CEFRIVI 50 oral nuggets 50 treatment of respiratory infections, skin infections, sore throat, tonsillitis (21 packs x 0.5g)

Dosage form Box of 21 packs x.
Specifications Cefditoren
Ingredient Pharbaco

Ingredient

Composition information	Content
Cefditoren	50mg

Uses

Indications

CEFRIVI 50 oral phase nuggets are used to be treated in the following cases:

Treatment of respiratory infections, skin infections and subcutaneous organization caused by gram-negative bacteria, sensitive grams, staphylococcus aureus strains (including β-lactamase secretions), sensitive staphyloccus pyogenes.

Treatment of sore throat and tonsillitis caused by streptococcus pyogenes strains (hemolytic strikes β group A) sensitive. Although Cefditoren has the effect of destroying Streptococcus Pyogenes in the nose and throat, the effects of the drug in rheumatism are still being considered.

Exacection treatment of mild and medium-sized chronic bronchitis caused by the haemophilus influenzae strains (including β-lactamase secretions), Haemophilus parainfluenzae (including β-lactamase secretions), Streptococcus pneumoniae (only sensitive to penicillin), Moraxella (including strains with β-lactamase secretion).

Treatment of cases of pneumonia is caused by the haemophilus influenzae strains (including β-lactamase secretions), Haemophilus parainfluenzae (including β-lactamase secretions), Streptococcus pneumoniae (only sensitive to penicillin), Moraxella cimxella (Moraxella The whole strain has β-lactamase secretion).

Pharmacology

Pharmacological group: Cephalosporin group 3rd generation.

ATC code: J01DD16.

Cefditoren Pivoxil is a semi -synthetic antibiotic of the 3rd generation cephalosporin group used by orally used in the treatment of acute bacterial infections or exacerbations of chronic bronchitis, acquired pneumonia in the community caused by sensitive bacteria, including:

Haemophilus Influenzae, Haemophilus parainfluenzae, Streptococcus pneumoniae sensitive to penicillin, moraxella catarrhalis, sore throat (Streptococcus pyogenes), skin infections and non -complications (stagylococcus aureus aureus pyogenes).

cefditoren is sustainable with a variety of ß-lactamase (including penicillinase and some cephalosporinase) produced by Gram-negative and gram-positive bacteria. Similar to the current 3rd generation cephalosporin (Cefdinir, Cefixim, Ceftibuten, Cefpodoxim) Cefditoren has a wider Gram -negative bacteria than the first and second -generation cephalosporin. Moreover, cefditoren acts better with Gram -positive bacteria than other 3rd generation cephalosporins because of the cefditoren structure with methylthiazolyl group, while other third -generation cephalosporins are not available.

The mechanism of action of Cefditoren Pivoxil is similar to antibiotics of the 3rd generation cephalosporin group. Cefditoren Pivoxil is a Prodrug (Prodrug) with very little antibacterial effects. Cefditoren Pivoxil is absorbed by the gastrointestinal tract and is hydrolyzed by esters to release the cefditoren that is active and pivalate into the bloodstream. Cefditoren has the effect of inhibiting the synthesis of bacterial cell walls by attaching one or more penicillin-binding proteins (penicillin-binding protein-pbps) as a final inhibiting amino acid between peptidoglycan synthesis in bacterial cell walls, due to inhibition of bacterial biological bio-cell walls. The bacteria are separated by the activity of the enzymes Autolysin and Murein Hydrolase.

Dynamic pharmacokinetics

cefditoren pivoxil is absorbed by the gastrointestinal tract and hydrolyzed by esterase into cefditoren that are active and pivalate into the bloodstream. When taken at hungry at the dose of 200 mg Cefditoren, the highest concentration achieved in plasma is about 1.8 micrograms/ml after taken 1.5 to 3 hours.

Birth when drinking at hunger is about 14% and increases if taken with a fatty meal.

The ratio attached to the plasma protein of cefditoren is 88%. The distribution of 9.3 ± 1.6 liters.

Cefditoren is not much metabolized and excreted in the urine in the form of unchanged in the glomerular filter and excreted in the renal tubules. The drug can be eliminated by dialysis outside the kidneys.

Half lifetime elimination of the drug is about 1.6 hours and lasts longer in patients with renal function.

Pivalat is formed by the hydrolytic process of cefditoren pivoxil will combine with carnitin in the blood to form a pigalolcarnitin and excreted in the urine.

Before taking CEFRIVI 50 oral nuggets 50 treatment of respiratory infections, skin infections, sore throat, tonsillitis (21 packs x 0.5g)

How to use

Caveive 50 drugs for oral, nuggets in the package with a sufficient amount of water, stir to disperse the drug evenly in water (into chisel mixture) and drink immediately. Take medicine with meals to increase the absorption of drugs into the blood.

Dosage

recommended dose:

The usual oral dose of Cefditoren Pivoxil is 9 - 18 mg (activity)/kg divided into 2 or 3 use/day, after meals. Dosage can be adjusted based on the age and condition of the patient.

Children weigh from 6 - 10kg: 50mg (activity) x 2 times/day (daily dose: 100 mg).

Children weigh 10 - 20kg: 50 mg (activity) x 3 times/day (daily dose: 150 mg).

Children weigh> 20 kg and adults: 100 mg (activity) x3 times/day.

Dosage in patients with renal insufficiency: No need to adjust the dose if patients with mild renal impairment (CLCR 50 - 80 ml/minute), recommend only 200 mg/time, 2 times/day for medium renal impaired patients (CICR 30 - 49 ml/minute) and 200 mg/time, 1 time for patients with severe renal impairment (CLCR

Dosage in patients with liver failure: It is recommended that there is no need to adjust the dose in patients with mild and medium -sized liver failure. There is no information on pharmacokinetics of cefditoren in patients with severe liver failure.

The elderly: There is no special recommendation of the dose if the patient has a normal renal function.

Specific dose 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 do

do when overdose? Symptoms of β-lactam antibiotic overdose include: nausea, vomiting, epigastric pain, diarrhea and seizures. Hemorrhage can be assisted in removing Cefditoren from the body, especially if the kidney function is damaged (30% decrease in plasma concentrations after 4 hours of hemorrhage). Treatment of overdose and use of supportive measures if necessary.

Studies on animal toxicity toxicity, using Cefditoren Pivoxil with a limited dose of 5,100 mg/kg in mice and 2,000 mg/kg in dogs do not see health. Observed some certain symptoms such as diarrhea and soft stools lasting for a few days on a few animals, like the usual side effects of most antibiotics due to inhibition of intestinal bacteria.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

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

Like all other drugs, CaveNid 50 may have some side effects, although not happening to everyone.

Very common side effects (ADR ≥ 1/10 people)

diarrhea (11 - 15%).

Common side effects (1/100 Central nervous system: headache (2 - 3%). Reduce hematocrite (2%).

(these side effects are rare but important or life -threatening).

Acute renal failure, allergies, joint pain, bronchial asthma, hyperplasia, hematuria, blood calcium, increased blood clotting time, pink rash fixed in chromosomes, fungal infections, hyperlemia, interstitial pneumonia, leukopenia, hyperkalemia, hypoglyc sodium, fake colitis, Stevens - Johnson syndrome, Hemorrhagic reduction of threlon, toxic skin.

Instructions on how to handle ADR

The method of handling some ADR is as follows:

If there is a fake colitis or diarrhea caused by Clostridium difficile, it is often necessary to stop antibiotics. There are cases where just stopping antibiotics is all symptoms. Cases of medium and severe diarrhea need to be infused, electrolytes, protein supplements, antibiotics that work with Clostridium difficile (such as oral metronidazol or vancomycin). In case of need for colon surgery.

If there is hypersensitivity due to cefditoren, Cefditoren is needed and appropriate symptom treatment.

Prothrombin's effects can occur with risky subjects (patients with renal impairment, liver failure, poor nutrition, prolonged antibiotic use, long -term treatment with anticoagulant drugs), these cases must monitor blood coagulation time and vitamin K supplement.

Notice immediately to the doctor or pharmacist the harmful reactions encountered when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Caveivivivical 50 contraindications in the following cases:

Hypersensitivity to cefditoren, other cephalosporins and any ingredients of the drug.

Be cautious when using

Antibiotic treatment including Cefditoren may cause an imbalance in the microbiology in the colon, making Clostridium difficile excessive. Clostridium difficile diarrhea and fake colitis may be at a level from mild to critical. The toxins secreted by Clostridium difficile increases the incidence of the disease and the mortality rate due to antibiotic resistance and must be removed. Need to monitor this expression during treatment.

Need to monitor and detect hypersensitivity expressions when using Cefditoren. Be cautious when used for patients with a history of hypersensitivity to penicillin (especially cases of hypersensitivity manifested through IgE intermediaries such as anaphylaxis, urticaria), poor eating patients or those who are being nourished on the intestinal tract and poor health patients (patients need to be carefully monitored due to the lack of vitamin K deficiency).

Be cautious when used for patients with a history of convulsions, if in the case of kidney failure, the risk of convulsions increases.

Use cautiously for the walls of liver failure, kidney failure, adjust the dose if the patient is severe.

For patients with carnitin deficiency, do not use prolonged cefditoren due to cefditoren causing increased carnitin elimination.

Because cefditoren can cause prothrombin time, so be cautious when used in patients with bleeding disorders.

According to the general principle, to prevent the appearance of anti -drug microorganisms, after determining the sensitivity of microorganisms to the drug, the time to use the drug should be limited to the minimum time needed to treat the patient's condition.

Children: The safety of Cefditoren Pivoxil in mild weight, infant and breastfed babies has not been determined.

Old people:

The rate of side effects in the elderly is no different from adults. However, the elderly often has a decrease in physiological function, so it is necessary to use the drug carefully.

Note two points:

Dosage and distance between doses should be adjusted according to the condition of the patient. Therefore, high serum drug concentration can last in the elderly.

Like other similar drugs, there has been a report on the risk of bleeding due to vitamin K deficiency in the elderly.

The effect of the drug on the ability to drive and operate machinery

The drug does not affect the ability to drive or operate machinery.

Use drugs for women during pregnancy and lactation

Pregnant women

Animal research does not see adverse reactions to the fetus. The safety of the drug for pregnant women has not been announced. In addition, carnitin reduction in plasma in women who use antibiotics containing pivoxil groups in the last three months of pregnancy has been reported, as well as in newborn babies of these mothers. Only use this drug for pregnant women or intend to get pregnant when the benefits of taking the drug beyond the risk may occur during treatment.

breastfeeding women

The drug is distributed into breast milk, so use carefully with nursing women.

Medicinal interaction

Need to notify your doctor or pharmacist other drugs that are using or used recently, including non -prescribed drugs.

Increased effects/toxicity: Probenecid increases cefditoren levels in plasma thus increasing the effect/toxicity of cefditoren.

Reduce effects: Antacids, proton pump inhibitors and H2 receptor antagonists reduce Cefditoren absorption, thus reducing the effect/toxicity of cefditoren.

Food interaction: Food increases the absorption of cefditoren. Fatty meals can increase the maximum of the drug.

Testing interactions: Can cause direct positive coombs reaction, fake negative test ferricyanid, pseudo -positive test glucose when using clinitest.

Storage

Leave a cool place, avoid light, temperature below 30⁰C.

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