Tetracycline with nystatin tablets 100 + 22.2mg, No. 10

• Pneumonia;

• bronchitis;

• tracheitis;

• empyema of the pleura;

• cholecystitis;

• pyelonephritis;

• intestinal infections;

• whooping cough;

• endocarditis;

• endometritis;

• prostatitis;

• syphilis;

• gonorrhea;

• brucellosis;

• rickettsiosis;

• purulent infections of soft tissues;

• osteomyelitis;

• trachoma;

• conjunctivitis;

• blepharitis;

• tonsillitis;

• otitis;

• pharyngitis;

• furunculosis;

• infected eczema;

• rash;

• acne;

• folliculitis;

• prevention of postoperative infections.

Inside, 250 mg 4 times / day.

Film-coated tablets

1 tab.

tetracycline 100 mg

nystatin 22.2 mg

• Hypersensitivity to the components of the drug,

• pregnancy, lactation period,

• leukopenia,

• liver failure,

• peptic ulcer of the stomach and duodenum,

• children and adolescence.

• With caution Renal failure.

pharmachologic effect

Combined antibacterial agent. Tetracycline is a bacteriostatic antibiotic from the tetracyclines group. It is active against gram-positive (Staphylococcus spp., Including those producing penicillinase; Streptococcus spp., Streptococcus pneumoniae; Haemophilus influenzae, Listeria spp., Bacillus anthracis) and gram-negative microorganisms (Neisseria gonteorrhoeae. , Klebsiella spp., Salmonella spp., Shigella spp.), As well as Rickettsia spp., Chlamydia spp., Mycoplasma spp., Treponema spp. Resistant: Pseudomonas aeruginosa, Proteus spp., Serratia spp., Most strains of Bacteroides spp. and fungi, small viruses. Nystatin is a polyene fungicidal antibiotic highly active against yeast-like fungi of the genus Candida spp.

Pharmacokinetics

The main pharmacokinetic parameters relate to tetracycline. Absorption - 75 - 77%, with food intake decreases, binding to plasma proteins - 55 - 65%. The time to reach Cmax when taken orally is 2 to 3 hours (it may take 2 to 3 days to reach a therapeutic concentration). Over the next 8 hours, the concentration gradually decreases. Cmax - 1.5 - 3.5 mg / l (to achieve a therapeutic effect, a concentration of 1 mg / l is sufficient). Penetrates through the placental barrier and into breast milk. Vd - 1.3 - 1.6 l / kg. It is distributed unevenly in the body: Cmax is determined in the liver, kidneys, lungs, spleen, lymph nodes. Concentration in bile is 5-10 times higher than in blood serum. In the tissues of the thyroid and prostate gland, the concentration of tetracycline corresponds to that found in plasma; in pleural, ascitic fluid, saliva,milk of lactating women - 60 - 100% plasma concentration. It accumulates in large quantities in bone tissue, tumor tissues, dentin and enamel of milk teeth. Poorly penetrates the BBB. With intact meninges, the cerebrospinal fluid is not detected or is found in insignificant amounts (5-10% of the plasma concentration). In patients with diseases of the central nervous system, especially in inflammatory processes in the membranes of the brain, the concentration in the cerebrospinal fluid is 8 - 36% of the concentration in the plasma. Slightly metabolized in the liver. T1 / 2 - 6 - 11 hours, with anuria - 57 - 108 hours. In urine it is found in high concentration 2 hours after administration and lasts for 6 - 12 hours; in the first 12 hours, up to 10 - 20% of the dose is excreted by the kidneys. In smaller quantities (5-10% of the total dose) is excreted in the bile into the intestines,where partial reabsorption occurs, which promotes long-term circulation of the active substance in the body (intestinal-hepatic circulation). Excretion through the intestines - 20 - 50%. It is removed slowly during hemodialysis. Nystatin is practically not absorbed from the gastrointestinal tract. Nystatin does not have cumulative properties.

Side effect

From the digestive system: anorexia, vomiting, diarrhea, nausea, abdominal pain, glossitis, esophagitis, gastritis, ulceration of the stomach and duodenum, hypertrophy of the papillae of the tongue, discoloration of tooth enamel in children, irritation of the oral mucosa, dysphagia, hepatitis , pancreatitis. Local reactions: photosensitivity, allergic reactions (maculopapular rash, skin flushing, angioedema, anaphylactoid reactions, medicinal lupus erythematosus). From the hematopoietic system: hemolytic anemia, thrombocytopenia, neutropenia. On the part of laboratory parameters: increased activity of hepatic transaminases, hypercreatininemia, azotemia, hyperbilirubinemia. Others: hypovitaminosis B; superinfection (including fungal).

Application during pregnancy and lactation

Contraindicated during pregnancy and lactation (breastfeeding).

Application for violations of liver function

Contraindication: liver failure.

Application for impaired renal function

With caution: renal failure.

Application in children

Contraindication: children and adolescents.

special instructions

In connection with the possible development of photosensitization, it is necessary to limit insolation. With prolonged use, periodic monitoring of the function of the kidneys, liver, and hematopoietic organs is necessary. It can mask the manifestations of syphilis, and therefore, if a mixed infection is possible, it is necessary to conduct a monthly serological test for 4 months. Reception during the development of teeth can cause irreversible discoloration. For the prevention of hypovitaminosis, vitamins of group B and K, brewer's yeast should be prescribed.

Drug interactions

Due to the suppression of intestinal microflora, it reduces the prothrombin index (requires dose adjustment of indirect anticoagulants). Reduces the effectiveness of bactericidal antibiotics that disrupt the synthesis of the cell wall (penicillins, cephalosporins). Absorption is reduced by antacids containing calcium, aluminum and / or magnesium, iron preparations. Chymotrypsin increases the concentration and duration of circulation. The effectiveness of estrogen-containing oral contraceptives decreases and the risk of bleeding increases.