Tavanik - instructions for the use of antibiotics, reviews, analogs and forms of release (tablets 250 mg and 500 mg, injections in injections) of a drug for the treatment of prostatitis, cystitis and pyelonephritis in adults, children and pregnancy
In this article, you can read the instructions for using the drug Tavanik. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Tananik antibiotic 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 Tavanik in the presence of existing structural analogs.Use for the treatment of prostatitis, cystitis and pyelonephritis in adults, children, as well as during pregnancy and lactation.
Tavanik - a synthetic antimicrobial drug from the group of fluoroquinolones, the left-handed isomer of ofloxacin. Has a wide spectrum of antimicrobial action.
Levofloxacin (the active substance of the Tavanic drug) blocks DNA gyrase (topoisomerase 2) and topoisomerase 4, 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 microorganisms are sensitive; anaerobic microorganisms; other microorganisms: Bartonella spp., Chlamydia pneumoniae (chlamydia), Chlamydia psittaci, Chlamydia trachomatis, Legionella pneumophila (Legionella), Legionella spp., Mycobacterium spp. (including Mycobacterium leprae, Mycobacterium tuberculosis), Mycoplasma hominis (mycoplasmas), Mycoplasma pneumoniae, Rickettsia spp., Ureaplasma urealyticum (ureaplasma).
Tavanik is resistant to aerobic Gram-positive microorganisms: Corynebacterium jeikeium, Staphylococcus aureus (methicillin-resistant strains), Staphylococcus spp. (coagulase-negative methicillin-resistant strains); aerobic gram-negative microorganisms: Alcaligenes xylosoxidans; anaerobic microorganisms: Bacteroides thetaiotaomicronron; other microorganisms: Mycobacterium avium.
Due to the peculiarities of the mechanism of action of levofloxacin, there is usually no cross-resistance between Tavanic and other antimicrobial agents.
Composition
Levofloxacin hemihydrate + excipients.
Pharmacokinetics
Binding to plasma proteins - 30-40%. Levofloxacin penetrates well into the bronchial mucosa, epithelial lining fluid, alveolar macrophages with penetration coefficients in the bronchial mucosa and epithelial lining fluid compared to the concentration in the plasma. Levofloxacin well penetrates into the lung tissue with penetration factors of 2-5 compared to the concentration in the plasma. Levofloxacin penetrates well into the alveolar fluid with a coefficient of penetration compared with the concentrations in the plasma of 1. Levofloxacin penetrates well into the cortical and spongy bone tissue, both in the proximal and distal parts of the femur with a coefficient of penetration (bone tissue / plasma) 0, 1-3. Levofloxacin poorly penetrates into the cerebrospinal fluid. Levofloxacin well penetrates into the tissue of the prostate gland.In the urine, high concentrations of levofloxacin are created, several times higher than the concentration of levofloxacin in plasma.
Levofloxacin is metabolized to a small extent (5% of the dose taken). Its metabolites are demethyllevofloxacin and N-oxide levofloxacin, which are excreted by the kidneys. Levofloxacin is stereochemically stable and does not undergo chiral transformations.
There are no significant differences in the pharmacokinetics of levofloxacin with its intravenous administration and ingestion, which confirms that oral and intravenous routes of administration are interchangeable.
Indications
Bacterial infections caused by susceptible to levofloxacin microorganisms in adults:
- acute sinusitis;
- exacerbation of chronic bronchitis;
- community acquired pneumonia;
- uncomplicated urinary tract infections;
- complicated urinary tract infections (including pyelonephritis);
- chronic bacterial prostatitis;
- infections of the skin and soft tissues;
- septicemia / bacteremia associated with the above indications;
- infection of the abdominal cavity;
- for the complex treatment of drug-resistant forms of tuberculosis.
Forms of release
Tablets coated with 250 mg and 500 mg.
Solution for infusions (injections in ampoules for injections).
Instructions for use and dosage
Pills
The drug is taken orally 250 or 500 mg 1 or 2 times a day. Tablets should be taken without chewing and drinking with a sufficient amount of liquid (0.5 to 1 cup). If necessary, the tablets can be broken on the separating groove.
The drug can be taken before meals or at any time between meals. eating does not affect the absorption of the drug.
The drug should be taken at least 2 hours before or 2 hours after taking antacid preparations containing magnesium and / or aluminum, iron salts or the administration of sucralfate.
Dosing regimen is determined by the nature and severity of the infection, as well as the suspected pathogen susceptibility. Duration of treatment varies depending on the course of the disease.
Patients with normal or moderately reduced renal function (CK> 50 mL / min) are recommended the following dosing regimen and duration of treatment.
Acute sinusitis: 2 tablets 250 mg or 1 tablet 500 mg once a day (correspondingly 500 mg of levofloxacin) - 10-14 days.
Exacerbation of chronic bronchitis: 1 tablet 250 mg (respectively 250 mg levofloxacin) or 2 tablets 250 mg or 1 tablet 500 mg once a day (respectively 500 mg levofloxacin) - 7-10 days.
Community-acquired pneumonia: 2 tablets 250 mg or 1 tablet 500 mg 1-2 times a day (respectively 500-1000 mg levofloxacin) - 7-14 days.
Uncomplicated urinary tract infections: 1 tablet 250 mg once a day (respectively 250 mg levofloxacin) - 3 days.
Complicated urinary tract infections (including pyelonephritis): 1 tablet 250 mg once a day (respectively 250 mg levofloxacin) - 7-10 days.
Chronic bacterial prostatitis: 2 tablets 250 mg or 1 tablet 500 mg once a day (correspondingly 500 mg of levofloxacin) - 28 days.
Infections of the skin and soft tissues: 1 tablet 250 mg once a day (respectively 250 mg levofloxacin) or 2 tablets 250 mg or 1 tablet 500 mg 1-2 times daily (respectively 500-1000 mg levofloxacin) - 7 -14 days.
Septicemia / bacteremia associated with the above indications: 2 tablets 250 mg or 1 tablet 500 mg 1-2 times a day (respectively 500-1000 mg levofloxacin) - 10-14 days.
Infections of the abdominal cavity: 2 tablets 250 mg or 1 tablet 500 mg once a day (500 mg of levofloxacin, respectively) - 7-14 days in combination with antibacterial drugs acting on anaerobic flora.
As part of the complex treatment of drug-resistant forms of tuberculosis: 1-2 tablets 500 mg 1-2 times a day (respectively 500-1000 mg levofloxacin) - up to 3 months.
For elderly patients, dosage adjustment is not required.
If you accidentally missed taking the drug, you should take a tablet as soon as possible and continue taking Tavanik according to the recommended dosing regimen.
Ampoules
The drug is taken orally, or intravenously, 250-500 mg 1-2 times a day.
Doses are determined by the nature and severity of the infection, as well as the suspected pathogen susceptibility.
Patients with normal or moderately impaired renal function (CK> 50 ml / min) the drug is recommended to be administered in the following doses.
Community-acquired pneumonia: 500 mg 1-2 times a day (daily dose - 500-1000 mg of levofloxacin). The course of treatment is 7-14 days.
Uncomplicated infections of the urinary tract: 250 mg once a day (daily dose - 250 mg of levofloxacin).The course of treatment is 3 days.
Complicated urinary tract infections (including pyelonephritis): 250 mg once daily. In severe infections, an increase in the dose is possible. The course of treatment is 7-10 days.
Chronic bacterial prostatitis: 500 mg once a day (daily dose - 500 mg of levofloxacin). The course of treatment is 28 days.
Septicemia / bacteremia: 500 mg 1-2 times a day (daily dose - 500-1000 mg levofloxacin). The course of treatment is 10-14 days.
Infection of the abdominal cavity: 500 mg once a day. The course of treatment is 7-14 days in combination with antibacterial drugs acting on anaerobic flora.
In the complex therapy of drug-resistant forms of tuberculosis Tavanik appoint 500 mg 1-2 times a day (500-1000 mg levofloxacin per day) up to 3 months.
Duration of treatment varies depending on the course of the disease and should be no more than 14 days.
As with the use of other antibiotics, treatment with Tananik is recommended to continue for at least 48-72 hours after the normalization of body temperature or after a reliable eradication of the pathogen.
With the positive dynamics of the clinical condition of the patient after a few days of treatment, it is possible to switch from intravenous drip administration to taking Tavanic in tablets at the same dose (due to the fact that the bioavailability of levofloxacin when ingested is 99-100%).
The patient should be warned about the inadmissibility of an independent break or early termination of therapy without instructions from the doctor.
If you accidentally missed the introduction of the drug, you should, as soon as possible, to enter the missed dose and continue to enter Tavanik according to the recommended dosing regimen.
Rules of drug administration
The drug Tavanik in the form of a solution is administered intravenously drip (dropper) slowly. The duration of administration of the drug at a dose of 500 mg (100 ml infusion solution / 500 mg levofloxacin) should be at least 60 minutes, in the case of half-bottle administration (50 ml / 250 mg levofloxacin), the duration of administration is at least 30 minutes. The drug solution Tavanic 500 mg / 100 ml is compatible with the following infusion solutions: 0.9% sodium chloride solution, 5% Dextrose solution, 2.5% Ringer's dextrose solution, combined solutions for parenteral nutrition (amino acids, carbohydrates, electrolytes). The drug solution can not be mixed with Heparin or solutions with an alkaline reaction (for example, with sodium bicarbonate solution).
After removing the vial from the cardboard package, the infusion solution can be stored in the room light without light protection for more than 3 days.
Side effect
- phlebitis;
- sinus tachycardia;
- a decrease in blood pressure;
- leukopenia, eosinophilia, neutropenia, thrombocytopenia, pancytopenia, agranulocytosis, hemolytic anemia;
- headache;
- dizziness;
- drowsiness;
- tremor;
- dysgeusia (perversion of taste);
- paresthesia;
- convulsions;
- peripheral sensory neuropathy;
- extrapyramidal disorders;
- loss of taste;
- insomnia;
- feeling of anxiety;
- confusion of consciousness;
- depression;
- sleep disorders;
- nightmarish dreams;
- visual impairments, such as the vagueness of the visible image;
- Vertigo (feeling of deflection or twisting or own body or surrounding objects);
- tinnitus;
- hearing loss;
- dyspnea;
- bronchospasm;
- allergic pneumonitis;
- diarrhea;
- vomiting, nausea;
- stomach ache;
- dyspepsia;
- pseudomembranous colitis;
- acute renal failure (eg, due to the development of interstitial nephritis);
- rash;
- itching;
- hives;
- toxic epidermal necrolysis;
- exudative erythema multiforme;
- photosensitivity reaction (increased sensitivity to solar and ultraviolet radiation);
- angioedema;
- anaphylactic shock;
- arthralgia;
- myalgia;
- anorexia;
- asthenia;
- pyrexia (fever);
- reaction at the injection site (tenderness, skin hyperemia).
Contraindications
- epilepsy;
- lesions of tendons with the use of fluoroquinolones in the anamnesis;
- children and adolescents under 18 years of age (due to incomplete growth of the skeleton, as the risk of destruction of cartilaginous growth points can not be completely excluded);
- pregnancy (the risk of destruction of the cartilage growth points in the fetus can not be completely ruled out);
- lactation period (the risk of destruction of cartilage points of bone growth in an infant can not be completely ruled out);
- hypersensitivity to levofloxacin or other quinolones.
Application in pregnancy and lactation
The drug is contraindicated for use in pregnancy and lactation (breastfeeding).
Use in children
Tavanik is contraindicated for use in children and adolescents under the age of 18 years.
special instructions
When hospital infections caused by Pseudomonas aeruginosa may require the use of combination therapy.
Duration of infusion
It should be strictly adhered to the recommended duration of administration, which should be at least 60 minutes for 100 ml of infusion solution.The experience with levofloxacin shows that during the infusion, there can be increased heart rate and transient drop in blood pressure. In rare cases, there may be vascular collapse. If there is a marked drop in blood pressure during infusion, the administration is immediately stopped.
Patients who are predisposed to develop seizures
Like other quinolones, levofloxacin should be used with great caution in patients with predisposition to seizures: in patients with previous CNS lesions, such as stroke, severe craniocerebral trauma; in patients receiving concomitant medications that lower the threshold for convulsive brain readiness, such as fenbufen and other non-steroidal anti-inflammatory drugs (NSAIDs) similar to it, as well as drugs such as theophylline.
Pseudomembranous colitis
The diarrhea that developed during or after treatment with levofloxacin, especially severe, persistent and / or blood, may be symptoms of pseudomembranous colitis caused by Clostridium difficile. In case of suspected development of pseudomembranous colitis, treatment with levofloxacin should be stopped immediately and immediately begin specific antibiotic therapy (vancomycin, teicoplanin or Metronidazole inside).
Tendonitis
Tendonitis rarely observed in the application of quinolones, including levofloxacin, may lead to rupture of the tendon, including the Achilles tendon. This side effect can develop within 48 hours after the start of treatment and can be bilateral. Patients of advanced age are more predisposed to the development of tendonitis. The risk of rupture of tendons may increase with simultaneous admission of GCS. If tendinitis is suspected, immediately discontinue treatment with Tavanic and start the appropriate treatment of the affected tendon, for example, to provide him with adequate immobilization.
Patients with renal insufficiency
Because levofloxacin is excreted mainly by the kidneys, in patients with impaired renal function, mandatory monitoring of kidney function is required, as well as correction of the dosing regimen. In the treatment of elderly patients, it should be borne in mind that patients of this group often suffer from impaired renal function.
Prevention of the development of photosensitization reactions
Although photosensitization with levofloxacin is very rare, forprevention of its development, patients are not recommended to be subjected to severe sunlight or artificial ultraviolet irradiation without special need (for example, to visit a solarium).
Superinfection
As with the use of other antibiotics, the use of levofloxacin, especially for a long time, can lead to increased multiplication of insensitive microorganisms, which can cause changes in microflora (bacteria and fungi), which is normally present in humans, which can lead to the development of superinfection . Therefore, during the treatment, it is mandatory to reevaluate the patient's condition and, if it develops during the treatment of superinfection, appropriate measures should be taken.
Patients with glucose-6-phosphate dehydrogenase deficiency
Patients with latent or manifested deficiency of glucose-6-phosphate dehydrogenase have a predisposition to hemolytic reactions in the treatment with quinolones, which should be taken into account when treating with Tavanicom.
Hypoglycaemia
In patients with diabetes mellitus receiving oral hypoglycemic agents, for example, glibenclamide or insulin, the use of quinolones increases the risk of developing hypoglycemia.These patients with diabetes require careful monitoring of the concentration of glucose in the blood.
Peripheral Neuropathy
In patients receiving fluoroquinolones, including levofloxacin, sensory and sensory-motor peripheral neuropathy was noted, the onset of which can be rapid. If the patient has symptoms of neuropathy, the use of levofloxacin should be discontinued. This minimizes the possible risk of irreversible changes.
Exacerbation of pseudo-paralytic myasthenia gravis (myasthenia gravis)
Tavanik should be used with caution in patients with pseudo-paralytic myasthenia gravis (myasthenia gravis).
Impact on the ability to drive vehicles and manage mechanisms
Such side effects of Tavanic, as dizziness or vertigo, drowsiness and visual impairment, can reduce psychomotor reactions and the ability to concentrate. 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
Combinations that require caution
The pharmacokinetic interaction of levofloxacin with theophylline has not been revealed.
The concentration of levofloxacin with simultaneous administration of fenbufen is only increased by 13%.
However, with the simultaneous administration of quinolones and theophylline, NSAIDs and other drugs that lower the threshold for convulsive brain readiness, there may be a marked decrease in the threshold of convulsive readiness of the brain.
In patients treated with levofloxacin in combination with indirect anticoagulants (eg, warfarin), prothrombin time / INR and / or bleeding increased, incl. and heavy. Therefore, with simultaneous use of indirect anticoagulants and levofloxacin, regular monitoring of blood clotting parameters is necessary.
With simultaneous use of drugs that disrupt the renal tubular secretion of levofloxacin, such as probenecid and cimetidine, caution should be used especially in patients with renal insufficiency. Removal (renal clearance) of levofloxacin is slowed by cimetidine by 24% and probenecid by 34%.It is unlikely that this can be of clinical significance in normal kidney function
Levofloxacin increased T1 / 2 cyclosporine by 33%. Because this increase is clinically insignificant, correction of the dose of cyclosporine with its simultaneous application with levofloxacin is not required.
With simultaneous admission with glucocorticosteroids (GCS), the risk of rupture of tendons increases.
Tavanyk, like other fluoroquinolones, should be used with caution in patients receiving QT prolonging drugs (eg, antiarrhythmic drugs of class 1A and 3, tricyclic antidepressants, macrolides).
Other combinations
Clinical and pharmacological studies to study the possible pharmacokinetic interaction of levofloxacin with calcium carbonate, digoxin, glibenclamide, ranitidine, and Warfarin showed that the pharmacokinetics of levofloxacin, when used simultaneously with these drugs, does not change sufficiently to make it clinically important.
Analogues of drug Tavanik
Structural analogs for the active substance:
- Glevo;
- Ivacin;
- Lebel;
- Levot P;
- Levotech;
- Levoflox;
- Levofloxabol;
- Levofloxacin;
- Leobeg;
- Leflobact;
- Lefokcin;
- Matlevo;
- OD Levoks;
- Oftakwix;
- Remedy;
- Signictsef;
- Tavanik;
- Tanflomed;
- Flexine;
- Floracid;
- Hayleflex;
- Ecology;
- Eleflox.
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