​Herpes Siplex & Zoster Cream — Payayor Cream (ABHAI)

Herpes Siplex & Zoster Cream — Payayor Cream (ABHAI)

Product Name: Герпес и опоясывающий лишай крем, Payayor Cream, Creme gegen Herpes simplex und Herpes zoster, Crema contra el herpes simple y herpes zóster, Crème contre l'herpès simplex et le zona, كريم ضد الهربس البسيط والحزام الناري, ครีมพญายอสำหรับเริมและงูสวัด, Герпесга қарши крем, Герпеске каршы крем, Herpesə qarşı krem, Крем барои герпес ва зостер, Kremas nuo paprastojo pūslelinės ir juostinės pūslelinės, Krēms pret herpes simplex un jostas rozi, Крем проти герпесу простого та оперізувального, קרם נגד הרפס סימפלקס ושלבקת חוגרת

Main Indications for Use of Herpes Siplex and Zoster Cream (Payayor Cream): Herpes simplex labialis, herpes simplex genitalis, herpes zoster (shingles), herpesvirus skin infection, herpesvirus infection of mucous membranes, herpesvirus infection of the perioral area.

Indications for Use of Herpes Siplex and Zoster Cream (Payayor Cream) as Part of Therapeutic Complexes: Atopic dermatitis, microbial eczema, dermatoses of mixed etiology, papillomavirus skin infection, human immunodeficiency virus with skin manifestations, cytomegalovirus skin infection, Kaposi's sarcoma, skin carcinoma, squamous cell skin cancer, basal cell skin cancer, skin lymphoma.

Main Pharmacological Properties of Herpes Siplex and Zoster Cream (Payayor Cream): Antiviral, anti-inflammatory, immunomodulatory, analgesic, antipruritic, antioxidant, regenerative, keratoprotective.

Composition of Herpes Siplex and Zoster Cream (Payayor Cream): Clinacanthus nutans extract, Ointment base

Functions of the Components in Herpes Siplex and Zoster Cream (Payayor Cream):

• Clinacanthus nutans extract — Source of flavonoids and polysaccharides, exerts pronounced antiviral action against Herpes simplex and Varicella zoster viruses, reduces inflammation, alleviates pain syndrome, accelerates skin regeneration.
• Ointment base — Ensures even distribution of the active substance over the skin surface, promotes penetration of active components, moisturizes and protects damaged epithelium.

Product Form of Herpes Siplex and Zoster Cream (Payayor Cream): Cream for topical use in 10 g tubes. 100 g of cream contains 1.75 g of Clinacanthus nutans extract and up to 100 g of ointment base. One tube contains 0.175 g of active substance (Clinacanthus nutans extract) and 9.825 g of ointment base.

Dosage of Herpes Siplex and Zoster Cream (Payayor Cream)

Standard Dosage for Herpes Siplex and Zoster Cream (Payayor Cream): Apply a thin layer to the affected skin area 3–4 times a day. The standard dosage is used for herpes simplex labialis and herpes simplex genitalis in the acute stage, as well as for herpetic infection of mucous membranes. The cream is applied after hygienic treatment of the affected area, with gentle movements, without intensive rubbing. Use preferably during the daytime.

Enhanced Dosage for Herpes Siplex and Zoster Cream (Payayor Cream): Apply a thin layer to the affected area 5–6 times a day. The enhanced dosage is used for herpes zoster and for extensive localizations of herpesvirus skin lesions. Used in the morning and evening after skin treatment, combined use with systemic agents is allowed.

Maximum Dosage for Herpes Siplex and Zoster Cream (Payayor Cream): Application up to 8 times per day on limited skin areas. The maximum dosage is permissible for severe pain syndrome, multiple foci of herpesvirus skin infection. Use only short-term (1–3 days).

Pediatric Dosage for Herpes Siplex and Zoster Cream (Payayor Cream): Use is permitted in children over 3 years of age with local manifestations of herpesvirus skin infection. Apply 2–3 times a day, in a thin layer, for no more than 7 consecutive days. Data on use in children under 3 years of age and in newborns are not available.

Preventive Dosage for Herpes Siplex and Zoster Cream (Payayor Cream): Application 1–2 times a day on the area of potential rash localization in chronic recurrent herpes during remission, in patients with immunodeficiency states and in chronic dermatoses of viral etiology. The preventive course is 7–10 days monthly.

Contraindications for Herpes Siplex and Zoster Cream (Payayor Cream): Individual intolerance to the components of the drug, deep wounds, purulent inflammatory skin processes. No scientific data on contraindications during pregnancy, lactation, and in children under 3 years of age have been registered.

Side Effects of Herpes Siplex and Zoster Cream (Payayor Cream): With overdose, local skin irritation, contact dermatitis, allergic reactions in the form of itching, burning, erythema may develop. Systemic side effects have not been registered.

Adjustment Based on Patient Body Weight: For topical application, adjustment based on body weight is not required.

Storage Conditions for Herpes Siplex and Zoster Cream (Payayor Cream): Store at a temperature from +5 °C to +25 °C, in a dry place, protected from direct sunlight. Avoid exposure to high-intensity electromagnetic fields. Shelf life — 3 years. After opening the tube, use within 6 months.

Toxicity and Biosafety — Herpes Siplex and Zoster Cream (Payayor Cream)

In animal studies, Clinacanthus nutans extract showed low acute toxicity. LD₅₀ upon oral administration of the leaf extract to rats is more than 5 g/kg body weight. With topical application, toxic effects were not detected. The cumulative toxicity of the ointment base and the extract is estimated as extremely low, biosafety is high. Data on cumulative toxicity are absent.

Synergy — Herpes Siplex and Zoster Cream (Payayor Cream)

Clinacanthus nutans extract contains flavonoids (orientin, isoorientin, vitexin, isovitexin), polysaccharides and sterols, which have multifaceted pharmacological activity. Research shows that the flavonoids of C. nutans can potentiate the action of other antiviral agents of plant and synthetic origin through an additive and modulating mechanism. In particular, they enhance the inhibition of herpes simplex virus replication when used together with acyclic nucleosides (acyclovir, valacyclovir) due to synergy at the level of suppression of viral DNA polymerase. The plant's polysaccharides exhibit an immunomodulatory effect, activating macrophages and stimulating interferon production, which enhances the action of immunomodulators. Antioxidant components (vitexin, isovitexin) exhibit a protective potentiating effect in combination with vitamins C and E, reducing the level of oxidative stress in skin cells. The cumulative effect can be characterized as potentiating antiviral and anti-inflammatory action, protective regarding cellular structures and additive regarding the modulation of the local immune response.
References: PubMed, PMC, ScienceDirect, SpringerLink.

Pharmacodynamics of Herpes Siplex and Zoster Cream (Payayor Cream)

The pharmacodynamic effects of the drug are determined by the action of Clinacanthus nutans extract. At the local level, the drug exerts a direct antiviral effect, suppressing the replication of viruses of the Herpesviridae family. Flavonoids inhibit the activity of viral enzymes, including DNA polymerase, and disrupt the assembly of viral capsids. Polysaccharides and sterols exert a modulating influence on the immune system, increasing macrophage activity and stimulating cytokine secretion. Antioxidant components bind free radicals, reducing the level of oxidative stress in the skin. At the systemic level, participation in the modulation of the inflammatory response is assumed due to the suppression of NF-κB expression and reduction in the production of pro-inflammatory mediators. The drug acts locally, systemic absorption is minimal.
References: PubMed, Wiley Online Library, WHO Phytomedicine Monographs.

Pharmacokinetics of Herpes Siplex and Zoster Cream (Payayor Cream)

The active substances of Clinacanthus nutans extract — primarily flavonoids, sterols, polysaccharides and glycosides — upon transdermal application, are absorbed through the stratum corneum of the epidermis and penetrate into the deeper layers of the skin. The main route of entry of active compounds is associated with intercellular and transcellular diffusion, to a lesser extent — through hair follicles and sweat glands. With topical application, systemic absorption is minimal, the main action develops at the local level.

The distribution of active components is predominantly limited to the dermal layers and subcutaneous tissue. Concentrations in blood plasma are extremely low; however, flavonoid structures can, to a limited extent, bind to albumin and other blood proteins upon penetration through a damaged epidermal barrier. Lipophilic components, such as sterols and triterpenoids, demonstrate more pronounced penetration into the lipid layers of membranes, where they realize membrane-stabilizing and antioxidant effects.

Metabolism is presumed to be predominantly local — in the skin, active substances undergo partial degradation under the action of tissue enzymes (β-glucuronidases, esterases). When insignificant amounts enter the systemic circulation, the main biotransformation is carried out in the liver with the participation of phase I enzymes (cytochrome P450) and conjugation in phase II (glucuronidation, sulfation).

Excretion occurs primarily through the skin as a result of local metabolism and natural epidermal renewal. Insignificant amounts of metabolites may be excreted by the kidneys in the urine or with bile. No cumulative effect has been detected with topical application. With long-term use, the likelihood of systemic accumulation is extremely low, which is associated with minimal absorption through the intact skin barrier.

References: PubMed, ScienceDirect, SpringerLink.

Mechanisms of Action and Scientific Justification: Herpes Siplex and Zoster Cream (Payayor Cream)

Liver and Gastrointestinal Tract. Flavonoids and sterols of Clinacanthus nutans can exert membrane-stabilizing and antioxidant effects at the cellular level, reducing lipid peroxidation and protecting hepatocyte membranes. In experimental models, it has been shown that the plant's compounds inhibit the activity of cytochrome P450 enzymes, which is manifested by a modulating influence on biotransformation processes. Local application does not exert a pronounced systemic load, but data on hepatoprotective properties confirm the general safety of the metabolism of the active components.
Reference: https://pubmed.ncbi.nlm.nih.go...

Immune System. Polysaccharides and flavonoids of the plant activate macrophages and increase interferon secretion, which enhances the non-specific antiviral response. A modulating effect on the cytokine profile is noted, with suppression of the production of pro-inflammatory mediators (TNF-α, IL-1β, IL-6) and stimulation of antiviral interleukins. Interaction with cellular targets is realized at the level of macrophages, neutrophils and epithelial cells, which ensures tissue-specific antiviral and anti-inflammatory action.
Reference: https://www.sciencedirect.com/...

Nervous System. Flavonoid compounds exhibit antioxidant and membrane-stabilizing effects on neurons, reducing the level of oxidative stress and inhibiting NF-κB and MAPK cascades associated with inflammation and neurodegeneration. This provides an additive protective effect in case of damage to nerve endings in the area of herpetic rashes. In cell culture studies, a reduction in apoptotic activity upon exposure to C. nutans extract has been noted.
Reference: https://link.springer.com/arti...

Endocrine and Metabolic Regulation. Phenolic compounds of the plant participate in the regulation of carbohydrate and lipid metabolism by inhibiting α-glucosidase and reducing lipoxygenase (LOX) activity. This effect has a modulating character and contributes to the reduction of systemic inflammation by decreasing the production of arachidonic acid metabolites. At the level of signaling cascades, participation in the regulation of JAK/STAT and suppression of NF-κB activation has been confirmed, which is reflected in the reduction of the inflammatory response.
Reference: https://www.tandfonline.com/do...

Cellular Level. Active substances of C. nutans act on skin cells, reducing the expression of viral proteins and preventing capsid assembly. A potentiating interaction between polysaccharides and flavonoids is noted, enhancing the local immune response. The nature of the interaction is potentiating and additive, which is expressed in the comprehensive protection of cellular structures.
Reference: https://pubmed.ncbi.nlm.nih.go...