Place of the drug Imudon in the pharmacotherapy of diseases of the maxillofacial area

Composition and release form

8 pcs in blister; There are 5 blisters in a cardboard box.

Indications for the drug Imudon®

Treatment and/or prevention:

superficial and deep periodontal disease, periodontitis, stomatitis, glossitis, aphthous stomatitis;

inflammatory and infectious diseases of the oral cavity and pharynx;

erythematous and ulcerative gingivitis;

dysbacteriosis of the oral cavity;

pharyngitis;

chronic tonsillitis;

ulcerations caused by dentures;

infections after tooth extraction, implantation of artificial dental roots;

preoperative preparation for tonsillectomy;

postoperative period after tonsillectomy.

Reviews of Imudon tablets

Parents leave positive reviews about the medication:

• the medicine quickly helps with sore throat, stomatitis;
• when using the medication, oral diseases disappear in 3 days, not in a week;
• it tastes good.

But there are also negative reviews about the medication:

• the medicine is expensive;
• may be allergic to Imudon;
• the medication needs to be dissolved every 2 hours, which is not very convenient and you have to set an alarm so as not to forget about taking the medication;
• Not every child can dissolve the drug; it is difficult to explain to some children so that they do not chew the tablets or swallow them.

Directions for use and doses

Inside.

Adults and teenagers over 14 years old

For acute inflammatory diseases of the oral cavity and pharynx and exacerbation of chronic diseases: - 8 tables. in a day. The tablets are dissolved (without chewing) in the mouth at intervals of 1 hour. The average duration of treatment is 10 days.

For the prevention of chronic inflammatory diseases of the oral cavity and pharynx: 6 tablets. in a day. The tablets are dissolved (without chewing) in the oral cavity at intervals of 2 hours. The course duration is 20 days.

Children from 3 to 14 years old

In the treatment of acute and exacerbation of chronic inflammatory diseases of the oral cavity and pharynx, as well as for prevention: 6 tablets. in a day. The tablets are dissolved (without chewing) in the oral cavity at intervals of 2 hours. The duration of treatment for acute diseases is 10 days, for the prevention of chronic diseases - 20 days.

It is recommended to carry out preventive courses of taking Imudon® 3-4 times a year.

Place of the drug Imudon in the pharmacotherapy of diseases of the maxillofacial area

Zoryan E. V.

Candidate of Medical Sciences, Associate Professor, Department of Pharmacology, Moscow State Medical University

The oral cavity is the initial section of the digestive tract, which involves a high risk of traumatic injuries, and the universal protective reactions to any damaging influence are inflammatory reactions. That is why inflammation plays an important role in the pathogenesis of most diseases of the maxillofacial area. The oral mucosa in healthy people plays an important protective role, maintaining a balance between the oral microflora and the body's defenses. In turn, the symbiosis that has developed between the non-pathogenic and pathogenic flora of the oral cavity serves as a biological barrier, restraining each other’s growth due to antagonistic properties and preventing the entry of more pathogenic, aggressive flora into the body.

Disruption of this balance also contributes to the intensive growth and reproduction of microorganisms, including pathogenic ones, and the development of inflammation, including purulent inflammation. In this regard, in dental practice, along with local and resorptive anti-inflammatory drugs (astringents, enzyme preparations, dimexide, heparin ointment, steroidal and non-steroidal anti-inflammatory drugs, vitamins, calcium salts, etc.), antibacterial drugs are widely used ( antiseptics, antibiotics, synthetic chemotherapeutic agents).

The specificity of the pharmacological regulation of inflammatory processes is determined by their etiology, features of pathogenesis and the presence of concomitant pathology in the patient. The daily appearance of new anti-inflammatory drugs on the pharmaceutical market indicates that the problem of pharmacotherapy of inflammatory processes, including the oral cavity, is still relevant. Physicians and patients are increasingly concerned about the significant increase in complications caused by anti-inflammatory and antibacterial drugs.

The oral mucosa maintains a certain balance of microflora and participates in the creation of specific local immunity of the oral cavity. The use of antibacterial anti-inflammatory drugs changes the ratio between individual strains of microorganisms, reduces not only the immunobiological reactivity of the body as a whole, but also local immunity, weakens the reaction to the introduction of an infectious agent, promotes intensive growth and reproduction of microorganisms, including potentially pathogenic ones, progression of the pathological process, development of degenerative changes in tissues.

Therefore, among the complications caused by these drugs are stomatitis, gingivitis, glossitis, cheilitis, lichenoid rashes, clinically indistinguishable from lichen planus, etc. Moreover, in recent years there has been a significant increase in chronic diseases of the maxillofacial region, the persistence and recurrent nature of which indicates the need to find new approaches to the treatment of inflammatory processes in the oral cavity.

One of the promising areas that increases the effectiveness of therapy, allowing for the prevention of many diseases, including inflammatory diseases, and their relapses, is the use of drugs with immunocorrective properties. Traditionally used immunostimulants (levamisole, prodigiosan, T-activin, etc.) have a greater effect on general immunity and when using them, the patient’s initial immune status should be taken into account and, if necessary, consult with immunologists. In this regard, immunostimulants of biological origin are of interest. Among the drugs that stimulate immune processes and specifically activate immunocompetent cells (T- and B-lymphocytes) and additional immune factors (macrophages, secretory immune globulins, etc.), microbial immunomodulators are distinguished origin, containing lipopolysaccharide complexes (prodigiosan and pyrogenal), bacterial ribosomes in combination with membrane proteoglycans (ribomunil) and lysates of infectious agents (IRS19 and bronchomunal).

The drug Imudon was created especially for dental practice, which contains a mixture of purified lysates of bacteria and fungi, which most often initiate pathological processes in the oral cavity.

Experimental studies have shown that bacterial lysates of the drug Imudon have antigenic properties. The drug in vitro stimulates the mitosis of lymphocytes, the production of lymphocyte-activating factor by peripheral blood monocytes, reduces the ability of stimulated polymorphonuclear neutrophils to release toxic radicals into the intercellular space, and has a chemotactic effect on polymorphonuclear neutrophils and monocytes. Further study showed that in vivo Imudon:

• increases salivation;
• significantly increases the level of secretory immunoglobulins A in salivary fluid;
• promotes the formation after immunization of specific antibodies to bacteria that play an important role in the development of gingivitis;
• increases the content of lysozyme in salivary fluid;
• stimulates cells of the reticuloendothelial system (RES);
• has an antibacterial effect on animals infected with Escherichia coli and Streptococcus pyogenes group A;
• in low doses, it corrects disorders of oxidative metabolism and local suppression of the immune system; in high doses, it reduces the rate of oxidative metabolism of polymorphonuclear neutrophils, reducing pain and inflammation.

Being a local drug, Imudon does not enter the bloodstream and does not affect metabolism.

All this made it possible to recommend Imudon for testing in dental practice. The drug was used for gingivitis, periodontitis, stomatitis, herpes and other diseases of the oral mucosa, as well as in surgical practice for preoperative preparation of patients and in complex therapy of postoperative complications. When taking the drug, Imudon tablets were kept in the mouth until completely dissolved, without chewing.

Admission courses:

In acute conditions, the drug was recommended to take up to 10 tablets per day with an average duration of up to 10 days.

For chronic diseases - up to 6 tablets per day for 10 - 20 days, depending on the severity of the disease.

For the prevention and treatment of postoperative complications - for one week before and after surgery, 8-10 tablets per day.

Repeated courses are possible, but not more often than 2-3 times a year.

Clinical studies have shown that treatment with Imudon

• sharply reduces gum bleeding and periodontal index in gingivitis and periodontitis,
• significantly reduces the cellular infiltration of plasma cells and lymphocytes through the gum mucosa,
• reduces plaque index and gingival index,
• significantly reduces inflammation and reduces the inflammatory index (Daniel A., 1981, Chaigau.J-P. 1968, Chambas ZN1974, etc.).

However, the use of the drug does not eliminate the need to carry out routine periodontal treatment (removal of plaque, careful removal of dental plaque and teaching the patient proper oral hygiene).

Imudon has a therapeutic effect and prevents the development of relapses, which is due to the immunostimulating effect of the drug on the defenses of the oral mucosa and increased local immunity.

Most authors note very good tolerability of Imudon during a long course of treatment (up to 4 weeks), including pregnant women and children (Fouques R., 1975; Deffez J.-P. et al, 1985). During the entire period of use of the drug, not a single complication was recorded. Nausea and gastralgia were observed extremely rarely.

The results obtained in experimental and clinical studies allowed us to recommend the use of Imudon as a drug:

• increasing local immunity of the oral cavity in acute and chronic inflammatory diseases of the oral mucosa
• as monotherapy for the treatment of catarrhal inflammatory processes, aphthae and ulcerations caused by dentures;
• for preoperative preparation of the patient;
• for purulent-inflammatory, fungal and herpetic lesions of the oral cavity as part of complex therapy.
• in severe purulent-inflammatory processes, combine its use with antibacterial therapy.

The immunostimulating effect of Imudon allows:

• increase the effectiveness of therapy,
• reduce the possibility of relapse of the disease,
• prevent the development of superinfection when treating severe purulent-inflammatory processes in the oral cavity with antibacterial drugs.

Observed by Benque E.-R. et al (1977) a significant reduction in gingival inflammation in healthy volunteers who did not perform oral hygiene for 10 days but used 10 tablets per day of Imudon, compared with a placebo control group, suggests that the drug can be used for prevention of the development of gingivitis in cases where oral hygiene is difficult, for example, during orthodontic treatment.

The article was published on the website https://www.medafarm.ru

special instructions

Children from 3 to 6 years old must dissolve tablets in the mouth under the supervision of an adult!

If necessary, you can rinse your mouth no earlier than 1 hour after administration (so as not to reduce the therapeutic activity of the drug). When prescribing the drug to patients on a salt-free or low-salt diet, it is necessary to take into account that 1 table. Imudon® contains 15 mg sodium.

There is no data indicating the need for any restrictions on activities related to driving a car or other machinery during the treatment period.

Adverse reactions

The medication is usually well tolerated, but sometimes Imudon can cause adverse reactions:

• allergies, manifested by rash, nettle fever, Quincke's edema;
• nausea, vomiting, abdominal pain;
• decreased platelet levels;
• fever;
• cough;
• inflammation of small vessels of the skin with the formation of nodes;
• rheumatic purpura;
• attacks of bronchial asthma.

There have been no recorded cases of drug overdose.