Cifral pills coated 250mg №10

Composition

Digital coated tablets: 1 pill contains Ciprofloxacin (in the form of monohydrate hydrochloride) - 250 or 500 mg;
10 or 100 pcs. in a carton box.
Digital solution for infusion: 1 ml of solution contains ciprofloxacin (in the form of lactate) - 2 mg (1 bottle - 200 mg);
100 ml in a bottle, 1 bottle in a box.
Digital eye drops: 1 ml contains ciprofloxacin (in the form of hydrochloride) - 3 mg;
other ingredients: benzalkonium chloride;
10 ml in a bottle of dark glass, 1 bottle in a carton box.

Mechanism of action

Cifran is a broad-spectrum antimicrobial drug from the fluoroquinolone group. The mechanism of action is associated with inhibition of the bacterial DNA gyrase enzyme and impaired DNA synthesis. Cifran increases the permeability of the cell wall of bacteria. It has a bactericidal effect on bacteria that are both in the breeding phase and in the resting phase.
Active against aerobic gram-negative bacteria: Escherichia coli, Klebsiella spp., Proteus spp. (indole-positive and indole-negative), Serratia spp., Enterobacter spp., Morganella morganii, Providencia spp., Citrobacter spp., Salmonella spp., Shigella spp., Yersinia enterocolitica, Vibrio cholerae, Vibrio parahaemothyo rythyo, us ter us us us us bac bac bac bac bac bac bac bac us us us us,, V V V V V je je us us us us us us ((((Indole-positive and indole-negative), Serratia spp., Enterobacter spp., Morganella morganii, Providencia spp., Citrobacter spp., Salmonella s. aeruginosa, Neisseria gonorrhoeae, Neisseria meningitidis, Haemophilus influenzae, Acinetobacter anitratus, Branhamella catarrhalis, Gardnerella vaginalis, Moraxella spp., Pasteurella spp.; aerobic gram-positive bacteria: Staphylococcus aureus, including penicillinase-producing strains and methicillin-resistant strains, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus viridans, Listeria monocytocycus intracellular bacteria: Chlamydia trachomatis, Mycoplasma hominis, Legionella spp., Brucella spp.
To drug resistant anaerobic bacteria: most strains of Clostridium spp., Fusobacterium spp., Actinomyces spp.
The drug has a long-term (up to 6 h) post-antibiotic effect, preventing the growth of bacteria in concentrations below BMD.
Cifran has no significant effect on anaerobic microorganisms and does not violate the normal intestinal microflora and vagina. Chromosome-mediated resistance to Cifran is rare, plasmid-mediated resistance is absent. Cross-resistance with other antibiotics other than fluoroquinolones is absent.
Cifran is active against gram-positive and gram-negative pathogens resistant to penicillins, cephalosporins and aminoglycosides.

Indications and usage

Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the drug:
- respiratory tract infections (pneumonia, bronchopneumonia, acute bronchitis, exacerbation of chronic bronchitis, pleurisy, empyema, lung abscesses, infected bronchiectasis, including in patients with cystic fibrosis);
- infections of the genitourinary system (acute and chronic pyelonephritis, prostatitis, cystitis, epididymitis, including complicated and recurrent);
- gonorrhea (urethritis, proctitis or pharyngitis, including those caused by resistant gonococci);
- infections of upper respiratory tract (including external and middle otitis, sinusitis, mastoiditis);
- infections of the skin and soft tissues (includinginfected ulcers, wounds and burns, abscesses, cellulites);
- gastrointestinal infections (including typhoid fever, peritonitis, intra-abdominal abscesses, cholangitis, cholecystitis, gallbladder empyema);
- infectious and inflammatory diseases of the pelvic organs (including salpingitis, endometritis);
- infections of bones and joints (including acute and chronic osteomyelitis, septic arthritis);
- septicemia, bacteremia and infections in immunocompromised patients;
Prevention of postoperative infections (for iv administration).

Contraindications

 
Hypersensitivity to ciprofloxacin and other quinolones; pregnancy; lactation (breastfeeding); children's age up to 12 years.

Dosage and administration

Set individually depending on the severity of the infection, the type of pathogen, age, body weight and kidney function of the patient.
Inside with uncomplicated urinary tract infections appoint 250 mg every 12 hours
With prostatitis and complicated urinary tract infections - 500 mg every 12 hours.
For infections of the lower respiratory tract mild - 250 mg every 12 hours; moderate and severe - 500 mg every 12 hours; caused by resistant gram-positive microorganisms (Streptococcus spp.) - 750 mg every 12 hours.
With infections of upper respiratory tract - 500-750 mg every 12 hours
With infections of bones and joints - 500-750 mg every 12 hours
With gastrointestinal infections - 250-500 mg every 12 hours
With typhoid fever - 500 mg every 12 hours.
For gynecological infections - 500 mg every 12 hours.
With gonorrhea (acute, uncomplicated) - 500 mg once.
When expressed impaired renal function (CC less than or equal to 20 ml / min) the daily dose should be reduced by 2 times.
Children over 12 years old appoint 5-10 mg / kg body weight / day, divided into 2 doses.
Tablets are preferably taken before meals.

In the form of infusions for adults with urinary tract infections, and lower respiratory infections appoint 200 mg 2 times / day, slowly in / in. For other infections, 200 mg every 12 hours, slowly IV.
When bacteremia, septicemia - 400 mg (200 ml) every 12 hours.
When expressed impaired renal function (CC less than or equal to 20 ml / min) the daily dose should be reduced by 2 times.
Duration of infusion The figure in the dose of 200 mg is 60 minutes.
If necessary, after the on / in the introduction switch to oral administration of digital.
With septicemia, bacteremia and intra-abdominal infections after intravenous therapy, the drug is administered orally, 500-750 mg every 12 hours.
The duration of the course of treatment depends on the severity of the infection, the clinical dynamics and the bacteriological analysis data. In acute infections, the duration of therapy is 5-7 days. Treatment is continued for 3 days after the disappearance of the clinical symptoms of the infection.

Eye drops for diseases easy and moderate severity 1-2 drops are instilled into the lower conjunctival sac of the affected eye every 4 hours.
With severe 2 drops are instilled every hour until improvement is achieved, after which the dose may be lowered.

Adverse reactions

Gastrointestinal: rarely - abdominal pain, vomiting, diarrhea; in some cases - increased activity of liver transaminases.
From the side of the central nervous system: rarely - headache, anxiety.
Local reactions: redness at the injection site, thrombophlebitis (with a / in the introduction).
Other: rarely - arthralgia, rash.
When used in recommended doses, side effects are unlikely.

In connection with the threat of adverse reactions from the central nervous system in patients with epilepsy, bouts of convulsions in history, vascular diseases and organic brain lesions, ciprofloxacin should be used only for life reasons.
Excessive exposure to direct sunlight should be avoided. If a photosensitivity reaction occurs, it is recommended to stop using the drug.

Special notes

In patients with allergic reactions to fluoroquinolone derivatives, these reactions to ciprofloxacin may occur.
With the use of almost all antibacterial drugs, including ciprofloxacin, the development of pseudomembranous colitis of varying severity (from mild to life-threatening) is possible. It should be borne in mind this diagnosis in the presence of intractable diarrhea in a patient taking antibacterial agents. If severe or prolonged diarrhea occurs during or after treatment, diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and appropriate treatment.
In order to avoid the development of crystalluria, it is unacceptable to exceed the recommended daily dose, in addition, sufficient fluid intake and maintenance of acidic urine is necessary.
If there is pain in the tendons or the first signs of tendovaginitis, treatment should be stopped.
Due to the fact that antacids containing Magnesium hydroxide and / or aluminum hydroxide can slow down the absorption of ciprofloxacin, Cifran should be administered 1-2 hours before and at least 4 hours after taking these drugs.
When using eye drops and other ophthalmic drugs, the interval between their administration should be at least 5 minutes.

The drug should be stored in a dry, dark place at temperatures not above 25 ° C.