Generic drug of the therapeutic class: Anti-inflammatories
Active ingredients: Cortivazol
laboratory: Sanofi-Aventis France
Box of 1 pre-filled syringe of 1.5 ml
These are those of local corticosteroid therapy, when the condition justifies a high local concentration. Any local injection prescription must be aware of the danger of infection, particularly the risk of promoting bacterial growth.
This product is indicated in rheumatological conditions:
- Intra-articular injection: inflammatory arthritis, osteoarthritis in thrust.
- periarticular injection: tendonitis, bursitis.
- Injection of the soft parts: talalgia, carpal tunnel syndrome, Dupuytren's disease.
- epidural injection: radiculalgia.
Dosage ALTIM 3.75 mg / 1.5 mL Suspension for injection Box of 1 pre-filled syringe of 1.5 ml
- Anti-inflammatory equivalence (equipotence) for 5 mg of prednisone = 0.3 mg of cortivazol.
- The dosage usually used is 0.5 to 1.5 ml depending on the location, injection intra-articular, peri-articular, or epidural, single or renewed (usually at intervals of 1 to 3 weeks).
- Note :
Do not use more than 1.5 ml per session, regardless of the number of joints infiltrated.
- It is useless:
. to do more than 2 injections in the first week,
. to practice series of more than 4 injections.
- The injection will be repeated only in case of reappearance or persistence of symptoms.
- This specialty is not suitable for inhaled administration by nebulizer.
- This medicine is contraindicated in the following situations:
. Hyper-sensitivity to one of the compounds,
. local or general infection, or suspicion of infection,
. Severe coagulation disorders, ongoing anticoagulant therapy,
- Do not inject in intratendinous.
- This medicine contains benzyl alcohol that can induce toxic reactions in infants and children under 3 years of age.
- Epidural injection in patients with severe coagulation disorders or those treated with anticoagulants, ticlopidine, clopidogrel, other antiplatelet agents or antithrombotic agents.NOT RECOMMENDED :
Concomitant use of cortivazol with sultopride or live attenuated vaccines is not recommended (see section interactions).
Altim side effects
The systemic adverse effects of glucocorticoids have a low risk of occurrence after local administration, given the low blood levels but the risk of hypercorticism (retention of water and sodium, imbalance of diabetes and hypertension ...) increases with dose and frequency of injections.
- Risk of local infection (depending on the injection site): arthritis, meningitis.
- Localized atrophy of muscle, subcutaneous and cutaneous tissues. Risk of tendon rupture when injected into the tendons.
- Some cases of tendon ruptures have been described in an exceptional way, in particular in co-prescription with fluoroquinolones.
- Acute microcrystalline arthritis (with microcrystalline suspension) early onset.
- Local calcifications.
- Local and systemic allergic reactions: cutaneous, exceptionally angioedema, anaphylactic shock.
- Flush: Headaches and flushing may occur. They usually go away in a day or two.
- Transient lumbago, exceptionally: chest pain.
- Blood pressure, exceptionally: hypotension.
- Pain at the injection site.
- Adverse effects specific to the epidural route:
. Transient exacerbation of the pain that caused the injection.
. Adverse effects following a gap in the dura mater: orthostatic headache, infectious or aseptic meningitis, cerebral thrombophlebitis.
. Administration to the cervical spine for radioguided foramina: very rare cases of cerebral or medullary infarction with tetraplegia, sometimes fatal.
. Administration to the lumbar spine: very rare cases of medullary infarction with paraplegia, mainly observed either by foraminal radioguidée or by various ways on rachis operated.
. Hematoma or epidural infections (abscess, epiduritis), with risk of acute medullary or radicular compression depending on the floor.