Usage
This topical medication is primarily prescribed for infected skin lesions and ulcers. It aids in wound healing after surgical procedures by preventing microbial contamination.
Pharmacological Classification:
- Ornidazole: Antiprotozoal, antibacterial
- Povidone Iodine: Antiseptic
- Sucralfate: Mucosal protectant, anti-ulcer
Mechanism of Action:
- Ornidazole: Disrupts DNA and other cellular components of anaerobic bacteria and protozoa.
- Povidone Iodine: Releases iodine, which oxidizes microbial proteins, causing cell death across a broad spectrum of microorganisms (bacteria, fungi, viruses, protozoa).
- Sucralfate: Forms a protective barrier over the ulcer or wound, protecting it from further irritation and promoting healing.
Alternate Names
Various brand names exist, including Wounsol Ointment, Povistop Ointment, Puradine Oz Ointment, Xtracare Ointment, Zeroseptic SF Ointment, and Zyodine Ointment.
How It Works
Pharmacodynamics: The combined action of ornidazole (antibacterial and antiprotozoal), povidone-iodine (antiseptic), and sucralfate (mucosal protectant) provides a comprehensive approach to treating infected wounds.
Pharmacokinetics: Primarily topical action. Systemic absorption of iodine may occur, especially with prolonged use on large areas. Ornidazole can be absorbed systemically to some extent. Hepatic metabolism and renal excretion are involved.
Mode of Action: See “Mechanism of Action” above. The drugs do not have specific receptor binding, enzyme inhibition, or neurotransmitter modulation properties relevant to their topical use for wound healing.
Elimination Pathways: Primarily renal and hepatic.
Dosage
Standard Dosage
Adults: Apply a thin layer to the cleansed affected area two to three times daily, or as directed by the physician.
Children: Use in children below 12 years of age is generally not recommended unless specifically prescribed by a physician. Pediatric dosage should be determined by the physician based on the child’s age and weight.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically required, but monitor thyroid function with prolonged use.
- Patients with Renal Impairment: Use with caution; monitor renal function. Dosage adjustment may be necessary.
- Patients with Hepatic Dysfunction: Use with caution; monitor liver function. Dosage adjustment may be necessary.
- Patients with Comorbid Conditions: Particular caution in patients with thyroid disorders (due to iodine content), diabetes, or other metabolic disorders.
Clinical Use Cases Dosing for these scenarios is determined by the physician on a case-by-case basis:
- Intubation: Not applicable (topical use).
- Surgical Procedures: May be used pre- and post-operatively for wound care.
- Mechanical Ventilation: Not applicable (topical use).
- Intensive Care Unit (ICU) Use: As directed by the physician for wound management.
- Emergency Situations: Not applicable (topical use).
Dosage Adjustments
Adjustments may be necessary based on the individual patient’s condition, the severity of the infection, and the response to treatment. Always follow physician guidance.
Side Effects
Common Side Effects
- Local skin reactions (itching, burning, redness, rash)
- Skin discoloration
- Dry Skin
Rare but Serious Side Effects
- Allergic reactions
- Thyroid dysfunction (with prolonged use or in susceptible individuals)
- Superficial keratitis (if accidentally applied to eyes)
Long-Term Effects
Potential thyroid issues with prolonged use.
Adverse Drug Reactions (ADR)
Severe allergic reactions (anaphylaxis) – requires immediate medical intervention.
Contraindications
- Hypersensitivity to ornidazole, iodine, povidone, or sucralfate
- Severe liver or kidney impairment
- Thyroid disorders (use with caution)
- Porphyria
- Lithium therapy or radioactive iodine treatment
Drug Interactions
- Other topical antiseptics, antibiotics, or corticosteroids
- Hydrogen peroxide; Neomycin; Hydrocortisone
- Products containing enzymes, alkali, mercury, silver, hydrogen peroxide, tannic acid, or taurolidine
- Some systemic medications (quinolone antibiotics, tetracyclines, antiepileptics, cardiac glycosides, antifungals)
Pregnancy and Breastfeeding
- Pregnancy: Use with caution, especially during the first trimester. Consult a physician.
- Breastfeeding: Consult a physician. Iodine can be excreted in breast milk, potentially affecting the infant’s thyroid.
Drug Profile Summary (See sections above for details.)
Popular Combinations
This medication itself is a combination product. No other specific drug combinations are routinely recommended.
Precautions (See sections above for details.)
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Ornidazole + Povidone Iodine + Sucralfate?
A: Apply a thin layer to the cleansed affected area two to three times daily, or as directed by your physician.
Q2: Can this ointment be used on children?
A: Use in children below 12 years of age is generally not recommended unless specifically prescribed by a physician.
Q3: What should I do if I miss a dose?
A: Apply the missed dose as soon as you remember. Do not apply extra to catch up.
Q4: Can I use this medication if I am pregnant or breastfeeding?
A: Consult your physician before using this medication during pregnancy or while breastfeeding.
Q5: Are there any dietary restrictions while using this medication?
A: No specific dietary restrictions are associated with the topical use of this medication.
Q6: Can I drive or operate machinery while using this ointment?
A: It does not typically impair driving or operating machinery, but avoid these activities if you experience side effects like dizziness.
Q7: What should I do if I experience side effects?
A: Most side effects are mild and resolve on their own. Consult your doctor if you experience severe or persistent side effects.
Q8: How should I store this medication?
A: Store at room temperature away from heat and moisture.
Q9: What are the long-term effects of using this ointment?
A: With prolonged use, monitor thyroid function due to the iodine content.
Q10: What if the wound doesn’t seem to be healing?
A: Consult your physician if the wound does not show signs of improvement within a reasonable timeframe.
