Ciprofloxacin

General characteristics. Structure:

Active ingredient: 250 mg of ciprofloxacin of a hydrochloride (in terms of ciprofloxacin).

Ciprofloxacin has antibacterial (bactericidal) effect.

Pharmacological properties:

Pharmacodynamics. Blocks DNK-girazu and interferes with DNA replication, breaks growth and division of bacteria. Causes the expressed morphological changes (including a cell wall and membranes) and bystry death of a cell. Affects microorganisms in a growth period and rest.

Ciprofloxacin possesses a wide range of antimicrobic action. Has effect on Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes, Campilobacter jejuni, Citrobacter diversus, Citrobacter freundii, Enterobacter cloaceae, Escherichia coli, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Morganella morganii, Neisseria gonorrhoeae, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, Pseudomonas aeruginosa, Salmonella typhi, Serratia marcescens, Shigella flexneri, Shigella sonnei, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus, Acinetobacter spp., Aeromonas caviae, Aeromonas hydrophilia, Brucella melitensis, Campylobacter spp. Edwardsiella tarda, Enterobacter aerogenes, Haemophilus ducreyi, Klebsiella oxytoca, Legionella pneumophila, Moraxella (Branhamella) catarrhalis, Neisseria meningitidis, Pasteurella multocida, Salmonella enteritidis, Vibrio cholerae, Vibrio parahaemolyticus, Vibrio vulnificus, Yersinia enterocolitica, Chlamydia trachomatis, Mycobacterium tuberculosis.

Pharmacokinetics. Ciprofloxacin is quickly and rather fully soaked up from digestive tract. Absolute bioavailability — 60 — 80%. The maximum concentration in a blood plasma is reached in 1 — 1,5 h. Meal slows down absorption. Contacts proteins of plasma for 20 — 40%.

Creates high concentration in kidneys, a gall bladder, a liver, lungs, mucous bronchial tubes and sine, female generative organs, the englobing cells (polinukleara, macrophages), urine, a phlegm, bile; it is found in a prostate, cerebrospinal fluid, saliva, skin, fatty tissue, muscles, bones, cartilages, passes through a placenta.

Elimination half-life at intake — 3,5 — 5 h. It is metabolized in a liver with formation of low-active metabolites. It is removed generally by kidneys, partially — with bile and excrements. Concentration in urine considerably surpass MPK for the majority of causative agents of infections of urinary tract.

Indications to use:

It is applied at infections urinary and respiratory tracts (pneumonia, except pneumococcal, acute and chronic bronchitis, bronchiectasias, aggravations at patients with cystous fibrosis); ENT organs (average otitis, sinusitis, mastoiditis, tonsillitis, pharyngitis), bodies of a small pelvis (cystitis, pyelonephritis, adnexitis, endometritis, oophoritis, tubular abscess, pelvic peritonitis, prostatitis); abdominal and gepatobiliarny infections (peritonitis, intraperitoneal abscesses, cholecystitis, cholangitis); infections of bones and joints (osteomyelitis, septic arthritis); skin and soft tissues (the infected ulcers, wounds, burns, abscesses, cellulitis, an infection of outside acoustical pass); venereal (gonorrhea, venereal ulcer, clamidiosis); heavy system infections (sepsis, infections at patients with a neutropenia); salmonellonositelstvo; to infectious diarrhea (activators strains of E. соli and Campylobacter jejuni are); to prevention of infections at surgical interventions (in urology, gastroenterology, orthopedics).

Route of administration and doses:

Accept inside, washing down with liquid: at uncomplicated infections of the lower and upper parts of urinary tract — on 250 mg in 2 times a day, within 3 days; at the complicated infections of upper and lower parts of urinary tract — inside on 500 mg 2 times a day within 14 days; at heavy infections (pneumonia, osteomyelitis) — inside on 750 mg 2 times a day; at a chronic salmonellonositelstvo — inside on 750 mg 2 times a day within 4 weeks; at acute gonorrhea — once inside 250 or 500 mg; at diarrhea — on 500 mg 2 times a day; for prevention of infections at surgical interventions — 500 — 750 mg inside in 30 — 60 min. prior to operation (lasting operation over 4 watch the dose is repeated).

Features of use:

Due to the incompleteness of formation of a skeleton drug is contraindicated to use for children and teenagers aged up to 15 years.

The patients applying ciprofloxacin should be careful during the driving of the car and occupations other potentially dangerous types of activity, especially at a concomitant use of alcohol.

Side effects:

At administration of drug nausea, vomiting, abdominal pains, a meteorism, appetite loss, diarrhea, a headache, dizziness, fatigue, vision disorders, a diplopia, a sonitus, spasms, increase in intracranial pressure, toxic psychosis, hallucinations, a photosensitization, allergic reactions (an erythema, an itch, a face edema, an eosinophilia), hypo - or hypertensia, tachycardia, a joint pain and muscles, a crystalluria, decline in the ability to bystry reaction, especially against the background of alcohol are possible.

Interaction with other medicines:

Activity increases at a combination to a beta laktamnymi antibiotics, aminoglycosides, Vancomycinum, clindamycin, metronidazole.

Sukralfat, the bismuth drugs, antacids containing aluminum, magnesium or calcium, Cimetidinum, ranitidine, vitamins C microelements, gland sulfate purgatives reduce absorption.

Reception of ciprofloxacin increases concentration of theophylline, Aminophyllinum and caffeine in plasma. Increases nephrotoxicity of cyclosporine, risk of convulsive reactions against the background of NPVS. Strengthens effect of warfarin, etc. peroral anticoagulants (extends a bleeding time).

The drugs alkalinizing urine reduce solubility (the probability of a crystalluria increases).

Ciprofloxacin inhibits oxidizing enzymes of a liver and can strengthen effect of the drugs which are metabolized with the participation of enzymes of system of P 450 cytochrome.

Contraindications:

Hypersensitivity (including to other drugs of group of ftorkhinolon), deficit glyukozo-6-fosfatdegidrogenazy, epilepsy, children's and teenage age (up to 15 years), pregnancy, feeding by a breast (for treatment stop).

Precautionary measures. Patients should appoint drug with care with atherosclerosis of vessels of a brain, disturbance of cerebral circulation, a convulsive syndrome.

The patient should be informed that if after use of drops the long time proceeds or the conjunctival hyperemia accrues, it is necessary to stop use of drug and to see a doctor.

Overdose:

There are no specific symptoms of overdose.

Treatment: a gastric lavage, introduction of a large amount of liquid, creation of acid reaction of urine, in addition — a hemodialysis and peritoneal dialysis (it is possible to remove less than 10% of the accepted dose); all events are held against the background of maintenance of the vital functions. There is no specific antidote.

Issue conditions:

According to the recipe

Packaging:

Capsules of 250 mg in a blister strip packaging No. 10х2.