Levodhg 750 medicine for infections (2 blisters x 7 tablets)
Dosage form Box of 2 blisters x 7 tablets
Specifications Levofloxacin
Ingredient
| Composition information | Content |
| Levofloxacin | 750mg |
Uses
Indications
Levodhg 750mg DHG 2X7 drug is indicated in the following cases:
Pharmacology
levofloxacin is a synthetic antibiotic with a broad spectrum belonging to the Fluoroquinolon group, which has bactericidal effects due to inhibition of Topoisomerase II (DNA-GYRASE) and Topoisomerase IV are essential enzymes of catalysts in catalysts in the Copy, Code and Code of Bacteria of bacteria. Levofloxacin works on multiple gram -negative and gram -positive bacteria. Levofloxacin (as well as sparfloxacin) works on Gram -positive bacteria and anaerobic bacteria than other fluoroquinolon (such as Ciprofloxacin, Enoxacin, LmeFloxacin, Norfloxacin, ofloxacin), however Levofloxacin and Sparfloxacin have In Viturro on Pseudonas Aeruginosa is weaker than Ciprofloxacin.
Effective spectrum
In vitro sensitive bacteria and clinical infections
Gram -negative bacteria: EnOther bacteria: Chlamydia pneumoniae, Mycopasma pneumoniae.
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.
Diagonal resistance: Fluoroquinolone resistance may arise due to mutations in the specified area of DNA Gyrase or Topoisomerase IV. In vitro, crossed between levofloxacin and other fluoroquinolon. Due to the mechanism of action, often without cross -resistant between levofloxacin and other antibiotics.
pharmacokinetics
After drinking, levofloxacin is absorbed quickly and almost completely, the peak concentration in plasma is often achieved after 1-2 hours, the 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 taken.
levofloxacin is widely distributed in the body, but it is difficult to penetrate into the cerebrospinal fluid. The ratio of plasma proteins is 30-40%. Levofloxacin is very little metabolized in the body and eliminates almost completely through the urine in the form of activity, only less than 5% of the treatment dose found in urine in the form of metabolic Desmethyl and N-OXID, these metabolites have very little biological activity.
Levofloxacin's semi -exhaust time is 6-8 hours and lasts longer in kidney failure. 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.
Before taking Levodhg 750 medicine for infections (2 blisters x 7 tablets)
How to use
Take oral use.
Dosage
Hospital pneumonia
Use 750mg, 1 time/ day, for 7-14 days.
Pneumonia is suffering from the community
Use 750mg, 1 time/day, for 5 days.
Skin infection and subcutaneous organization with complications
Use 750mg x 1 time/day, for 7-14 days.
Urinary tract infections have complications or acute nephritis
Use 750mg, 1 time/day, for 5 days.
Exacerbation of chronic bronchitis
Use 500mg, 1 time/ day, for 7 days. Recommendation should be used with appropriate content.
Acute sinusitis caused by bacteria
Use 750mg, 1 time/ day, for 5 days.
Dosage for patients with renal failure
Initial dose 750mg, maintenance dose 500mg every 48 hours.
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?
What to do when forgetting 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 LevodHG 750mg DHG, you may experience unwanted effects (ADR).
The following information is based on data from clinical studies on 8300 patients and after -sales experience.
The frequencies are determined by using the following conventions: Very common (≥ 1/10), common (≥ 1/100,
In each group, the unwanted effect is presented according to the degree of severity decreasing.
(1/100 to
(1/10,000 to
granulocytes. Eat. Depressed.
worried, abnormal dreams, nightmares.
The smell of smell. Movement disorders. Periodic disorders.
Loss of taste.
unconscious. Healthy hypertension. ears. prolonged. Allergic pneumonia. Pancreatitis. liver. leukemia.
Oral stomatitis. Achilles).
Broken ligament. place.
Instructions on how to handle ADR
It is necessary to stop levofloxacin in the following cases: Starting skin rash or any signs of sensitive reaction or ADR on the central nervous system. It is necessary to monitor patients to detect fake colitis and take appropriate measures when diarrhea appears while using levofloxacin.
When signs of tendonitis appear, it is necessary to stop the drug immediately, leave two heel tendons with appropriate fixed tools or heel brace and specialized consultation.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Levodhg 750mg DHG drug contraindicated in the following cases:
Be cautious when using
serious harmful reactions are likely to not recover and cause disabilities, including tendonitis, tendon breakdown, peripheral neuropathy and adverse effects on the central nervous system.
Fluoroquinolon antibiotics are associated with serious harmful reactions that can cause disabilities and non -recovery on different organs of the body. These reactions may appear simultaneously on the same patient. Harmful reactions are often recorded including tendonitis, tendon, joint pain, muscle pain, peripheral neuropathy and adverse effects on the central nervous system (hallucinations, anxiety, depression, insomnia, severe headaches and confusion). These reactions may occur within hours to a few weeks after using the drug. Patients at any age or no risk factors that exist before may have these harmful reactions.
Stop using the drug as soon as there are signs or first symptoms of any serious harmful reactions. In addition, avoid using Fluoroquinolon antibiotics for patients who have had serious reactions related to fluoroquinolon.
Staphylococcus aureus resistant to methicilin (MRSA)
s. Aureus resistant to methicilin is capable of resisting fluoroquinolon, including levofloxacin. Therefore, levofloxacin should not be used to treat prehistoric bacterial infections or MRSA doubts unless the test results have confirmed the sensitivity of bacteria for levofloxacin (and common antibacterial agents in the treatment of MRSA infections are considered inappropriate).
levofloxacin is used in the treatment of acute sinusitis and acute phase of chronic bronchitis when these diseases have been fully diagnosed.
resistance to the Fluoroquinolon group of E. Coli - the most common type of pathogenic bacteria involved in urinary tract infections - depending on the region throughout the European Union. The prescription should pay attention to local popularity about the resistance of E. coli with the Fluoroquinolon group.
Inhaling cohesion
Using in humans is based on the sensitivity of Bacillus anthracis in vitro and experimental data on animals and limited figures in humans. Doctors should refer to the unified nation or international documents related to the treatment of coal diseases.
tendonitis and tendons
Tenditis rarely occurs and often associated with Achilles tendon and can lead to tendons. Tendonitis and tendon breaks, sometimes bilateral, can occur within 48 hours after starting treatment with levofloxacin and exists up to several months after stopping treatment. The risk of tendonitis and tendon rupture increases in patients over 60 years old, patients taking a dose of 1000 mg daily and in patients using corticosteroids.
Daily dose should be adjusted in elderly patients based on creatinine clearance. Therefore, it is necessary to closely monitor patients if they are prescribed levofloxacin. All patients should consult a doctor if the symptoms of tendonitis appear. If suspected tendonitis, stop using levofloxacin immediately and must start appropriate treatment (such as fixed) for affected tendons.
Diseases related to Clostridium difficile
diarrhea, especially if serious, persistent or bloody, during or after treatment with levofloxacin (including a few weeks after treatment), may be a symptom of the disease related to Clostridium difficile (CDAD). CDAD can occur at a level from mild to life -threatening, the most serious is fake colitis. Therefore, it is important to consider diagnosing patients with severe diarrhea during or after treatment with levofloxacin. If suspected or confirmed as CDAD, levofloxacin should be stopped and appropriate treatment immediately (such as taking Metronidazol or Vancomycin). The anti -ease inhibitors are contraindicated in this clinical case.
Patients with convulsions
Quinolones can reduce seizures and can cause seizures. Levofloxacin is contraindicated in patients with a history of epilepsy and other quinolons, levofloxacin should be used with caution in patients with convulsions or simultaneous treatment with active ingredients that reduce the seizures in the brain, such as theophylin. In the case of convulsions, levofloxacin should be stopped.
Patients with G-6-phosphate dehydrogenase deficiency
Patients with or potentially defect Glucose-6-phosphate dehydrogenase may be susceptible to hemolytic reactions when treated with quinolon antibacterial agents. Therefore, if levofloxacin is used in these patients, it is necessary to monitor the likelihood of hemolysis.
Hypersensitivity reaction
Levofloxacin can cause serious hypersensitivity reactions, which can be fatal (such as an anaphylactic fedium), sometimes appearing immediately after the original dose. Patients should stop treating immediately and contact the doctor to apply appropriate treatment.
Serious water ball reaction
Cases of serious water glossy skin reactions such as Stevens-Johnson syndrome or poisoned epidermal necrosis are related to levofloxacin. Patients should consult a doctor right before continuing treatment if skin or mucous reactions occur.
Blood sugar disorders
Like all quinolones, blood sugar disorders, including hypoglycemia and hyperglycemia occur in diabetics treated simultaneously with an oral hypoglycemic agent (such as glibenclamide) or with insulin. In addition, coma hypoglycemia is also reported. In patients with diabetes, closely monitor blood sugar.
Prevention of light sensitivity
Light sensitivity is reported related to levofloxacin. Patients should avoid exposure under strong sunlight or artificial UV (such as ultraviolet lights, sunbathing rooms), during treatment and within 48 hours after stopping treatment to prevent light sensitivity.
Patients treated with vitamin K antagonists
Due to increased blood clotting test (PT/INR) or bleeding in patients treated with levofloxacin combined with vitamin K antagonists (such as warfarin), blood clotting tests should be monitored when these drugs are simultaneously used.
Psychotic reactions
Mental reactions occur in patients using quinolones, including levofloxacin. This reaction, very rare, leads to suicide thoughts and self -dangerous behaviors - sometimes only after taking a single dose of Levofloxacin. In the case of this reaction patient, levofloxacin should be stopped and applied appropriate measures. Levofloxacin should be used with caution in patients with mental disorders or a history of mental disorder.
extended QT range
Be cautious when using fluoroquinolon, including levofloxacin, in patients with prolonged QT risk factors, including:
Elderly and women may be more sensitive to drugs that extend QT. Therefore, cautious when using fluoroquinolon, including levofloxacin, in these objects.
Peripheral neuropathy
Peripheral neuropathy sensory or sensory sensation has been recorded in patients using fluoroquinolon groups, including levofloxacin and can quickly onset. Stop using levofloxacin if the patient has symptoms of neuropathy to prevent the development of an irreversible condition.
Liver disorders
Cases of liver necrosis leading to serious liver failure have been reported related to levofloxacin, mainly in patients with severe diseases, such as blood infections. Patients should stop treating and contacting the doctor if the signs and symptoms of liver disease develops such as anorexia, jaundice, dark urine, itching or soft belly.
Myastheniastick
Fluoroquinolon, including levofloxacin, have a neuromuscular activity and can increase muscle weakness in patients with myasthenia gravis. Serious after -sales side effects include death and respiratory support requirements related to the use of fluoroquinolon in patients with myasthenia gravis. Levofloxacin is not recommended in patients with a history of myasthenia disease.
visual disorders
If the vision becomes weaker or has any impact on the eyes, should go to the eye specialist for advice immediately.
superinfection
The use of levofloxacin, especially if prolonged, can lead to over -growth of non -sensitive bacteria. If superinfection occurs during treatment, appropriate measures are required.
Interventions in tests
In patients treated with levofloxacin, the determination of opiat in urine can give false positive results. It is necessary to determine the positive opiat test by more specific methods.
levofloxacin can inhibit the growth of mycobacterium tuberculosis, thus giving fake negative results in the diagnosis of tuberculosis bacteria.
levofloxacin is excreted mainly through the kidneys should adjust the dose in patients with renal failure.
excipients
In the excipients with starch, safe to use for people with coeliac disease, other allergies should not be used.
The ability to drive and operate machinery
Be cautious when driving and operating machinery because the drug can cause headaches, dizziness, stress, agitation.
Pregnancy
Do not use levofloxacin for pregnant women.
Breastfeeding period
Do not breastfeed when using levofloxacin.
Drug interaction
antacid, sucralfate, metal ions, multivitamin can reduce Levofloxacin absorption, so drink at least 2 hours.
Need to closely monitor theophylin concentration and adjust the dose if needed when used simultaneously with levofloxacin.
levofloxacin increases the effects of vitamin K (warfarin) and increases the risk of blood sugar disorders when used simultaneously with hypoglycemic drugs, increases the risk of central nerve stimulation and convulsions when used simultaneously with nonsteroidal anti -inflammatory drugs.
Calcium carbonate, digoxin, glibenclamid, ranitidin: interactions are not clinically significant, so there is no need to adjust the dose of these drugs when used simultaneously with levofloxacin.
Cyclosporin: Cyclosporin's waste time increases to 33% when used simultaneously with levofloxacin.
Be cautious when using levofloxacin with drugs that affect the excretion of renal tubules such as probenecid and cimetidine, especially for patients with renal failure.
levofloxacin reduces the effects of BCG, Mycophenolat, Sulfonylurea, typhoid vaccine.
Storage
In a dry place, the temperature does not exceed 300C, avoiding light.
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