Bicillinum-5

General characteristics. Structure:

Active ingredient: Bicillinum-5, powder of 1500 000 PIECES (mix of a benzatin of benzylpenicillin sterile (Bicillinum-1) – 1 200 000 PIECES, benzylpenicillin of novocainic salt sterile – 300 000 PIECES).

Pharmacological properties:

Pharmacodynamics. It is active rather gram-positive microorganisms:
Staphylococcus spp. (except producing a penicillinase), Streptococcus spp. (including Streptococcus pneumoniae), Corynebacterium diphtheriae, Bacillus anthracis; gram-negative: Neisseria gonorrhoae, Neisseria meningitidis, Actinomyces israelii, and also Treponema spp., anaerobic spore-forming. The majority of gram-negative bacteria, mycobacteria, mushrooms, viruses, the elementary are steady against effect of drug. Drug has bactericidal effect by inhibition of synthesis of mukopeptid of a cellular cover of microorganisms. Drug has the prolonged effect.

Pharmacokinetics. At intramuscular introduction the depot of drug in muscular tissue is formed. High level of concentration of drug is created already during the first hours after an injection, therapeutic concentration of benzylpenicillin remains in blood for 28 days and more at the vast majority of patients (children and adults). Out of an organism it is brought preferential by kidneys, a small amount of drug is allocated with a phlegm, then, saliva, the lacrimal liquid, gets into breast milk.
Pharmaceutical characteristics.
Main physical and chemical properties: powder of color, white or white with slightly yellowish shade.
Incompatibility. It is not necessary to mix Bitsillina®-5 solution with other injection solutions.

Indications to use:

Treatment of the infections caused by microorganisms, sensitive to benzylpenicillin, in need of long influence on the last. Use of Bitsillina®-5 is especially shown for year-round prevention of a recurrence of rheumatism at adults and children.

Route of administration and doses:

Before introduction it is necessary to collect the anamnesis of portability of drug and local anesthetic at the patient and to carry out a preliminary intracutaneous test on portability of drug and test on portability of local anesthetic!
Bicillinum ®-5 is entered only intramusculary! To children from 3 to 8 years Bitsillin®-5 enter disposable in a dose 600 000 PIECES of 1 times in 3 weeks. To children 8 years – in a dose of 1 200 000 PIECES of 1 times in 4 weeks are more senior. The adult enter disposable in a dose 1 500 000 PIECES of 1 times in 4 weeks. It is contraindicated to do injections of Bitsillina®-5 more often. Usually duration of treatment depends on disease severity and makes from 3 to 12 months.
Rules of preparation and administration of solution. Bitsillina®-5 suspension is prepared aseptically, just before use: with drug under pressure enter 9 ml of sterile water for injections into a bottle or 0,9% of solution of sodium of chloride, or 0,25-0,5% of solution of novocaine. Contents of a bottle are mixed before formation of homogeneous suspension. Suspension is entered deeply into an upper outside quadrant of a buttock (2 injections do in different buttocks).
At introduction of Bitsillina®-5 preparation of Bitsillina®-5 suspension using novocaine solution is contraindicated to children up to 18 years!

Features of use:

Before an initiation of treatment of Бициллином®-5 patients it is necessary to check for portability of drug and to take samples on portability of local anesthetic.
It is necessary to find out whether reactions to drugs of group of β-lactams and/or and/or novocaine were noted at their previous use. To the patients inclined to allergic reactions, drug is appointed with care. At emergence of signs of allergic reactions of Bitsillin®-5 it is necessary to cancel and appoint the corresponding therapy.
Ability to influence speed of response at control of motor transport or work with other mechanisms. At the moment there are no messages, however it is necessary to consider possibility of side reactions from the central nervous and cordial vascular system.

Side effects:

Hypersensitivity reactions: skin rash, itch, exfoliative dermatitis, mnogoformny exudative erythema, fever, arthralgia, small tortoiseshell, Quincke's disease of Quincke, acute anaphylaxis.
From a respiratory organs: bronchospasm.
From the central and peripheral nervous system: dizziness, sonitus, headache.
From a digestive tract: nausea, glossitis, diarrhea, abnormal liver functions, pseudomembranous colitis.
From urinogenital system: intersticial nephrite.
From cardiovascular system: disturbances of pumping function of a myocardium, fluctuation of arterial pressure, tachycardia.
From blood and lymphatic system: positive takes of the test of Koombs, hemolitic anemia, leukopenia, thrombocytopenia, agranulocytosis.
Local reactions: morbidity in an injection site is possible.
Others: eosinophilia. The weakened patients, newborns, elderly people at prolonged treatment can have a superinfection caused by microflora, steady against drug (drozhzhepodobny mushrooms, gram-negative microorganisms). At intravenous administration of high doses and at patients with a renal failure developing of hemolitic anemia, a neutropenia and increase in a blood clotting time is possible. Patients who receive medical treatment concerning syphilis can also have Yarisha-Gerksgeymer's reaction for the second time to a bacteriolysis.

Interaction with other medicines:

It is not recommended to combine administration of drug with nonsteroid antiinflammatory
means, ethinylestradiol, oral contraceptives. Drug increases efficiency of indirect anticoagulants. In combination with aminoglycosides, macroleads, streptocides drug shows synergistic action. The effect of drug is reduced by bacteriostatic medicines (chloramphenicol), and inhibitors beta лактамаз increase its activity. Diuretics, Allopyrinolum, blockers of kanaltsiyevy secretion, non-steroidal anti-inflammatory drugs block kanaltsiyevy secretion therefore concentration of drug in a blood plasma increases. At combined use with Allopyrinolum the risk of development of skin rash increases. Benzylpenicillin reduces clearance and increases toxicity of a methotrexate.

Contraindications:

Hypersensitivity to β-laktamny antibiotics (penicillin, cephalosporins, karbapenema), novocaine; bronchial asthma, small tortoiseshell, hay fever and other allergic diseases.

Use during pregnancy or feeding by a breast. Data on use of Bitsillin®-5 medicine are absent.
Children. Drug is appointed to children aged from 3 years. At introduction of Bitsillina®-5 preparation of Bitsillina®-5 suspension using novocaine solution is contraindicated to children up to 18 years.

Overdose:

It is shown by toxic action on TsNS: reflex excitement, headache, nausea, vomiting, spasms, mialgiya, arthralgia, symptoms of a meningism, lump. In such cases administration of drug should be stopped.
Treatment – symptomatic, includes a hemodialysis, peritoneal dialysis, special attention it is necessary to pay to recovery of water and electrolytic balance.

Storage conditions:

Period of validity 4 years. In original packaging, at a temperature not above 25 °C. To store in the place, unavailable to children.

Issue conditions:

According to the recipe

Packaging:

On 1 500 000 PIECES in bottles.