Levofloxacin - instructions for use, reviews, analogs and formulations (tablets 250 mg, 500 mg and 750 mg Hailefleks, solution for infusions, eye drops 0.5% antibiotic) for the treatment of pneumonia in adults, children and pregnancy. Composition
In this article, you can read the instructions for using the drug Levofloxacin. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of antibiotic Levofloxacin in their practice are presented. 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 Levofloxacin in the presence of existing structural analogues.Use for the treatment of pneumonia, prostatitis, chlamydia and other infections in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.
Levofloxacin - a synthetic antibacterial agent of a broad spectrum of action from the group of fluoroquinolones, containing as an active substance levofloxacin - the left-handed isomer of ofloxacin. Levofloxacin blocks DNA-gyrase, disrupts supercoiling and cross-linking of DNA gaps, inhibits DNA synthesis, causes profound morphological changes in the cytoplasm, cell wall and membranes.
Levofloxacin is active against most strains of microorganisms (aerobic Gram-positive and Gram-negative, as well as anaerobic).
Antibiotics are sensitive to Levofloxacin and other microorganisms: Bartonella spp, Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella pneumophila, Legionella spp, Mycobacterium spp, Mycobacterium leprae, Micobacterium tuberculosis, Mycoplasma hominis, Mycoplasma pneumoniae, Ricketsia spp, Ureaplasma urealyticum.
Composition
Levofloxacin hemihydrate + excipients.
Pharmacokinetics
Levofloxacin is rapidly and almost completely absorbed after oral administration. Food intake has little effect on the speed and completeness of absorption.It penetrates well into organs and tissues: lungs, bronchial mucosa, sputum, organs of the genitourinary system, bone tissue, cerebrospinal fluid, prostate gland, 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. After oral administration, approximately 87% of the dose is excreted unchanged for 48 hours, less than 4% with feces for 72 hours.
Indications
Infectious-inflammatory diseases caused by microorganisms sensitive to the preparation:
- infection of the lower respiratory tract (exacerbation of chronic bronchitis, community-acquired pneumonia);
- infection of the ENT organs (acute sinusitis);
- urinary tract infection and kidney infection (including acute pyelonephritis);
- infections of the genitals (including bacterial prostatitis);
- infections of the skin and soft tissues (festering atheromas, abscess, boils);
- intra-abdominal infections;
- tuberculosis (complex therapy of drug-resistant forms).
Forms of release
Tablets coated with 250 mg, 500 mg and 750 mg (Haileflox).
Solution for infusions 5 mg / ml.
Eye drops 0.5%.
Instructions for use and dosage
Inside, during a meal or during a break between meals, without chewing, squeezed with enough liquid.
Doses are determined by the nature and severity of the infection, as well as the suspected pathogen susceptibility,
The recommended dose of the drug for adults with normal renal function (CK> 50 ml / min):
In acute sinusitis - 500 mg once a day for 10-14 days;
With exacerbation of chronic bronchitis - from 250 to 500 mg once a day for 7-10 days;
With community-acquired pneumonia, 500 mg 1 or 2 times a day for 7-14 days;
In uncomplicated infections of the urinary tract and kidneys - 250 mg 1 time per day for 3 days;
With complicated infections of the urinary tract and kidneys - 250 mg once a day for 7-10 days;
With bacterial prostatitis - 500 mg once a day for 28 days;
For infections of the skin and soft tissues - 250 mg - 500 mg 1 or 2 times a day for 7-14 days;
Intra-abdominal infections - 250 mg twice a day or 500 mg once a day - 7-14 days (in combination with antibacterial drugs acting on anaerobic flora).
Tuberculosis - inside by 500 mg 1-2 times a day to 3 months.
If the liver function is not required, a special dose selection is required, since levofloxacin is only slightly metabolized in the liver and excreted mainly by the kidneys.
If you missed taking the drug should, as soon as possible, take a pill, until the time of the next admission is near. Then continue taking levofloxacin according to the scheme.
The duration of therapy depends on the type of disease. In all cases, treatment should continue from 48 to 72 hours after the disappearance of the symptoms of the disease.
Side effect
- itching and redness of the skin;
- general hypersensitivity reactions (anaphylactic and anaphylactoid reactions) with symptoms such as urticaria, constriction of the bronchi and possibly severe choking;
- swelling of the skin and mucous membranes (for example, in the face and throat area);
- sudden drop in blood pressure and shock;
- increased sensitivity to solar and ultraviolet radiation;
- allergic pneumonitis;
- vasculitis;
- toxic epidermal necrolysis (Lyell's syndrome);
- exudative erythema multiforme;
- nausea, vomiting;
- diarrhea;
- loss of appetite;
- stomach ache;
- pseudomembranous colitis;
- a decrease in the concentration of glucose in the blood, which is of particular importance for patients suffering from diabetes mellitus (possible signs of hypoglycemia: increased appetite, nervousness, sweating, trembling);
- exacerbation of porphyria in patients already suffering from this disease;
- headache;
- dizziness and / or stupor;
- drowsiness;
- sleep disorders;
- anxiety;
- shiver;
- psychotic reactions such as hallucinations and depressions;
- convulsions;
- confusion of consciousness;
- impaired vision and hearing;
- disorders of taste sensitivity and smell;
- decreased tactile sensitivity;
- increased heart rate;
- joint and muscle pain;
- rupture of tendons (eg Achilles tendon);
- impairment of kidney function up to acute renal failure;
- interstitial nephritis;
- increase in the number of eosinophils;
- decrease in the number of leukocytes;
- neutropenia, thrombocytopenia, which may be accompanied by increased bleeding;
- agranulocytosis;
- pancytopenia;
- fever.
Contraindications
- hypersensitivity to levofloxacin or other quinolones;
- renal failure (with creatinine clearance less than 20 ml / min - due to the inability to dispense this dosage form);
- epilepsy;
- lesions of tendons during the previous treatment with quinolones;
- children and adolescence (up to 18 years);
- pregnancy and lactation.
Application in pregnancy and lactation
Contraindicated in pregnancy and lactation.
Use in children
Levofloxacin can not be used to treat children and adolescents (under 18 years of age) because of the possibility of joint cartilage damage.
special instructions
In severe pneumonia caused by pneumococci, levofloxacin may not provide the optimal therapeutic effect. Hospital infections caused by certain pathogens (P. aeruginosa) may require combined treatment.
During treatment with Levofloxacin, an episode of seizures may develop in patients with previous brain damage due, for example, to a stroke or severe trauma.
Despite the fact that photosensitivity is noted with the use of levofloxacin very rarely, in order to avoid it, it is not recommended to be subjected to severe sunlight or artificial ultraviolet irradiation without special need.
If pseudomembranous colitis is suspected, levofloxacin should be immediately discontinued and appropriate treatment initiated. In such cases, drugs that depress intestinal motility should not be used.
The use of alcohol and alcoholic beverages in the treatment of Levofloxacin is prohibited.
Rarely observed with the use of the drug Levofloxacin tendonitis (primarily inflammation of the Achilles tendon) can lead to rupture of tendons. The elderly are more prone to tendinitis. Treatment with glucocorticosteroids in all likelihood increases the risk of rupture of tendons. If suspicion of tendonitis should immediately stop treatment with Levofloxacin and begin appropriate treatment of the affected tendon.
Patients with insufficiency of glucose-6-phosphate dehydrogenase (hereditary metabolic disorders) can react to fluoroquinolones by destruction of erythrocytes (hemolysis). In this regard, the treatment of such patients with levofloxacin should be carried out with great care.
Impact on the ability to drive vehicles and manage mechanisms
Such side effects of Levofloxacin, such as dizziness or stupor, drowsiness and visual impairment, may impair reactivity and concentration. This can represent a certain risk in situations where these abilities are of particular importance (for example, when driving, servicing machines and mechanisms, performing work in an unstable position).
Drug Interactions
There are reports of a marked decrease in the threshold of convulsive readiness with the simultaneous use of quinolones and substances that, in turn, can reduce the cerebral threshold of convulsive readiness. Equally, this also applies to the simultaneous use of quinolones and theophylline.
Effect of the drug Levofloxacin significantly weakened with simultaneous application with sucralfate. The same happens with the simultaneous use of magnesium- or aluminum-containing antacid agents, as well as iron salts. Levofloxacin should be taken at least 2 hours before or 2 hours after taking these drugs. Calcium carbonate was not detected.
With the simultaneous use of vitamin K antagonists, control over the blood coagulation system is necessary.
Elimination (renal clearance) of levofloxacin slightly slowed down by the action of cimetidine and probenicide. It should be noted that this interaction has practically no clinical significance. Nevertheless, with the simultaneous use of drugs such as probenicid and cimetidine blocking a certain way of excretion (tubular secretion), treatment with levofloxacin should be done with caution.This applies primarily to patients with limited renal function.
Levofloxacin slightly increases the half-life of cyclosporine.
The use of glucocorticosteroids increases the risk of rupture of tendons.
Analogues of the drug Levofloxacin
Structural analogs for the active substance:
- Glevo;
- Ivacin;
- Lebel;
- Levot P;
- Levotech;
- Levoflox;
- Levofloxabol;
- Levofloxacin STADA;
- Levofloxacin Teva;
- Levofloxacin hemihydrate;
- Levofloxacin hemihydrate;
- Leobeg;
- Leflobact;
- Lefokcin;
- Matlevo;
- OD Levoks;
- Oftakwix;
- Remedy;
- Signictsef;
- Tavanik;
- Tanflomed;
- Flexine;
- Floracid;
- Hayleflex;
- Ecology;
- Eleflox.
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