Lipotalon
definition
Lipotalon® is a drug from the group of glucocorticoids. Like all glucocorticoids, to which cortisone belongs, Lipotalon® has a strong anti-inflammatory effect. It contains the active ingredient Dexamethasone and is used for injection into joints to act locally.
indication
Lipotalon® can be used in inflammatory processes in the joints such as inflammatory activated osteoarthritis, tendinitis such as tennis elbow or golfers elbow (epicondylitis humeri).
application
The active ingredient is injected into the affected joint or into surrounding tissue that is painful. This is done with the help of a syringe. In order to keep the risk of infection as low as possible during this procedure, the doctor must work under strictly aseptic conditions. For example, it is essential to ensure that the skin has been disinfected beforehand and that the needle is sterile.
Once the Lipotalon® has been injected into the joint, the small fat globules that contain the actual glucocorticoid crystals dissolve. Compared to similar preparations, Lipotalon® consists of very small crystals, which can have the advantage that the edges of the crystals do not cause any injuries within the joint.
One application is often enough to relieve the patient of the pain. The anti-inflammatory effects in the joint can last for a few weeks. If you want to puncture a joint again due to insufficient effect, you should wait three to four weeks.It is also important that a joint is not injected with Lipotalon® more than three to four times a year, as there is an indication that its active ingredient Dexamethasone can attack the cartilage cells. If used more often, cartilage damage can occur in the joint.
Read more on the subject at: Cortisone therapy for joint diseases
Lipotalon® in the knee joint
Lipotalon® contains the active ingredient dexametasone, a glucocorticoid, which is produced synthetically. It has a much stronger effect than cortisone, but has the same mode of action. Other glucocorticoids include cortisone and prednisolone.
When injecting into the knee, make sure that this is done under sterile conditions. If pathogens get into the knee joint, this can lead to severe joint inflammation. In addition, it should be noted that the knee should be protected for one day after the injection and that it should not be subjected to heavy loads. If it is necessary to re-administer Lipotalon®, this should only take place after about four weeks.
Systemic (affecting the entire body) side effects can also occur when Lipotalon® is injected into the knee. If there is an allergy to the active ingredient, an injection must be avoided. Other side effects can be an increase in blood sugar level, a reduced production of the body's own mineral corticoids or weight gain with trunk obesity (fat accumulates on the trunk, the extremities become slimmer).
Lipotalon® in the shoulder
Lipotalon® can also be used in the shoulder. The same rules apply here as for the knee. The syringe should be administered under aseptic conditions and the shoulder should be protected after the injection. If after a few hours or sometimes days there is increased pain in the knee or if it becomes thick and overheated, a doctor should be consulted. Sometimes fever is added to these symptoms. These symptoms suggest a joint inflammation and definitely require treatment.
Lipotalon® on the spine
Lipotalon® can also be administered to the spine. There are many small joints on the spine that can cause inflammatory changes. A small dose of Lipotalon® is usually necessary here. Here, too, the back should be spared after the injection and no high stress should be exerted on the back.
Ampoules
Lipotalon® is available in so-called ampoules, which are filled with the injection solution. Each ampoule of Lipotalon® contains 1 ml of the solution. The active ingredient in the solution is called dexamethasone and each 4 mg is contained in the solution. The other components of the solution are water, soybean oil, fats, glycerol, and sodium hydroxide. This composition makes it easier to inject the actual active ingredient into the affected area.
Different packs are available, each containing either 1, 3 or 10 ampoules. The ampoules are usually injected by a doctor.
Joint diseases are the most common use of Lipotalon®. Depending on which joint is affected, a different number of ampoules are used for the application. It is common to use 3 ampoules for large joints, while only one or two ampoules are used for small joints.
However, the exact dosage also depends on the underlying disease. The ampoules are also available from a pharmacy with a prescription.
Mode of action
Lipotalon®, cortisone and all glucocorticoids have anti-inflammatory effects. Since cortisone is the body's own hormone, human cells have receptors for glucocorticoids. When activated by a glucocorticoid, the receptors mediate certain processes in the body. Medicine makes use of the fact that inflammation-promoting processes are stopped and anti-inflammatory mechanisms of the cell are set in motion. In addition, the immune system is slowed down, which also has an anti-inflammatory effect.
Another effect is a stabilizing effect on the cell wall, which additionally protects the tissue from inflammatory reactions. The body's own cortisone also has a so-called mineral corticoid effect, which among other things leads to increased water absorption. The synthetically produced glucocorticoids such as Lipotalon® do not have this effect, which reduces the side effects.
Duration of action
Lipotalon® contains the active ingredient dexamethasone, which belongs to the group of so-called glucocorticoids. This group can also be divided into short-acting and long-acting substances, with dexamethasone and thus Lipotalon® counting among the long-acting substances.
The biological half-life of dexamethasone is stated to be over 36 hours. This means that after 36 hours the effective amount of the ingested Lipotalon® has fallen by half due to the breakdown processes of the body. After 72 hours or 3 days, a quarter of the ingested amount of the active substance is still present in the body.
When taking Lipotalon®, in order to avoid unpleasant side effects, the exact dosage instructions of the doctor or pharmacist should be followed.
Due to the long duration of action, it is possible that if Lipotalon® is used too frequently, the concentration of the active ingredient in the body is too high. By observing the package insert, you can also check whether the correct distances and dosages are being adhered to.
Side effects
Joint injection can lead to pain, burning sensation and a feeling of heat, as well as intolerance reactions. With every joint injection there is a risk of infection from pathogens in the injection solution or on the syringe. It can also happen that skin germs get into the joint or adjacent tissue when pricking, which is why skin disinfection is essential. If the patient's complaints have been successfully relieved, there is a risk of overstraining, especially in large joints with a high weight load, such as the knee joint, due to the newly achieved freedom from pain. This can lead to increased wear and tear and cartilage damage.
If the active ingredient is injected into a tendon when used incorrectly, it can be damaged by Lipotalon® and, in the worst case, even tear.
Although Lipotalon® is only used locally and not regularly, the usual side effects of glucocorticoids such as edema, high blood pressure or skin problems can occur. Blood sugar may also be increased after treatment.
Injection side effects
Lipotalon® is injected into the affected area using a needle. During this injection, strict hygiene should be observed in order to avoid dangerous side effects of the injection. If both the skin and the needle are sterile and the injection takes place under sterile conditions, side effects from an injection of Lipotalon® are very rare. Infections under the skin can occur as a result of pathogens sticking to the needle or bacteria that remain on the skin. When Lipotalon® is injected into a joint, infections can lead to painful and dangerous joint inflammation.
Post-injection skin irritation is relatively common and initially not a cause for concern.
However, in rare cases, the skin at the injection site may die. Any heat development and severe skin irritation after the injection should therefore always be clarified. An allergic reaction to the active ingredient is also possible, which can sometimes affect the entire body. In rare cases, Lipotalon® may accidentally be injected into the bloodstream. If this is the case, blood sugar disorders and gastric side effects can occur.
Too frequent use of Lipotalon® should be avoided in order to avoid an accumulation of the active ingredient in the blood.
Contraindications
If there is a known allergy or hypersensitivity to the active ingredient dexamethasone, Lipotalon® must not be used. Other components of the Lipotalon® injection solution are soybean oil, glycerol and phospholipids from egg yolk. If treatment with Lipotalon® is to take place, there must be no allergy to these substances either. Another very important contraindication is bacterial inflammation of the respective joint. Since Lipotalon® causes a reduced inflammatory and, above all, defense reaction, the body's own defense mechanisms can no longer take effect. As a result, the bacteria continue to multiply and the inflammation spreads further. Treatment is also not recommended if there is a skin infection around the joint or if the patient has a severe general infection. If there is an increased tendency to bleeding, unstable joint conditions and joint effusions, Lipotalon® should also be avoided.
In diabetics, blood sugar must be checked closely after the administration of Lipotalon®. Since dexamethasone, like all glucocorticoids, causes an increase in blood sugar levels, the doses of medication and insulin may need to be adjusted. Particular caution also applies to patients with (difficult to control) high blood pressure, as the intake of any cortisone preparation can cause blood pressure to rise.
Lipotalon® should not be used in non-activated and non-inflammatory osteoarthritis. If, despite repeated treatment, symptoms and joint effusions occur again and again, no further applications should follow.
It has not been proven whether the use of Lipotalon® during pregnancy can harm the unborn child. However, the use should be viewed critically, as the active ingredient dexamethasone can cause child damage, especially at the beginning of pregnancy. In the last trimester of pregnancy, the increased dexamethasone level in the blood can lead to an underactive adrenal gland in the child.
In children, Lipotalon® should not be used due to a lack of clinical experience.
The use in athletes is to be viewed critically, as the WADA Prohibited List lists glucocorticoids and, among other things, prohibits intramuscular administration.
Can Lipotalon® be used during pregnancy?
In general, Liptalon® should be used cautiously during pregnancy. Although this is a local injection, the active substance can pass into the blood. Lipotalon® crosses the placenta. Especially in the first weeks in which the organ systems are formed, it cannot be ruled out that Lipotalon® could damage the fetus. In the last weeks of pregnancy, the child's own hormones may be underproduced, which then have to be substituted (administered) after birth.
Despite all this, pregnancy is not a complete contraindication for the administration of Lipotalon®. The risks that exist during pregnancy should be discussed thoroughly with the gynecologist in advance of the injection.
Read more on the subject at: Cortisone in Pregnancy
What does Lipotalon® cost?
Lipotalon® is available as an ampoule for injection. An ampoule costs around 3.50 euros. Depending on the joint and the severity of the symptoms, several ampoules are usually necessary. The pack sizes are variable, they range from 10 ampoules to 150 ampoules. In addition to the price of the drug, the injection must also be paid for at the doctor. This can also be covered by the health insurance company on a case-by-case basis.
Can I drink alcohol after an injection with Lipotalon®?
No interactions are known between Lipotalon® and alcohol. Alcohol can therefore be drunk after the administration of Liptalon®. It should be noted, however, that alcohol changes perception. Therefore, the affected joint can be subjected to additional stress. Care should be taken to ensure that the joint continues to be protected.
Read more on the subject at: Cortisone and alcohol - are they compatible?
Summary
The use of Lipotalon® in inflammatory joint diseases is widespread and can help the patient to at least temporarily relieve pain. As with all medications, it is important to know the contraindications and to use Lipotalon® only if there is an existing indication. Injection into joints or the surrounding tissue has various risks, of which infection is to be emphasized as the most important, but also very well manageable risk factor if you act correctly.
