Levoflox - instructions for use, reviews, analogs and forms of release (tablets of 250 mg and 500 mg, injections in ampoules for injections in Rowek solution) of a drug for the treatment of sinusitis, cystitis, chlamydia in adults, children and pregnancy

In this article, you can read the instructions for using the drug Levoflox. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of antibiotic Levoflox in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Levoflox in the presence of existing structural analogs.Use for the treatment of sinusitis, cystitis and chlamydiosis in adults, children, as well as during pregnancy and lactation.

Levoflox - a broad spectrum antimicrobial agent, fluoroquinolone. It is bactericidal. It blocks enzymes topoisomerase 2 and topoisomerase 4, disrupts supercoiling and cross-linking of deoxyribonucleic acid (DNA) breaks, inhibits DNA synthesis, causes profound morphological changes in the cytoplasm, cell wall and membranes.

Active with respect to Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes and Streptococcus agalactiae, Viridans group streptococci, Enterobacter cloacae, Enterobacter aerobes, Enterobacter agglomerans, Enterobacter sakazakii, Escherichia coli (E. coli), Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae (Klebsiella), Klebsiella oxytoca, Legionella pneumoniae (Legionella), Moraxella catarrhalis, Proteus mirabilis (proteus), Pseudomonas aeruginosa, Pseudomonas fluorescens, Chlamydia pneumoniae (Chlamydia), Mycoplasma pneumoniae, Acinetobacter anitratus, Acinetobacter baumannii , Acinetobacter calcoaceticus, Bordetella pertussis, Citrobacter diversus, Citrobacter freundii, Morganella morganii, Proteus vulgaris, Providencia rettgeri, Providcncia stuartii, Serratia marcescens, Clostridium pe rfringens.

Composition

Levofloxacin + auxiliary substances.

Pharmacokinetics

When ingested absorbed from the gastrointestinal tract (GIT) quickly and almost completely. Food intake has little effect on the speed and completeness of absorption. Bioavailability is 99%. The maximum concentration of Levoflox in the blood is achieved after 1-2 hours. Binding to plasma proteins - 30-40%.It penetrates well into organs and tissues: lungs, bronchial mucosa, sputum, organs of the genitourinary system, polymorphonuclear leukocytes, alveolar macrophages. In the liver, a small portion is oxidized and / or deacetylated. It is excreted from the body mainly by the kidneys through glomerular filtration and tubular secretion. Less than 5% of Levofloxacin is excreted as metabolites. In unchanged form with urine within 24 hours 70% are deduced and in 48 hours - 87%; in the stool for 72 hours found 4% of the dose taken internally.

 Indications

• chlamydial infections of the pelvic organs and other urogenital organs (urogenital chlamydia);
• purulent and unspecified otitis media (inflammation of the middle ear);
• acute sinusitis (inflammation of the paranasal sinuses);
• chronic sinusitis;
• bacterial pneumonia;
• acute bronchitis;
• Chronical bronchitis;
• abscess of skin, furuncle and carbuncle;
• acute tubulointerstitial nephritis (acute pyelonephritis);
• chronic tubulointerstitial nephritis (chronic pyelonephritis);
• cystitis (inflammation of the bladder);
• urethritis (inflammation of the urethra) and urethral syndrome;
• inflammatory diseases of the prostate;
• salpingitis (inflammation of the fallopian tubes) and oophoritis (inflammation of the ovaries);
• inflammatory disease of the uterus, except the cervix (including endometritis, myometrium, metritis, pyometra, abscess of the uterus);
• inflammatory disease of the cervix (including cervicitis, endocervicitis, exocervicitis).

Forms of release

Tablets coated with 250 mg and 500 mg.

Solution for infusions Rutek 5 mg in 1 ml (injections in ampoules for injections).

Instructions for use and dosing regimen

Apply Levoflox inside or intravenously.

With sinusitis - inside 500 mg once a day, with exacerbation of chronic bronchitis - 250-500 mg once a day. With pneumonia: inside 250-500 mg 1-2 times a day (500-1000 mg per day), intravenously - 500 mg 1-2 times a day. With infections of the urinary tract - inside 250 mg 1 time per day or intravenously in the same dose. With infections of the skin and soft tissues, 250-500 mg orally 1-2 times a day or intravenously 500 mg twice a day. After intravenous introduction in some days transition to reception inside in the same dose is possible.

In renal diseases, the dose of Levoflox is reduced in accordance with the degree of impaired function: when creatinine clearance (CC) is equal to 20-50 ml per minute, 125-250 mg 1-2 times a day, with a CS equal to 10-19 ml per minute - 125 mg once every 12-48 hours, with CC less than 10 ml per minute - 125 mg after 24 or 48 hours. The duration of treatment is 7-10 (up to 14) days.

Side effect

• nausea, vomiting, diarrhea;
• anorexia (a neuropsychic disorder manifested by an obsessive desire to lose weight, fear of obesity);
• abdominal pain (abdominal pain);
• pseudomembranous enterocolitis (inflammation of the intestine);
• increased activity of hepatic transaminases, hyperbilirubinemia;
• hepatitis (inflammation of the liver);
• dysbacteriosis (microbial imbalance in the body);
• lowering blood pressure;
• cardiovascular collapse (one of the forms of heart failure that occurs due to a sharp drop in the tone of blood vessels);
• tachycardia (heart palpitations);
• hypoglycemia (increased appetite, sweating, trembling);
• headache, dizziness;
• weakness;
• drowsiness, insomnia;
• paresthesia (a type of sensitivity disorder characterized by sensations of numbness, tingling sensations, crawling crawling);
• anxiety, fear;
• hallucinations, confusion;
• depression;
• motor disorders, convulsions;
• impaired vision, hearing;
• violation of smell, taste and tactile sensitivity;
• arthralgia (joint pain);
• Myalgia (pain in the muscle);
• rupture of tendons;
• muscle weakness;
• tendonitis (inflammation and dystrophy of the tendon tissue);
• hypercreatininaemia;
• interstitial nephritis (inflammation of the kidney tissue);
• eosinophilia, hemolytic anemia, leukopenia, neutropenia, agranulocytosis, thrombocytopenia, pancytopenia;
• hemorrhages (hemorrhages on the skin and mucous membranes);
• photosensitization (the phenomenon of increasing the sensitivity of the body, more often the skin and mucous membranes, to the action of ultraviolet or visible radiation);
• itching, swelling of the skin and mucous membranes;
• malignant exudative erythema (Stevens-Johnson syndrome);
• toxic epidermal necrolysis (Lyell's syndrome);
• hives;
• bronchospasm, choking;
• anaphylactic shock;
• allergic pneumonitis (inflammation of the walls of the alveoli and parenchyma of the lungs);
• vasculitis (inflammation of the walls of blood vessels);
• exacerbation of porphyria (disturbance of pigment metabolism);
• rhabdomyolysis (destruction of cells of muscle tissue);
• persistent fever;
• development of superinfection.

Contraindications

• hypersensitivity;
• epilepsy;
• the defeat of the tendons during the previous treatment with quinolones;
• pregnancy, lactation;
• children and adolescence up to 18 years.

Application in pregnancy and lactation

Levoflox is contraindicated in pregnancy and lactation (breastfeeding).

Use in children

Contraindicated in children and adolescents under 18 years.

Application in elderly patients

With care, prescribe Levoflox to elderly patients (high probability of concomitant decrease in kidney function).

special instructions

After normalizing the temperature, it is recommended to continue treatment with Levoflox at least 48-78 hours. The duration of intravenous infusion of 500 mg (100 ml infusion solution) should be at least 60 minutes. During treatment, sunlight and artificial ultraviolet irradiation should be avoided to avoid damage to the skin (photosensitization). When there are signs of tendonitis, levofloxacin is immediately withdrawn. It should be borne in mind that the development of seizures is possible in patients with a history of brain injury (stroke, severe trauma), with the insufficiency of glucose-6-phosphate dehydrogenase - the risk of hemolysis.

Impact on the ability to drive vehicles and manage mechanisms

During the treatment period it is necessary to refrain from engaging in potentially hazardous activities,requiring increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

Levofloxacin increases the half-life of cyclosporine.

The effect of Levoflox reduces drugs that depress intestinal motility, sucralfate, magnesium and aluminum-containing antacids and iron salts (a break between taking at least 2 hours is necessary).

With simultaneous use of non-steroidal anti-inflammatory drugs (NSAIDs) and theophylline increase convulsive readiness, glucocorticosteroids (GCS) increase the risk of rupture of tendons.

Cimetidine and drugs that block tubular secretion, slow the withdrawal of levofloxacin.

The solution of levofloxacin for intravenous administration is compatible with 0.9% sodium chloride solution, 5% Dextrose solution, 2.5% Ringer's solution with dextrose, combined solutions for parenteral nutrition (amino acids, carbohydrates, electrolytes).

A solution of levofloxacin for intravenous administration should not be mixed with Heparin and solutions that have an alkaline reaction.

Analogues of the drug Levoflox

Structural analogs for the active substance:

• Ashlyov;
• Glevo;
• Ivacin;
• Lebel;
• Levoxime;
• Levot;
• Levostar;
• Levotech;
• Levofloxabol;
• Levofloxacin;
• Leobeg;
• Leflobact;
• Leflobact Forte;
• Lefokcin;
• Luffy;
• Matlevo;
• OD-Levoks;
• Oftakwix;
• Remedy;
• Roflox-Scan;
• Signictsef;
• Tavanik;
• Tanflomed;
• Flexine;
• Floracid;
• Hayleflex;
• Ecology;
• Eleflox.

Analogues of Levoflox on the pharmacological group (quinolones / fluoroquinolones):

• Abaktal;
• Avelox;
• Aquamox;
• Afenoxin;
• Basijen;
• Betaciprol;
• Vigamox;
• Gatispan;
• Gatifloxacin;
• Glaoufos;
• Glevo;
• Gramurin;
• Dancyl;
• Zanotsin;
• Zimar;
• Zofloks;
• Ivacin;
• Isfipro;
• Quintor;
• Levoxime;
• Levofloxacin;
• Liprokhin;
• Maksakvin;
• Microfleks;
• Moxifloxacin;
• Moflaxia;
• Nevigramon;
• The Negroes;
• Norfloxacin;
• Okatsin;
• Oflo;
• Ofloks;
• Ofloxabol;
• Ofloxacin;
• Palin;
• Peflacine;
• Pefloxabol;
• Pefloxacin;
• Pimidel;
• Plevilox;
• PROCIPRO;
• Raksar;
• Signictsef;
• Siflox;
• Sofazine;
• Sparfloxacin;
• Sparfl;
• Tavanik;
• Tanflomed;
• Ultramox;
• Uniflox;
• Urotraktin;
• Floracid;
• Flociprin;
• Hayleflex;
• Heinemox;
• Ceprova;
• Ciloxane;
• The cynobacterium;
• Tsiprolet;
• Ciprofloxabol;
• Ciprofloxacin;
• Cytar;
• Cifloxinal;
• Tsifran;
• Cyphrazide;
• Chibroxin;
• Ecology;
• Enoksor;
• Unikpef;
• Utibid.

Response of a gynecologist

A good antibiotic, a broad spectrum of action. I apply Levoflox for the treatment of patients with inflammatory processes in the uterus, fallopian tubes, ovaries. Most often I prescribe the drug in tablet form, but in severe cases it is necessary to resort to intravenous infusions of Levoflox. Sometimes, with a rapid positive dynamics after a three-day parenteral administration of the drug, I transfer patients to oral medication in tablets. Women, as a rule, tolerate treatment well, without any adverse reactions.

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