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ADJUSAN 140MG/G PERIDONTAL GEL

Active substance(s): DOXYCYCLINE HYCLATE

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Ligoslo, PIL - Common

PACKAGE LEAFLET: INFORMATION FOR THE PATIENT
Ligoslo 140 mg/g Periodontal gel
Doxycycline
Read all of this leaflet carefully before you start using this medicine.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your dentist or pharmacist.
- This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if
their symptoms are the same as yours.
- If you get any side effects talk to your dentist or pharmacist. This includes any possible side effects
not listed in this leaflet. See section 4.
In this leaflet:
1. What Ligoslo is and what it is used for
2. What you need to know before you use Ligoslo
3. How to use Ligoslo
4. Possible side effects
5. How to store Ligoslo
6. Contents of the pack and other information
1. What Ligoslo is and what it is used for
Ligoslo is a medicinal product for the treatment of periodontitis and contains doxycycline, an antibiotic
from the tetracycline group.
Ligoslo is for the treatment of the chronic and aggressive form of periodontitis with a pocket depth of
≥ 5 mm in adults as an adjunct to conventional non-surgical treatment of periodontitis.
Consideration should be given to official guidance on the appropriate use of antibacterial agents.
2. What you need to know before you use Ligoslo
Do not use Ligoslo
 if you are allergic to doxycycline, to other tetracycline antibiotics or to any of the other ingredients
of this medicine (listed in section 6).
 if you did receive beta-lactam antibiotics shortly before or during your periodontitis is treated with
Ligoslo. Please inform your dentist, if you have received antibiotics, but are not sure, whether these
are beta-lactam antibiotics.
 during tooth development (odontogenesis).
 if you are pregnant.
 if you are at a higher risk for developing an acute disorder of the generation of the red blood pigment
(acute porphyria).
 if your liver function is severely impaired.
Warnings and precautions
Talk to your dentist before using Ligoslo
 The treatment with tetracycline antibiotics like doxycycline is known to be potentially associated
with increased light sensitivity and can result in hypersensitivity reactions following light exposure.
In case of any apparent skin reactions, e.g. reddening of skin, you should inform your dentist, who
will discontinue the treatment.
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If you suffer from hepatic impairment or if you are treated with hepatotoxic medicinal products,
tetracycline antibiotics such as doxycycline should be used with caution.
If you suffer from renal impairment, accumulation of tetracycline antibiotics such as doxycycline
can occur, which may lead to hepatic toxicity. It appears unlikely that these effects occur
following treatment with Ligoslo, since the levels of doxycycline in the blood were found to be
very low following treatment with Ligoslo.
In patients with a previous history of yeast infection (candida infection), treatment with
doxycycline might increase the risk of oral candida infections. As with other antibiotics, the use
of Ligoslo may result in an increase of resistance of micro-organisms (including fungi) to
tetracyclines.
Tetracycline antibiotics can cause a decreased activity of blood clotting factor II (plasma
prothrombin). Therefore, if you are simultaneously being treated with anticoagulants, a dose
reduction of the anticoagulant may be necessary. Although this effect is unlikely to occur with
Ligoslo due to the low levels of doxycycline in the blood, these patients need to be treated with
special caution.

Children and adolescents
Ligoslo is not for patients who are under 18 years.
Other medicines and Ligoslo
Tell your doctor, dentist or pharmacist if you are taking or have recently taken or might take any other
medicines.
The effects of other medicinal products and the effect of Ligoslo may influence each other. The following
interactions are possible:
 Since an interaction with beta-lactam antibiotics is possible, simultaneous administration of
doxycycline to patients receiving beta-lactam antibiotics is not recommended.
 Simultaneous administration of tetracycline antibiotics such as doxycycline and an anaesthesia
with methoxyflurane can cause severe (fatal) kidney failure.
 Doxycycline can increase the toxic effect of cyclosporine A.
The doxycycline exposure of other regions of the body except the treated region (systemic doxycycline
exposure) after treatment with Ligoslo is very low. It appears unlikely that the above-mentioned
interactions, which are affecting untreated regions of the body, occur, taken into consideration the low
blood levels of doxycycline after administration of Ligoslo.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your
doctor, dentist or pharmacist for advice before using this medicine.
Pregnancy
The use of Ligoslo is contraindicated, if you are pregnant.
The use of tetracycline antibiotics during tooth development can cause permanent discoloration of the
teeth and defects of the dental enamel.
Breast-feeding
Since tetracycline antibiotics such as doxycycline pass into breast milk, administration of Ligoslo is not
recommended, if you are breastfeeding.
Driving and using machines
Ligoslo has no influence on the ability to drive and use machines.
3. How to use Ligoslo
Ligoslo should only be administered by dental care professionals into periodontal pockets using a
designated device (periodontal use).
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Posology
The usual dosage of Ligoslo depends on the size, shape and depth of the periodontal pockets.
Method of administration
For periodontal use.
Instructions on use
Ligoslo is to be administered exclusively using the prefilled cylinder cartridge with Ligoslo in connection
with the cartridge gun.
- Remove the laminated bag from the refrigerator 20 minutes prior to the start of treatment. Let the
laminated bag closed for proper adaption to room temperatur and to avoid moisture by condensation of
water.
- Open the sealed laminated bag directly before use and remove the cylinder cartridge which contains
the Ligoslo.
- Insert the cylinder cartridge into the cartridge gun and remove the closure from the tip of the cartridge
nozzle.
- Operate the handle of the cartridge gun until Ligoslo is extruded from the tip of the cartridge nozzle.
- The product is now ready for administration.
- Clean and dry the periodontal pocket as usual.
- Gently insert the tip of the cartridge nozzle into the periodontal pocket. Place the tip of the cartridge
nozzle at the basis of the pocket and operate the handle of the cartridge gun to extrude the gel. Slowly
remove the tip of the cartridge nozzle from the periodontal pocket whilst continuously extruding the
gel.
The administration should be continued until excess gel appears at the gingival line, which shows the
entire pocket is completely filled with the gel. Any excess gel can be removed using a paper tip or wetted
cotton pellet.
Any mechanical tooth cleaning other than brushing the chewing surface of the teeth (occlusal area) and
the tongue should be avoided on any area treated with Ligoslo for the following 7 days after treatment.
Duration of the treatment
Ligoslo is used once.
If you receive more Ligoslo than you should
Acute overdosing is not expected. If Ligoslo has been overdosed, it should be removed from the
periodontal pocket.
It is known that the harmful effects for health (acute toxicity) of medicinal products containing
doxycycline is low, even after intake of comparatively high doses. In cases of accidental overdose, gastrointestinal absorption can be prevented by administration of medicinal products, which neutralize excess
stomach acid (antacids) or by administration of magnesium or calcium containing salts. This is based on
the absorption of the active substance doxycycline into compounds, which cannot be absorbed by the
body (non-absorbable chelate complexes). If necessary, other general supportive measures should be
undertaken. Doxycycline can not be removed from the bloodstream by blood purification (dialysis).
If you have any further questions on the use of this medicine, ask your dentist or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Frequencies of undesirable effects are defined as:
Very common:
may affect more than 1 in 10 people
Common:
may affect up to 1 in 10 people
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Uncommon:
Rare:
Very rare:
Not known:

may affect up to 1 in 100 people
may affect up to 1 in 1,000 people
may affect up to 1 in 10,000 people
frequency cannot be estimated from the available data

Side effects reported in a clinical study:
Uncommon:
- swelling of the gums (gingiva)
- a chewing-gum like taste
General disorders and administration site conditions
- Hypersensitivity reactions
Unknown frequency: Hives with formation of blisters (urticaria), transient local swelling under the
skin and mucous membranes (angioneurotic oedema), hypersensitivity reactions (anaphylaxis), purple
patches on the skin (allergic purpura)
A complete cross-allergy exists within the group of tetracycline antibiotics.
Undesirable effects reported for orally taken doxycycline are not listed here.
Reporting of side effects
If you get any side effects, talk to your dentist orpharmacist. This includes any possible side effects not
listed in this leaflet.
You can also report side effects directly via the Yellow Card Scheme, website www.mhra.gov.uk/yellowcard.
By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Ligoslo
Keep out of the reach and sight of children.
Do not use Ligoslo after the expiry date which is stated on the laminated bag and carton after “EXP”. The
expiry date refers to the last day of that month.
Store the cylinder cartridge in a refrigerator (2–8 C) in the original unopened laminated bag.
After first opening of the laminated bag: Use immediately.
Signs of non usability: Do not use Ligoslo if the laminated bag surrounding the cylinder cartridge is
damaged.
Discard any remaining gel after first use.
6. Contents of the pack and other information
What Ligoslo contains
The active substance is doxycycline.
1 g of periodontal gel contains 140 mg doxycycline equivalent to 161.5 mg doxycycline hyclate.
1 pre-filled cylinder cartridge with 260 mg periodontal gel contains 36.40 mg doxycycline.
The other ingredients are:
Polyglycolide, Macrogol-DL-lactide/glycolide copolymer (high viscosity), Macrogol-DLlactide/glycolide copolymer (low viscosity).
What Ligoslo looks like and contents of the pack
Ligoslo is a yellow gel and packed in prefilled cylinder cartridges.
Pack sizes with 2, 4, 8, 10 or 16 pre-filled cylinder cartridges.
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Not all pack sizes may be marketed.
Marketing Authorisation Holder
Heraeus Kulzer GmbH
Grüner Weg 11
63450 Hanau
Germany
Manufacturer
Artesan Pharma GmbH & Co. KG
Wendlandstr. 1
29439 Lüchow
Germany
This medicinal product is authorised in the Member States of the EEA under the following names:
Austria, Liechtenstein, Italy, Poland, Spain
Germany, Finland
Belgium, The Netherlands, United Kingdom

Ligosan
Ligoslo
Adjusan

This leaflet was last approved in 12/2013.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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