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Caripazim® - Turkmenistan

Caripazim® - Turkmenistan

A complex of proteolytic enzymes of plant origin, obtained from the milk-juice of the immature fruits of the melon tree (papaya). The active components of the drug are: papain, chymopapain A, chymopapain B, peptidases A and B, as well as the mucolytic enzyme lysozyme.

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Instructions for use

CARIPAZIM

Trade name:  Caripazim

International non-patented name:-

Dosage form:

Lyophilized powder 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:

Proteolytic agent of plant origin.

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.

In case of third-degree burns, it helps to accelerate the rejection of scabs and to cleanse granulating wounds from the remnants of purulent-necrotic tissues.

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

Diseases of the nervous system, including:

- cerebral (including optochiasmal) and spinal arachnoiditis

- neuritis of the facial nerve

Diseases of the mouth, salivary glands and jaws, including:

- chronic periodontitis, pulpitis, gingivitis

- periodontal disease, aphthous and ulcerative necrotizing stomatitis

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 distilled water 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 strip is 10x15, 15x20 cm.

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.

Simultaneous infut of caripazim and lithium chloride (3% solution) by electrophoresis is also possible. In this variant the drugs are placed on the same diapers, but the preparations must be soaked in filter papers separately. The input conditions are the same, but lithium should not be used under Voltaren treatment.

 II. Caripazim electrophoresis in keloid scars area:

A) Caripazim directly on scars (+)

Euphyllin or potassium iodide on the anti-surface e.g. Transversely (-);

B) Caripazim directly on scars (+)

Euphyllin - 15-20 cm away from the first layer (-).

III.  Caripazim electrophoresis in some forms of facial neuritis:

    Power strength from 1 to 5 milliamperes.

    Caripazim in the form of a Berganie face mask (+)

    Euphyllin in the intercostal area or opposite shoulder (-).

IV. Caripazim electrophoresis for the treatment of cerebral arachnoiditis (including optochemical):

Caripazim endonasally (+)

Euphyllin in the upper part of the thoracic spine (-).

In stomatology - Caripazim is applied to wash tooth root channels with Caripazim solution. Contents of a bottle is dissolved in 5-10 ml distilled water or physiological solution. For the treatment of chronic Periodontitis washing tooth root channels and in-channel electrophoresis is applied (3-5 sessions) with 1-2% Caripazim solution and wetted tampon is left for 3-4 days. For the treatment of Gingivitis, Paradontosis, traumatic erosion and ulcers Caripazim application is applied for 15-20 minutes (4-10 procedures).

The Medication is used for in-patient and out-patient treatment.

Side effects :

Allergic reactions

Contraindications:

- acute inflammatory processes in tissues

- sequestration of disc herniation and foramenal arrangement of sequestration

- children's age up to 15 years

Interaction with other medicinal products:

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

Special instructions

Pregnancy and lactation

The drug is not absorbed and does not have a systemic effect during pregnancy and lactation.

The peculiarities of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms are not affected.

The drug should not be used after the expiration date and should be kept out of the reach of children.

No overdose has been identified

Release form

Vials of 350 PE

Storage instructions:

Store temperatures from + 2 ° C to + 8 ° C. Store in a dry, dark place

Shelf life:

2 years.

Mode of dispensing:

Dispensed 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