Mixed and oral powder 250mg Medisun for infections caused by sensitive bacteria (20 packs)

Dosage form Box of 20 packs
Specifications Ciprofloxacin
Ingredient Medisun Pharmaceutical Joint Stock Company

Ingredient

Composition information	Content
Ciprofloxacin	250mg

Uses

Indications

Mixed powdered powder for oral compacin indicated treatment in the following cases:

Ciprofloxacin is indicated for infections caused by sensitive bacteria, severe bacterial infections that conventional antibiotics do not work to avoid developing ciprofloxacin resistant bacteria such as:

upper and lower urinary tract infections.

Gonorrhea has no complications. Translation.

Uncomplicated urinary tract infections: Due to fluoroquinolon antibiotics, in which compacin is related to serious harmful reactions (see warning and caution) and non -complicated urinary tract infections in some patients who go away on their own, they should only use compacin for patients without other treatment options instead.

Acute bacterial infections of chronic bronchitis: Due to Fluoroquinolon antibiotics, including compacin associated with serious harmful reactions (see warning and caution) and acute bacterial infections of chronic bronchitis in some patients, only compacin should be used for patients without other treatment options instead.

Acute sinusitis caused by bacteria: Fluoroquinolone antibiotics, including compacin, are related to serious harmful reactions and acute sinusitis caused by bacteria that some diseases can go away on their own, only compacin should be used for patients without other treatment options instead.

Pharmacokic

ciprofloxacin is a semi -semi -antibiotic, wide antibacterial spectrum, belonging to the Fluoroquinolon group, also known as DNA inhibitors.

Ciprofloxacin works well with antibiotic -resistant bacteria from other groups (aminoglycosides, cephalosporin, tetracyclin, penicilin ...).

Antibacterial spectrum includes:

Ciprofloxacin has a very wide antibacterial spectrum, including most important pathogens. Most gram -negative bacteria, including pseudomonas and enterobacter are sensitive to the drug. Gram -positive bacteria (Enterococcus strains, Staphylococcus, Streptococcus, Listeria monocytogenes ...) are less sensitive. Ciprofloxacin does not work on most anaerobic bacteria.

Bacteria that cause intestinal diseases such as Salmonella, Shigella, Yersina and Vibrio Cholerae are often highly sensitive. The bacteria that cause respiratory diseases such as Haemophilus and Legionella are often sensitive, Mycoplasma and Chlamydia are only sensitive to the drug. Neisseria is often very sensitive to drugs.

According to the report of Vietnam's National Supervisory Program on the anti -drug properties of common pathogenic bacteria (1997) and information No. 4 in 1999, Ciprofloxacin still works high for Salmonella Typhi (100%), Shigella Flexneri (100%). The bacteria are increasing Ciprofloxacin resistant including Staphylococcus aureus resistant Ciprofloxacin with a rate of 20.6%, Escherichia coli -resistant Ciprofloxacin coli at 27.8%and S. Pneumonia Ciprofloxacin resistant at 30%. Antibiotic resistance in the southern provinces is higher than the northern provinces. The use of Ciprofloxacin needs to be cautious, with the right indications, because Ciprofloxacin resistance is like resistance to other antibiotics is an increasingly common problem.

Mechanism of action:

Ciprofloxacin inhibits DNA Gyrase enzyme, prevents Chromosom's copy that makes bacteria not reproduce quickly.

Dynamic pharmacokinetics

absorption: Ciprofloxacin absorbs quickly and easily in the digestive tract. When food and anti -acid drugs, the absorption of drugs is slower but not significantly affected. After drinking, the maximum concentration of Ciprofloxacin in the blood appears after 1-2 hours with absolute bioavailability of 70 - 80%.

Maximum maximum concentration in serum corresponding to the dose of 500 mg is 2.4 mg/liter.

Distribution: The distribution of Ciprofloxacin is very large (2 - 3 liters/kg body weight). The drug is widely distributed and has high concentrations in places where infections (body fluids, tissues). The concentration in tissue is usually higher than the serum concentration, especially in parenchyma, muscle, bile and prostate. Ciprofloxacin passes through the placenta and excreted through breast milk.

Metabolism: Half life in plasma is about 3.5 to 4.5 hours in patients with normal kidney function, this time is longer in patients with kidney failure and in the elderly

Elimination: about 40 - 50% of oral dose excreted in the form of unchanged urine by filtering in the glomerular filter and excreted in the renal tubules. Other excreted lines are metabolic in the liver, excreted bile, and excreted through the mucosa into the intestine (this is a mechanism of clearing compensation in patients with severe kidney failure). The drug is excreted within 24 hours.

Before taking Mixed and oral powder 250mg Medisun for infections caused by sensitive bacteria (20 packs)

How to use

Mix powder into a sufficient amount of water (about 20ml). Do not use milk, tea, coffee or carbonated, alcoholic or calcium drinks to make medicine.

Dosage

Ciprofloxacin treatment time depends on the type of infection and the severity of the disease and should be determined depending on the clinical response and microorganisms of the patient. For most infections, the treatment should continue at least 48 hours after the patient has no symptoms. The treatment time is usually 1-2 weeks, but with severe or complicated infections, may need longer treatment.

Ciprofloxacin treatment may need to continue for 4-6 weeks or longer in bone and joint infections. Bacterial diarrhea is usually treated for 3-7 days or may be shorter.

Dosage for 24 hours Most

chronic prostatitis 500 mg x 2

Treatment dose:

Preventive dose

500 mg x 2

500 mg x 1

Adults and children over 20 kg

500 mg, the only dose Infections in people with immunodeficiency 500 - 750mg × 2

The urinary tract infection is not complicated 250 - 500 mg per hour, for 3 days.

For menopausal women with single dose 500 mg)

Acute bacterial infections of chronic bronchitis 500 - 750 mg every 12 hours, for 7-14 days acute sinusitis due to bacteria 500mg every 12 hours, for 10 days Liver function. In the case of a person with renal function, if low doses are used, there is no need to reduce the dose; If high doses are used, the dose must be adjusted based on creatinine clearance, or serum creatinine levels.

Creatinine clearance (ml/min/1.73m2) 2 ≤ 30 (Creatinininin): ≥ 175 micromol/liter dose ≥ 500 mg x 2 should be reduced to 500 mg x1

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? Need to monitor patients need kidney and timely support treatment.

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

In general, ciprofloxacin tolerates well. The side effects of the drug are mainly on the stomach - intestines, central nerves and skin.

Common, ADR> 1/100

Digestive: Nausea, vomiting, diarrhea, abdominal pain

Systemic: headache, drug fever. Agriculture.

Systemic body: Anaphylaxis or anaphylaxis. intracranial pressure. There are a few cases of tendon broken, especially in the elderly when used in combination with corticosteroids. ADR:

To avoid the crystal, maintain the amount of drinking water, not to keep the urine too alkaline.

If diarrhea has severe and prolonged diarrhea during the treatment, the patient may have severe disorders in the intestine (fake colitis). Ciprofloxacin should be discontinued and replaced with other appropriate antibiotics (for example, vaomycin).

If there is any sign of side effects, it is necessary to stop using ciprofloxacin and patients need to be treated at a medical facility, although these side effects are usually mild or moderate and will quickly stop using Ciprofloxacin.

Notify the physician the unwanted effects when using the drug.

Warnings

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

Contraindicated

Mixed powder for oral compacin contraindicated in the following cases:

People with a history of hypersensitivity to ciprofloxacin and related drugs such as nalidixic acid and other quinolons. Do not take medicine for people who are taking tizanidin.

Be cautious when using

be careful when using ciprofloxacin for people with a history of epilepsy or central nervous system disorders, people with liver function or kidney function, people with glucose 6 phosphate dehydrogenase, people with myasthenia gravis.

It is necessary to maintain enough water during treatment with ciprofloxacin and avoid leaving urine too alkaline due to the risk of crystal - urinary.In general, the drug should not be used for patients under 18 years of age, pregnant women, nursing mothers, unless it is necessary and the benefits of the use of drugs greater than risks because Ciprofloxacin and fluoroquinolones are related to nalidixic acid, causing cartilage degeneration in gravity joints in adult animal studies.

tendonitis or tendons occurred when using Quinolon antibiotics. This risk increases when used simultaneously with corticosteroids, organ transplants and patients over 60 years old.

Ciprofloxacin must be stopped if the patient has a tendon swelling and then contraindicated use of fluoroquinolon in these patients.

Avoid exposure to the sun when the sun is intense and the lights have large capacity when treated with ciprofloxacin.

Must be cautious in the elderly because of increased risk of prolonged QT.

Must pay attention to sensitivity, a fatal self -defense reaction occurred.

Must stop taking the drug when there are signs of rash, or other signs of sensitivity.

When using Ciprofloxacin, you must avoid exertion, exercise severe exercise because of the increased risk of tendons.

The long -term use of ciprofloxacin can cause non -sensitive bacteria to overdue drugs. It is necessary to monitor patients and make antibiotics regularly to take appropriate treatments according to antibiotics.

ciprofloxacin can make mycobacterium tuberculosis tests negative.

Avoid using or cautious use for patients with prolonged QT interval or related risk factors such as uncontrolled electrolyte disorders, bradycardia, and previous heart disease.

Need to limit the use of caffeine when there is excessive arrhythmia and nerve stimulation.

ciprofloxacin and fluoroquinolon should be avoided in MRSA infection due to high level of resistance.

Serious 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 are likely to 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 from 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.

Use drugs for women during pregnancy and lactation

Pregnant women:

should only use ciprofloxacin for pregnant women in cases of severe infections without other antibiotics instead, forced to use Ciprofloxacin.

breastfeeding women:

Do not use ciprofloxacin for nursing mothers, because ciprofloxacin accumulates in milk and can reach the concentration that can cause harm to children. If the mother is forced to use ciprofloxacin, they must stop breastfeeding.

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

ciprofloxacin can cause dizziness, whirling mind, affecting vehicles or operating machinery.

Medicinal interaction

oral Ciprofloxacin simultaneously with theophylin, clozapin, Ropinirol, tizanidin may increase the concentration of these drugs in plasma. So contraindicated use of ciprofloxacin with tizanidine; The chest of theophylin concentration in the blood and the canopylin can be tested if they are required to take 2 drugs; With Clozapine and Ropinirol can also be used with clinical monitoring with the necessary dose adjustment.

Ciprofloxacin increases the effect of anticoagulant drugs and anti -diabetic oral diabetes drugs Glibenclamid.

Need to regularly check prothrombin or blood glucose when taking these drugs. Drugs. Gluconate, sulfate) significantly reduces the absorption of ciprofloxacin in the intestine. Zinc preparations have less effects.

Avoid using ciprofloxacin at the same time with iron and zinc -containing preparations; Should take these drugs as far as possible. Sharing anti -acid drugs with aluminum and magnesi will reduce serum levels and reduce bioavailability of ciprofloxacin. Do not take Ciprofloxacin at the same time with anti-acid drugs, need to take these drugs apart (should take anti-acid drugs 2-4 hours before taking Ciprofloxacin), although this method does not thoroughly solve the problem.

The serum phenyltoin concentration is changed when used with ciprofloxacin.

Ciprofloxacin can reduce the effects of mycophenolate, phenyltoin, sulfonylurea, typhoid vaccine.

Ciprofloxacin should be avoided with quinidine, processine, amiodarone, sotalol and drugs in the same group. Ciprofloxacin should also be avoided with antihistamine Astemizol and Terfenadin, Cisaprid, Erythromycin, Pentamidin, Phenothiazine or 3 -round depression drugs.

Take the sucralfate at the same time will reduce the absorption of ciprofloxacin significantly. Antibiotics should be given 2 - 6 hours before taking sucralfat.

Ciprofloxacin absorption may be reduced half if used simultaneously some cyclophosphamide, vincistin, doxorubicin, cytosin arabinosid, mitozantron).

If using the Convidinosin simultaneously, the concentration of ciprofloxacin is significantly reduced. Ciprofloxacin should be taken before using Didanosin for 2 hours or after using Didanosin 6 hours.

ciprofloxacin and ciclosporin use simultaneously can cause temporary increased serum creatinine. Should check blood creatinine twice a week.

Probenecid reduces glomerular filtration level and reduces the excretion in the renal tubules, thus reducing the elimination of drugs through urine.

warfarin in combination with ciprofloxacin can cause prothrombin. Need to regularly check blood prothrombin and adjust the dose of anticoagulants.

Storage

Store at a temperature not exceeding 30 ° C in the original packaging, avoid moisture and avoid light.

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