Lorakson

Lorakson – a tsefalosporinovy antibiotic of the III generation.

Form of release and structure

Dosage form – powder for preparation of solution for intravenous (in/in) and intramuscular introduction (in oil): crystal weight from white with a yellow shade till white color (on 0,5 g or 1 g in bottles of 10 ml, in a cardboard pack of 1 or 12 bottles complete with 1 or 12 ampoules of solvent respectively, or without them).

Active ingredient of Lorakson – цефтриаксон (in the form of sodium salt), in 1 bottle – 500 or 1000 mg.

Solvent: water for injections, in 1 ampoule – 5 or 10 ml.

Indications to use

Lorakson's use is shown for treatment of the diseases caused by microorganisms, sensitive to a tseftriakson:

• Meningitis;
• Sepsis;
• Peritonitis, inflammatory pathologies of biliary tract and digestive tract;
• Pneumonia and other respiratory infections;
• Skin infections;
• Infections of urinary tract and kidneys;
• Infections of joints and bones;
• Gonorrhea and other infections of generative organs;
• Infectious and inflammatory diseases in otolaryngology;
• Infections at patients with the lowered immunity.

Besides, drug is appointed for prevention of infections in the postoperative period.

Contraindications

• I trimester of pregnancy;
• Hypersensitivity to cephalosporins and penicillin.

With care need to appoint drug premature children, newborns with a hyperbilirubinemia, at development of enteritis or colitis against the background of reception of antibacterial agents, at nonspecific ulcer colitis, a renal and/or liver failure, in II and III trimesters of pregnancy and during breastfeeding.

Route of administration and dosage

Powder after preparation of solution is entered in/in or in oil.

The recommended rules of dissolution and administration of drug:

• In/in jet introduction: 1 g of powder part in 10 ml of solvent (water for injections), make introduction slowly within 2-4 minutes;
• In/in drop introduction: 2 g of powder dissolve in 40 ml not of calciferous solution (5% or 10% solution of a dextrose, 5% solution of fructose or 0,9% chloride sodium solution), enter infusionally within 30 minutes;
• Injection in oil: 1 g of powder dissolve 1% of solution of lidocaine in 3,5 ml, carry out deep introduction to a gluteus (no more than 1 g of drug in 1 buttock). It is impossible to enter lidocaine solution in/in!

The dose and the period of treatment are appointed by the attending physician on the basis of clinical indications.

The recommended one-time daily dosing of Lorakson has age restrictions:

• Patients are more senior than 12 years: 1-2 g (for the infections caused by moderately sensitive pathogens, and severe forms of a disease increase in a dose to 4 g is allowed);
• Children up to 12 years, including babies: drug is appointed at the rate of 0,02-0,075 g to 1 kg of weight, at a dose higher than 0,05 g on 1 kg of weight it is necessary to administer the drug in/in kapelno within 30 minutes. Children weighing 50 kg are also more recommended to appoint doses for adults;
• The newborn aged up to 2 weeks: at the rate of 0,02-0,05 on 1 kg of weight.

At children, including newborns, treatment of bacterial meningitis begin with a daily dose 0,1 g on 1 kg of weight, the most admissible dose – 4 g a day. The dose needs to be adjusted after allocation of a pathogenic microorganism and definition of its sensitivity. The period of treatment depends on a contagium:

• Meningokokk – 4 days;
• Hemophilic stick (Pfeyfer's stick) – 6 days;
• Pneumococcus – 7 days;
• Sensitive enterobakteriya – 10-14 days.

At treatment of the gonorrhea caused by the strain which is forming and not forming a penicillinase appoint single introduction of 0,25 g in oil of drug.

For prevention of development of an infection against the background of surgical intervention, it is recommended in 1-1,5 hours prior to operation once to enter 1-2 g of a tseftriakson.

Patients with renal failures at clearance of creatinine (KK) is higher than 10 have some and normal function of a liver the dose of a tseftriakson should not be reduced.

At the expressed renal failure (KK less than 10 ml/min.) the daily dose of Lorakson should not exceed 2 g. At patients after carrying out a hemodialysis the dose of drug should not be changed.

At the broken function of a liver and normal function of kidneys the dose should not be reduced. It is regularly necessary to control the level of concentration of a tseftriakson in blood serum at patients with simultaneous heavy pathology of a liver and kidneys.

Side effects

• Alimentary system: taste disturbance, nausea, vomiting, a lock or diarrhea, abdominal pains, a meteorism, a glossitis, a pseudomembranous coloenteritis, stomatitis, dysbacteriosis, an abnormal liver function (in the form of increase in activity of liver enzymes, it is rare – an alkaline phosphatase or bilirubin, cholestatic jaundice);
• System of a hemopoiesis: neutropenia, leukopenia, granulocytopenia, thrombocytopenia, thrombocytosis, lymphopenia, hypocoagulation, hemolitic anemia, lengthening of a prothrombin time, decrease in concentration of plasma factors of coagulation (II, VII, IX, X);
• Urinary system: a renal failure (increase in content of urea in blood), an azotemia, a giperkreatininemiya, a cylindruria, a glucosuria, an oliguria, an anury, a hamaturia;
• Allergic reactions: skin rash, itch, small tortoiseshell, fever or fever; seldom – an eosinophilia, a bronchospasm, a serum disease, a polymorphic exudative erythema (including Stephens-Johnson's syndrome), an acute anaphylaxis, a Quincke's disease;
• Local reactions: morbidity on the vein course, phlebitis, in the place in oil of introduction morbidity and infiltrate;
• Others: dizziness, headache, nasal bleedings, superinfection, candidiasis.

Special instructions

Purpose of drug has to be made on detailed collecting the anamnesis.

It is regularly necessary to control the level of concentration of a tseftriakson in a blood plasma at patients with the simultaneous expressed liver and renal failure and the patients who are on a hemodialysis.

At long therapy it is regularly necessary to control indicators of a functional condition of kidneys and a liver, a picture of peripheral blood.

In rare instances ultrasound examination (ultrasonography) of a gall bladder can note passing blackouts which sometimes are followed by pains in right hypochondrium. In this case the patient should appoint an additional symptomatic treatment and to continue therapy by drug.

During Lorakson's use the use of alcoholic beverages is contraindicated.

In case of development of an acute anaphylaxis, the patient should immediately in/in enter Epinephrinum, and then – a glucocorticosteroid.

At treatment of the elderly and weakened patients there can be a need for purpose of vitamin K.

Considering ability of a tseftriakson to force out the bilirubin connected with blood serum albumine it is necessary to carry out carefully treatment of newborns with a hyperbilirubinemia, especially premature.

Medicinal interaction

Despite a synergism between tseftriaksony and aminoglycosides concerning influence on a significant amount of gram-negative bacteria, at heavy, life-threatening infections of the patient their co-administration is shown. Considering physical incompatibility of drug with aminoglycosides it is necessary to appoint their reception separately in the recommended doses.

Drug is incompatible with ethanol.

At Lorakson's combination to inhibitors of aggregation of thrombocytes, including non-steroidal anti-inflammatory drugs, the probability of bleeding increases. At joint reception with nefrotoksichny drugs (including loopback diuretics) the risk of development of nephrotoxicity increases.

Drug cannot be mixed in one syringe or an infusional bottle with other antibiotic.

Terms and storage conditions

To store in the place protected from light at a temperature up to 25 °C. To protect from children.

Period of validity – 2 years.