CARIPAZIM

Trade name:  Caripazim

International non-patented name:-

Dosage form:

Lyophilized powder for solution for external use 350 pe

Composition

Each bottle contains:

Enzymes obtained from dried milk juice of Papaya (Melon tree - Carica papaya L., Papaev family - Caricaceae), with a total proteolytic activity of 350 PE.

Active ingredients: papain, chymopapain A, chymopapain B, peptidase A and B, mucolytic enzyme - lysozyme.

Description:

White-yellowish lyophilized powder or porous mass with a faint specific odor.

Pharmacotherapeutic group:

Preparations for the treatment of wounds and ulcers. Enzyme preparations.

ATC code: [D03B]

Pharmacological features:

External proteolytic agent. It removes necrotic tissues and  viscous secretion, dilutes exudates and  blood clots. Similar in action to chymotripsin and trypsin.

Pharmacokinetics

When applied externally, the drug is not absorbed and does not have a systemic effect on the body. With electrophoretic injection, Karipazim selectively accumulates in the area of the affected intervertebral discs. The enzymes that make up Karipazim are destroyed and completely biotransformed in the liver.

Pharmacodynamics:

Karipazim belongs to proteolytic compounds of plant origin. The properties of the drug are due to the activity of three proteolytic enzymes: papain, chymopapain and proteinase, as well as the mucolytic enzyme lysozyme, containing sulfhydryl groups in active centers.

Caripazim penetrates the tissues and creates a depot in the area of the affected intervertebral discs, has a local effect on the connective tissue, including the tissue of the disc itself and hernial protrusion. The drug causes an increased secretion of collagen protein, which leads to moderate scarring of the reticular fibrous membrane of the disc. Preservation of the biosynthesis of chondroitin sulfates by part of the disc cells increases the trophic role of the nucleus pulposus and restores the disc turgor, making it more elastic.

In addition to proteolytic activity, the enzymes that make up the drug also have a pronounced anti-edema and anti-inflammatory effect. They improve blood circulation, stimulate phagocytosis, inhibit hyaluronidase activity and enhance tissue regeneration.

Therapeutic indications:

Diseases of the musculoskeletal system and connective tissue, including:

- osteocondritis of the spine

- various forms of herniated intervertebral discs

- discogenic radiculitis, Schmorl's hernia

- post-traumatic flexion contractures of the fingers

- keloid scars of various origins

- arthrosis-arthritis of large joints

- humeral-scapular periarthritis

- burns

Dosage and Directions for use:

Caripazim is administered locally in the treatment of burn wound infections, as solutions with concentrations 17.5PU/ml, 35 PU/ml, 70 PU/ml depending upon scab thickness. Solution is to be prepared immediately before usage, dissolved in 0.5% aqueous solution of novocaine or natrium chloride isotonic solution. To obtain a concentration of 17.5 PU / ml, it is necessary to add 20 ml of solvent to the Karipazim bottle, to obtain a concentration of 35 PU / ml, add 10 ml of solvent to the Karipazim bottle, and to obtain a concentration of 70 PU / ml, add 5 ml of solvent to the Karipazim bottle.  Absorbent paper wetted with the said solution is put on the burn surface area, and then covered by moistureproof bandage. Simultaneously solution is applied to 30% of the body area. Bandage is changed daily or twice a day, removing loose distal necrotic tissues. Treatment cours lasts for 4-12 days.

With the above pathology of the musculoskeletal system, keloid scars. Karipazim is administered by electrophoretic method.

* Use of caripazim by electrophoresis method

By electrophoresis, caripazim is injected only from the positive pole.

I. Caripazim electrophoresis in cases of osteochondrosis and discogenic sciatica in the spine:

Treatment is course - 3 courses (1 course 20-30 procedures). A 1-2 day break between procedures is allowed. Repeat courses after 30-60 days.

Karipazim 1 or 0.5 vial is diluted in 5-10 ml of physiological solution immediately before the procedure. Add 1-2 drops of Dimexide to the solution. The solution is applied to filter paper placed on the electrode pads. The size of the pad is 10x15.15x20cm. Apply 3-5 ml of 2.4% aminofolin (zuphilin) solution on the negative electrode pad.

Diaper layout options:

Along:

A) Caripazim in the neck area (+)

Euphyllin in the waist area (-)

B) Caripazim in the neck area (+)

Euphyllin in the shoulder area (-)

C) Caripazim in the neck area (+)

Euphyllin with double-sided electrode on both shoulder (-)

D) caripazim in the waist area (+)

Euphyllin at the point of exit of the sciatic nerve (-)

(Posterior surface of thigh)

E) Caripazim in the waist area  (+)

Euphyllin with double-sided electrode in the thigh area  (-)

Transversely:

F) Caripazim in the waist area  (+)

Euphyllin in the abdomen (-).

Diaper temperature 37-39 ° C (checked with water thermometer). Power output is 10-15 mA (should be increased gradually).

Exposure time from 10 to 20 minutes (should be increased gradually). Adherence to the given parameters is essential; Otherwise the effectiveness of the drug is sharply reduced. After the procedure, the skin at the injection site should be rinsed with warm soapy water. A variant of the combined administration of Karipazim with lithium chloride (in the form of a 3% solution) is possible. The medicines are placed on one pad, but on different filter papers. The conditions of administration are the same, however, lithium treatment should not be combined with the use of Voltaren.

II. Electrophoresis of Karipazim on the area of ​​keloid scars:

                          a) Karipazim directly on the scar (+)

                             Euphyllin or potassium iodide on the opposite

                             surface, i.e. transversely (-)

                          b) Karipazim directly on the scar (+)

                              Euphyllin longitudinally at a distance of 15-20 cm from the 1st

                             pads (-)

The drug is used on an inpatient or outpatient basis.

Side effects and Special precautions:

Caripazim may cause an allergic reaction,  

Contraindications

Sequestration and foramel location of the hernia - with this variant of the course of the disease, the use of caripazim is ineffective; significant displacement of the vertebrae (listeza), the use of caripazim for listeza can cause additional destabilization in the segment,oncological diseases in the pelvic area; pregnancy; acute viral diseases; children under 15 years of age.

Relative contraindications for the use of caripazim are unbearable pain, gross persistent disturbances in sensitivity, a decrease in muscle strength or plegia in the innervation zone of the affected segment, dysfunctions of the pelvic organs in the absence of the effect of conservative therapy.

Interaction with other medicinal products:

Interaction of clinical significance with other medicinal products has not been established

Special instructions:

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms Does not affect.

No overdose has been identified

Release form:

Bottles No. 1 of 350 PE

Storage instructions:

Store at a dry place at +2 + 8°C; protect from light.

Shelf life:

2 years

Mode of dispensing:

With a prescription

 Manufacturer:

LEPL TSMU Iovel Kutateladze Institute of Pharmacochemistry

Address: Georgia, Tbilisi 0159, p. Sarajishvili st. №36

Phone: 253-14-94, 252-19-04

Email: ikip@tsmu.edu

Website:  www.ikip.tsmu.edu