Zinnat pills 250 mg 10 pcs
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Active ingredients
Cefuroxime
Release form
Pills
Composition
Active ingredient: Cefuroxime Concentration of the active substance (mg): 250 mg.
Pharmacological effect
Cefuroxime axetil is a prodrug of cefuroxime, an antibiotic of the group II cephalosporins with bactericidal action. Cefuroxime is active against a wide range of pathogens, including strains that produce beta-lactamase. Cefuroxime is resistant to bacterial β-lactamase, therefore, it is effective against ampicillin-resistant or amoxicillin-resistant strains. The bactericidal effect of cefuroxime is associated with the suppression of the synthesis of a cellular stem cell synthesis as a result of binding to the main target proteins. The prevalence of acquired resistance of bacteria to cefuroxime varies depending on the region and over time, certain types of microorganisms resistance can be very high. It is preferable to have local data on sensitivity, especially in the treatment of severe infections. Cefuroxime in vitro is usually active against the following microorganisms. Bacteria usually sensitive to cefuroxime: Gram-positive aerobes - Staphylococcus aureus (strains sensitive to methicillin) 1, coagulase-negative staphylococci (strains) , sensitive to methicillin), Streptococcus pyogenes1 (beta-hemolytic streptococci), gram-negative aerobes — Haemophilus influenzae1 (including ampicillin-resistant strains), Haemophilus parainfluenzae1, Moraxella catarrhalis1, Neisheria-neisheriaia, neisheriaeusya, iraisellausarinfluenzae1; Keys producing strains not producing penicillinase), Gram-positive anaerobes - Peptostreptococcus spp, Propionibacterium spp .;. Gram-negative spirochetes - Borrelia burgdorferi.1 Bacteria for which acquired resistance to cefuroxime are likely: Gram-positive aerobes - Streptococcus pneumoniae1; Gram-negative aerobes - Citrobacter spp. (except C. freundii), Enterobacter spp. (except for E. aerogenes and E.cloacae), Escherichia coli1, Klebsiella spp. (including Klebsiella pneumonia1), Proteus mirabilis, Proteus spp. (except P. penneri and P. vulgaris), Providencia spp.; gram-positive anaerobes - Clostridium spp. (with the exception of C. difficile), gram-negative aerobes - Bacteroides spp. (with the exception of B. fragilis), Fusobacterium spp. Bacteria with natural resistance to cefuroxime: gram-positive aerobes - Enterococcus spp. (including E. faecalis and E. faecium), Listeria monocytogenes; Gram-negative aerobes - Acinetobacter spp., Burkholderia cepacia, Campylobacter spp., Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Morganella morganii, Proteus penneri, s, patron, Morganella morgani, Proteus penneri, s, patron, Morganella morgani, Proteus penneriros, pathorester, Morganella morganelii, Proteus penner aerogenes; (including Pseudomonas aeruginosa), Serratia spp., Stenotrophomonas maltophilia; gram-positive anaerobes - Clostridium difficile; gram-negative aerobes - Bacteroides fragilis); others — Chlamydia spp., Mycoplasma spp., Legionella spp.1 — for these bacteria, clinical efficacy of cefuroxime has been demonstrated in clinical studies.
Pharmacokinetics
Absorption After ingestion of cefuroxime axetil is absorbed from the gastrointestinal tract and quickly hydrolyzed in the mucous membrane of the small intestine and in the blood to release cefuroxime. / l for dosage of 125 mg, 4.1 mg / l for dosage of 250 mg, 7.0 mg / l for dosage of 500 mg are observed in approximately 2-3 hours when taking the drug during a meal. Distribution By binding to plasma proteins is about 33-50% and depends on the method of determination. Metabolism Cefuroxime is not metabolized. Excretion of T1 / 2 is 1-1.5 hours. Cefuroxime is excreted by glomerular filtration and tubular secretion. With the simultaneous administration of probenecid, the AUC is increased by 50%. Pharmacokinetics in special clinical situationsPatients with impaired renal function The pharmacokinetics of cefuroxime were studied in patients with impaired renal function of varying severity. Cefuroxime T1 / 2 increases with decreasing renal function, which underlies the recommendations for the correction of the dosing regimen for this group of patients (see section Dosing regimen). In patients on hemodialysis, at least 60% of the total amount of cefuroxime present in the body at the time of onset of dialysis will be removed during the 4-hour period of dialysis. Thus, an additional single dose of cefuroxime should be administered after completion of the hemodialysis procedure.
Indications
The drug is used to treat acne (acne vulgaris).
Contraindications
Individual sensitivity to the components of the drug, allergic reactions to penicillins in history, bleeding and diseases of the gastrointestinal tract, including ulcerative colitis, pregnancy, breast-feeding. Children age up to 3 months.
Use during pregnancy and lactation
Allergological history must be carefully collected before use. In the treatment process, kidney function must be monitored, especially in patients receiving the drug at a high dose. A false positive reaction of urine to glucose is possible while taking Zinnat. As with other antibiotics, long-term use of Zinnat can lead to excessive growth of fungi of the genus Candida.Prolonged use may cause the growth of other resistant microorganisms (Enterococcus and Clostridium difficile), which may require cessation of treatment. Cases of pseudomembranous colitis occur when taking antibiotics, the severity of which can range from mild to life-threatening. Therefore, it is necessary to carry out a differential diagnosis of pseudomembranous colitis in patients with diarrhea that occurred during or after treatment with antibiotics. If the diarrhea is long-lasting or severe, or the patient experiences abdominal cramps, Zinnat treatment should be immediately discontinued and the patient should be examined. causative agent of the disease Spirochetes Borrelia burgdorferi. Patients should be informed that these symptoms are a typical consequence of the use of antibiotics for this disease. In case of step therapy, the time for switching to oral therapy is determined by the severity of the infection, the clinical condition of the patients and the sensitivity of the pathogen. If the clinical effect is not achieved within 72 hours from the start of treatment, the parenteral therapy course should be continued. Before starting the step therapy, one should carefully read the instructions for using cefuroxime sodium salt for parenteral administration (Zinatse preparation). Therefore, this dosage form is not used to treat patients with difficulties in swallowing, incl. young children who cannot swallow a whole pill. The sucrose content of Zinnat suspension should be considered when treating patients with diabetes.5 ml of prepared Zinnat suspension contains 0.25 bread units (HE) .The effect on the ability to drive vehicles and control mechanisms. Since cefuroxime axetil can cause dizziness, it is necessary to warn patients about precautions when driving or working with moving machinery.
Dosage and administration
The drug is recommended to be taken during or immediately after a meal. The course of treatment and dose is selected by the attending physician individually in each case.The average course of treatment is 7 days. The average doses of the drug are: In the treatment of infections of the lower respiratory tract of mild and moderate severity: Adults 250 mg 2 times a day; children 3-6 months 40-60mg 2 times a day; children 6 months - 2 years 60-120 mg 2 times a day; children 2-12 years old 125mg 2 times a day. In the treatment of severe lower respiratory tract infections or otitis media: Adults 500mg 2 times a day; children 3-6 months 60-90mg 2 times a day; children 6 months - 2 years 90-180 mg 2 times a day; children 2-12 years old 180-250 mg 2 times a day. When treating infections of the urogenital system: Adults 125 mg 2 times a day. In pyelonephritis: Adults 250 mg 2 times a day. When treating uncomplicated gonorrhea: Adults are prescribed 1 g once.
Side effects
Drugs that reduce the acidity of gastric juice, can reduce the bioavailability of cefuroxime when compared with the observed after taking the drug on an empty stomach, as well as level the effect of increased absorption of the drug after a meal. As with other antibiotics, Zinnat can affect the intestinal microflora, which leads to a decrease in reabsorption estrogen and, consequently, to reduce the effectiveness of oral hormonal combined contraceptives. When conducting a ferrocyanide test, a false negative can be observed Therefore, it is recommended to use glucose oxidase or hexokinase methods to determine the level of glucose in the blood and / or plasma. The Zinnat preparation does not affect the quantitative determination of creatinine by the alkali-picrate method. Simultaneous intake with loop diuretics slows down tubular secretion, reduces renal clearance, increases plasma concentration and increases T1 / 2 cefuroxime. Simultaneous administration of cefuroxime and probenecid leads to an increase in AUC by 50%. When taken simultaneously with aminoglycosides and diuretics n Witzlaus risk of nephrotoxic effects.
Overdose
On the part of the digestive system: nausea, vomiting, diarrhea, cholestatic jaundice, hepatitis, a temporary increase in the activity of liver enzymes; On the part of the hematopoietic system: hemolytic anemia, eosinophilia, thrombocytopenia, leukopenia, hypoprothrombinemia; convulsions; Allergic reactions: skin rash, itching, urticaria, fever, in rare cases, anaphylaxis may develop; Other: interstitial nephritis, candidiasis, vaginosis, dysbacteriosis.
Interaction with other drugs
Precautionary measures
special instructions
Symptoms: an overdose of cephalosporins can cause an increase in the excitability of the brain with the development of convulsions. Treatment: symptomatic therapy is carried out. Cefuroxime serum concentrations decrease with hemodialysis and peritoneal dialysis.