Advantan during pregnancy, is the hormonal drug safe?

Composition and form

The drug is produced in several forms:

• 0.1% cream. It is presented as a white opaque substance, packaged in 15 gram tubes.
• 0.1% ointment. It is a yellow-white opaque mass with a homogeneous viscous consistency. One tube contains 15 or 50 g of this ointment.
• 0.1% fatty ointment. This substance is translucent, with a white or yellowish tint. It is packaged in 15 g tubes.
• 0.1% emulsion. It is presented as an opaque white mass in tubes weighing 20 grams.

Additional substances in the cream are water, cetosteryl and benzyl alcohol, glycerol and other compounds. In addition to methylprednisolone and water, the ointment contains liquid paraffin and white wax, as well as petroleum jelly and an emulsifier.

The fatty ointment contains castor oil, paraffin (both liquid and soft) and microcrystalline wax. Auxiliary ingredients of Advantan emulsion are glycerol, medium chain triglycerides, Na edetate, water and other compounds.

Watch the video in which practicing dermatovenerologist Vyacheslav Vasilyevich Makarchuk answers popular questions regarding the use of Advantan:

Advantan is produced in the form:

• ointment 0.1% (tubes 15 g);
• cream 0.1% (tubes 5 and 15 g);
• fatty ointment 0.1% (tubes 5 and 15 g);
• cutaneous emulsion 0.1% (tubes of 10, 20 and 50 g).

Advantan ointment in the form of fatty and regular ointments of white or yellowish tints is on the list of other methylprednisolone-containing local forms of glucocorticoid agents.

Methylprednisolone is contained in Advantan in the form of aceponate salt in the ratio of 1 milligram of active substance per 1 gram of total volume. The rest of the mass is filled in different proportions with the following chemical compounds:

• white beeswax;
• emulsifier Dehimuls E;
• purified water.

In the “fatty” ointment, methylprednisolone is contained in the same concentration, the difference is in the accompanying components: white soft and liquid paraffins, microcrystalline wax, hydrogenated castor oil.

Indications for use

Indications for the use of ointments and creams include inflammatory skin pathologies that are sensitive to therapy with topical corticosteroids:

• allergic (contact) dermatitis;
• dyshidrotic eczema;
• true eczema;
• atopic dermatitis, neurodermatitis, childhood eczema;
• occupational eczema;
• simple contact dermatitis;
• microbial eczema.

Why is Advantan emulsion prescribed for external use? This form is shown when:

• photodermatitis, sunburn;
• seborrheic dermatitis or eczema;
• allergic (contact) dermatitis;
• atopic dermatitis, neurodermatitis, childhood eczema;
• true eczema;
• microbial eczema;
• simple contact dermatitis.

In accordance with the instructions, Advantan has the following contraindications for use:

• syphilis;
• intolerance to any component of the drug Advantan, from which the ointment can cause side effects;
• viral infections;
• lupus.

Do not apply the drug to large areas of skin for longer than 3 months. Pregnant women can use the drug, but with caution and under the supervision of the attending physician.

Lubrication with Advantan is most often indicated for skin diseases that are successfully treated with local glucocorticoids - dermatitis and eczema. In childhood, the drug is mainly prescribed for atopic dermatitis. This drug is also effective for severe sunburn, contact dermatitis, microbial eczema, neurodermatitis and some other skin lesions.

Advantan should not be applied to the skin if:

• Intolerance to the components of the drug.
• Tuberculous skin lesions.
• Inflammation of the skin due to syphilis.
• For chickenpox and skin lesions due to other viral diseases.
• Perioral dermatitis.
• Rosacea.
• Skin post-vaccination reactions.

Dr. Komarovsky’s opinion on the use of hormonal ointments for children, which is Advantan, see here:

Application and dosage

The medicine is intended for the treatment of patients of all age groups, starting from the age of four months. Both cream and ointments should be applied to the affected skin in a thin layer once a day.

Fatty ointment is an anhydrous dosage form of Advantan, so its use is advisable for the treatment of dermatological diseases that are chronic inflammatory in nature and exist in the patient for a long period of time. Oily ointment is most effective in patients with very dry skin.

https://www.youtube.com/watch?v=gvy8Xh4IrkM

Cream is a substance with a high water content and low fat content. The use of this dosage form is indicated for the treatment of inflammatory processes that occur in acute or subacute form and are not accompanied by pronounced weeping.

The use of the cream allows you to stop the inflammatory process, both on smooth and hairy areas of the skin, including on skin that is prone to oiliness.

For adults

The drug is available in the form of ointment, fatty ointment, cream and emulsion. The choice of the form of the drug depends on the symptoms of the dermatological disease.

The cream is used for weeping eczema and acute inflammation in patients with oily skin, as well as for application to areas of skin with hair.

The ointment is used for chronic dermatological diseases in patients with dry skin. The emulsion is used in the treatment of solar dermatitis and acute forms of atopic dermatitis or exogenous eczema.

In accordance with the instructions, Advantan is applied to the affected area once a day. For solar dermatitis, it is permissible to apply the emulsion 2 times a day. Daily use of the drug should not exceed 12 weeks for adults.

For children

In accordance with the instructions, Advantan is applied to the affected area once a day. For solar dermatitis, it is permissible to apply the emulsion 2 times a day. Daily use of the drug should not exceed 4 weeks for children.

The drug cannot be used externally in the first trimester of pregnancy, as well as other medications containing corticosteroids.

Also, do not use it during breastfeeding, that is, you cannot apply the medicine to the mammary glands or large areas of the skin for a long time.

advantan during pregnancy

I want to share my story about how I started to fight this unpleasant disease and almost defeated it.

Let me start with the fact that I started getting sick with this disease as a child. Almost from birth. The diagnosis was atopic dermatitis, atopic asthma... I remember that I spent my entire childhood in hospitals, sometimes hives, sometimes asthma, shortness of breath, terrible itching on my arms and legs... My mother didn’t treat me with anything... It was a nightmare... But thank God everything passed, and until now I forgot what allergies, scratching, blisters and pimples are... I am now 29 years old.

And so I became pregnant, now I’m 22 weeks old. It all started at the end of the 1st - beginning of the 2nd trimester. The wrists on both hands began to itch, then on the neck, above and under the eyes, around the lips, elbows, and in general in other different places. At the site of scratching, dry plaques formed, similar to dry lichen (as we call it “timiryayu”) I remember from childhood that I applied “flucinar” and “sinaflana” ointments, but they are hormonal and it is especially not recommended to apply them during pregnancy. I started to apply a thin layer, the redness seemed to go away the next day, but as soon as I scratched there, the same thing happened again.

Then I discovered two or three small pimples on my toes, they were very itchy! Of course, I combed them and literally after a couple of days all my toes were covered with these blisters and began to itch very much, the same picture was on my fingers, it was very itchy... I went to a dermatologist, diagnosed allergic dermatitis, prescribed Advantan ointment and fenistil drops and a diet - hypoallergenic. I started smearing and drinking. But the effect is zero! And there are more and more blisters... on the feet, on the palms. It was just terrible itching at night... I couldn’t sleep. There was a birthday and a new year ahead. Of course, I didn’t follow any diet, I ate everything)) Well, it’s New Year, and I’m on a diet! No)) Well, of course, after that it got even worse... I smeared it with iodine, brilliant green, Mikoseptin ointment (you never know, it might be something fungal))) soaked my feet and hands in ice water, bought a solution of Fukortsin, applied it once, but it was so pink) )) My stepfather crumpled and said that I looked like an avatar...

I read online that baths with oak bark and a string of chamomile help. I started doing baths (I did it for two days). Of course I went on a strict diet. I excluded everything allergenic, wet cleaning every day, but with gloves, since you can’t get it wet often, turned on a humidifier (I remember when I was a child, my mother used it instead, she simply heated pots of water and placed them in the room, as it helps to humidify the air and get rid of allergens flying in the air), thank God we don’t have a carpet or rug, the window is open all the time, since the room must be ventilated. And then I remembered that I hadn’t walked much for about a week... and over the holidays I had eaten so much... Most likely, the body became intoxicated. I ran to the pharmacy, bought Duphalac, made yoghurt with beneficial bacteria (by the way, I wrote a recipe in my diary before), cottage cheese, kefir, kiwi)) The result was only on the 3rd day. I decided to visit another dermatologist-allergist. She looked at my hands and prescribed Suprastin IM 1 ml in the evening - 3 days

Anti-allergenic tea 1 bag 2-3 times a day (7-10 days)

Ovesol 1 tab 2 times a day with meals (20 days)

Instead of Normobact, I bought Vivo acidolact starter, it is very useful when taking all kinds of medications and antibiotics (a lot has been said on the Internet about its beneficial effects in treatment)

Celestoderm ointment (can be used during pregnancy) 2 times a day

I wrote out a prescription for mash, which was prepared for me in the pharmacy (Anaesthesini Novocaini ana 0.5 Mentholi 1.25 Spiritus aethylici 70% 50ml Translation of anesthesin novocaine 0.5 g menthol 1.25 g ethyl alcohol 70% 50 ml) 1 ruble/day

Activated carbon 3 tablets 2 times/day 5 days

There was light at the end of the tunnel))) The swelling began to subside, the pimples began to dry out, I could already bend my fingers, the itching was almost gone. Of course, I’m still on a diet, God forbid this happens again... This is pure Hell...

And while I was reading all sorts of literature, I found that it is advisable to start following a hypoallergenic diet from the 22nd week so that the child does not develop allergies from an early age. Okay, we adults will still endure, we will survive, but how sorry I am for my child... God forbid... as I remember my torment from almost birth... I won’t wish it on anyone...

Later I will write my results on the fight against dermatitis.

Side effects

In rare cases, a child’s body may react to the application of any form of Advantan with local skin reactions - redness, blistering rash, itching or burning. Very rare side effects of treatment may include hypertrichosis, perioral skin inflammation or folliculitis. On the eye side, a side symptom of using Advantan can be glaucoma or cataracts (if you smear it with your hand and the product gets on the mucous membrane).

The drug is usually well tolerated. In isolated cases, local reactions may be observed, such as:

• itching;
• burning;
• erythema;
• bubble formation.

Very rarely - folliculitis, hypertrichosis, oral dermatitis, depigmentation, allergic reactions.

Long-term uncontrolled use of ointment in large quantities (taking into account the properties of other drugs in the group) can contribute to the development of atrophied skin at the site of application, telangiectasias, and systemic disorders, but clinical trials have not confirmed the possibility of the development of such abnormalities.

Instructions for use

The duration of the therapeutic course with Advantan is up to 11 weeks.
But during pregnancy it is significantly limited. During pregnancy, treatment rarely lasts more than a month. Throughout therapy in the 1st, 2nd, and 3rd trimesters, women are advised to undergo regular laboratory monitoring. If test results indicate negative changes in blood composition, the hormonal drug is discontinued.

Mode of application

Hormonal cream, ointment, emulsion are quickly absorbed and do not require rubbing into the skin. They are spread in a thin layer or used in combination with occlusive dressings. To do this, the products are evenly distributed on a sterile napkin and applied to the damaged skin. The bandage is fixed with a bandage or adhesive tape. Advantan in the 1st, 2nd, 3rd trimesters of pregnancy in the form of dressings is used only as prescribed by a doctor. This treatment method is used to maximize the absorption of ingredients. In the third trimester, occlusive dressings with hormones are prescribed in exceptional cases.

Side effects and special instructions

Pregnancy medications are good at helping to cope with rashes caused by an allergic reaction. But Advantan ointments and cream themselves can provoke local side effects. These include rash, itching, burning, redness and swelling.

If any allergy symptom is detected, the ointment, cream, emulsion is replaced with other means.

Without exception, all hormonal drugs are characterized by a withdrawal syndrome. If the patient stops using the drug, the clinical manifestations of the pathology return. Treatment should end with a gradual reduction in daily doses.

Overdose

It is likely that with excessive frequency and volume of use, atrophic changes in the skin areas may develop. In this case, it is recommended to stop using the ointment.

Studies have shown that a single use of Advantan in a larger dosage (lubricating a large area of ​​skin) or accidental ingestion of the drug does not have a toxic effect. If you use Advantan for longer than the recommended period (four weeks in children) or constantly lubricate the skin too much, this can cause thinning of the skin, the formation of stretch marks or the appearance of dilated small vessels. To treat such problems, the drug is discontinued.

special instructions

Use is recommended after a conversation with a dermatologist. If there is concomitant fungal infection of the skin and nails, combine the use of Advantana cream with antifungal agents.

Protect the eye mucosa as much as possible from possible contact with the drug. When applied in large quantities to the area around the eyes, the possible development of glaucoma cannot be ruled out.

The ointment is contraindicated for use in children under 4 months. For older children, the recommended period for using Advantan is no more than 4 weeks.

Advantan can be used during pregnancy and lactation after consulting a doctor and assessing the risks of use. Applying ointment to the breast area while breastfeeding is contraindicated.

Advantan is not recommended for use with other topical medications.

Storage conditions

The ointment is stored in places with temperatures up to 25 degrees Celsius for no longer than 3 years. The form of the fatty ointment is less demanding; with a shelf life of up to 5 years, the storage temperature is up to 30 degrees.

Contraindications

Absolute obstacles to treatment with ointments based on methylprednisolone aceponate:

• open or closed forms of tuberculosis;
• acute viral diseases with skin manifestations (for example, chickenpox, herpes zoster);
• rosacea or syphilitic rashes at the site of use;
• hypersensitivity to the composition of the drug;
• infants up to 4 months.

Advantan ointment should not be used on mucous membranes. Before each application, the skin area should be washed in running water and dried. The dosage should be strictly observed and not exceed the course of therapy.

How long can it be used?

The drug acts predominantly locally, and even with repeated treatment of large areas or application of an occlusive dressing to lubricated skin, it does not disrupt the functioning of the adrenal glands.

That is why the instructions for use for children of such forms of the drug limit the time of continuous use of the product to 4 weeks. As for the emulsion, it can be applied daily to the affected skin for no longer than two weeks in a row. In addition, emulsion-treated skin should not be covered with a bandage (remember that in infants, a diaper is considered an option for such a bandage).

Analogs

If for some reason it is impossible to use Advantan, you can use other hormonal ointments instead of this drug. These may be the following Advantan substitutes:

• Akriderm. This medicine containing betamethasone is available in the form of an ointment or cream and is prescribed from 1 year of age.
• Beloderm. The active ingredient in this product is also betamethasone. In pediatrics, Beloderm cream or ointment is used from 6 months of age.

• Elokom. This cream containing mometasone is used from 2 years of age. The drug is also available in the form of lotion or ointment.
• Momat. The basis of this cream or ointment is also the substance mometasone. The product is used at the age of 2 years and older.

• Synoderm. This drug, containing fluocinolone acetonide, can be prescribed in infancy under the supervision of a physician. The medicine is presented as ointment, gel and cream.
• Cutivate. The active substance in this product is fluticasone. The ointment can be used from 6 months of age, and the cream is prescribed after a year.
• Lokoid. This ointment containing hydrocortisone is allowed to be used in children from six months of age.

If a mother prefers to get rid of her child’s allergies with non-hormonal medications, she can be advised to use Elidel cream (allowed from 3 months), Desitin ointment (safe for infants), Pantoderm ointment (used from birth), Protopic ointment 0.03% (prescribed to children over 2 years), Sudocrem (allowed at any age) and similar products.

There are no complete analogues of Advantan ointment, because Methylprednisolone in the form of aceponate salt is available only in Advantan.

Methylprednisolone drugs contain:

• Urbazon;
• Medrol;
• Depo-Medrol;
• Lemod;
• Solu-Medrol;
• Metipred.

Pharmacological activity

Advantan cream and ointment provide a complex of therapeutic effects for allergies:

• relieving inflammation;
• relief of allergic reactions;
• constriction of blood vessels in inflamed tissues;
• aneticexudative effect (decongestant);
• eliminating itching.

When using topical ointment, cream or suspension based on methylprednisolone, there is no systemic effect. With proper course use, the concentration of the drug eliminates overdose, but if you exceed the recommended volume and frequency of applications, negative reactions are possible.

Pharmacokinetics

The active substance accumulates in the epidermis and dermis. The level of absorption is determined by the form used and method of application (bandage, thin layer application). Creams and ointments are characterized by a higher penetrating ability - 2.1-2.7%, for suspensions the figure is lower - 0.28-0.59%.

The main metabolite of drug metabolism in the body is 6α-methylprednisolone-17-propionate. The compound interacts with corticosteroid receptors in the skin and has natural bioactivation. Thanks to this, it is possible to quickly neutralize the effect of allergens.

Excretion from the body

6α-methylprednisolone-17-propionate is deposited with glucuronic acid, forms glucuronide propionate and thus loses its activity. Metabolic compounds are eliminated by the kidneys after 16 hours. Methylprednisolone does not accumulate in the body, it does not have an addiction/withdrawal syndrome.

Ointment or cream - which is better?

To decide on the appropriate Advantan option, you should know about the following features of the different forms of this medicine:

• The cream contains more water and less fat, so this form is recommended for acute inflammation of the skin, as well as for weeping rashes. This Advantan is used for oily skin. In addition, the cream can be applied to the scalp. If the product causes severe drying of the skin, it is abandoned in favor of an ointment.
• The ointment has a slightly higher amount of fat and a reduced water content. This Advantan is preferable for infiltrates and inflammations in which the rash is not weeping. After applying the ointment, the skin becomes a little oily, but moisture and heat are not retained.
• There is no water in the fatty ointment at all, so the level of fat is the highest among all types of Advantan. This drug is indicated for chronic skin diseases. It is chosen if the affected surface is too dry.
• The emulsion can be used for any skin disease, but this form is most often chosen for sunburn and contact dermatitis.

What kind of drug is Advantan?

Advantan is a cutaneous ointment prescribed for pathological conditions of the skin. The main active ingredient is the corticosteroid methylprednesalone, that is, a hormonal ointment. It is highly effective, has a small number of contraindications and side effects, and helps well with severe systemic inflammation without disrupting the function of the adrenal cortex even with long-term use of large dosages.

The ointment has a homogeneous structure, color from white to light yellow, and a mild medicinal odor. Easy to apply, quickly absorbed, leaving virtually no traces on clothing (if the product is allowed to absorb well).

Reviews

There are mostly good reviews about Advantan and its use for children. Parents who have used this medicine for diathesis, in most cases confirm the effectiveness of the medicine. Mothers note that when an allergic rash is lubricated with Advantan, the pain, irritation and redness go away quickly enough, and the itching stops tormenting the child. The main disadvantage of Advantan for many parents is its fairly high price. For this reason, some mothers choose inexpensive analogues.

Dr. Komarovsky considers Advantan one of the most effective drugs used for diathesis in children. He emphasizes that the product is modern, so it is almost not absorbed through the skin and only acts at the site of application. At the same time, the popular doctor emphasizes that hormonal creams only help get rid of external symptoms and do not eliminate the cause of the allergy.

Watch the episode of the famous doctor’s program dedicated to the treatment of diathesis in children here:

Reviews about Advantan cream, as well as ointments, are quite contradictory: some call these products a salvation for skin prone to inflammatory and allergic diseases, others not only do not see an improvement in the condition, but, on the contrary, believe that the use of the drug only aggravated the course of the disease.

In reviews of Advantan cream for children, many mothers write that the drug quickly copes with itching and unpleasant skin rashes, but in order to consolidate the result and prevent relapses, it is necessary not only to undergo a course of treatment, but also to review the diet and eliminate all possible allergens.

Some patients indicate that the drug helps improve the condition of the skin with psoriasis.