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Lorangin® (Spray) Instructions for Use

Marketing Authorization Holder

Penta Group NPO, LLC (Russia)

Manufactured By

YUGPHARM, LLC (Russia)

ATC Code

A01AD02 (Benzydamine)

Active Substance

Benzydamine (Rec.INN registered by WHO)

Dosage Form

Bottle OTC Icon Lorangin® Metered-dose topical spray 0.255 mg/1 dose: 30 ml bottle (176 doses)

Dosage Form, Packaging, and Composition

Metered-dose spray for topical application as a colorless, transparent solution with a characteristic mint odor.

1 dose 100 ml
Benzydamine (in the form of hydrochloride) 0.255 mg 0.15 g

Excipients: ethanol 95%, glycerol, methylparaben, menthol flavor, sodium saccharin dihydrate, sodium bicarbonate, polysorbate 20, purified water.

30 ml (176 doses) – polyethylene bottles (1) with a dispenser and a folding tip – cardboard packs.

Clinical-Pharmacological Group

NSAIDs for topical use in ENT practice and dentistry

Pharmacotherapeutic Group

Drugs used in dentistry; other drugs for the local treatment of oral diseases

Pharmacological Action

NSAID, an indazole derivative, without a carboxyl group. The absence of a carboxyl group imparts the following features: Benzydamine is a weak base (whereas most NSAIDs are weak acids), has high lipophilicity, penetrates well into the site of inflammation along the pH gradient (where pH is lower) and accumulates in therapeutic concentrations.

It has an anti-inflammatory and local analgesic effect, and has an antiseptic (against a wide range of microorganisms), as well as an antifungal effect.

The anti-inflammatory effect is due to a decrease in capillary permeability, stabilization of cell membranes due to inhibition of the synthesis and inactivation of prostaglandins, histamine, bradykinin, cytokines, complement factors and other nonspecific endogenous damaging factors.

Benzydamine suppresses the production of pro-inflammatory cytokines, especially TNFα, and to a lesser extent IL-1β. The main feature of benzydamine is that, being a weak inhibitor of prostaglandin synthesis, it demonstrates powerful inhibition of pro-inflammatory cytokines. For this reason, Benzydamine can be classified as a cytokine-suppressing anti-inflammatory drug.

The local anesthetic effect of benzydamine is associated with the structural features of its molecule, similar to local anesthetics. The analgesic effect is due to an indirect decrease in the concentration of biogenic amines with algogenic properties and an increase in the pain sensitivity threshold of the receptor apparatus; Benzydamine also blocks the interaction of bradykinin with tissue receptors, restores microcirculation and reduces pain sensitivity at the site of inflammation.

Benzydamine has an antibacterial effect due to rapid penetration through the membranes of microorganisms with subsequent damage to cellular structures, disruption of metabolic processes and the function of cell lysosomes.

It has an antifungal effect against 20 strains of Candida albicans and Candida non-albicans, causing structural modifications of the fungal cell wall and their metabolic chains, thus preventing their reproduction.

Pharmacokinetics

When applied topically, it is well absorbed through the mucous membranes and quickly penetrates into inflamed tissues. It is detected in the blood plasma in an amount insufficient to obtain systemic effects. It is excreted mainly by the kidneys and through the intestines in the form of metabolites or conjugation products.

Indications

Symptomatic therapy of pain syndrome in inflammatory diseases of the oral cavity and ENT organs (of various etiologies): pharyngitis, laryngitis, tonsillitis; gingivitis, glossitis, periodontitis, stomatitis (including after radiation and chemotherapy); calculous inflammation of the salivary glands; after dental treatment or extraction; after surgical interventions and injuries (tonsillectomy, jaw fractures); candidiasis of the oral mucosa (as part of combination therapy).

ICD codes

ICD-10 code Indication
B37.0 Candidal stomatitis
J02 Acute pharyngitis
J03 Acute tonsillitis
J04.0 Acute laryngitis
J31.2 Chronic pharyngitis
J35.0 Chronic tonsillitis
J37.0 Chronic laryngitis
K05 Gingivitis and periodontal diseases
K08.8 Other specified disorders of teeth and supporting structures (including toothache)
K11.5 Sialolithiasis
K12 Stomatitis and related lesions
K14.0 Glossitis
R07.0 Pain in throat
T79.3 Posttraumatic wound infection, not elsewhere classified
ICD-11 code Indication
1F23.0 Candidiasis of the lips or oral mucosa
CA02.Z Acute pharyngitis, unspecified
CA03.Z Acute tonsillitis, unspecified
CA05.0 Acute laryngitis
CA09.2 Chronic pharyngitis
CA0F.Y Other specified chronic diseases of the palatine tonsils and adenoids
CA0G Chronic laryngitis or laryngotracheitis
DA01.Z Diseases of the oral mucosa, unspecified
DA03.0 Glossitis
DA04.4 Sialolithiasis
DA0A.Z Diseases of teeth and supporting structures, unspecified
DA0B.Z Gingival diseases, unspecified
DA0C.Z Periodontal diseases, unspecified
DA0Z Diseases or disorders of the orofacial complex, unspecified
LA30.5Z Anomalies of tooth resorption or loss, unspecified
MD36.0 Pain in throat
NF0A.3 Posttraumatic wound infection, not elsewhere classified

Dosage Regimen

The method of application and dosage regimen for a specific drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly adhere to the compliance of the dosage form of a specific drug with the indications for use and dosage regimen.

Administer topically into the oral cavity or oropharynx.

Prime the pump before first use by spraying several times into the air.

For adults and children 12 years and older: administer 4-8 doses (approximately 1-2 mg of benzydamine) 2 to 6 times daily.

For children 6 to 12 years old: administer 4 doses (approximately 1 mg of benzydamine) 2 to 6 times daily.

For children 3 to 6 years old: administer 1 dose per 4 kg of body weight, with a maximum single dose of 4 doses (approximately 1 mg of benzydamine), 2 to 6 times daily; administration should be supervised by an adult.

Direct the spray stream toward the affected area.

Refrain from eating or drinking for 15-20 minutes after application.

The duration of treatment depends on the indication and clinical response.

For postoperative pain and inflammation, use for up to 7 days.

For infectious conditions, use as an adjunct to specific antimicrobial therapy.

If symptoms persist for more than 3 days, discontinue use and consult a physician.

Do not exceed the recommended daily dosage.

Adverse Reactions

Local reactions: rarely – dry mouth, burning sensation in the oral cavity; frequency unknown – numbness in the oral cavity.

Allergic reactions: infrequently – photosensitivity; rarely – sensitivity reactions, skin rash, skin itching; very rarely – angioedema, laryngospasm; frequency unknown – anaphylactic reactions.

Contraindications

Children under 3 years of age; children over 3 years of age (depending on the dosage form used); hypersensitivity to benzydamine.

With caution

Hypersensitivity to acetylsalicylic acid or other NSAIDs; bronchial asthma (including history).

Use in Pregnancy and Lactation

Should not be used during pregnancy and breastfeeding.

Pediatric Use

Contraindicated in children under 3 years of age; in children over 3 years of age – depending on the dosage form used.

Geriatric Use

There are no special instructions for limiting use in elderly patients.

Special Precautions

If there is an ulcerative lesion of the oropharyngeal mucosa, the patient should consult a doctor if symptoms persist for more than 3 days.

Not recommended for use in patients with hypersensitivity to acetylsalicylic acid or other NSAIDs.

Use with caution in patients with bronchial asthma, as bronchospasm may develop.

Storage Conditions

Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Over-the-Counter

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.

Medical Disclaimer

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