Klion pills 250mg №20

Active ingredient and dosage form

pills white or white with yellowish-greenish to light yellow with a greenish tint, flat-cylindrical, with a chamfer and a little one on one side.
1 pill contains Metronidazole 250 mg;
Excipients: corn starch, MCC, glycerin, polyvidone, talc, aerosil, Magnesium stearate;
20 pcs. packaged.

Mechanism of action

Klion is an antiprotozoal and antimicrobial drug.
Metronidazole derivative of 5-nitroimidazole. The mechanism of action consists in the biochemical reduction of 5-nitro groups by intracellular transport proteins of anaerobic microorganisms and protozoa. The restored 5-nitro group interacts with the DNA of microbial cells, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria.
Active against Trichomonas vaginalis, Entamoeba histolytica, Gardnerella vaginalis, Lamblia spp. (including Giardia intestinalis); and obligate anaerobes, incl. anaerobic gram-negative bacteria: Bacteroides spp., Including the Bacteroides fragilis group, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus), Fusobacterium spp., Veillonela spp., Prevotella spp. (Prevotella bivia, Prevotella buccae, Prevotella disiens); anaerobic gram-positive bacteria: Clostridium spp., Eubacterium spp., Peptococcus spp., Peptostreptococcus spp.
The minimum inhibitory concentration for these strains is 0.125-6.25 mcg / ml.
In combination with Amoxicillin, it is active against Helicobacter pylori (amoxicillin inhibits the development of metronidazole resistance).
To metronidazole are resistant facultative anaerobes and obligate aerobes, but in the presence of mixed flora (aerobes and anaerobes), metronidazole works synergistically with antibiotics that are effective against conventional aerobes.
Increases the sensitivity of tumors to radiation, causes sensitization to alcohol (disulfiramopodobnoe action), stimulates reparative processes.

Indications and usage

- protozoal infections: extraintestinal amebiasis (including amebic liver abscess), intestinal amebiasis (amebic dysentery), giardiasis (giardiasis), balantidiasis, cutaneous leishmaniasis, trichomoniasis, trichomonas vaginitis, trichomonas urethritis;
- infections caused by Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus): infections of bones and joints, CNS infections (including meningitis, brain abscess), bacterial endocarditis, pneumonia, emp, inactivating heart disease, pneumonia, epic, endocarditis, pneumonia;;
- infections caused by Bacteroides spp. (including Bacteroides fragilis), Clostridium spp., Peptococcus spp., Peptostreptococcus spp.: infections of the abdominal cavity (peritonitis, liver abscess), infections of the pelvic organs (endometritis, endomyometritis, abscess of the fallopian tubes and ovaries, infections of the vault in the body of the vault in the body of the body of the vagina, endometritis, endomyometritis, abscess of the fallopian tubes and ovaries, infections of the vault in the body of the body of the vagina, endometritis, endomyometritis, abscess of the fallopian tubes and ovaries, infections of the vault in the body of the vault in the body of the body of the body of the abdominal cavity (endometritis, endomyometritis, abscess of the fallopian tubes and ovaries; after surgery), skin and soft tissue infections;
- sepsis caused by Bacteroides spp. (including Bacteroides fragilis) and Clostridium spp.;
- pseudomembranous colitis (associated with the use of antibiotics);
- gastritis or duodenal ulcer associated with Helicobacter pylori;
- alcoholism;
- prevention of postoperative infections (especially after operations on the colon, near-rectal area, appendectomy, gynecological interventions);
- in radiation therapy of patients with tumors - as a radiosensitizing agent (in cases where the resistance of the tumor is due to hypoxia in the tumor cells).

Contraindications

- blood diseases;
- leukopenia (including in history);
- incoordination;
- organic lesions of the central nervous system (including epilepsy);
- liver failure (in the case of the use of the drug in high doses);
- I trimester of pregnancy;
- lactation (breastfeeding);
- hypersensitivity to the drug or other derivatives of nitroimidazole.

Dosage and administration

Klion pills taken orally during or after a meal (or squeezed milk), without chewing.
With trichomoniasis adults are prescribed 250 mg 2 times / day for 10 days, or 400 mg 2 times / day for 5-8 days. Women need to additionally appoint metronidazole in the form of vaginal suppositories. If necessary, you can repeat the treatment or increase the dose to 0.75-1 g / day.
Between courses, you should take a break of 3-4 weeks with repeated laboratory tests. An alternative treatment regimen is the administration of the drug in a dose of 2 g once to the patient and his sexual partner.
Children aged 2 to 5 years - 250 mg / day, 5-10 years - 250-375 mg / day, over 10 years old - 500 mg / day. The daily dose should be divided into 2 doses). The course of treatment is 10 days.
With giardiasis for adults appoint 500 mg 2 times / day for 5-7 days.
Children under 1 year - 125 mg / day, from 2 to 4 years - 250 mg / day, 5-8 years - 375 mg / day, over 8 years old - 500 mg / day (in 2 doses). The course of treatment is 5 days.
For adults with asymptomatic amebiasis (when a cyst is detected) the drug is prescribed in a daily dose of 1-1.5 g (500 mg 2-3 times / day) for 5-7 days.
In chronic amebiasis the daily dose is 1.5 g in 3 doses for 5-10 days, with acute amebic dysentery - 2.25 g in 3 doses until the symptoms disappear.
With liver abscess the maximum daily dose is 2.5 g for 1 or 2-3 doses, for 3-5 days in combination with antibiotics (tetracyclines) and other methods of therapy.
For children at the age of from 1 to 3 years - 1/4 adult dose from 3 to 7 years - 1/3 adult dose, from 7 to 10 years - 1/2 dose of an adult.
With balantidiasis - 750 mg 3 times / day for 5-6 days.
With ulcerative stomatitis for adults appoint 500 mg 2 times / day for 3-5 days; for children in this case, the drug is not shown.
With pseudomembranous colitis appoint 500 mg 3-4 times / day.
For eradication of Helicobacter pylori - 500 mg 3 times / day for 7 days (as part of a combination therapy, for example, a combination with amoxicillin, 2.25 g / day).
In the treatment of anaerobic infection the maximum daily dose is 1.5-2 g.
In the treatment of chronic alcoholism appoint 500 mg / day for a period of up to 6 (not more) months.
For the prevention of infectious complications - 750-1500 mg / day in 3 doses for 3-4 days before the operation or once 1 g on the first day after the operation. 1-2 days after surgery (when oral administration has already been approved), it is recommended to take the drug at a dose of 750 mg / day for 7 days.
When using the drug in patients with severe impaired renal function (CC less than 10 ml / min) The daily dose of the drug should be halved.

Adverse reactions

Gastrointestinal: diarrhea, anorexia, nausea, vomiting, intestinal colic, constipation, metallic taste in the mouth, dry mouth, glossitis, stomatitis, pancreatitis.
Nervous system: dizziness, incoordination, ataxia, confusion, irritability, depression, irritability, weakness, insomnia, headache, convulsions, hallucinations, peripheral neuropathy.
Allergic reactions: skin rash, urticaria, skin flushing, nasal congestion, fever, arthralgia.
Urogenital: dysuria, cystitis, polyuria, urinary incontinence, urine staining in red-brown color.
Other: candidiasis, neutropenia, leukopenia, flattening of the T wave on the ECG.

WITH extra care Klion should be prescribed to patients with hepatic and / or renal insufficiency.
It should be borne in mind that in the period of use of the drug ethanol is contraindicated because may develop disulfiramopodobnoy reaction (spastic abdominal pain, nausea, vomiting, headache, sudden rush of blood to the face).
With prolonged therapy should monitor the blood picture.
In case of leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process.
With the development of neurological symptoms (ataxia, dizziness), discontinue use of the drug.
The drug can immobilize treponema and lead to a false-positive Nelson test.
When treating Trichomonas vaginitis in women and Trichomonas urethritis in men, it is necessary to abstain from sex. Simultaneous treatment of sexual partners is required. During menstruation, treatment should continue. After the end of treatment for trichomoniasis, follow-up studies should be carried out for 3 regular cycles before and after menstruation.
After termination of giardiasis treatment (if symptoms persist), after 3–4 weeks, 3 stool tests should be performed at intervals of several days (in some successfully treated patients, lactose intolerance caused by invasion may persist for several weeks or months, recalling the symptoms of giardiasis).
It is not recommended to combine with non-depolarizing muscle relaxants (for example, with vecuronium bromide).
Use in pediatrics
It is not recommended to use the drug in combination with amoxicillin in children and adolescents under the age of 18.

With simultaneous use Klion enhances the effect of indirect anticoagulants, which leads to an increase in the time of formation of prothrombin.
With simultaneous use with ethanol, the development of disulfiram-like reactions is observed (the interval between the appointment of at least 2 weeks).
With simultaneous use with cimetidine, inhibition of metronidazole metabolism is noted, which can lead to an increase in plasma plasma metronidazole concentration and an increased risk of adverse reactions.
With simultaneous use with metronidazole of drugs that stimulate the enzymes of microsomal oxidation in the liver (phenytoin, phenobarbital), the excretion of metronidazole can be accelerated, as a result of which its concentration in blood plasma decreases.
With simultaneous use of Klion with lithium preparations, it is possible to increase the concentration of lithium in the blood plasma and develop intoxication symptoms.
Sulfonamides enhance the antimicrobial action of metronidazole.

The drug should be stored in a dark place at a temperature of from 15 ° to 30 ° C.

Klion