Note; This article is a supplementation to the comment in the following article.
[Paradoxical idea of systemic steroids use for withdrawal from topical steroids]
Strong Neo-Minophagen C（SNMC） is an old medicine made in Japan. It is administered only by intravenous injection.
The active ingredient is glycyrrhetinic acid, a constituent of liquorice.
The efficacy of Chinese herbs containing liquorice is thought to be due to glycyrrhetinic acid at least partially.
Some doctors in Japan prefer SNMC for suppressing rebound after TSW. The mechanism is considered as 11 beta-OHSD suppression. 11 beta-OHSD is an enzyme which changes cortisol to cortisone: inactive form of cortisol.
The below graph is from Greaves’s article. The horizontal axis is the concentration of medicines and longitudinal axis is human skin branching due to topical steroids.
Beclomethasone dipropionate and hydrocortisone acetate are both TC and the former is stronger than the latter. The data tells the effect of hydorocortisone acetate is amplified by the addition of glycyrrhetinic acid.
Potentiation of hydrocortisone activity in skin by glycerrhetinic acid. Greaves MW. Lancet. 1990 Oct 6;336(8719):876.
Doctors using SNMC for the rebound seem to consider it is safe because it is not an administration of extrinsic steroids. However, it is very near to the weak systemic steroids injection in fact.
I also have experience of this method. It was rather weak and didn’t become popular among my patients. Systemic steroids injection is more recommendable than SNMC from my thinking but it is certain that SNMC is an alternative method anyway. I have never heard or read that SNMC caused rebound.
SNMC is provided by Minophagen pharmaceutical co. ltd.
The product is provided overseas to Asia area.
If any medical doctor who is reading my blog and interested in SNMC, don’t hesitate to contact me. I can export SNMC to your clinic. It is legal under Japanese law. The attached document of SNMC is here (just click).
Or I can export SNMC to any patient who prefer to use SNMC and could find a doctor who would inject it to you in your area. Please contact me by e-mail : fukaya*tclinic.jp (replace *to@).
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