Efodyl 125mg Merap nuggets treat mild to medium infections (20 packs)
Dosage form Box of 20 packs
Specifications Cefuroxim
Ingredient
Thành phần cho 1.5g
| Composition information | Content |
| Cefuroxim | 125mg |
Uses
Indications
Efodyl 125 drugs are indicated for use in cases of mild infections that are mild due to sensitive bacteria including:
Pharmacokology
Mechanism of action
Cefuroxime acetyl is a precursor, has no antibacterial effect, into the body hydrolyzed under the effect of enzyme esterase into cefuroxime to work. Cefuroxime has the effect of killing bacteria in the stage of growth and division by inhibiting the synthesis of bacterial cells. The drug is attached to proteins attached to penicillin (penicillin binding protein, PBP), which are proteins involved in the composition of bacterial cell membrane structure, acting as a catalytic enzyme for the final stage of the synthesis of cell walls. As a result, the synthetic cell wall will be weakened and unstable under the impact of osmotic pressure. The affinity for attaching cefuroxime with PBP of different types will be the drug effect.
Medicine resistance mechanism
Cefuroxime resistant bacteria may be due to one or more mechanisms:
hydrolyzed by beta-lactamase; Including (but not limited) by the broad spectrum beta-lactamase (ESBLS), and ampc enzymes, which may be due to induction or stable release in some Gram-negative aerobic bacteria.
Reduce the affection of penicillin -mounted proteins with cefuroxime.
Reducing the permeability of cefuroxime through bacterial cell membranes, limiting the approach of cefuroxime with penicillin -mounted proteins in Gram -negative bacteria.
Antibiotic pump out of bacterial cells.
The organisms with resistance to other injection cephalosporins are expected to resist cefuroxime. Depending on the anti -drug mechanism, penicillin -resistant bacteria may manifest sensitivity or cefuroxime resistance.
antibacterial spectrum
The anti -drug resistance ratio depends on geography and time and for certain bacteria. Information about local drug resistance is very important, especially treating serious infections.
cefuroxime often has the activity against the in vitro bacteria below
Aerobic gram -positive bacteria: Staphylococcus aureus (methicillin sensitivity), staphylococcus negative coagulase (methicillin sensitivity), Streptococcus pyogenes, Streptococcus agalactiae.
Aerobic gram -negative bacteria: Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella CatVrhalis.
Bacteria: Borrelia Burgdorferi.
Bacteria may have problems due to anti -drug resistance
Aerobic grams: Streptococcus pneumoniae.
Aerobic grams: Citrobacter Freundii, Entobacter Aerogenes, Entobacter Clox, Escherichia Coli, Klebsiella Pneumoniae, Proteus Mirabilis, Proteus spp. (Triv P. Vulgaris), Providencia spp.
Anaerobic gram: pepfostrepfoccus spp., Propionibacterium spp. Anaerobic gram: Fusobacterium spp., Bacteroides spp.
Bacteria that have been resistant to drugs
Aerobic grams: Enterococcus Faecalis, Enterococcus Faecium.
Aerobic grams: Acinetobacter spp., Campylobacter spp.anaerobic gram: bacteroides fragilis.
Other: Chlamydia spp, Mycoplasma spp., Legionella spp.All S. Aureus strains are resistant to methicillin are resistant to cefuroxime.
pharmacokinetic
absorption
After taking Cefuroxime Acetyl, the gastric - intestinal tract is quickly hydrolyzed in the intestinal mucosa and blood release of Cefuroxime in the body's overall circulation. The drug is best absorbed when taken immediately after eating. The absorption rate of Cefuroxime from the mixture decreases compared to the tablet form, which leads to lower serum peak concentration, the peak time is slower and reduces the bioavailability (lower than 4 to 17%)
distribution
The protein mounting ratio is recorded different, between 33 to 50%, depending on the method of use. After taking a dose of Cefuroxime Acetil 500 mg in 12 healthy volunteers, the apparent distribution of 50 liters (CV%= 28%). Cefuroxime concentration exceeds the minimum inhibitor for common pathogens that can be achieved in tonsils, sinuses, bronchial mucosa, bones, pleura fluid, joint fluid, interstitial fluid, bile, sputum and aquarium. Cefuroxime passes through the blood-flabby barrier when the meninges are inflamed
transformation
cefuroxime is not metabolized.
Elimination
Serum disposal time is from 1 to 1.5 hours. Cefuroxime is excreted through the renal tubules and glomerular filtration. The clearance of the kidney is ranging from 125 to 148 ml/minute/1.73 m2.
Special patients
Gender
There is no difference in pharmacokinetics of Cefuroxime observed on men and women.
Elderly
There is no special warning in elderly patients with normal kidney function with a maximum dose of 1 g/day. Elderly patients are often at risk of renal function, so the dosage should be adjusted in accordance with the kidney function in the elderly.
Children
In newborns greater than 3 months old and children, the pharmacokinetics of Cefuroxime are similar to adults. There is no clinical test data on the use of cefuroxime acetyl in infants under 3 months of age.
Before taking Efodyl 125mg Merap nuggets treat mild to medium infections (20 packs)
How to use
Should drink Efodyl nuggets with food to achieve optimal absorption.
How to mix the chaos
Dosage
A round of treatment is usually 7 days (from 5 to 10 days).
Adults and children> 40 kg
Indications
Dosage
250mgx 2 times/day
500mg x 2 times/day 500mg x 2 times/day 250mg x 2 times/day 250mg x 2 times/day 250mg x 2 times/day
Lyme disease
500mg x 2 times/day for 14 days (about 10 to 21 days)
Indications
Dosage
10mg/kg x 2 times/day to maximum 125mg x 2 times/day
15mg/kg x 2 times/day to maximum 250mg x 2 times/day
15mg/kg x 2 times/day to maximum 250mg x 2 times/day
15mg/kg x 2 times/day to maximum 250mgx 2 times/day for 10 to 14 days
15mg/kg x 2 times/day to maximum 250mg x 2 times/day
Lyme disease
15mg/kg x 2 times/day to maximum 250mg 2 times/day for 14 days (10 to 21 days)
Cefuroxime acetyl and nuggets of Cefuroxime acetyl oral phase nuggets are not equivalent to biological, so it cannot be replaced on the basis of mg/mgIn newborns (from 3 months of age) and young children under 40 kg, adjusting the dose by weight or age. Dosage in infants and children from 3 months to 18 years old is 10mg/kg x 2 times/day for most cases of infection, up to 250mg daily. In otitis media or infections heavier than the recommended dose is 15mg/kg x 2 times/day to a maximum of 500mg per day
Dosage 10 mg⁄kg for most cases of infection.
Age
Dosage mg x 2 times/day
Number of nuggets
125mg
250mg
3 months to 6 months
40 to 60
1/2
-
6 months to 2 years old 60 to 120 ½ to 1 -
2 years old to 18 years old
125
1
½
Age
Dosage mg x 2 times/day
Number of nuggets
125mg
250mg
3 months to 6 months
60 to 90
1/2
-
6 months to 2 years old 90 to 180 ½ to 1 -
2 years old to 18 years old 180 to 250 1 ½
The safety and effectiveness of cefuroxime acetyl in patients with renal failure has not been set. Cefuroxime is mainly excreted through the kidneys. In patients with impaired renal function, Cefuroxime should be reduced to compensate for delayed elimination. Cefuroxime can be effectively removed by dialysis
Creatinine clearance
t1/2
Recommended dose
1.4 - 2.4 hours
No need to adjust the dose (standard dose 125mg to 500 mg x 2 times/day)
10 - 29 ml/min/1.73 m
4.6
Standard doses for each person every 24 hours
16,8
Standard doses for each person every 48 hours
2 - 4
Should use the standard doses of each person at the end of each stage of discrimination
There is no available data for patients with liver failure. Because Cefuroxime is mainly excreted through the kidneys, liver dysfunction will not affect the pharmacokinetics of Cefuroxime.
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 overdose?
Overdose can lead to nerve sequelae including brain disease, convulsions and coma. Overdose symptoms may occur if the dose is not appropriate in patients with renal impairment.
Handling
Cefuroxime concentration in serum can be reduced by hemolysis or peritoneal fertilizer. It is necessary to care about the overdose of many drugs, abnormal drug interaction and pharmacokinetics in patients. Protect the respiratory tract of patients, support ventilation and infusion.
If developing convulsions, stop using the drug immediately; Anti -seizure therapy may be used if necessary. Hemorrhage can eliminate blood from the blood, but most of the treatment is supporting or resolving symptoms.
What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.
Side Effects
When using Efodyl 125, you may experience unwanted effects (ADR).
The harmful reactions of the drug are listed below by the organ system and the frequency of encounter. Determined frequency is: very common (> 1/10), common (≥1/100 to 1/10), rarely (≥1/1000 to 1/100), rare (≥1/10000 to 1/1000), to not known (not estimated from available data).
Infections and parasites
Unknown: Increasing Clostridium difficile.
Blood disorders and lymphatic systems
immune system disorders
Nervous system disorders
Gastrointestinal disorders
Liver -biliary disorders
Skin disorders and subcutaneous tissues
Unknown: urticaria, itching, diverse roses, Stevens Johnson syndrome, epidermal necrosis due to poisoning (foreign necrosis).
Instructions on how to handle ADR
When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
EFODIN 125 contraindications in the following cases:
Patients with a history of hypersensitivity to cephalosporin.
Precautions when using
Hypersensitivity reaction
It is necessary to be careful especially for patients with a history of allergic reactions to penicillin or other betalactam antibiotics because of the risk of cross -reaction.
Like all betalactam antibiotics, serious hypersensitivity reactions and sometimes death have been reported. In case of serious hypersensitivity reactions, Cefuroxime must be discontinued and must take appropriate emergency measures. Before starting treatment, it is necessary to determine if the patient has a history of hypersensitivity to cefuroxime, cephalosporin or any other betalactam antibiotic. Caution should be used when using cefuroxime for patients with a history of severe hypersensitivity to other betalactam drugs.
Jarisch-HERXHEIMER reaction
Has the Jarisch-HERXHEIMER reaction after taking Cefuroxime Acetil in the treatment of Lyme disease. It is a direct result from the bactericidal activity of Cefuroxime Acetyl for Lyme pathogenic bacteria, Borrelia Burgdorferi. Patients should be known that this reaction is a common consequence and often recovered from the treatment of Lyme with antibiotics (see the unwanted effect).
Excessive development of non -sensitive microorganisms. Like other antibiotics, the use of cefuroxime acetyl can lead to over -development of Candida. Long -term use can lead to excessive growth of other non -sensitive microorganisms (for example, Enterococci and Clostridium difficile), may need to interrupt the treatment.
Colitis and fake colitis are found in most antibiotics including cefuroxime and can fluctuate in mild to life -threatening levels. Therefore, this diagnosis is considered in patients with diarrhea during or after using Cefuroxime. Discontinue treatment with cefuroxime and specific treatment for Closfridium difficile should be considered. Do not use intestinal inhibitors.
affect diagnostic tests
The use of Cefuroxime is related to positive Coombs test may affect the cross -blood reaction because the fake negative results may occur when using Ferricyanide tests, so the method of glucose oxidase or hexokinase is recommended to use to determine blood/ plasma glucose/ plasma concentration in patients using EFILYL nuggets.
Caution information about excipients
Sucrose, sucralose: Patients with rare genetic problems such as galactose intolerance, Nap fructose, lactase deficiency, Glucose-Galactose or Sucrase-Isomaltase Should not take this drug.
The ability to drive and operate machinery
The drug is likely to cause headaches, dizziness, should not drive or operate machinery while using the drug.
Pregnancy
There is very little data from the use of cefuroxime in pregnant women. Animal studies show that there is no harmful effects on pregnant women, fetal development, childbirth or the development of babies after birth. Efodyl should only be indicated for pregnant women when benefits exceed risk.
breastfeeding period
cefuroxime is excreted in breast milk in small quantities. Unwanted effects in the treatment dose do not usually occur, although it is not possible to eliminate the risk of diarrhea and mucosal fungal infection. Efodyl should only be used during breastfeeding after evaluating risk benefits.
Medicinal interaction
Medications that reduce gastric acid can reduce the bioavailability of Cefuroxime acetyl compared to bioavailability when hungry and tend to lose strength -intensity after meals.
Cefuroxime Acetyl can affect the bacterial system, leading to reducing the reabsorption of the estrogen and reducing the effectiveness of oral contraceptives used in combination.
Probenecid is simultaneously reducing the clearance of Cefuroxime in the kidney, increasing the meaning of the peak concentration, the area of the curve and the sale time of Cefuroxime.
Simultaneous use of cefuroxime with aminoglycosides or strong diuretics (such as Furosernide) may increase the likelihood of kidney toxicity.
Simultaneous use with oral anticoagulants can increase the INR.
Storage
In closed packaging, dry place, under 30 ° C, avoid direct light.
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