Bisetol Medana medicine for respiratory infections (80ml)
Dosage form Box of 1 bottle x 80ml
Specifications Sulfamethoxazole, trimethoprim
Ingredient Otitis media, sinusitis, prostatitis, urinary tract infections, pyelonephritis, dysentery, shigella infection, chronic bronchitis
Ingredient
| Composition information | Content |
| Sulfamethoxazole | 200mg |
| Trimethoprim | 40mg |
Uses
indications
80 ml biseptol drugs are indicated in the following cases:
Treatment of infections when bacteria are still sensitive:
sulfamethoxazole belongs to the sulfamid group, inhibit the use of para-aminobenzoic acid during the synthesis of dihydrofolate of bacterial cells, thereby bactericidal effect.
When combining these two active ingredients in the same formula will prevent 2 consecutive steps in the path of purine biosynthesis, or more broadly, nucleic acid synthesis is necessary for the survival of bacteria. Therefore, this combination is considered to have a combination of energy to increase the effectiveness of treatment and at the same time reduce the resistance of bacteria.
Pharmacokinetics
absorption
trimethoprim and sulfamethoxazole absorb quickly and almost completely after drinking and not affected by food. The peak concentration in the blood is about 1-4 hours after digestion and depends on the dose. Effective concentration in the blood maintains about 24 hours after loading the treatment dose. Stable concentration in the blood in adults achieved 2-3 days after drinking. Both active ingredients do not affect each other's concentrations.
Distribution
about 50% trimethoprim attaches plasma proteins. Trimethoprim is distributed in higher tissue than in the blood, especially in the lungs and kidneys. Trimethoprim concentration in blood is lower than the concentration of trimethoprim in bile, prostate secretion, tissue, saliva, sputum and vaginal discharge. Trimethoprim concentration in aquatic fluid, cerebrospinal fluid, milk glands, middle ear fluid, discharge and tissue fluid is sufficient for antibacterial effects. Trimethoprim has the ability to pass through the amniotic fluid into the fetal tissue with the corresponding concentration of the mother's blood.
about 66% sulfamethoxazole is attached to plasma proteins. The activity concentration of sulfamethoxazole in amniotic fluid, aquatic fluid, bile, cerebrospinal fluid, middle ear fluid, sputum, discharge and tissue fluid accounts for about 20-50% of plasma concentrations.
Metabolism
sulfamethoxazole is eliminated through the original renal, accounting for about 15-30% of the dose. Sulfamethoxazole is more widely metabolized than trimethoprim, via acetylation, oxidation and glucuronic acid complex. After each 72-hour cycle, about 85% of the dose can be found through the urine in the form of constant and constant metabolism (n4-acetylation).
Elimination
Trimethoprim's waste time in people with normal kidney function is 8.6 - 17 hours and does not change significantly in the elderly. This time can be increased by 1.5 to 3 times when creatinine clearance is less than 10 ml/min.
Trimethoprim's main elimination path is the kidney with about 50% of the dosage excreted through the kidneys within 24 hours in the form of constant. Many other metabolites are also found in urine. Trimethoprim concentration in urine is quite wide.
Salfamethoxazole's semi -waste time in people with normal kidney function is approximately 9 - 11 hours. In people with impaired renal function, the sale time of sulfamethoxazole does not change but there is a prolongation of the semi -waste time of the main metabolic (acetylation) when creatinine clearance is less than 25 ml/min.
The main elimination path of sulfamethoxazole is the kidney with about 15-30% of the dose found in urine is in the active form. In the elderly, there is a reduction in sulfamethoxazole elimination through the kidney. This decline has not been found for trimethoprim.
Before taking Bisetol Medana medicine for respiratory infections (80ml)
How to use
Shake well before using to help obtain a homogeneous mixture and divide the dose most accurately. Should consider using food to reduce side effects on the gastrointestinal tract.
Dosage
Dosage depends on age.
For common acute infections
Standard doses for children are equivalent to 6 mg of trimethoprim and 30 mg of sulfamethoxazole on kg weight per day, divided into 2 equal doses.
Treatment should be continued until the patient has all symptoms of 2 days; The vast majority of patients will need to use about 5 days. If clinical symptoms do not improve after 7 days, the patient needs a doctor's re -examination. For non-complicated urinary tract infections, it is possible to shorten about 1-3 days.
For kidney function impairment
Adults (> 18 years old) and children (> 12 -
Dosage depends on creatinine clearance:
No specific data.
Recommended measurement of sulfamethoxazole concentration in plasma every 2-3 days and should take 12 hours after drinking. If the total concentration of sulfamethoxazole exceeds 150 mcg/ml, the treatment should be paused until this concentration drops below 120 mcg/ml.
For pneumonia caused by PNEMOCYSTIS JIROVECII infection
Treatment in children 6 weeks - 2 years old and children> 2 -
Recommendations are higher than the usual dose, using 20 mg of trimethoprim and 100 mg of sulfamethoxazole on kg per day divided into 2 times lasting 2 weeks. The main goal is to achieve the peak concentration of trimethoprim ≥5 mcg/ml.
Treatment in children (> 12-
Recommendations are higher than the usual dose, using 20 mg of trimethoprim and 100 mg of sulfamethoxazole on kg per day divided into 2 times lasting 2 weeks. The main goal is to achieve the peak concentration of trimethoprim ≥5 mcg/ml.
Preventive infection in adults (18 years old)
Can consider the following dose modes:
Normal doses for children are equivalent to about 6 mg of trimethoprim and 30 mg of sulfamethoxazole on kg per day to divide into 2 equal doses. The recommended dose depends on age.
Backup in children 6 weeks - 2 years old and children> 2 -
Normal doses for children are equivalent to about 6 mg of trimethoprim and 30 mg of sulfamethoxazole on kg per day to divide into 2 equal doses. The recommended dose depends on age.
Treatment of Nocardia infections
No consensus in the appropriate dose recommendations.
Treatment of Toxoplasma Gondii parasites
No consensus in the appropriate dose recommendations. The decision should be based on clinical experience. For backups, the dosage may be equivalent to the dosage to prevent pneumonia caused by Pneumocystis Jirovecii.
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.
What to do when using overdose? Overdose of this drug can cause dizziness, drowsiness, vomiting, loss of taste, abdominal pain, headache, jaundice, yellow eyes, bleeding, fever, confusion or fainting. What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.
Side Effects
When using 80 ml biseptol drugs, you may experience unwanted effects (ADR).
Common, ADR> 1/100
Uncommon, 1/1000 Instructions on how to handle ADR Can reduce the side effects of the drug by reducing the dose. Need to stop taking the drug and come to the doctor immediately when there are symptoms such as severe abdominal pain, rash, jaundice, yellow eyes, convulsions, dry mouth, thirst, new or unusual joint pain, confusion, chest pain, fever, mouth sores, cold hands and feet ...
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
80 ml biseptol drugs in the following cases:
People with a history of platelet reduction when using trimethoprim and/or sulfamethoxazole.
Be cautious when using
Do not use this medication if you are allergic to the ingredients of the drug, pregnant and lactating women as well as a history of anemia due to folic acid deficiency.
Before using this medication, you need to tell your doctor if you have liver or kidney disease, folic acid deficiency, bronchial asthma, serious allergy, AIDS, G6PD or malnutrition deficiency.
Need to use this medication enough treatment. Symptoms may improve before the infection is completely cured. This drug does not treat viral infections such as colds or flu.
Antibiotics can cause diarrhea, which is usually a symptom of a new infection. Go to the doctor as soon as water is filled with water or blood. Do not use drugs to prevent diarrhea unless you are prescribed by a doctor.
Avoid exposure to direct sunlight because this drug can make the skin more sensitive to the sun that can lead to skin burns. Wear closed clothes and use sunscreen when you go out.
The ability to drive and operate machinery
has not had a specific research on the impact of the drug on the ability to drive and operate machinery. However, the clinical condition of the patient and the harmful events of the drug should be noted when considering the ability to drive and operate machinery.
Pregnancy
trimethoprim and sulfamethoxazole can be through the placenta and their safety in pregnant women has not been confirmed. Some reports show that there may be correlation between exposure and folate inhibitors and fetal defects.
trimethoprim is a folate opposite substance and in animals, both trimethoprim and sulfamethoxazole have teratized reports.
Trimethoprim should not be used for PNCT, especially in the first 3 months of pregnancy unless really necessary. Folate supplements should be considered if this drug is used during pregnancy.
Sulfamethoxazole competes with plasma protein binding to bilirubin. If this drug is prescribed for women near birth, it can cause it to maintain for a long time in the newborn blood, leading to an increase in the risk of jaundice of newborns, which leads to the risk of brain jaundice. This risk is increasing in premature children or children with G6PD deficiency.
The period of breastfeeding
both active ingredients trimethoprim and sulfamethoxazole are excreted through breast milk. This drug should be avoided in the late stage of pregnancy and breastfeeding stage when a mother or newborn is at high risk of jaundice due to bilirubin. In addition, this drug should be avoided in infants who are less than 8 weeks old.
Interactive drug
You may need to see a doctor more often if you are also taking medicine to treat depression, diabetes, epilepsy or HIV.
Let the doctor know all the drugs you are taking. Many drugs can affect the concentration of sulfamethoxazole in the blood, especially:
Storage
Store drugs in a cool, dry place, avoid mold and sunlight, it is best to store at temperatures below 30 ° C.
To be out of reach of children.
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