Imexime 100 Imexpharm oral media treat urinary tract infections, nephritis - pyelonephritis (12 packs x 2g)

Dosage form 12 package box
Specifications Cefixim

Ingredient

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Composition information	Content
Cefixim	100mg

Uses

indications

Imexime 100 drugs are indicated in the following cases:

Treatment of infections caused by sensitive bacteria strains such as:

Inhabited urinary tract infections. (including beta-lactamase strains).

ATC code: J01DD08.

Cefixim is an antibiotic of the 3rd generation cephalosporin group, used by oral. The drug has a bactericidal effect. Cefixim's bactericidal mechanism is attached to the target protein - a penicillin -attached protein inhibits the synthesis of mucopeptide in the bacterial cell wall.

antibacterial spectrum:

Gram -positive bacteria: Gram -positive air -demands: Streptococcus pyogenes (Beta hemolytic bacterial bacteria), S. Agalactiae (Bacterial League B) and streptococcal group C, F and G; Some S. Pneumoniae strains are worse than some other oral cephalosporins (such as Cefdinir, Cefpodoxim, Cefprozil, Cefuroxim).

Gram -negative bacteria: Neisseria meningitidis, N. Gonorrhoeeae secreted or without penicillinase. The drug also has in vitro effects on N. Gonorrhoeae resistant to penicillin through chromosomes or tetracycline resistance through plasmid intermediaries.

Cefixim also has a vitro printing effect on most H. Influenzae secretion or no beta-lactamase and H. parainfluenzae. In vitro, Cefixim work for Moraxella Catnrhalis, even when ampicillin resistance, cefaclor, cephalexin. In vitro, Cefixim works for most important animaliaceae. In vitro, Cefixim work for many strains E. Coli, Citrobacter Freundii, K. Pneumoniae and P. Mirabilis resistant to other antibiotics (aminoglycosides, tetracyclin, ampicilin, amoxicilin, cefaclor, cephalexin), samonella typhi resistance and/or co-trimoxazol). Many pseudomonas strains are resistant to cefixim.

Despite

Although Cefixim stimulates the production of beta-lactamase in some Morganella Morganii strains, Cefixim still has the effect of in vitro for these strains after releasing beta-lactamase.

Bacteria: Cefixim also works for Borrelia Burdorferi which is the cause of Lyme disease (concentration of 0.8 micrograms/ml).

anti -drug:

Cefixim is highly sustainable, not hydrolyzed by lots of beta-lactamase through plasmid and chromosomes, but the drug is hydrolyzed by some betalactamase of Enterobacter, Klebsiella Oxytoca, Proteus vulgaris and Pseudomonas Cepacia, Citrobacter Freundii, Enterobacter CloeaCaE, Flavobacterium and bacteroides fragilis.

Staphylococcus CEFIXIM staphylococcus is caused by a weak drug for PBP2 of bacteria. Enterococcus and Listeria Monocytogenes resistant to drugs are due to poor affinity for bacterial PBPs.

Citrobacter Freundii and Enterobacter resistant Cefixim are caused by the factors that prevent the drug from penetrating bacteria and produce beta-lactamase.

Pseudomonas and acinetobacter resistant drugs are caused by bacterial cell membranes.

The following bacteria strains are almost resistant to cefixim: staphylococci (secretive or not beta-lactamase secretion) such as Staphylococcus aureus, streptococcal group D and S. Viridan, S. Pneumoniae, S. Epidermidis, and S. Saprophyticus, Staphylococci antigen (resistant. methicilin), Enterococci and Listeria spp., En Trachomatis, Ureaplasma Urealyticum.

Cefixim has limited in vitro activity on anaerobic bacteria, most Clostridia strains (including C. difficile) are resistant to drugs.

pharmacokinetics

absorption:

After taking a single dose of Cefixim, only 30-50% of the dose is absorbed through the digestive tract, regardless of or after meals or after meals, although the absorption rate can be reduced when taken with meals. Drugs in the form of oral fluid are better absorbed than tablets.

The absorption of drugs is relatively slow. The peak concentration of plasma is 2 micrograms/ml (for 200 mg), 3.7 micrograms/ml (for 400 mg dose) and reaches after taken from 2 to 6 hours. In healthy people, dose of 100 mg - 2 g in the form of capsules, oral solution or chaos, the peak concentration in serum and AUC increases when the dose increases but not proportional to the dose; Absorption through the gastrointestinal tract decreases when the dose increases. In children, the dose of 4 - 8 mg/kg also shows that the serum cefixim concentration is not proportional to the dose.

Cefixim does not accumulate in serum or urine in humans with normal kidney function after taking multiple doses, frequency 1-2 times/day. In the elderly, taking a dose of 400 mg orally once a day for 5 days, showing the peak concentration of Cefixim in serum is 20-26% higher and AUC is 40 -42% higher than the 18-35 people, but not clinical significance.

Semi -selling time in plasma is usually about 3-4 hours and may be prolonged when kidney failure. Cefixim's serum sale time does not depend on drug form and does not depend on the dose.

distribution:

After drinking, the drug is distributed into bile, sputum, tonsils, jaw sinus mucosa, middle ear pus, burns, prostate epidemic. About 65% Cefixim in the blood is attached to plasma proteins. There is no adequate data on the concentration of drugs in cerebrospinal fluid. The drug is over the placenta and can reach relatively high concentrations in bile, urine.

There is no data on the drug distribution into breast milk.

transformation:

There is no evidence of the metabolism of in vivo.

excretion:

About 20% of oral doses (or 50% of absorption dose) are eliminated in the form of unchanged urine within 24 hours. Up to 60% of oral doses are not passed through the kidneys. Maybe part of the drug is excreted from the bile to the feces.

The drug is not equal to the hemorrhage.

Before taking Imexime 100 Imexpharm oral media treat urinary tract infections, nephritis - pyelonephritis (12 packs x 2g)

How to use

Put the powder in the cup containing a little water, stir and use immediately.

Depending on the type of infection, it is advisable to prolong the drug for 48 - 72 hours after the symptoms of infections have gone. Common treatment time:

Inhabited urinary tract infections and upper respiratory tract infections: 5 - 10 days (if due to streptococcus group A, Beta hemolysis, must be treated for at least 10 days to prevent heart rheumatism or glomerulonephritis). Or weighing over 50 kg:

Common dose: 200 - 400 mg/day can be used once or divided into 2 times 12 hours apart. Higher doses can be used (800 mg/time) to treat gonorrhea. At least 1 week.

Children from 6 months to 12 years old:

Common dose: 8 mg/kg/day, can be used once or divided into 2 times a day, each time 12 hours apart. 16 months of age use 5 - 10 mg/kg, twice a day, in 14 days; If only used for 7 days, the high rate does not recover from the disease or recurrence has been reported.
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.
Patients with renal failure:
Dosage depends on the degree of renal failure and creatinine clearance according to the following table:
Creatinin clearance coefficient (ml/minute) Dosage 21 200 mg/day
How to handle: Because there is no specific treatment, it is mainly symptomatic treatment. When symptoms of overdose, stop immediately and gastric lavage, anti -convulsions may be used if clinical indications. Because the drug is not eliminated by hemolysis, no dialysis or peritoneal filter.
In an emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when forgetting a dose? If near the next dose time (less than 6 hours), skip the forgotten dose, the next dose is then continued to use according to the doctor's prescription. Do not take double dose to compensate for the forgotten dose.

Side Effects

When using the drug often has unwanted effects (ADR) such as:

Cefixim is often well tolerated, unwanted effects are often fleeting, light and medium. The rate of unwanted effects is up to 50% of patients taking the drug but only 5% of patients need to stop the drug.

Common, ADR> 1/100:

Digestive: up to 30% of adults use Cefixim tablets with digestive disorders, but about 20% of mild manifestations, 5-9% moderate manifestations and 2-3% in severity. Common symptoms are diarrhea and stool (27%), abdominal pain, vomiting, nausea, flatulence, not delicious, dry mouth. Gastrointestinal disorders usually occur in the first 1-2 days of treatment and respond to symptomatic medications, rarely stop the drug. - 5%), but there is no correlation between increased blood amylase level and unwanted effect in the digestive tract of patients.

digestive: severe diarrhea caused by Clostridium difficile and fake colitis. Reduce hemoglobin and hematocrit concentrations. Dao.

Hematology: Prothrombin time.

Neuroscope: mental disorders.

If hypersensitivity occurs, the drug should be stopped, cases of severe hypersensitivity, need to support support (use epinephrin, oxygen breathing, antihistamine and corticosteroids).

If there is convulsions, stop cefixim and take anti -convulsions.

When diarrhea is caused by Clostridium difficile and fake colitis, if mild just stop the drug. In medium and severe cases, electrolytes, protein supplements and metronidazol treatment.

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

Imexime 100 contraindicated drug in the following cases:

Patients with a history of hypersensitivity to cefixim, other cephalosporin antibiotics or any ingredients of the drug.

Be cautious when using

need to be very careful when taking the drug for patients in the following cases:

There has been a report on serious allergic reactions (including anaphylaxis) when treating with beta-lactam antibiotics (penicilin and cephalosporin). Therefore, before starting treatment, it is necessary to learn about the patient's allergic history for penicillin and other cephalosporins; Attention should be paid to the diagonal hypersensitivity between beta-lactam antibiotics, including penicillin, cephalosporin and cephamycin. If mild diarrhea for 1-2 days after taking Cefixim, no need to stop the drug. In case of severe diarrhea, medication should be discontinued and treated C. Difficile with antibiotics such as Metronidazol, Vancomycin. Cefixim also changes the bacteria in the intestine. Gram -positive bacteria have occurred in patients using Cefixim to treat otitis media or urinary tract infections. Therefore, it is necessary to be careful and monitor patients during treatment if superinfection occurs. cefixim. Therefore, patients with phenylketon urine and patients need to control phenylalanin to be cautious when using this drug.

It should be noted when using cefixim during treatment with nifedipine, because nifedipine increases the bioavailability of cefixim up to 70%.

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

The drug can cause headaches, dizziness in some cases should be cautious when driving or operating machinery.

Using drugs for women during pregnancy and lactation

used for pregnant women: so far, there is no full data on the use of Cefixim in pregnant women, during labor and birth. Therefore, only using Cefixim for cases when really necessary.

Using drugs for nursing women: Currently, it has not yet been confirmed that Cefixim is distributed into milk in breastfeeding women. Therefore, Cefixim should be used for women to breastfeed carefully, can suspend breastfeeding during medication.

Drug interaction

Probenecid increases the peak and AUC concentration of Cefixim, reducing the clearance of the kidneys and the distribution of the drug.

anticoagulants like warfarin when used with cefixim increase prothrombin time, with or without bleeding.

Carbamazepin taken with cefixim increases carbamazepine levels in plasma.

Nifedipin when taken with Cefixim increases the bioavailability of Cefixim (up to 70%) manifests itself by increasing the peak and AUC concentration.

CEFIXIM's activity may increase when used together with ureteric acidic agents.

Cefixim can reduce the activity of typhoid vaccine.

Cefixim treatment can cause false positive results in the test to find glucose in urine by reacting with Benedict solution, fehling solution or clinitest tablet; But does not affect the test by using glucose oxidase.

cefixim causes fake positive tests Coombs.

Cavalry of the drug: due to the lack of studies on the correlation of the drug, not mixing this drug with other drugs.

Storage

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

To be out of reach of children, read the instructions carefully before use.

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