Composition
1 tablet contains ciprofloxacin hydrochloride (based on ciprofloxacin) – 500 mg
Pharmacological action
Ciprofloxacin is a broad-spectrum antimicrobial agent from the group of fluoroquinolones.
It acts bactericidal.
The drug inhibits the enzyme DNA gyrase of bacteria, as a result of which DNA replication and synthesis of bacterial cell proteins are disrupted.
Ciprofloxacin acts both on multiplying microorganisms and on those in the dormant phase.
Ciprofloxacin Active against Gram-negative aerobic bacteria: Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Klebsiella spp., Enterobacter spp., Proteus mirabilis, Proteus vulgaris, Serratia marcescens, Hafnia alvei, Edwardsiella tarda, Providencia spp., Morganella morganii, Vibrio spp., Yersinia spp., Haemophilus spp., Pseudomonas aeruginosa, Moraxella catarrhalis, Aeromonas spp., Pasteurella multocida, Plesiomonas shigelloides, Campylobacter jejuni, Neisseria spp. ; intracellular pathogens: Legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Mycobacterium avium-intracellulare; 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 also resistant to ciprofloxacin. Streptococcus pneumoniae, Enterococcus faecalis are moderately sensitive to the drug. The drug is resistant to Corynebacterium spp., Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides.
The effect of the drug on Treponema pallidum has not been sufficiently studied.
Indications
Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
– kidney and urinary tract
– reproductive system (including gonorrhea, prostatitis);
– respiratory;
musculoskeletal system;
– sepsis;
– peritonitis;
ear, nose and throat;
gynecology (including adnexitis) and postnatal infection;
– the digestive system (including the mouth, teeth, jaws);
– gallbladder and biliary tract;
– skin, mucous membranes and soft tissues;
Prevention and treatment of infections in immunocompromised patients (with immunosuppressant therapy).
Use during pregnancy and lactation
Contraindicated.
Contraindications
With caution, the drug should be prescribed in patients with severe atherosclerosis of the cerebral vessels, cerebral circulation disorders, mental illnesses, convulsive syndrome, epilepsy, severe renal and/or liver failure, and elderly patients.
– children under 18 years of age (before the completion of the skeletal formation process);
– pregnancy;
– lactation (breastfeeding);
-glucose-6– phosphate dehydrogenase deficiency;
– pseudomembranous colitis;
– hypersensitivity to Ciprofloxacin or other drugs from the group of fluoroquinolones.
Side effects
Allergic reactions: pruritus, urticaria, blistering accompanied by bleeding, papules forming scabs, drug fever, spot hemorrhages (petechiae), swelling of the face or larynx, shortness of breath, eosinophilia, increased photosensitivity, vasculitis, erythema nodosum, exudative erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell’s syndrome).
Local reactions: pain and burning at the injection site, phlebitis.
From the digestive system: nausea, diarrhea, vomiting, abdominal pain, flatulence, anorexia, cholestatic jaundice (especially in patients with previous liver diseases), hepatitis, hepatonecrosis.
From the central nervous system and peripheral nervous system: dizziness, headache, fatigue, anxiety, tremor, insomnia, “nightmare” dreams, peripheral paralgesia (abnormal perception of pain), sweating, increased intracranial pressure, anxiety, confusion, depression, hallucinations, manifestations of psychotic reactions (sometimes progressing to conditions in which the patient can harm himself), migraine, fainting, thrombosis cerebral arteries.
From the sensory organs: taste and smell disorders, visual disturbances (diplopia, color perception changes), tinnitus, hearing loss.
From the cardiovascular system: tachycardia, cardiac arrhythmias, decreased blood pressure, flushes of blood to the skin of the face.
From the hematopoietic system: leukopenia, granulocytopenia, anemia, thrombocytopenia, leukocytosis, thrombocytosis, hemolytic anemia.
From the laboratory parameters: hypoprothrombinemia, increased activity of hepatic transaminases and alkaline phosphatase, hypercreatininemia, hyperbilirubinemia, hyperglycemia.
From the urinary system: hematuria, crystalluria (especially with alkaline urine and low diuresis), glomerulonephritis, dysuria, polyuria, urinary retention, albuminuria, urethral bleeding, hematuria, decreased nitrogen-releasing function of the kidneys, interstitial nephritis.
Musculoskeletal disorders: arthralgia, arthritis, tendovaginitis, tendon tears, myalgia.
Other: general weakness, superinfections (candidiasis, pseudomembranous colitis).
Interaction
Pharmaceutical interaction The infusion solution of the drug is pharmaceutically incompatible with all infusion solutions and preparations that are physically and chemically unstable in an acidic environment (the pH of the ciprofloxacin infusion solution is 3.5-4.6). Do not mix the solution for intravenous use with solutions having a pH of more than 7.
Due to a decrease in the activity of microsomal oxidation processes in hepatocytes, ciprofloxacin increases the concentration and prolongs the half-life of theophylline and other xanthines (for example, caffeine), oral hypoglycemic drugs, indirect anticoagulants, and helps to reduce the prothrombin index.
Concomitant use with NSAIDs (with the exception of acetylsalicylic acid) increases the risk of seizures. Metoclopramide accelerates the absorption of ciprofloxacin, which reduces the time to reach the maximum concentration of the latter.
Co-use of uricosuric drugs leads to a slowdown in excretion (up to 50%) and an increase in the plasma concentration of ciprofloxacin. When combined with other antimicrobials (beta-lactam antibiotics, aminoglycosides, clindamycin, metronidazole), synergy is usually observed.
Therefore, Ciprofloxacin can be successfully used in combination with azlocillin and ceftazidime for infections caused by Pseudomonas spp. ; with mezlocillin, azlocillin and other beta-lactam antibiotics – for streptococcal infections; with isoxazolpenicillins and vancomycin – for staphylococcal infections; with metronidazole and clindamycin – for anaerobic infections.
Ciprofloxacin enhances the nephrotoxic effect of cyclosporine, an increase in serum creatinine is also noted, so in such patients it is necessary to monitor this indicator 2 times a week.
When taken simultaneously, Ciprofloxacin enhances the effect of indirect anticoagulants.
How to take Ciprofloxacin, the course of use and dosage
of Ciprofloxacin depends on the severity of the disease, the type of infection, the state of the body, age, weight and kidney function of the patient.
Usually recommended doses: Ciprofloxacin in dosage form tablets of 250 mg and 500 mg for oral use: Diseases of the lower respiratory tract of moderate severity-250 mg, and in more severe cases-500 mg,2 times a day;
Uncomplicated diseases of the kidneys and urinary tract-250 mg, and in complicated cases 500 mg,2 times a day;
For the treatment of gonorrhea, a single dose of Ciprofloxacin 250-500 mg is recommended;
Gynecological diseases, enteritis and colitis with severe course and high fever, prostatitis, osteomyelitis-500 mg 2 times a day (for the treatment of banal diarrhea, you can use a dose of 250 mg 2 times a day).
The drug should be taken on an empty stomach, washed down with a sufficient amount of liquid.
Patients with severe renal impairment should be given a half – dose of the drug.
The duration of treatment depends on the severity of the disease, but treatment should always be continued for at least two more days after the symptoms of the disease disappear.
Usually, the duration of treatment is 7-10 days.
Overdose
Use as an infusion
Symptoms: Â nausea, vomiting, confusion, mental agitation.
Treatment: Â the specific antidote is unknown. It is necessary to carefully monitor the patient’s condition, conduct symptomatic therapy, and ensure sufficient fluid intake. In order to prevent the development of crystalluria, it is recommended to monitor kidney function, including the acidity (pH) of urine.
Oral use
Symptoms: Â dizziness, tremor, headache, fatigue, seizures, hallucinations, prolongation of the QT interval, gastrointestinal disorders, impaired liver and kidney function, crystalluria, hematuria.
Treatment: Â the specific antidote is unknown. Gastric lavage, taking activated charcoal, antacids containing calcium and magnesium to reduce the absorption of ciprofloxacin. To prevent the development of crystalluria, monitoring of renal function, including pH and acidity of urine, is recommended. Symptomatic therapy. Careful monitoring of the patient’s condition, ensuring sufficient fluid intake.
Only a small amount (less than 10%) of ciprofloxacin can be removed by hemo – or peritoneal dialysis.
Ophthalmic use
No overdose data are available. If you experience unpleasant sensations in the eye area, it is recommended to rinse your eyes with warm water.
Special instructions
Influence on the ability to drive motor vehicles and manage mechanisms
Patients taking Ciprofloxacin should exercise caution when driving a car or engaging in other potentially dangerous activities that require increased attention and speed of psychomotor reactions (especially when drinking alcohol at the same time).
If severe and prolonged diarrhea occurs during or after Ciprofloxacin treatment, the diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and appropriate treatment. During treatment with Ciprofloxacin, it is necessary to provide a sufficient amount of fluid while maintaining normal diuresis.
During treatment with Ciprofloxacin, avoid contact with direct sunlight. Patients with epilepsy, seizures in the anamnesis, vascular diseases and organic brain damage due to the threat of adverse reactions from the central nervous system Ciprofloxacin should be prescribed only for vital indications.
If severe and prolonged diarrhea occurs during or after Ciprofloxacin treatment, the diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and appropriate treatment.
If there is pain in the tendons or if the first signs of tendovaginitis appear, treatment should be discontinued due to the fact that individual cases of inflammation and even tendon rupture have been described during treatment with fluoroquinolones.
Form of production
Film-coated tablets
Storage conditions
Store in a dark place at a temperature of 5 ° C to 20°C out of the reach of children. Do not freeze!
See expiration date. on upakvok.
Active ingredient
Ciprofloxacin
Conditions of release from pharmacies
By prescription
Dosage form
Tablets
Purpose
Children as prescribed by a doctor, Adults as prescribed by a doctor
Indications
Intestinal Infections, Respiratory Tract Infections, Infectious Diseases, Urinary Tract Infections, Otitis Media, Biliary Tract Infections, Sinusitis, Skin Infections, Pneumonia
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Side effects of Ciprofloxacin, pills 500mg, 10pcs.
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