Levofloxacin pills 500mg №14

Composition
1 pill contains:active substance Levofloxacin (Levofloxacin Hemigadrate) 500.00 (512.46) mg,Excipients:colloidal silicon dioxide 12.00 mg, hyprolosis 28.00 mg, sodium carboxymethyl starch, type A 55.00 mg, talc 55.20 mg, croscarmellose sodium 20.60 mg, Magnesium stearate 6.74 mg, Opadray shell 15В26688 brown (hypromellose 2910 3 CP 4.760 mg, hypromellose 2910 6 CP 4.760 mg, titanium dioxide E171 3.044 mg, macrogol-400 1.120 mg, polysorbate-800.140 mg, iron dye oxide yellow E172 0.120 mg, iron dye oxide red E172 0.043 mg, iron dye oxide black E172 0.013 mg).

Packaging
14 pcs.

pharmachologic effect
The optically active levorotatory isomer of Ofloxacin - L-ofloxacin (S - (-) - enantiomer). It has a broad spectrum of antimicrobial activity. Blocks bacterial topoisomerase IV and DNA gyrase (topoisomerase II). Violates supercoiling and crosslinking of DNA breaks, causes profound morphological changes in the cytoplasm and cell wall. In concentrations that are equivalent to or exceed the minimum inhibitory concentrations (BMD), most often has a bactericidal effect. The main mechanism of resistance development is associated with the mutation of the gyr-A gene with the possible development of cross-resistance between levofloxacin and other fluoroquinolones. Cross-resistance between levofloxacin and antibacterial drugs of other classes usually does not occur.

Indications
Infectious and inflammatory diseases caused by microorganisms susceptible to levofloxacin:

• acute bacterial sinusitis,
• exacerbation of chronic bronchitis,
• community-acquired pneumonia,
• complicated infectious diseases of the kidneys and urinary tract, including pyelonephritis,
• chronic bacterial prostatitis,
• infections of the skin and soft tissues.

Contraindications
Hypersensitivity to levofloxacin, to other quinolones or other components of the drug, epilepsy, including a history, tendon damage associated with taking fluoroquinolones, in history, children and adolescents under 18 years of age, pregnancy, breastfeeding period.

Dosage and administration
Levofloxacin-Teva is taken orally 1-2 times a day. The dose and duration of treatment are determined by the nature and severity of the infection, as well as the sensitivity of the suspected pathogen. pills should be taken without chewing and drinking plenty of fluids (½ to 1 cup). When selecting doses, pills can be broken down into equal parts along the separation groove. The drug can be taken before meals or at any time between meals.
Treatment with Levofloxacin-Teva is recommended to continue for at least 48-72 hours after normalization of body temperature or after reliable eradication of the pathogen.
Acute bacterial sinusitis: 1 pill (500 mg) 1 time per day for 10-14 days.
Acute bronchitis and exacerbation of chronic bronchitis: on ½-1 pill (250-500 mg) once a day for 7-10 days.
Community-acquired pneumonia: 1 pill (500 mg) 1-2 times a day for 7-14 days.
Complicated infectious diseases of the kidneys and urinary tract, including pyelonephritis: on ½ pill (250 mg) once a day for 7-10 days.
Chronic bacterial prostatitis: 1 pill (500 mg) 1 time per day for 28 days.
Skin and soft tissue infections: 1 pill (500 mg) 1-2 times a day for 7-14 days.
Patients with impaired liver function correction dosage is not required.
Patients with impaired renal function (QC less than 50 ml / min) correction of the dosage regimen is required depending on the QC value.

Side effects
The frequency of adverse reactions is classified according to the WHO recommendations: often - at least 1% and less than 10%, infrequently - at least 0.1% and less than 1%, rarely - at least 0.01% and less than 0.1%, very rarely - less than 0.01%, including isolated cases.
Infections and invasions: infrequently - the addition of a fungal infection, the growth of resistant microorganisms, very rarely - superinfection.
From the hematopoietic and lymphatic systems: infrequently - eosinophilia, leukopenia, rarely - neutropenia, thrombocytopenia, very rarely - agranulocytosis, isolated cases - hemolytic anemia, pancytopenia, hemorrhages.
Metabolism: very rarely - hyperglycemia (increased appetite, increased sweating, tremors), hypoglycemia.
Nervous system: infrequently - insomnia, nervousness, dizziness, headache, drowsiness, rarely - anxiety, depression, psychotic reactions, agitation, clouding of consciousness, convulsions, tremor, paresthesias, very rarely - sensorimotor peripheral neuropathy, hallucinations, psychotic reactions associated with causing the patient self-harm, suicidal behavior, extrapyramidal symptoms and disorders of muscle coordination.
Special senses: very rarely - visual impairment, hearing loss, tinnitus, impaired sense of smell, taste and tactile sensitivity.
Cardiovascular: rarely - lowering blood pressure, vascular collapse, tachycardia, very rarely - prolongation of the QT interval, atrial fibrillation.
Gastrointestinal: often - nausea, diarrhea, increased activity of "liver" transaminases and alkaline phosphatase in the blood plasma, rarely - vomiting, anorexia, abdominal pain, dyspepsia, dysbacteriosis, flatulence, constipation, hyperbilirubinemia, rarely - hemorrhagic diarrhea, rarely pseudomembranous colitis, jaundice, hepatitis, liver failure.
Urogenital: infrequently - hypercreatinemia, very rarely - interstitial nephritis, acute renal failure.
Allergic reactions: infrequently - rash, itching, rarely - urticaria, skin flushing, very rarely - anaphylactic and anaphylactoid reactions, including shock, angioedema, photosensitization, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal nephritis (anesthetic syndrome), an syndrome of erythema (Stevens-Johnson syndrome), toxic epidermal nephrosis, rash syndrome, erythema, erythema erythema multiforme, vasculitis, bronchospasm, allergic interstitial pneumonitis.
Musculoskeletal system: rarely - disorders of the tendons, including Achilles tendonitis, arthralgia, myalgia, muscle weakness, very rarely - tendon rupture, frequency not established - rhabdomyolysis.
Other: infrequently - asthenia, weakness, very rarely - persistent fever, exacerbation of porphyria.

special instructions
When levofloxacin was used, cases of tendinitis were observed, which mainly affects the Achilles tendon and can lead to its rupture. In elderly patients, as well as with the concomitant use of GCS, the likelihood of tendinitis and tendon rupture when using levofloxacin increases. If you suspect tendonitis, you should immediately cancel levofloxacin and begin appropriate treatment, ensuring a state of rest in the affected area.
If pseudomembranous colitis is suspected (diarrhea appears, in particular, severe and / or with blood), levofloxacin should be discontinued and appropriate treatment should be initiated.
During treatment with levofloxacin, a seizure seizure may develop in patients with previous brain damage (including stroke or severe brain injury).
When quinolones are used in patients with glucose-6-phosphate dehydrogenase deficiency, erythrocyte hemolysis is possible.
If you need to use levofloxacin in patients with diabetes, it is necessary to control the concentration of glucose in the blood.
Sometimes, after taking the first dose of levofloxacin, severe, potentially dangerous hypersensitivity reactions may develop (angioedema, anaphylactic shock).
Despite the fact that photosensitivity is observed when levofloxacin is used very rarely, patients should avoid exposure to the sun or UV radiation to prevent its development.
With simultaneous use of levofloxacin and indirect anticoagulants, it is necessary to monitor the state of the blood coagulation system.
When you take fluoroquinolones, including levofloxacin, you may develop psychotic reactions, which very rarely can lead to suicidal thoughts and potentially dangerous behavior during progression. With the development of such phenomena, the drug should be discontinued.
When levofloxacin is used in patients who have predisposing factors to prolonging the QT interval, an electrocardiogram should be investigated before and during levofloxacin treatment.
When taking fluoroquinolones, cases of the development of sensory or sensorimotor peripheral neuropathy were observed. To prevent the development of irreversible effects in the development of symptoms of peripheral neuropathy, levofloxacin should be immediately canceled.
Patients may receive false-positive tests for the presence of opiates in the urine when taking levofloxacin in patients. To confirm a positive test result, more specific methods should be used.
There are reports of rare cases of liver failure during treatment with levofloxacin, primarily in patients with serious illnesses such as sepsis.If symptoms of liver dysfunction, such as loss of appetite, jaundice, dark urine, itching or sensitivity of the abdominal wall during palpation, levofloxacin should be canceled.
When prescribing the drug to elderly patients, it should be borne in mind that patients in this group often have impaired renal function.

Interaction
Levofloxacin absorption is significantly reduced with simultaneous use with sucralfate, magnesium- or aluminum-containing antacid agents, as well as with iron salts (the interval between taking levofloxacin and these medicines should be at least 2 hours). No interaction with Calcium carbonate has been identified.
Quinolones can enhance the ability of drugs (including theophylline) to lower the threshold of convulsive readiness. When taken simultaneously with fenbufen, higher concentrations of levofloxacin were observed (by 13%) than with monotherapy.
Levofloxacin elimination slows down under the action of cimetidine (by 24%) and probenecid (by 34%).
Levofloxacin causes a slight increase in cyclosporin T1 / 2.
Simultaneous administration with glucocorticosteroids (GCS) increases the risk of tendon rupture.
The simultaneous intake of levofloxacin with oral anticoagulants increases the coagulation time and / or bleeding.
Levofloxacin with simultaneous use with class IA and III antiarrhythmic drugs, tricyclic antidepressants, macrolides can cause prolongation of the QT interval.

Overdose
Symptoms: nausea, erosive lesions of the mucous membranes of the gastrointestinal tract, dizziness, clouding of consciousness and seizures of type epileptic seizures.
Treatment: conduct symptomatic therapy, ECG monitoring. There is no specific antidote. Hemodialysis is not effective.

Storage conditions
At a temperature not higher than 25 ° С in the place protected from light. Keep out of the reach of children.