Ciprolet 500mg №10 pills

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Ciprolet 500mg №10 pills

Pharmaceutical action

A broad-spectrum antimicrobial agent, a fluoroquinolone derivative, inhibits bacterial DNA gyrase (topoisomerases II and IV, which are responsible for the supercoiling of chromosomal DNA around nuclear RNA, which is necessary for reading genetic information), violates the synthesis of DNA, growth and division of bacteria causes pronounced morphological changes (including cell walls and membranes) and the rapid death of a bacterial cell. It acts bactericidal on Gram-negative organisms in the period of rest and division (because it affects not only the DNA gyrase, but also causes lysis of the cell wall), on gram-positive microorganisms - only in the period of division. Low toxicity to the cells of the microorganism is explained by the absence of DNA gyrase in them. While receiving ciprofloxacin, there is no parallel development of resistance to other aktibiotics not belonging to the group of inhibitors of gyrase, which makes it highly effective against bacteria that are resistant, for example, to aminoglycosides, penicillins, cephalosporins, tetracyclines and many other antibiotics. Gram-negative aerobic bacteria - enterobacteria are sensitive to ciprofloxacin (Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Chile, and 2010). , Morganella morganii, Vibrio spp., Yersinia spp.), Other Gram-negative bacteria (Iekshav, Sme., Pseudomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida, Plesiomonas shigelloides, Ie, Zeros, Aeromonas spp., Pasteurella multocida, Plesiomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida, Plesudomonas aeruginosa, Moraxella catarrhalis Legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Corynebacterium diphtheriae. Gram-positive aerobic bacteria - Staphylococcus spp. (Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus), Streptococcus spp. (Streptococcus pyogenes, Streptococcus agalactiae). Most methicillin-resistant staphylococci are resistant to ciprofloxacin. The sensitivity of Streptococcus pneumoniae, Enterococcus faecalis, Mycobacterium avium-intracellulare bacteria is moderate (high concentrations are required to suppress them). The drug resistant: Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides. Not effective against Treponema pallidum. Resistance develops extremely slowly, since, on the one hand, after the action of ciprofloxacin, there are practically no persistent microorganisms left, and on the other, bacterial cells do not have enzymes that inactivate it.

Contraindications

Hypersensitivity, pseudomembranous colitis, children's age (up to 18 years - until the completion of the skeleton formation process), pregnancy, lactation period.With care - pronounced atherosclerosis of the cerebral vessels, impaired cerebral circulation, mental illness, epileptic syndrome, epilepsy, severe renal and / or hepatic insufficiency, old age.

special instructions

Side effects:

On the part of the digestive system: nausea, diarrhea, vomiting, abdominal pain, flatulence, anorexia, cholestatic jaundice (especially in patients with past liver diseases), hepatitis, hepatonecrosis. On the part of the nervous system: dizziness, headache, fatigue, anxiety, tremor, insomnia, “nightmarish” dreams, peripheral paralgesia (abnormal perception of pain), sweating, increased intracranial pressure, confusion, depression, hallucinations, and others. manifestations of psychotic reactions (occasionally progressing to conditions in which the patient may harm himself), migraine, syncope, cerebral artery thrombosis. On the part of the senses: impaired taste and smell, impaired vision (diplopia, change in color perception), noise in the ears, hearing loss. On the part of the cardiovascular system: tachycardia, heart rhythm disturbances, decrease in blood pressure, flushing of the skin of the face On the part of the hematopoietic system: leukopenia, granulocytopenia, anemia, thrombocytopenia, leukocytosis, thrombocytosis, hemolytic anemia. On the part of laboratory parameters: hypoprothrombinemia, increased activity of “liver” transaminases and alkaline phosphatase, hypercreatininemia, hyperbilirubinemia, hyperglycemia. On the part of the urinary system: hematuria, crystalluria (especially with alkaline urine and low diuresis), glomerulonephritis, dysuria, polyuria, urinary retention, albuminuria, urethral bleeding, hematuria, reduced nitrogen-excreting kidney function, interstitial nephritis. Allergic reactions: itching, hives, blisters, accompanied by bleeding, and the appearance of small nodules that form scabs, drug fever, petechial hemorrhages in the skin (petechiae), swelling of the face or throat, shortness of breath, eosinophilia, increased sensitivity, vasculitis, nodular erythema, exudative erythema multiforme, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome). Others: arthralgia, arthritis, tendovaginitis, tendon ruptures, general weakness, myalgia, superinfection (candidiasis, pseudomembranous colitis). Overdose. Treatment: The specific antidote is unknown.It is necessary to carefully monitor the condition of the patient, to wash the stomach and other emergency measures, to ensure adequate flow of fluid. With the help of hemo- or peritoneal dialysis, only an insignificant (less than 10%) amount of the drug can be derived.



It is a pharmaceutical drug. Use only as directed by your doctor.

Mode of application

Inside, at 0.25 g 2-3 times a day, with severe infections - 0.5-0.75 g 2-3 times a day. For urinary tract infections - 0.25-0.5 g 2 times a day, the course of treatment is 7-10 days. With uncomplicated gonorrhea - 0.25-0.5 g once with a combination of gonococcal infection with chlamydia and mycoplasma - 0.75 g every 12 hours for 7-10 days. With chancroid - 0.5 g 2 times a day for several days. For meningococcal carriage in the nasopharynx - once, 0.5 or 0.75 g. For chronic carriage of Salmonella - orally 0.25 g 4 times the course of treatment is up to 4 weeks. If necessary, the dosage can be increased to 0.5 g 3 times a day. With pneumonia, osteomyelitis - inside, at 0.75 g, 2 times a day. The duration of treatment of osteomyelitis can be up to 2 months. For gastrointestinal infections caused by Staphylococcus aureus, 0.75 g every 12 hours for 7-28 days. Treatment should continue for at least 3 days after normalization of temperature or disappearance of clinical symptoms. With a glomerular filtration rate (CK 31-60 ml / min / 1.73 sq. M or serum creatinine concentration from 1.4 to 1.9 mg / 100 ml), the maximum daily dose is 1 g. With a glomerular filtration rate below 30 ml / min / 1.73 sq. M. m or serum creatinine concentration above 2 mg / 100 ml, the maximum daily dose is 0.5 g. If hemodialysis or peritoneal dialysis is given to the patient, 0.25-0.5 g / day, but the drug should be taken after a hemodialysis session. In severe infections (for example, in recurrent cystic fibrosis, infections of the abdominal cavity, bones and joints) caused by Pseudomonas or staphylococcus, in acute pneumonia caused by Streptococcus pneumoniae, and in chlamydial infections of the urinary tract, the dose should be increased to 0.75 g each. pills should be swallowed whole with a small amount of liquid after meals. When taking a tablet on an empty stomach, the active substance is absorbed faster. In / in drip: the duration of the infusion is 30 minutes at a dose of 0.2 g and 60 minutes at a dose of 0.4 g. Infusion solutions ready for use can be combined with 0.9% sodium chloride solution, Ringer's solution and Ringer's lactate solution, 5% and 10 % dextrose solution, 10% fructose solution, as well as a solution containing 5% dextrose solution with 0.225% or 0.45% sodium chloride solution.For uncomplicated urinary tract infections, infections of the lower respiratory tract, a single dose - 0.2 g for complicated infections of the upper urinary tract, for severe infections (including pneumonia, osteomyelitis), a single dose - 0.4 g. especially severe, life-threatening or recurrent infections caused by Pseudomonas, staphylococcus or Streptococcus pneumoniae, the dose can be increased to 0.4 g with a frequency of administration up to 3 times per day. The duration of treatment with osteomyelitis can reach up to 2 months. With chronic carriage of Salmonella - 0.2 g 2 times a day, the course of treatment is up to 4 weeks. If necessary, the dosage can be increased to 0.5 g 3 times a day. In acute gonorrhea, once - 0.1 g. For the prevention of infections during surgical interventions - 0.2-0.4 g for 0.5-1 h before the operation with the duration of the operation over 4 h administered again in the same dose. Average duration of treatment: 1 day - for acute uncomplicated gonorrhea and cystitis up to 7 days - for infections of the kidneys, urinary tract and abdominal cavity, during the whole period of the neutropenic phase - in patients with weakened protective forces of the body, but not more than 2 months - for osteomyelitis and 7-14 days for all other infections. With streptococcal infections due to the danger of late complications, as well as chlamydial infections, treatment should last at least 10 days. In patients with immunodeficiency treatment is carried out during the entire period of neutropenia. Treatment should be carried out at least 3 days after the temperature normalizes or the clinical symptoms disappear. With a glomerular filtration rate (CC of 31-60 ml / min / 1.73 sq. M or serum creatinine concentration from 1.4 to 1.9 mg / 100 ml), the maximum daily dose is 0.8 g. With a glomerular filtration rate below 30 ml / min / 1.73 sq. M. m or serum creatinine concentration above 2 mg / 100 ml maximum daily dose - 0.4 g. Elderly patients reduce the dose by 30%. With peritonitis, it is permissible to use intraperitoneal administration of infusion solutions at a dose of 50 mg 4 times daily for 1 l of dialysate. After i / v use, you can continue the treatment orally.