Weakly oncogenic microorganisms can provoke warts on the skin. Strongly oncogenic strains more often cause the formation of genital warts.

For warts, Cycloferon tablets can be used for 2 weeks. For HPV affecting the genital organs, the injection form of the drug is most often indicated. If HPV symptoms appear, you should visit a dermatologist (as well as a urologist or gynecologist if the genital organs are affected). The doctor will tell you whether you can take Cycloferon and prescribe the correct therapy. You should not treat the disease yourself.

special instructions

Before using the medication, patients with thyroid diseases should see an endocrinologist. If one single dose has been missed, it is recommended to take it as soon as possible (regardless of the interval between doses and doubling the dose). Then they drink the drug according to the scheme. If the medication does not help, it is recommended to see a doctor for examination and treatment adjustment.

The medicine does not affect concentration. During therapy, it is allowed to drive a car and operate complex machinery.

For the local form of the drug:

Do not rub too hard into the gums;
if the medication gets on the conjunctiva, you should rinse your eyes with water;
has a bitter taste.

When a medication is prohibited

The medication has absolute and relative contraindications. The absolute ones include:

period of gestation and breastfeeding;
patients under 4 years of age;
allergy to the components of the medication.
patients with liver cirrhosis in the stage of decompensation.

Relative restrictions are:

pathologies of the digestive tract (ulcerative defects and inflammation of the mucous membrane of the stomach and duodenum);
burdened allergic history (allergic diseases are present, such as urticaria, hay fever, allergic dermatitis and others).

In these conditions, therapy with Cycloferon can be started only on the recommendations of a doctor.

Which is better: Kagocel or Cycloferon?

Cycloferon and Kagocel belong to the same group of drugs. The medications differ only in the time of exposure. Cycloferon is an early inducer of interferons, Kagocel is a late inducer. Accordingly, the clinical effect when taking Cycloferon will occur earlier (4 hours after use). Both drugs stimulate the formation of their own endogenous interferons, which reduces the likelihood of allergies, in contrast to interferon drugs (Anaferon, Viferon), which have foreign antibodies for the human body.

Cycloferon is considered an effective medicine for the prevention and treatment of respiratory diseases. It can be used from 4 years of age. It is advisable to use the medication immediately after the first symptoms of the disease appear in order to quickly reduce the concentration of viral particles in the blood. Early initiation of therapy will prevent the occurrence of severe forms of viral pathologies and the development of complications.

Similar medications

Cycloferon has analogues that have a similar therapeutic effect. These include:

Kagocel is an interferon inducer;
Viferon is an antiviral medication containing interferon alpha-2b, approved for newborns and pregnant women; possible for coronavirus and influenza as part of general treatment; the effectiveness of the product is quite high;
Anaferon is an antiviral drug approved from 1 month; the medicine is less effective;
Arbidol - contains umifenovir, allowed from 3 years of age; can be used for coronavirus infection as part of the main treatment;
Amiksin - contains tilorone, is used in patients from 7 years of age

Kagocel, 12 mg, tablets, 30 pcs.

Nearmedic Plus, Russia

Price from 639₽

Anaferon for children, lozenges, 20 pcs.

MATERIA MEDICA HOLDING NPF, Russia

Price from 236₽

Arbidol, 100 mg, capsules, antiviral against influenza and ARVI, 40 pcs.

OTC Pharm, Russia

Price from 936₽

There are contraindications. Specialist consultation is required.