Levomycetin Actitab, pills 500mg, 10pcs

Composition

Active ingredient:

chloramphenicol – 500 mg;

Auxiliary substances:

colloidal silicon dioxide (aerosil),

microcrystalline cellulose,

povidone,

crospovidone,

calcium stearate,

opadray II (series 85) [polyvinyl alcohol, macrogol, talc, titanium dioxide, aluminum varnish based on quinoline yellow, aluminum varnish based on Indigo Carmine];

Pharmacological action

Levomycetin Actitab is a broad-spectrum bacteriostatic antibiotic that disrupts protein synthesis in the microbial cell during the transfer of t-RNA amino acids to ribosomes.

It is effective against bacterial strains resistant to penicillin, tetracyclines, and sulfonamides.

Active against the following microorganisms: Escherichia coli, Shigella dysenteria, Shigella flexneri spp., Shigella boydiispp., Shigellasonnei, Salmonellaspp. (including Salmonella typhi, Salmonella paratyphi), Staphylococcus spp., Streptococcus spp. (including Streptococcus pneumoniae), Neisseria meningitidis, Neisseria gonorrhoeae, a number of strains Proteus spp., Burkholderia pseudomallei, Rickettsia spp., Treponema spp., Leptospira spp., Chlamydia spp. (including Chlamydia trachomatis), Coxiella burnetii, Ehrlichia canis, Bacteroides fragilis, Klebsiella pneumoniae, Haemophilus influenzae.

It has no effect on acid-resistant bacteria (including Mycobacterium Tuberculosis), anaerobes, methicillin-resistant strains of staphylococci, Acinetobacterspp., Enterobacterspp., Serratiamarcescens, indole-positive strains of Proteusspp., Pseudomonasaeruginosaspp., protozoa and fungi. Microbial resistance develops slowly.

Pharmacokinetics

After use, the connection with plasma proteins is 50-60%. The time to reach the maximum concentration (TCmax) after use is 1-3 hours. The volume of distribution is 0.6-1.0 l/kg. The therapeutic concentration in the blood is maintained for 4-5 hours after use. Penetrates well into body fluids and tissues. Its greatest concentrations are created in the liver and kidneys. Up to 30% of the administered dose is detected in the bile. The maximum concentration (Cmax) in the cerebrospinal fluid is determined 4-5 hours after a single dose and can reach 21-50% of the Cmax in plasma in the absence of inflammation of the meninges and 45-89% in the presence of inflammation of the meninges. Passes through the placental barrier, fetal serum concentrations can be 30-80% of those in the mother’s blood. Penetrates into breast milk. The main amount (90%) is metabolized in the liver. In the intestine, under the influence of intestinal bacteria, it is hydrolyzed to form inactive metabolites.

Excreted within 24 hours by the kidneys – 90% (by glomerular filtration-5-10% unchanged, by tubular secretion in the form of inactive metabolites-80%), through the intestine-1-3%. The half-life (T1 / 2) in adults is 1.5-3.5 hours, with impaired renal function-3-11 hours. T1 / 2 in children is 3.0-6.5 hours. It is poorly excreted during hemodialysis.

Indications

Urinary and biliary tract infections caused by sensitive microorganisms.

Contraindications

Hypersensitivity, inhibition of bone marrow hematopoiesis, acute intermittent porphyria, glucose-6-phosphate dehydrogenase deficiency, hepatic and / or renal failure, skin diseases (psoriasis, eczema, fungal lesions), pregnancy, lactation, children under 3 years of age and/or body weight less than 20 kg.

Side effects

From the digestive system:  dyspepsia, nausea, vomiting (the probability of development decreases when taken 1 hour after eating), diarrhea, irritation of the oral and pharyngeal mucosa, dermatitis, dysbiosis (suppression of normal microflora).

From the side of hematopoietic organs:  reticulocytopenia, leukopenia, granulocytopenia, thrombocytopenia, erythrocytopenia; rarely-aplastic anemia, agranulocytosis.

Nervous system disorders:  psychomotor disorders, depression, confusion, peripheral neuritis, optic neuritis, visual and auditory hallucinations, decreased visual and hearing acuity, headache.

Allergic reactions:  skin rash, angioedema.

Other services:  secondary fungal infection.

Interaction

Inhibits microsomal liver enzymes, so when used simultaneously with phenobarbital, phenytoin, indirect anticoagulants, there is a weakening of the metabolism of these drugs, slowing down the excretion and increasing their concentration in plasma.

Reduces the antibacterial effect of penicillins and cephalosporins. When used concomitantly with erythromycin, clindamycin, lincomycin, there is a mutual weakening of the action due to the fact that chloramphenicol can displace these drugs from the bound state or prevent their binding to the 50S subunit of bacterial ribosomes.

Concomitant use with drugs that inhibit hematopoiesis (sulfonamides, cytostatics), affect the metabolism in the liver, with radiation therapy increases the risk of side effects.

When administered with oral hypoglycemic drugs, their effect is enhanced (due to the suppression of metabolism in the liver and an increase in their concentration in plasma).

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

How to take, course of use and dosage

Inside (30 minutes before meals, and with the development of nausea and vomiting-1 hour after meals),3-4 times a day. A single dose for adults – 0.25-0.5 g, daily-2 g. In severe forms of infections (in a hospital setting), it is possible to increase the dose to 3-4 g/day (under the control of blood status, kidney and liver function).

Children older than 3 years and / or weighing more than 20 kg are prescribed 12.5 mg / kg every 6 hours or 25 mg every 12 hours, with severe infections-up to 75-100 mg / kg / day (under the control of the drug concentration in the blood serum).

The average duration of treatment is 8-10 days.

Overdose

Symptoms: nausea, vomiting.

Treatment: gastric lavage, symptomatic therapy, hemosorption.

Special instructions

Severe complications from the hematopoietic system, as a rule, are associated with the use of high doses for a long time.

When taking ethanol at the same time, a disulfiram-like reaction may develop (facial hyperemia, abdominal and stomach cramps, nausea, vomiting, headache, decreased blood pressure, tachycardia, shortness of breath).

Composition

Tablet Form of production

Storage conditions

Store in a dry place, protected from light, at a temperature not exceeding 25 ° C.

Shelf life

2 years

Active ingredient

Chloramphenicol

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Indications

Gastrointestinal Infections, Conjunctivitis, Pneumonia, Sepsis