Zanocin pills 200mg №10

ZANOCIN (ZANOCIN)

OFLOXACINUM J01M A01

Ranbaxy

COMPOSITION AND FORM OF ISSUE:

tabl. p / o 200 mg, number 10

Ofloxacin 200 mg

Other ingredients: lactose, microcrystalline cellulose, corn starch, polysorbate 80, talc, Magnesium stearate, anhydrous colloidal silica gel, sodium starch glycolate.

№ UA / 0314/03/01 from 12/07/2009 to 12/07/2014

Zanocin OD

tabl. prolong action., p / o 400 mg, № 5

Ofloxacin 400 mg

Other ingredients: xanthan gum, sodium alginate, hypromellose, sodium bicarbonate, crospovidone, magnesium stearate, anhydrous colloidal silica gel, lactose monohydrate, carbomer.

№ UA / 0314/01/01 from 01.22.2009 until 01.22.2014

tabl. prolong action., p / o 800 mg, № 5

Ofloxacin 800 mg

Other ingredients: xanthan gum, sodium alginate, hypromellose, sodium bicarbonate, crospovidone, magnesium stearate, anhydrous colloidal silica gel, lactose monohydrate, carbomer.

№ UA / 0314/01/02 from 01.22.2009 until 01.22.2014

PHARMACOLOGICAL PROPERTIES:

Pharmacodynamics. Ofloxacin ((&№177;) -9-fluoro-2,3-dihydro-3-methyl-10- (4-methyl-1-piperazinyl) -7-oxo-7H-pyrido [1,2,3] -de-1, 4-benzoxazin-6-carboxylic acid) is an antimicrobial agent for the fluoroquinolone group. The bactericidal action of ofloxacin, as well as other fluorinated quinolones, is due to its ability to block the bacterial enzyme DNA gyrase.
The antibacterial spectrum of the drug covers microorganisms that are resistant to penicillins, aminoglycosides, cephalosporins, as well as microorganisms with multiple resistance.
Zanocin OD is a drug with a prolonged release of the active substance - ofloxacin. The drug is taken 1 time per day. 1 pill Zanocin OD 400 or 800 mg, taken once a day, provides a therapeutic effect equivalent to taking 2 regular pills ofloxacin 200 and 400 mg, respectively, taken 2 times a day.
Zanocin pill form is active against a broad spectrum of bacteria.
Aerobic gram-negative bacteria: E. coli, Klebsiella spp., Salmonella spp., Proteus spp., Shigella spp., Yersinia spp., Enterobacter spp., Morganella morganii, Providencia spp., Vibrio spp., Citrobacter spp., Serra, siro., Serra. Campylobacter spp., Pseudomonas aeruginosa, P. cepacia, Neisseria gonorrhoeae, N. meningitidis, Haemophilus influenzae, H. ducreyi, Acinetobacter spp., Moraxella catarrhalis, Gardnerella vaginalis, Pasteure chyristychristychristychristychristychristychristy,. Different susceptibility to the drug have strains of Brucella melitensis.
Aerobic gram-positive bacteria: staphylococci, including penicillinase-producing strains, methicillin-resistant strains, streptococci (especially Streptococcus pneumoniae), Listeria monocytogenes, Corynebacterium spp.
Ofloxacin is more active than Ciprofloxacin for Chlamydia trachomatis.It is also active against Mycobacterium leprae and Mycobacterium tuberculosis and some other Mycobacterium species. There are reports of a synergistic effect of ofloxacin and rifabutin against M. leprae.
Treponema pallidum, viruses, fungi and protozoa are insensitive to ofloxacin.
Pharmacokinetics. The drug is quickly and almost completely absorbed in the digestive tract. The absolute bioavailability of ofloxacin is 96% after oral administration. Concentration in blood plasma reaches 3–4 mcg / ml 1–2 h after administration at a dose of 400 mg. Meal does not reduce the absorption of ofloxacin, but may somewhat slow down the rate of absorption. The drug T&№189; is 5–8 hours. Since ofloxacin is mainly excreted by the kidneys, its pharmacokinetics significantly change in patients with impaired renal function (creatinine clearance <50 ml / min) and therefore they need dose adjustment.
Hemodialysis slightly reduces the concentration of ofloxacin in the blood plasma. Ofloxacin is widely distributed in tissues and biological fluids of the body, including CSF; volume of distribution - from 1 to 2.5 l / kg. About 25% of the drug is bound to plasma proteins. Ofloxacin passes through the placenta and into breast milk. It reaches high concentrations in most tissues and biological fluids of the body, including ascitic fluid, bile, saliva, bronchial secretions, gallbladder, lungs, prostate gland, bone tissue.
Ofloxacin has a pyridobenzoxazine ring, which reduces the metabolic rate of the parent compound. The drug is mainly excreted in the urine unchanged, and 65–80% within 24–48 hours. Less than 5% of the dose is excreted in the urine as dimethyl or N-oxide metabolites. 4-8% of the dose taken out with feces. A small amount of ofloxacin is excreted in the bile.
There were no differences in the distribution of the drug in the elderly; the drug is excreted mainly by the kidneys in unchanged form, although in a smaller volume. Since ofloxacin is excreted primarily by the kidneys, and in elderly patients, renal dysfunction is more often noted, the dose of the drug is corrected when renal dysfunction is observed, as recommended for all patients.
The pharmacokinetic characteristics of Zanocin OD contribute to its systemic use. Food does not affect the degree of absorption of the drug.Extended-release ofloxacin pills are absorbed faster and have a greater degree of absorption compared to conventional ofloxacin pills taken 2 times a day. After oral administration of Zanocin OD 400 mg Cmax of ofloxacin in the blood plasma is achieved in 6.778 &№177; 3.154 h and is 1.9088 μg / ml &№177; 0.46 588 μg / ml. AUC0–1 is 21.9907 &№177; 4.60 537 μg &№183; g / ml. After oral administration of Zanocin OD at a dose of 800 mg Cmax, the drug in plasma is reached in 7.792 &№177; 3.0357 hours and is 5.22 &№177; 1.24 μg / ml. The AUC0-t level is 55.64 &№177; 11.72 μg &№183; g / ml. In vitro drug binds to plasma proteins by approximately 32%.
The equilibrium concentration of the drug in the blood plasma is achieved after 4-fold administration of the drug, and AUC is approximately 40% more than that after a single use.
The removal of ofloxacin from the body is two-phase. With repeated oral administration, T&№189; of the drug is about 4–5 hours and 20–25 hours. Indicators of total clearance and volume of distribution are approximately similar for single or multiple use.

INDICATIONS:

infections caused by susceptible microorganisms:

• urinary system - acute and chronic pyelonephritis, prostatitis, epididymitis, surgical infections of the urinary tract; Chlamidia trachomatis and Neisseria gonorrhoeae, uncomplicated cystitis caused by Citrobacter diversus, Enterobacter aerogenes, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis or Pseudomonas aeruginosa, complicated and recurrent infe tion of the urinary tract caused by Klebsiella pneumoniae, Proteus mirabilis, Citrobacter diversus1 or Pseudomonas aeruginosa1, non-gonococcal urethritis and cervicitis due to C. trachomatis;
• respiratory tract - pleurisy, empyema, infected bronchiectasis, lung abscess, cystic fibrosis, exacerbation of chronic bronchitis caused by Haemophilus influenzae or Streptococus pneumoniae, non-hospital pneumonia caused by Haemophilus influenzae or Streptococus pneumonia
• ENT organs, including otitis, sinusitis, tonsillitis, etc.;
• uncomplicated infections of the skin and subcutaneous tissues, caused by the microorganisms sensitive to methicillin, Staphylococcus aureus, Streptococcus pyogenes, Proteus mirabilіs;
• acute inflammatory diseases of the pelvic organs (including severe infectious diseases) caused by Chlamidia trachomatis and / or Neisseria gonorrhoeae;
• sexually transmitted diseases - infections of the urethra, cervix, rectum, pharynx, caused by penicillin-resistant gonococci, chlamydia and other microorganisms;
• other infectious diseases - typhoid fever, salmonellosis, shigellosis, abdominal organs and biliary tract;
• in the complex treatment of septicemia, endocarditis, osteomyelitis, mycobacterial infections, leprosy, prevention of infectious complications in patients with immunodeficiency or neutropenia;
• perioperative prophylaxis or postoperative treatment of surgical infections.

1 Despite the fact that the treatment of infectious diseases caused by these microorganisms (for this organ system), showed clinically significant results, the effectiveness of therapy was investigated in less than 10 patients.
To prevent the development of drug-resistant microorganisms and preserve the effectiveness of ofloxacin and other antibacterial drugs, ofloxacin is prescribed to treat and prevent only infectious diseases caused (confirmed or most likely) by microorganisms that are sensitive to the drug. With established culture and sensitivity of the microorganism, an appropriate selective or combination antibiotic therapy is determined. In the absence of the above information, as well as epidemiological data and sensitivity data, the drug can be prescribed as an empirical therapy.
Determine the culture and sensitivity of the pathogen should be prior to treatment. Treatment of ofloxacin can be started before the test results are obtained, after the results are obtained, the therapy is continued.
As with the use of other drugs in this series, some strains of Pseudomonas aeruginosa can quickly become resistant to the action of ofloxacin. Periodically, during treatment, a culture should be isolated and the sensitivity of the pathogen should be determined (monitoring the effectiveness of treatment with an antibacterial drug and the possible development of bacterial resistance).

APPLICATION:

Zanoqin: the dose depends on the type of microorganism and the severity of the infection, age, body weight and kidney function of the patient. In most cases, the course of treatment is 7–10 days; treatment must be continued for another 2–3 days after the symptoms of the infection have been eliminated. In severe and complicated infections, therapy may be extended. The dose of the drug is 200-400 mg / day in 2 divided doses. A dose of 400 mg (2 tablets) can be taken at once, preferably in the morning. A single dose of 400 mg can be recommended for acute fresh uncomplicated gonorrhea.A dose of 400 mg is recommended by WHO for the treatment of leprosy.
In / drip injected at a dose of 200 mg (100 ml) at a rate of 400 mg / h at 200-400 mg 2 times a day.
In case of impaired renal function, the dose is determined taking into account the severity of renal failure and creatinine clearance. The recommended initial dose of the drug in violation of renal function is 200 mg; in the future, the dose is corrected taking into account the creatinine clearance: at a rate of 50–20 ml / min - in the usual dose every 24 hours; less than 20 ml / min - 100 mg (1/2 tablets) every 24 hours.
It is not recommended to continue treatment with the drug for more than 2 months.
Zanocin OD is taken 1 time per day simultaneously with a meal. The daily dose is set according to the table (see below). These recommendations apply to patients with normal renal function (creatinine clearance> 50 ml / min). pills swallow whole.

Disease 1 Duration of treatment, days Daily dose, mg Exacerbation of chronic bronchitis 10 800 Non-hospital pneumonia 10 800 Uncomplicated infectious diseases of the skin and subcutaneous tissues 10 800 Acute uncomplicated urethral and cervical gonorrhea 1 400 Non-gonococcal cervicitis / urethritis caused by C. trachomatis 7 400 Mixed infections of the urethra and cervix caused by Chlamidia trachomatis and / or Neisseria gonorrhoeae 7 400 Acute inflammatory diseases of the pelvic organs 10–14 800 Uncomplicated cystitis caused by Escherichia coli or Uncomplicated cystitis caused by Escherichia coli or Complicated pelvic organs 10-14 148 Uncomplicated cystitis caused by Escherichia coli or Klebsiella pneumonia 3 400 urinary tract infection 10 400

1Installed pathogen.
In case of impaired renal function, the dose is corrected with creatinine clearance ≤50 ml / min. After the usual initial dose when using Zanocin OD 400 mg dose is adjusted as follows:

Creatinine clearance, ml / min. Maintenance dose and frequency of administration 20–50 For infectious diseases of the skin and soft tissues, pneumonia or exacerbation of chronic bronchitis, acute pelvic inflammatory diseases, it is recommended to take Zanocin OD 400 mg every 24 hours. To date, there are no reliable data in regarding changes in recommended doses <20 So far there is not enough data on changes in recommended doses for patients with creatinine clearance <20 ml / min

With the use of Zanocin OD at 800 mg, there is still no sufficient data on the change in recommended doses for patients with creatinine clearance ≤50 ml / min. If only the plasma creatinine concentration is known, creatinine clearance can be determined by the formula:
for men:

for women:
creatinine clearance (ml / min) = 0.85 &№183; the amount of male creatinine clearance.
The concentration of creatinine in the blood plasma is monitored to determine the state of renal function.
Liver dysfunction / cirrhosis.
The excretion of ofloxacin can be reduced in case of severe violations of the liver (cirrhosis of the liver with / without ascites), therefore, the maximum dose of ofloxacin - 400 mg / day should not be exceeded.
Elderly patients do not need to correct the dose, except in cases where there are impaired renal or liver function.

CONTRAINDICATIONS:

Hypersensitivity to ofloxacin or other fluoroquinolones, period of pregnancy and lactation, age up to 18 years.
For Zanocin, OD - including a history of tendinitis or convulsions, congenital intolerance of galactose, Lappa lactase deficiency or glucose-galactose malabsorption.

SIDE EFFECTS:

As a result of clinical studies with repeated use of ofloxacin, the most frequently observed were nausea (3%), headache (1%), dizziness (1%), diarrhea (1%), vomiting (1%), rash (1%), itching skin (1%), itching of the vulva in women (1%), vaginitis (1%), dysgeusia (1%).
In clinical studies, the most common side effects that occurred regardless of the duration of the drug use were nausea (10%), headache (9%), dyssomnia (7%), itching of the vulva in women (6%), dizziness (5 %), vaginitis (5%), diarrhea (4%), vomiting (4%).
In clinical studies, the most common side effects that occurred regardless of the duration of the drug use and were observed in 1-3% of patients were abdominal pain and colic, chest pain, loss of appetite, dry lips, dysgeusia, fatigue, flatulence, disorders of the Gastrointestinal tract, nervousness, pharyngitis, itching, fever, rash, dysomnia, drowsiness, pain in the body, vaginal discharge, blurred vision, constipation.
Side effects that have been reported in clinical studies in less than 1% of cases, regardless of the duration of use of the drug:
general disorders: asthenia, chilliness, malaise, pain in the limbs, nosebleeds;
on the part of the cardiovascular system: cardiac arrest, edema, hypertension, arterial hypotension, feeling of palpitations, vasodilation;
from the gastrointestinal tract: dyspepsia ;
on the part of the urogenital system: sensation of heat, irritation, pain and a rash in the genital area of ​​women, dysmenorrhea, metrorrhagia;
from the musculoskeletal system: arthralgia, myalgia;
on the CNS side: convulsions, anxiety, cognitive impairment, depression, abnormal dreams, euphoria, hallucinations, paresthesias, disturbances of consciousness, vertigo, tremor;
on the part of the metabolism: thirst, weight loss;
on the part of the respiratory system: respiratory arrest, cough, rhinorrhea;
allergic and skin reactions: angioedema, hyperhidrosis, urticaria, vasculitis;
on the part of the senses: reduced hearing acuity, tinnitus, photophobia;
on the part of the urinary system: dysuria, frequent urination, urinary retention.
Changes in laboratory parameters were detected in ≥1% of patients with repeated use of ofloxacin. These changes are caused by both the drug intake and the main disease:
on the part of the blood system: anemia, leukopenia, leukocytosis, neutropenia, neutrophilia, stab neutrophiliasis, lymphocytopenia, eosinophilia, lymphocytosis, thrombocytopenia, thrombocytosis, increased ESR;
on the part of the hepatobiliary system: increased levels of alkaline phosphatase, AsAT, AlAT;
laboratory indicators: hyperglycemia, hypoglycemia, hypercreatininemia, increased urea levels, glucosuria, proteinuria, alkalinuria, hypostenuria, hematuria, pyuria.
Post marketing experience
Additional side effects that occurred regardless of the duration of the drug use were noted as a result of quinolone marketing research, including ofloxacin.
Since the cardiovascular system: cerebral thrombosis, pulmonary edema, tachycardia, arterial hypotension / shock, fainting, ventricular tachycardia such as pirouette.
On the part of the endocrine system and metabolism: hyper- or hypoglycemia, especially in patients with diabetes, using insulin therapy or oral hypoglycemic drugs.
On the part of the gastrointestinal tract: hepatonecrosis, jaundice (cholestatic or hepatocellular), hepatitis, intestinal perforation, liver failure (including fatal cases), pseudomembranous colitis (symptoms of pseudomembranous colitis can occur both during and after antibiotic therapy), bleeding from hiccups, soreness of the oral mucosa, heartburn.
From the genitourinary system: vaginal candidiasis.
On the part of the blood system: anemia (including hemolytic and aplastic), hemorrhage, pancytopenia, agranulocytosis, leukopenia, reversible inhibition of bone marrow function, thrombocytopenia, thrombocytopenic purpura, petechiae, subcutaneous hemorrhage / hemorrhage.
On the part of the musculoskeletal system: tendonitis, tendon ruptures, weakness, acute skeletal muscle necrosis.
On the CNS side: nightmares, suicidal thoughts or actions, disorientation, psychotic reactions, paranoia, phobia, agitation, anxiety, aggressiveness / hostility, mania, emotional lability, peripheral neuropathy, ataxia, impaired coordination, possibly exacerbation of myasthenia gravis and extrapyramidal drugs. dysphasia, dizziness.
On the part of the respiratory system: dyspnea, bronchospasm, allergic pneumonitis, wheezing.
And allergic skin reactions: anaphylactic / anaphylactoid reaction / shock, purpura, serum sickness, erythema multimorfnaya / Stevens - Johnson syndrome, erythema nodosum, exfoliative dermatitis, hyperpigmentation, toxic epidermal necrolysis, conjunctivitis, photosensitivity reaction / phototoxicity vesiculobullous rash.
On the part of the senses: diplopia, nystagmus, blurred vision, dysgeusia, impaired sense of smell, hearing and balance, which, as a rule, disappear after stopping the drug.
On the part of the urinary system: anuria, polyuria, calculus in the kidneys, renal failure, interstitial nephritis, hematuria.
Laboratory indicators: prolongation of prothrombin time, acidosis, hypertriglyceridemia, increased cholesterol, potassium, liver function indicators, including gamma-glutamyl transpeptidase, LDH, bilirubin, albuminuria, candiduria.
In clinical trials with repeated use of quinolones, ophthalmic disorders were detected, including cataracts and a point opacification of the lens. The relationship of taking the drug and the occurrence of these disorders is currently not installed.
Crystalluria and cylindruria have been reported with other quinolones.

SPECIAL INSTRUCTIONS:

reported the occurrence of seizures, increased intracranial pressure and toxic psychosis in patients taking quinolone drugs, including ofloxacin.Quinolones, including ofloxacin, can also have a stimulating effect on the central nervous system, which can lead to tremor, anxiety / agitation, nervousness / anxiety, dizziness, confusion, hallucinations, paranoia and depression, nightmares, dyssomnia, and, rarely, suicidal thoughts and actions. Such reactions may occur after taking the first dose. If such symptoms occur in patients who take ofloxacin, the drug should be discontinued and appropriate action taken. Dissomnia is the most frequent disorder when using ofloxacin than other quinolone drugs. Like all quinolones, ofloxacin is used with caution when it is established / suspected disorders of the nervous system, since these drugs can provoke convulsions or lower the threshold of convulsive readiness (severe cerebral atherosclerosis, epilepsy), or other risk factors (against the background of ongoing therapy, violation of kidney function), which can provoke seizures or lowering the threshold of convulsive readiness.
Severe and lethal (rarely) hypersensitivity reactions and / or Anaphylactic reactions have been reported in patients treated with quinolones, including ofloxacin. Such reactions are often noted after taking the first dose. Some reactions were accompanied by cardiovascular collapse, hypotension / shock, convulsions, loss of consciousness, tinnitus, angioedema (including swelling of the tongue, larynx, pharynx, or face), airway obstruction (including bronchospasm, shortness of breath and acute respiratory failure), dyspnea, urticarial rash, itching and other severe skin reactions. The drug is immediately canceled at the first sign of skin rash or other hypersensitivity reactions. In severe acute hypersensitivity reactions, there may be a need for epinephrine therapy and other resuscitation measures, including oxygen therapy, infusion therapy, administration of antihistamine and corticosteroid drugs, vasopressor amines, and restoration of airway patency.
Other severe and lethal (sometimes) cases associated with a hypersensitivity reaction or unknown etiology have been reported with quinolone therapy, including ofloxacin.Such cases could be severe and, in general, occurred after repeated administration of the drug.
The drug is immediately canceled at the first manifestations of skin rash, jaundice or other symptoms of hypersensitivity and prescribe symptomatic therapy.
In the treatment of quinolones, including ofloxacin, isolated cases of the development of sensory or sensorimotor neural polyneuropathy were reported, involving small and / or large neurons, which was manifested by paresthesia, hypesthesia, dysesthesia and weakness. To prevent the development of irreversible conditions, treatment with ofloxacin is stopped when symptoms of neuropathy develop (pain, burning sensation, tingling, numbness and / or weakness) or other tactile, pain, temperature, positional, vibration sensitivity disorders.
The occurrence of diarrhea associated with Clostridium difficile has been reported in the use of virtually all antibacterial agents, including ofloxacin; the disease can manifest from mild diarrhea to fatal colitis. Treatment with antibacterial drugs affects the normal intestinal microflora and leads to increased growth of Clostridium difficile. The risk of diarrhea associated with Clostridium difficile should be considered in all cases of diarrhea after taking antibacterial drugs. Medical observation is necessary because cases of diarrhea associated with Clostridium difficile have been reported 2 months after discontinuation of antibiotics. If suspected or confirmed diarrhea associated with Clostridium difficile, antibacterial drugs that are not directed to Clostridium difficile, are canceled.
It was reported about the tendon ruptures of the upper (shoulder tendons), lower (Achilles tendon) limbs and others that required surgery or caused long-term disability in patients who received quinolone treatment, including ofloxacin. In post-marketing studies it is indicated that the risk of musculoskeletal disorders is increased with the combined use of GCS, especially if they are elderly patients. Ofloxacin is canceled if there is pain, inflammation, or a tendon rupture.The patient is recommended bed rest and movement restriction until tendonitis is confirmed / eliminated or the tendon is broken. Tendon ruptures can occur both during and after treatment with quinolone preparations, including ofloxacin.
Ofloxacin is not effective for syphilis. Antibiotic therapy, prescribed in a high dose and for a short period for the treatment of gonorrhea, may mask or delay the manifestations of the incubation period of syphilis. All patients with gonorrhea are given a serological test for syphilis during a diagnostic examination. When using ofloxacin for the treatment of gonorrhea, a serological test for syphilis is performed 3 months after treatment and appropriate antibiotic therapy is prescribed in the event of a positive test result.
With the appointment of ofloxacin and the absence of data on the confirmed or most probable causative agent of the disease, or for prophylactic treatment, the benefit to the patient will be unlikely; this increases the risk of bacterial resistance to the drug. To prevent the development of crystalluria should ensure adequate fluid intake.
After taking quinol antibacterial drugs and the subsequent action of sun or ultraviolet radiation, moderate to severe photosensitivity / phototoxicity reactions may occur, which are manifested by sunburns (hyperemia, erythema, exudation, vesicles, edema) in open skin areas (face, anterior surface of the neck, extensor surface of the forearm, dorsal surface of the upper extremities). Therefore, insolation should be avoided during the treatment period.
Some quinolones, including ofloxacin, can cause prolonged Q – T interval on the ECG and rarely arrhythmia. Individual cases of ventricular tachycardia of the type of pirouette in quinolone patients, including ofloxacin, have been reported during post-marketing studies. Ofloxacin should not be prescribed for a prolonged Q – T interval, uncorrected hypokalemia and patients taking antiarrhythmic drugs IA (quinidine, procainamide) or class III (amiodarone, sotalol).
During pregnancy and breastfeeding.Reliable and controlled studies of the use of the drug during pregnancy were not conducted. The safety and efficacy of ofloxacin during pregnancy has not been established, so the drug during this period is not prescribed.
When taking ofloxacin during lactation in a single dose of 200 mg, the level of drug concentration in breast milk corresponded to a similar level in blood plasma. Since there is a risk of severe adverse reactions in infants, breastfeeding should be discontinued or the drug withdrawn (depending on the clinical significance of the drug for a woman).
Children. Ofloxacin is not indicated for the treatment of children and adolescents under the age of 18 years.
The ability to influence the reaction rate when driving or working with mechanisms. Since it was reported on isolated cases of drowsiness, dizziness and visual impairment associated with taking the drug, it is impossible to drive vehicles or work with other mechanisms during the treatment period.

INTERACTIONS:

Antacids, sucralfate, metal cations, multivitamins. Quinolones form chelate compounds with alkaline agents and carriers of metal cations. The use of quinolones in combination with antacid preparations containing Calcium, magnesium or aluminum, sucralfate, two- or trivalent cations (iron), multivitamin preparations containing zinc, didanosine can significantly reduce the absorption of quinolones, thereby reducing their systemic concentration. The above drugs are taken 2 hours before or after taking ofloxacin.
Caffeine. No interaction found.
Cyclosporins. There are no messages on increase of level of cyclosporine in a blood plasma at the combined use with quinolones. The potential interaction between quinolones and cyclosporins has not been studied.
Cimetidine caused a violation of the elimination of some quinolones, and it led to an increase in the half-life of the drug and AUC. The possible interaction between ofloxacin and cimetidine has not been studied.
Drugs that are metabolized by cytochrome P450 enzymes. Most quinolone drugs inhibit the enzyme activity of cytochrome P450.This can lead to prolongation of the half-life of drugs that are metabolized by the same system (cyclosporine, theophylline / methylxanthines, warfarin) when they are combined with quinolones.
NSAIDs. The combined use of NSAIDs and quinolones, including ofloxacin, can lead to an increased risk of a stimulating effect on the central nervous system and seizures.
Probenecid. The combined use of probenecid and quinolone may affect renal tubular excretion. The effect of probenecid on the excretion of ofloxacin has not been studied.
Theophylline. Plasma theophylline levels may increase when combined with ofloxacin. Like other quinolones, ofloxacin may lengthen the half-life of theophylline, increase the level of theophylline in the blood plasma and the risk of side effects of theophylline. You should regularly determine the level of theophylline in the blood plasma and adjust the dose when administered simultaneously with ofloxacin. Side effects (including convulsions) may occur with or without an increase in plasma levels of theophylline.
Warfarin. Some quinolones may enhance the effects of oral administration of Warfarin or its derivatives. Therefore, with the combined appointment of quinolones and warfarin or its derivatives, prothrombin time and other blood coagulation parameters are regularly monitored.
Antidiabetic agents (insulin, glyburide / glibenclamide). Reported changes in blood glucose levels, including hyper-and hypoglycemia, while taking quinolone drugs and anti-diabetic drugs, therefore, it is necessary to constantly monitor blood glucose in the combined use of the above drugs.
Drugs that affect renal tubular excretion (furosemide, methotrexate). With the simultaneous appointment of quinolones and drugs that affect renal tubular excretion, there may be a violation of excretion and an increase in the level of quinolones in the blood plasma.
Effects on laboratory or diagnostic tests. Some quinolones, including ofloxacin, can give false-positive results in the determination of opiates in the urine when administered orally with immunological agents.
In the absence of data on the compatibility of p-ra with other infusion solutions or drugs Zanozin in the form of p-ra for infusion should be used separately.The drug is compatible with the isotonic solution of sodium chloride, Ringer&№39;s solution, 5% solution of glucose or fructose.

OVERDOSE:

data on the overdose of ofloxacin is limited.
Symptoms: confusion, drowsiness, lethargy, disorientation, dizziness, nausea, vomiting.
Treatment: there is no specific antidote. In case of an overdose, the stomach is washed, an adsorbent and sodium sulfate are prescribed (if possible, during the first 30 minutes), antacid preparations are used to protect the gastric mucosa. The patient is examined and, if necessary, hydrated.
Forced diuresis accelerates the elimination of ofloxacin from the body. Hemodialysis or ne