Avelox tabs 400mg #5

Antibiotic Avelox instruction for use

You can buy Avelox here

Composition

One tablet contains moxifloxacin hydrochloride - 436, 8 mg + excipients (microcrystalline cellulose, magnesium stearate, yellow iron oxide, titanium dioxide, red iron oxide, lactose monohydrate, croscarmellose sodium, hypromellose, macrogol 4000).
One milliliter of the solution contains active ingredient moxifloxacin 1.6 mg + auxiliary elements (hydrochloric acid, water, sodium chloride, 2N sodium hydroxide solution).

Form of issue

    Avelox is released in the form of convex pink matte tablets, oblong form. On the tablet, the bevel and the inscription Bayer on one side, M400 on the other. In blisters for 5 or 7 pieces, in cardboard packs of 1 or 2 blisters.
    The preparation also has the form of a yellow-green transparent liquid. In bottles of 250 ml, one bottle in a pack or in plastic bags of the same capacity, 12 in a pack.

pharmachologic effect

Antibacterial action.

Pharmacodynamics and pharmacokinetics

The active substance is moxifloxacin - an antibacterial agent of 4 generations of quinolones, a group of trifluoroquinolones. It has broad antibacterial activity. The substance penetrates directly into the cell, disrupts the processes of replication of DNA hydrazide, this leads to the death of the bacterium due to a violation of the integrity of the cell. It should be noted that pathogenic agents do not have time to allocate a significant amount of toxins, severe intoxication does not occur.
A number of mechanisms that lead to resistance to cephalosporins, macrolides, penicillins, aminoglycosides, tetracyclines, do not work in the case of moxifloxacin. There is no cross and plasmid resistance. If resistance occurs, it does not happen immediately, after many mutations in harmful organisms. Rarely there was cross-resistance to quinolones.
Due to the added methoxy group on the structure of the molecule, on the eighth carbon atom, the activity of the antibiotic increases, the formation of resistant strains decreases.
Moxifloxacin shows activity to a fairly wide spectrum of acid-fast, Gram-positive and-negative bacteria, anaerobes, atypical agents (chlamydia, mycoplasma and legionella).
When using oral forms of the drug, there are changes in the intestinal microflora, the concentrations of bacteria necessary for the normal functioning of the gastrointestinal tract decrease. However, already two weeks after the end of the antibiotic course, the microflora is restored.
According to the results of in vitro laboratory tests, Moxifloxacin is sensitive to: Gardnerella vaginalis, Streptococcus pyogenes, Streptococcus angiosus, Streptococcus intermedius, Streptococcus agalactiae, Staphylococcus aureus, S. cohnii, S. haemolyticus, S. saprophyticus, Streptococcus pneumoniae, Streptococcus constellatus , group Streptococcus viridans, Streptococcus dysgalactiae, S. epidermidis, S. Hominis. Sensitivity is also manifested by: Haemophillus influenzae, Moraxella catarrhalis, Legionella pneumophila, Proteus vulgaris, Fusobacterium spp., Prevotela spp., Chlamydia pneumoniae, Mycoplasma pneumoniae, Mycoplasma enitalium, Coxiella burnetii, Chlamydia trachomatis, Mycoplasma hominis, Legionella pneumophila, Propionibacterium spp., Porphyromonas spp., Haemophillus parainfluenzue, Bordetella pertussis, Acinetobacter baumanii.
Sensitive sensitivity is possessed by: Enterococcus faecalis strains sensitive to vancomycin and gentamicin; Enterococcus faecium; Klebsiella pneumoniae, Citrobacter freundii, Enterobacter cloacae, Enterobacter cloacae, Enterobacter cloacae, Pseudomonas fluorescens, Stenotrophomonas maltophilia, Morganella morganii, Bacteroides spp., Clostridium spp. and others.
Moxifloxacin has the ability to penetrate the placenta. This was proved by carrying out studies in rats and monkeys. There have been cases of increased incidence of miscarriages, improper skeletal formation, premature birth and weight loss, even with doses slightly higher than therapeutic doses.
With oral administration of the drug, the antibiotic is quickly and almost completely absorbed and enters the bloodstream. About 90% of the drug is found in the blood plasma after half an hour, and after 4 reaches its maximum. If the agent is taken during a meal, the C max and suction time values ​​vary, but to a minor extent.
With an infusor input, the maximum concentration is reached by the end of the injection, it is 25% more than when taking tablets. The antibiotic quickly binds to albumins (50%) and other plasma proteins, spreads throughout the body, reaching a variety of target organs. Antibiotic is easy to detect in unchanged form in saliva, abdominal cavity, interstitial fluid, peritoneal fluid and genital organs.
Part of the drug in the body undergoes biotransformation and is excreted through the kidneys and the gastrointestinal tract. Formed metabolites do not have a negative effect on tissues and organs.
12 hours after taking the antibiotic, its plasma concentration is reduced by half, so it is advisable to take the next dose of the drug. Partial canaliculia reabsorption occurs in the kidneys. The fourth part of unchanged moxifloxacin is excreted through the kidneys and another 22% with feces.
Significant changes in pharmacokinetic parameters in patients with kidney and liver diseases, depending on age and race, were not revealed.

Indications for use

The drug is prescribed for the treatment of infections and inflammations caused by agents sensitive to its action:
    for the treatment of acute and chronic sinusitis;
    infections of the skin and soft tissues;
    chronic bronchitis;
    pneumonia;
    intra-abdominal abscesses, polymicrobial infections;
    endometritis, salpingitis, and other inflammatory diseases of the pelvic organs.

Contraindications

The drug is not prescribed:
    Children under 18 years of age, due to the lack of research;
    with allergies to the components of the agent, antibiotics of this series;
    during pregnancy and lactation;
    with congenital or acquired heart disease, accompanied by an elongation of the QT interval;
    hypokalemia;
    with bradycardia;
    heart failure (disruption of the right ventricle);
    arrhythmias;
    with intolerance to lactose;
    in the presence of serious liver disease.

Care should be taken:

    at psychoses, other mental illnesses, illnesses of a central nervous system;
    with acute myocardial ischemia;
    cirrhosis of the liver;
    when combined with the means that affect the activity of the heart.

Side effects

The drug is well researched. From the results of post-marketing research and clinical trials, we can conclude about the frequency and nature of the manifestations of adverse reactions.
The most frequent and common of the effects are nausea, diarrhea and vomiting.

With a frequency of less than 3% there were:

    fungal infections;
    headache and dizziness;
    occurrence of cardiac arrhythmia;
    pain in the epigastric region;
    increase in the level and activity of liver enzymes (transmiases);
    intramuscular administration of pain and reactions at the site of infusion.

Rarely and very rarely observed:

    leukopenia, thrombocytopenia, anemia, changes in the concentration of prothrombin or thromboplastin;
    Hyperuricemia, hyperlipidemia and hyperglycemia;
    state of anxiety, depression, emotional lability, suicidal tendencies and actions, depersonalization, psychomotor agitation;
    impairment and loss of vision and hearing;
    itching, urticaria, eosinophilia, allergies, angioedema, anaphylactic or anaphylactoid shock;
    discenezia, paresthesia, disorientation and disturbances in sleep, vertigo, tremor, drowsiness, disorders in taste and olfactory sensations, convulsions, amnesia, hyperesthesia;
    tachycardia, palpitation, increase or decrease in blood pressure, ischemia;
    Stephen-Johnson syndrome (occurs very rarely);
    shortness of breath and a decrease in appetite, flatulence, constipation, stomatitis, dysphagia;
    problems in the work of the liver, increased bilirubin, jaundice, hepatitis;
    disorders in the work of the kidneys, dehydration.

Instructions for use (Method and dosage)

Tablets are taken without chewing and not dividing, regardless of the meal.
According to the instructions for Avelox 400 mg, for adults the daily dosage is one tablet or 400 mg of antibiotic.
Duration and mode of admission should be determined by the attending physician, depending on the severity of the infection, its effectiveness and the sensitivity of the patient.
As a rule, at the beginning of treatment, the drug is prescribed in injections, then, after the onset of improvements, they can prescribe tablets.
With an exacerbation of chronic bronchitis, the course of treatment with the drug is 5 days. With pneumonia, from 7 (injections) to 10 days.
In acute sinusitis and uncomplicated skin and tissue infections, the duration of the antibiotic is one week.
With uncomplicated infections of the pelvic organs, the course of treatment is two weeks.
With complicated skin infections and structures under the skin, the therapy is performed stepwise and lasts from 5 days to 2 weeks.
Persons who have irregularities in the work of the kidneys and liver, elderly people, and for different ethnic groups do not make a dose adjustment.

Instructions for the use of Avelox for injection

Use only a clear solution, without sediment or clouding.
The drug is injected intravenously for a long time, for 60 minutes, at least not diluting. Also, often the antibiotic is mixed with a T-shaped adapter with water for injection, a solution of sodium chloride (0.9% or 1 M), a solution of dextrose (5%, 10%, 40%), a solution of xylitol 20%, Ringer's solution. The prepared mixture can be stored at room temperature for 24 hours.
In one syringe or dropper other means are not mixed.

Overdose

There are not so many data on overdose.
When consumed to 1200 mg at a time or 600 mg for 10 days, no side effects were recorded.
If an overdose has occurred, it is necessary to perform symptomatic therapy with careful control of the heart rhythm.
Immediately after taking super-large doses of the tablet form of the agent, enterosorbents can be taken, this will reduce the likelihood of side reactions.

Interaction

The drug is well combined with atenolol, theophylline, calcium preparations, ranitidine, oral contraceptives, intraconazole, morphine, Glibenclamide, digoxin, warfarin, probenecid.
However, when combined with indirect anticoagulants, you should consider and periodically check the INR, correct the dose of the antibiotic correctly.
When combined with antacids, multivitamins and minerals, chelate complexes with polyvalent cations are formed, the concentration of antibiotic in the blood decreases. In this regard, you should observe an interval of 4 hours between taking medications.
If you combine the drug with activated carbon or other enterosorbents, the bioavailability of the drug is greatly reduced (by approximately 80%). At intravenous introduction this indicator reaches 20%.
Solution for infusion can not be administered with 10% and 20% of sodium chloride, sodium hydrogencarbonate 4.2% and 8.4%.

Storage conditions

The tablets are stored in a dry, cool place, out of reach of children.
Solution for infusions - at a temperature of 15-25 degrees.

Shelf life

Tablets, bottles of glass - 5 years.
Polymer containers - 3 years.

Reviews about Avelox

The doctors' comments about Avelox diverge. Someone considers it to be a strong and effective antibiotic and prescribes it even against flu and cold, with pyelonephritis, E. coli and chlamydia. Some consider it not effective enough, but with significant side effects.
Reviews on the forums are also ambiguous. Many are confused by the resulting side reactions in the form of nausea and loss of appetite. However, patients agree that this is a strong enough and effective antibiotic.