Instillagel 0,12 g - 0,0031 g gel pre-filled syr. 10 x 6 ml

Instillagel 6ml 10 amww

Indications:

catheterisations and urethral / vesicale probing, urethral expulsions, urethroscopieën endoscopies and all kinds even in the operating room, and everywhere renewal fistelsonden elsewhere where they might need a lubricant, which local anesthetic properties (gynécologie, surgery, anesthesia, pediatrics).

Composition:

6 ml: Lidocaini hydrochloridum. 0.12 g - 0.0031 g Chlorhexidini gluconas - Hydroxyethylcellulosum - Methylis parahydroxybenzoas - Propylis parahydroxybenzoas - Propylenglycolum - Aqua ad purificata 6 ml.
11 ml: Lidocaini hydrochloridum 0.23 g - 0.0057 g Chlorhexidini gluconas - Hydroxyethylcellulosum - Methylis parahydroxybenzoas - Propylis parahydroxybenzoas - Propylenglycolum - purificata Aqua ad 11 ml.

Posology and method of use:

a.) and urethral sounding vesicale: instilling 6 to 11 ml.
Advance acorn uretheropening usual way and disinfection, instilling Instillagel in urether, press for a few minutes the glans between thumb and forefinger to force the anesthesische occurs.
Any blockages occurring small probes can be removed by a slight pressure on the abdomen as urineafvloeiïng caused when the bladder is filled, or by instillation of a few milliliters of sterile physiological solution by means of a syringe.
b) and cystoscopy Uretroscopie: tools for easy and painless to make, the whole urether and the sphincter externus geanesthesieerd and covered with a glijgel.
trade as mentioned above.
transurethral for endoscopies and in pediatric urology are 6 to 11 ml Instillagel suffice. In adults, instilling 11 ml.
Penis at very long and very sensitive patients is recommended additional 6 to 11 ml Instillagel instilling. It puts a soft penis clamp at the base of the glans for several minutes. The full anesthetic effect after approximately 3 to 5 minutes.
When performing a progressive uretroscopie can clearly see how the sphincter externus geanesthesieerde simultaneously opens, but only by the pressure of the water.

This is a medicine, no prolonged use without medical advice, keep away from children, read the leaflet carefully. Ask your doctor or pharmacist. In case of side effects, contact your doctor.

Contraindications:

Local anesthetics will only very cautiously used in patients with epilepsy, with reduced blood flow or heart suffering from respiratory disorders, as well as liver disease, patients with a low pseudo-cholinesterase levels, they can be very dangerous for patients with myasthenia gravis.
Since lidocaine is also internally as antiarythmicum, although not in the form of Instillagel will caution essentially no cumulative dose should be administered.
Hypersensitivity to local anesthetics of the amide.
Hypersensitivity to any component.

Special precautions:

Instillagel is intended only for the stated indications and may in no circumstances intra-vascular or intramuscular injection. The outcome could be fatal.
We will address both the risk and caution in patients with epilepsy, impaired cardiac function or with liver function and also those with respiratory disorders.
When using severe injuries of the urethra or the bladder are found eg, The physician will consider the risk, taking into account the necessity to go on sounding.
acute side effects occur when symptomatic they will proceed, and such blood pressure reduction by intravenous administration of combat isoprenaline, bradycardia by intravenous administration of atropine and cramps with small doses of rapid-acting barbiturate, hyperventilation and administration of oxygen may also be necessary.

Pregnancy and lactation:

Pregnancy.
It is known that lidocaine passes through the placental barrier, especially in premature infants than does the slower degradation of the mother.
We will use during pregnancy minimizing unless urgent indication. There appears to be no risk to human life for teratogenicity niettengenstaande were least frequent use of lidocaine in dentistry as intravenous injection and no cases described in current textbooks.
Lactation. There
lidocaine also may diffuse into breast milk is the same as for pregnancy advice: Avoid unless urgent indication. For occasional use of Instillagel will be during the first 24 hours the milk drain (not used) and the other infant breast feeding.
Since course in the application of Instillagel difficult to determine what quantity is absorbed lidocaine was not be possible to provide concentrations in breast milk.
Instillagel Should it be used during lactation, without anyone to temporarily 'weaning' of the infant would have gone, we will pay particular attention to respiratory and cardiac function and if necessary the necessary measures.
It will include the advice of the 'Overdose' in mind.

Undesirable effects:

Instillagel is generally well tolerated, side effects for a contributory factor is the existence of a serious illness or injury of the urethra to urethral sounding.
When urethral injury can, given the strong absorption rapidly toxic plasma levels are reached.
The risk with which, in addition, special consideration should be taken, patients with epilepsy, a heart or liver problems and those suffering with myasthenia gravis, patients with respiratory acidosis and extremely sensitive individuals.
Hypotension seems to be the main side effect. Other possible side effects: bradycardia, cramps, headache, nervositas, vertigo, tinnitus, nausea, tremor, seizures and even respiratory arrest, cardiovascular collapse and cardiac arrest.

Driving and vehicles using machines:

Since lidocaine may cause drowsiness and dizziness, it is advisable, if the condition of the patient permits it to wait a reasonable time before the commencement of this work beginning.
The use of alcohol should be fully advised in the first 24 hours.

Overdose:

In normal use (the doctor), the 'overdose' a result of increased individual sensitivity, either because of larger and faster resorption such a serious disease of the urethral intra-urethral use.
For accidental ingestion, instance by children, we will try as soon as possible to carry out gastric lavage, the begetting of vomiting will indeed difficult, if not impossible because of the local anesthesia of the esophagus and stomach.
Hospitalization is urgent, hyperventilation by administration of oxygen during transport is appropriate.
Subsequent measures will the situation appropriate, especially where one first heart operation, blood pressure and breathing will think.
Symptoms of poisoning include:
at cardiovascular level, cardiovascular collapse and cardiac arrest.
at central level: headache, nervositas, vertigo, tinnitus, nausea, tremor, seizures and even respiratory arrest.
Blood Pressure Reduction may be contested by isoprenaline (intravenous), bradycardia with atropine (intravenous) and cramps with fast-acting barbiturates.

Interactions:

Adverse interactions may occur with procainamide (hallucinations or delirium), with phenytoin (toxicity to the central nervous system), with beta blockers (delayed plasma clearance of lidocaine), with antiarrhythmic drugs in the meaning of tocaïnamide with digitalis preparations and cimetidine.

Incompatibilities:

Instillagel will be used pure, without admixture of any other drugs.