Cefalexin

General characteristics. Structure:

Active ingredient: 540,54 mg of cefalexin of monohydrate (in terms of cefalexin of 500 mg).

Excipients: lactoses monohydrate, magnesium stearate, talc (for a dosage of 250 mg), colloid silicon dioxide (for a dosage of 250 mg).

Semi-synthetic tsefalosporinovy antibiotic for oral use with pronounced bactericidal effect.

Pharmacological properties:

Pharmacodynamics. Cefalexin - represents the semi-synthetic tsefalosporinovy antibiotic of the I generation intended for oral use. Oppresses transpeptidase - the enzyme participating in biosynthesis of a mukopeptid of a cell wall of bacteria renders bactericidal effect. It is steady in acid medium. Cefalexin is active concerning the following microorganisms: streptococci (Streptococcuspyogenes, Streptococcuspneumoniae) and metitsillinochuvstvitelny stafilokokk.

Cefalexin has the low level of activity concerning gram-negative bacteria. From representatives of the Enterobacteriaceae family Escherichia coli, Proteus mirabilis are sensitive, however, among their strains, defiant extra hospital and especially nozokomialny infections the acquired stability is eurysynusic.

Note: The majority of strains of enterococci (Enterococcusfaecalis, mainly Streptococcusfaecalis) and some strains of stafilokokk are steady in relation to cefalexin. Drug is not active concerning the majority of strains of Enterobacter, Morganellamorganii (mainly Proteusmorganii) and Proteusvulgaris. Drug is not active also concerning Pseudomonasili Acinetobactercalcoaceticus (mainly Mimai Herella). In the researches invitrostafilokokki found cross stability between Cefalexin and antibiotics like Methicillinum.

Pharmacokinetics. After intake on an empty stomach quickly (during 1-2 h) and almost completely (to 95%) it is soaked up from a GIT. Meal slows down a resorption, without influencing its completeness. Therapeutic concentration in blood remains 4-6 hours. Proteins of plasma about 15% communicate. Well gets into fabrics (lungs, kidneys, a liver, heart), passes through a placenta, in a small amount it is found in breast milk. T1/2 makes of 30 min. to 2 h. It is removed generally by kidneys by glomerular filtering and canalicular secretion in an invariable look (70-89%), in a small amount with bile.

Indications to use:

Not heavy infectious and inflammatory processes of various localization caused by microorganisms, sensitive to drug: infections of upper and lower parts of respiratory tracts (pharyngitis, acute pneumonia, bronchial pneumonia, etc.); tonsillitis, quinsy, average otitis, sinusitis; infections of skin and soft tissues (furunculosis, abscesses, pyodermas, lymphangitis, etc.); acute and chronic pyelonephritises, cystitis, uretrita, prostatitises, gynecologic infections, gonorrhea; acute and chronic osteomyelitis.

Special instructions: the culture and tests of sensitivity have to be defined to and during treatment. If necessary it is necessary to carry out control of function of kidneys.

Route of administration and doses:

Capsules apply inside entirely, washing down with a small amount of water. Cefalexin кислотоустойчив can be also applied irrespective of meal time.

Adults. The daily dose varies within 1-4 g a day, divided into 2-4 receptions. A usual dose are 0,5-1,0 g each 6 hours. At a streptococcal tonzillofaringit the dose of 500 mg is appointed by each 12 hours within 10 days.

At heavier infections higher doses can be required.

Children. To children up to 7 years do not appoint in connection with difficulty of swallowing of capsules.

To children drug is appointed at the rate of 45 mg/kg a day.

Frequency rate of administration of drug of 3-4 times/days. Duration is treatment-7-14 days. At the infectious diseases caused by streptococci, the course of treatment has to make not less than 10 days.

At a streptococcal tonzillofaringit the dose of 12,5-25 mg/kg is accepted by each 12 hours within 10 days.

Features of use:

Use of cefalexin is possible only on doctor's orders.

Before purpose of cefalexin it is necessary to conduct comprehensive examination of the patient taking into account possible hypersensitivity reactions to cephalosporins and penicillin.

With care apply at the expressed renal failures and/or a liver, instructions on colitis in the anamnesis.

At treatment it is impossible to take alcohol and medicines containing alcohol.

At appointment practically all antibiotics of a broad spectrum of activity (including macroleads, semi-synthetic penicillin and cephalosporins) chances of pseudomembranous colitis therefore it is necessary to consider this diagnosis at patients with the developed diarrhea after use of antibiotics. Such colitis can be shown both benign, and in shape, life-threatening. Easy forms of pseudomembranous colitis usually pass after the termination of administration of drug. Averages and severe forms demand carrying out a rektosigmoskopiya, and also the bacteriological analysis, administration of liquid, electrolytes and proteinaceous additives. If after the termination of administration of drug the condition of the patient did not improve or in cases of heavy colitis Vancomycinum is appointed orally. Other reasons of colitis are excluded.

During reception of cefalexin false positive reaction to sugar in urine when using reactants of Benedict and Felinga is possible, and also positive forward reaction of Koombs.

Side effects:

At reception of cefalexin disorder of function of digestive tract (nausea, vomiting, abdominal pains, in rare instances diarrhea) is possible, at prolonged use - development of dysbacteriosis. After drug phase-out these phenomena pass.

Also allergic reactions in the form of rashes, a small tortoiseshell are possible, it is rare - a Quincke's disease. At emergence of these phenomena use of cefalexin is stopped and carry out the desensibilizing therapy. At patients with hypersensitivity to penicillin allergic reactions to cefalexin are observed more often.

At prolonged treatment by cefalexin tranzitorny increase in activity of transaminases in blood, in rare instances a reversible neutropenia, an eosinophilia can be observed.

Among other side reactions it should be noted a genital and proctal itch, genital candidiasis, vaginita and vulval allocations, dizziness, fatigue, a headache, alarming arousing, confusion of consciousness, a hallucination, an arthralgia, arthritis and disturbances in joints. Sometimes intersticial nephrite, eosinophilia, neutropenia, thrombocytopenia.

Interaction with other medicines:

Furosemide, Acidum etacrynicum and nefrotoksichny antibiotics increase risk of damage of kidneys.

Strengthens effect of indirect anticoagulants.

Salicylates and indometacin slow down removal.

Contraindications:

Allergic reactions in the anamnesis (anaphylaxis) to the penicillin derivative of penicillin, Penicillaminum or cephalosporins; digestive tract diseases, especially nonspecific ulcer colitis connected using antibiotics (cephalosporin can cause pseudomembranous colitis); the expressed disturbances of functions of a liver and kidneys.

To children to 7 leena appoint in connection with difficulty of swallowing of capsules.

Use at pregnancy and feeding by a breast

It is possible if the expected effect of therapy exceeds potential risk for a fruit. For the period of treatment it is necessary to stop breastfeeding.

Overdose:

Symptoms: nausea, vomiting, unpleasant feelings in epigastric area, diarrhea and a hamaturia. If other symptoms are observed they, apparently, are secondary in relation to the main state.

Treatment: symptomatic therapy.

Storage conditions:

List B. To store in the place protected from moisture and light at a temperature not above + 25 °C, in the place, unavailable to children. Period of validity 3 years.

Issue conditions:

According to the recipe

Packaging:

On 10 or 20 capsules in polymeric banks. On 10 capsules in a blister strip packaging. One bank or 1 or 2 blister strip packagings together with a leaf insert in secondary packaging.