Suprax caps 400mg #6

Suprax instruction

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pharmachologic effect

Semisynthetic cephalosporin antibiotic III generation for oral administration in a broad spectrum of action. It is bactericidal. The mechanism of action is due to the inhibition of the synthesis of the cell membrane of the pathogen. Cefixime is resistant to the action of β-lactamases produced by most gram-positive and gram-negative bacteria.
In vitro cefixime is active against gram-positive bacteria: Streptococcus agalactiae; Gram-negative bacteria: Haemophilus parainfluenzae, Proteus vulgaris, Klebsiella pneumoniae, Klebsiella oxytoca, Pasteurella multocida, Providencia spp., Salmonella spp., Shigella spp., Citrobacter amalonaticus, Citrobacter diversus, Serratia marcescens.
In vitro and under clinical practice, cefixime is active against gram-positive bacteria: Streptococcus pneumoniae, Streptococcus pyogenes; Gram-negative bacteria: Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, Escherichia coli, Proteus mirabilis, Neisseria gonorrhoeae.
To the cefixime are resistant Pseudomonas spp., Enterococcus (Streptococcus) serogroup D, Listeria monocytogenes, the majority of Staphylococcus spp. (including methicillin-resistant strains), Enterobacter spp., Bacteroides fragilis, Clostridium spp.

Pharmacokinetics

When administered, bioavailability of cefixime is 40-50% regardless of food intake, however, C max cefixime in serum is achieved faster by 0.8 h when taking the drug with food. The binding with plasma proteins, mainly with albumins, is 65%. About 50% of the dose is excreted in the urine unchanged for 24 hours, about 10% of the dose is excreted with bile. T1 / 2 depends on the dose and is 3-4 hours. In patients with impaired renal function with KK from 20 to 40 ml / min, T1 / 2 increases to 6.4 hours, with KK 5-10 ml / min - up to 11.5 hours.

Indications for Suprax

Infectious-inflammatory diseases caused by sensitive microorganisms: pharyngitis, tonsillitis, sinusitis, acute and chronic bronchitis, otitis media, uncomplicated urinary tract infections, uncomplicated gonorrhea.

Contraindications of Suprax

Hypersensitivity to cephalosporins and penicillins.

Dosage

For adults and children over 12 years of age with a body weight of more than 50 kg, the daily dose is 400 mg (1 time / day or 200 mg 2 times / day). The duration of the course of treatment is 7-10 days. With uncomplicated gonorrhea - 400 mg once.
Children under the age of 12 years - 8 mg / kg body weight 1 time / day or 4 mg / kg every 12 hours.
For infections caused by Streptococcus pyogenes, the course of treatment should be at least 10 days.
In case of violations of kidney function (with CC from 21 to 60 ml / min) or in patients on hemodialysis, the daily dose should be reduced by 25%.
With KK≤20 ml / min or in patients on peritoneal dialysis, the daily dose should be reduced by 2 times.

Side effects

On the part of the digestive system: dry mouth, anorexia, diarrhea, nausea, vomiting, abdominal pain, flatulence, transient increase in hepatic transaminase and alkaline phosphatase activity, hyperbilirubinemia, jaundice, candidiasis GI, dysbiosis; rarely - stomatitis, glossitis, pseudomembranous enterocolitis.
On the part of the hematopoiesis system: leukopenia, thrombocytopenia, neutropenia, hemolytic anemia.
From the side of the central nervous system: dizziness, headache.
From the side of the urinary system: interstitial nephritis.
Allergic reactions: skin itching, urticaria, skin hyperemia, eosinophilia, fever.

Overdose

The tubular secretion blockers (allopurinol, diuretics) delay the excretion of cefixin by the kidneys, which can lead to an increase in toxicity.
Cefixim reduces the prothrombin index, increases the effect of indirect anticoagulants.
Antacids, containing magnesium or aluminum hydroxide, slow the absorption of cefixime.

special instructions

With caution should be used in elderly patients, patients with chronic renal failure or pseudomembranous colitis (in the anamnesis), in children under 6 months of age.
With prolonged use, there may be a violation of normal intestinal microflora, which can lead to the growth of Clostridium difficile and cause the development of severe diarrhea and pseudomembranous colitis.
In patients with a history of allergic reactions to penicillins, there may be manifestations of hypersensitivity to cephalosporin antibiotics.
During treatment, a positive direct Coombs reaction and a false positive urine reaction to glucose are possible.

Pregnancy and lactemia

Use in pregnancy is possible only if the intended benefit to the mother exceeds the potential risk to the fetus.
If necessary, use during lactation should stop breastfeeding.

Application in childhood

With caution should be used in children under 6 months.

In case of violations of kidney function

In case of violations of kidney function (with CC from 21 to 60 ml / min) or in patients on hemodialysis, the daily dose should be reduced by 25%. At KK ≤20 ml / min, the daily dose should be reduced by a factor of 2.

Application in old age

Caution should be used in elderly patients.