Feomin 500mg General Pharm medicine for infections (6 blisters x 4 tablets)

Exacerbivorce of chronic bronchitis.

Community pneumonia.

Prostatitis.

Surely or not.

Skin infections and subcutaneous organization with complications or not.

Bile infection.

Infections.

Pharmacy

levofloxacin is a broad -spectrated synthetic antibiotic belonging to the quinolon group (fluoroquinolon). Like other fluoroquinolon, Levofloxacin has bactericidal effects due to inhibiting Topoisomerase II (DNA-GYRASE) or Topoisomerase IV are essential enzymes of bacterial catalysts involved in bacterial copy, code and DNA repair process.

Levofloxacin is the isomorphic S-(-)-Isomer of of Ofloxacin, it has a strong bactericidal effect of 8-128 times higher than the D-Isomer isomer and is about 2 times stronger than Ofloxacin Racemic. Levofloxacin, as well as other fluoroquinolones are broad -spectrum antibiotics, which work on many gram -negative and gram -positive bacteria strains.

levofloxacin (as well as sparfloxacin) works on gram -positive bacteria and anaerobic bacteria than other fluoroquinolon (such as ciprofloxacin, enoxacin, lomefloxacin, norfloxacin, ofloxacin), however levofloxacin and sparfloxacin have Intudomonas Aeruginosa is weaker than Ciprofloxacin.

Effect spectrum

In vitro sensitive bacteria and clinical infections: Gram -negative air -loving bacteria: En Aeruginosa.

Gram-positive bacteria: Bacillus anthracis, Staphylococcus aureus sensitive methicilin (METI-S), Staphylococcus coagulase negative methicilin sensitivity, streptococcus pneumoniae.

Anaerobic bacteria: Fusobacterium, peptostreptococcus, propionibacterium.

Intro -sensitive bacteria in vitro

Gram -positive air -loving bacteria: Enterococcus Faecalis.

Anaerobic bacteria: Bacteroides Fragilis, Prevotella.

Levofloxacin resistant bacteria

Gram-positive bacteria: Enterococcus Faecium, Staphylococcus aureus meti-r, Staphylococcus coagulase negative meti-r.

Cross resistance

In vitro, cross -resistant between levofloxacin and other fluoroquinolones. Due to the mechanism of action, often without cross -resistant between levofloxacin and other antibiotics.

pharmacokinetic

absorption

After drinking, Levofloxacin is absorbed quickly and almost completely, the peak concentration in plasma is usually achieved after 1-2 hours, absolute bioavailability is approximately 99%. Levofloxacin pharmacokinetics parameters after intravenous and oral route with equivalent dose are almost the same, so it is advisable to prioritize oral and only use the injection route when not drinking. Food less affects absorption when drinking.

Distribution

levofloxacin is widely distributed in the body, but the drug is difficult to penetrate into the cerebrospinal fluid. The ratio of plasma proteins is 30-40%.

Metabolism

Levofloxacin is very less metabolized in the body and eliminates almost entirely through the urine in the active form, only less than 5% of the treatment dose found in the urine in the form of metabolic Desmethyl and N-OXID, these metabolites have very little biological activity.

Elimination

Levofloxacin's semi -waste time is from 6 to 8 hours, prolonged in patients with renal impairment. The drug excreted in urine is about 87% in the form of unchanged and crossing about 12.8%. The drug cannot be removed by hemons or peritoneal.

Liver: Increased liver enzyme. nerve: Insomnia, headache. Skin: irritating in the injection place, itching, skin rash.

Uncommon, 1/1000

Be cautious when using

Achille, especially tendonitis, can lead to tendons. This complication may appear at the first 48 hours, after starting the medication and may be both sides. The tendonitis occurs mainly in risky subjects: people over 65 years old, using corticosteroids (including inhalation lines). These two factors increase the risk of tendonitis. To prevent, need to adjust the daily dosage of drugs in older patients according to glomerular filtration level.

influence on the skeletal muscle system

levofloxacin, like the majority of other quinolons, can cause cartilage degeneration in joint gravity joints on many young animals, so levofloxacin should not be used for children under 18 years old, unless the benefits are out of risk.

My body weakness

Be cautious in patients with myasthenia gravis because the manifestations may get worse.

Effects on TKTW

There have been notices of adverse reactions such as mental disorders, increased intracranial pressure, stimulating TKTW leading to convulsions, trembling, restlessness, headache, insomnia, depression, confusion, hallucinations, nightmares, intentions or suicide (rare) actions when using quinolon antibiotics, even when used at the first dose. If these adverse reactions occur while using levofloxacin, it is necessary to stop the drug and take appropriate symptomatic management measures. Be careful when used for patients with diseases on TKTW such as epilepsy, cerebral artery ... because it may increase the risk of convulsions.

Sensitive reaction

Hypersensitivity reactions with many different clinical manifestations, even anaphylaxis when using quinolones, including levofloxacin, has been informed. It is necessary to stop the drug as soon as there are the first signs of sensitive reaction and apply appropriate treatment.

Clostridium difficile colitis

This adverse reaction has been informed to many antibiotics including levofloxacin, which can occur at all levels from mild to life -threatening. It should be noted that the accurate diagnosis of diarrhea occurs during the time the patient is using antibiotics for appropriate treatment.

Hypersensitivity to medium to severe light has been informed with many Fluoroquinolon antibiotics, including levofloxacin (although so far, this adverse reaction rate when using Levofloxacin is very low

Effects on metabolism

Like other quinolones, levofloxacin can cause sugar metabolic disorders, including hyperemia and hypoglycemia often occur in people with diabetes using levofloxacin simultaneously with a hypoglycemic oral medication, so it is necessary to monitor blood sugar on this patient. If hypoglycemia occurs, levofloxacin should be stopped and properly handled.

extends the QT range on the electrocardiogram

Using Quinolones can cause QT extension on an electrocardiogram in some patients and some rarity of the arrhythmia, so it is necessary to avoid use in patients with prolonged QT interval, patients with potassium potassium, patients who are using anti -arrhythmic drugs IA (quinidine, processine ...) or group III (Amiodaron, Sotalol ...) The disease is in the condition of arrhythmia such as slow rhythm and acute myocardial ischemia.

The ability to drive and operate machinery

using Levofloxacin can cause side effects such as headaches, dizziness ... can affect the ability to drive and operate machinery. Be careful to drive or operate machinery while using levofloxacin.

Pregnancy

Do not use levofloxacin for pregnant women.

Breastfeeding period

has not measured levofloxacin concentration in breast milk, but based on the ability to distribute into of Ofloxacin's milk, it can be predicted that Levofloxacin is also distributed into the mother's milk. Because the drug has many risks of articular cartilage damage on young children, not breastfeeding when using levofloxacin.

Drug interaction

antacid, sucralfate, metal ions, multivitamin: When used simultaneously, it can reduce the absorption of Levofloxacin, need to take these drugs away from Levofloxacin at least 2 hours.

Theophylin

Some studies on healthy volunteers show that there is no interaction. However, due to the concentration of plasma and AUC Theophylin is often increased when used simultaneously with other quinolons, it is still necessary to closely monitor theophylin concentration and adjust the dose if needed when used simultaneously with levofloxacin.

warfarin

Due to the announcement of Warfarin increasing the effect when used with levofloxacin, it is necessary to monitor blood clotting indicators when used simultaneously these two drugs.

cyclosporin, digoxin

Interactions are not clinically significant, so there is no need to adjust the dose of these drugs when used simultaneously with levofloxacin.

Steroid anti -inflammatory drugs

Ability to increase the risk of stimulating TKTW and convulsions when using simultaneously with levofloxacin.

Hypoglycemic drugs

Concentrated with levofloxacin may increase the risk of blood sugar disorders, need closely monitoring.

levofloxacin reduces the effects of BCG, Mycophenolat, sulfonylurea, Korean vaccine.