Levomycetin Actitab tablets 500mg, No. 10

Infections of the urinary and biliary tract caused by sensitive microorganisms.

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

Children over 3 years old and / or weighing more than 20 kg are prescribed 12.5 mg / kg every 6 hours or 25 mg every 12 hours, in severe infections - up to 75-100 mg / kg / day (under control concentration of the drug in serum). The average duration of treatment is 8-10 days.

Pills

1 tab.

chloramphenicol 500 mg

• Hypersensitivity;

• oppression of bone marrow hematopoiesis;

• acute intermittent porphyria;

• deficiency of glucose-6-phosphate dehydrogenase;

• hepatic and / or renal failure;

• skin diseases (psoriasis, eczema, fungal infections);

• pregnancy;

• lactation period;

• children under 3 years of age and / or body weight less than 20 kg.

• Use with caution in patients who have previously received treatment with cytostatic drugs or radiation therapy.

pharmachologic effect

A bacteriostatic antibiotic with a broad spectrum of action, disrupts the process of protein synthesis in a microbial cell at the stage of transfer of t-RNA amino acids to ribosomes. Effective against strains of bacteria resistant to penicillin, tetracyclines, sulfonamides. It is active against the following microorganisms: Escherichia coli, Shigella dysenteriae, Shigellaf Iexneri, Shigella boydii, Shigella sonnei, Salmonella spp (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, Klebsiella pneumoniae, Haemophilus influenzae.It has no effect on acid-fast bacteria (including Mycobacterium tuberculosis), anaerobes, methicillin-resistant strains of staphylococci, Acinetobacter spp., Enterobacter spp., Serratia marcescens, indole-positive strains Proteus spp., Pseudomonas aeruginosa, protozoa and fungi. Resistance of microorganisms develops slowly.

Pharmacokinetics

After administration, the connection with plasma proteins is 50-60%. Tmax after administration - 1-3 hours. Vd- 0.6-1.0 l / kg. The therapeutic concentration in the blood is maintained for 4-5 hours after administration. It penetrates well into body fluids and tissues. Its highest concentrations are found in the liver and kidneys. Up to 30% of the administered dose is found in bile. Cmax in cerebrospinal fluid is determined 4-5 hours after a single dose and can reach, in the absence of meninges inflammation, 21-50% of Cmax in plasma and 45-89% - in the presence of meninges inflammation. Passes through the placental barrier, the concentration in the serum of the fetus can be 30-80% of that 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.It is 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 intestines - 1-3%. T1 / 2 in adults - 1.5-3.5 hours, with impaired renal function - 3-11 hours. T1 / 2 in children - 3.0-6.5 hours. Poorly excreted during hemodialysis.

Side effect

From the digestive system: dyspepsia, nausea, vomiting (the likelihood of development decreases when taken 1 hour after eating), diarrhea, irritation of the oral mucosa and pharynx, dermatitis, dysbiosis (suppression of normal microflora). From the side of hematopoietic organs: reticulocytopenia, leukopenia, granulocytopenia, thrombocytopenia, erythrocytopenia; rarely - aplastic anemia, agranulocytosis. From the nervous system: psychomotor disorders, depression, confusion, peripheral neuritis, optic neuritis, visual and auditory hallucinations, decreased visual acuity and hearing, headache. Allergic reactions: skin rash, angioedema. Others: secondary fungal infection.

Application during pregnancy and lactation

Contraindicated during pregnancy and lactation.

Application for violations of liver function

Contraindicated in liver failure.

Application for impaired renal function

Contraindicated in renal failure.

Application in children

Contraindicated in children under 3 years of age, as well as in children weighing less than 20 kg.

special instructions

Severe complications from the hematopoietic system, as a rule, are associated with the use of high doses for a long time. With the simultaneous administration of ethanol, a disulfiram-like reaction may develop (flushing of the face, cramps in the abdomen and in the stomach, nausea, vomiting, headache, decreased blood pressure, tachycardia, shortness of breath).

Overdose

Symptoms: nausea, vomiting. Treatment: gastric lavage, symptomatic therapy, hemosorption.

Drug interactions

It inhibits microsomal liver enzymes, therefore, when used simultaneously with phenobarbital, phenytoin, indirect anticoagulants, a weakening of the metabolism of these drugs is noted, a slowdown in excretion and an increase in their concentration in plasma. Reduces the antibacterial effect of penicillins and cephalosporins. With simultaneous use with erythromycin, clindamncin, lincomycin, a mutual weakening of the action is noted due to the fact that chloramphenicol can displace these drugs from the bound state or prevent them from binding to the 50S subunit of bacterial ribosomes. Simultaneous administration with drugs that inhibit hematopoiesis (sulfonamides, cytostatics), affecting the metabolism in the liver, with radiation therapy increases the risk of side effects.When administered with oral hypoglycemic drugs, an increase in their action is noted (due to the suppression of metabolism in the liver and an increase in their concentration in plasma). Myelotoxic drugs increase the manifestations of the drug's hematotoxicity.