Xorimax 500mg Sandoz treats acute sinusitis, acute otitis media (1 blister x 10 tablets)
Dosage form Box of 1 blister x 10 tablets
Specifications Cefuroxim
Ingredient
| Composition information | Content |
| Cefuroxim | 500mg |
Uses
Indications
Treatment of infections listed below on adults and children from 3 months of age:
Skin infections and soft tissue infections.
Pharmacology
Pharmacological group: antibiotics used systemic, belonging to the 2nd generation cephalosporin group.
ATC code: J0IDC02
Mechanism of action
cefuroxim acetyl is hydrolyzed by enzyme esterase into active substance, cefuroxim.
Cefuroxim inhibits the synthesis of bacterial cells by attaching penicillin (Pbps) proteins. The result is inhibiting the cell wall biosynthesis process (peptidoglycan) that leads to bacterial cell death and death.
Pharmacokinetics
absorption
After drinking, Cefuroxim acetyl is absorbed through the gastrointestinal tract and is quickly hydrolyzed in the intestinal mucosa and in the blood to release Cefuroxime during circulation. The drug is absorbed maximum when taken immediately after the meal.
The peak concentration of the tablet of Cefuroxim acetyl tablets below (2.9 µg/ml for 125 mg dose; 4.4 µg/ml for a dose of 250 mg; 7.7 µg/ml for a dose of 500 mg and 13.6 µg/ml for a dose of 1000 mg) after about 2.4 hours after the drug is taken at meals. The absorption rate of Cefuroxime from the chewing is reduced compared to the tablet, leading to lower serum peak concentration and reducing the bioavailability of the body (less than 4-17%).
Oral acetyl cefurox moca is not biological equivalent with cefuroxim acetyl tablets when tested on healthy adults and therefore irrevocable on the basis of this dosage milligram for each other dosage milligram. The pharmacokinetics of Cefuroxim are linearly in the dose range from 125 - 1000 mg. There is no cefuroxiim accumulation when the dose is repeated from 250 - 500 mg.
Distribution
33 - 50% of the drug is associated with protein depending on the method of use. After taking the single dose of Cefuroxim acetyl for 12 healthy volunteers, the distribution voltage is 50 l (CV% = 28%). Cefuroxim concentration surpasses the minimum inhibitory concentration with common pathogenic bacteria that can be achieved in tonsils, sinus tissue, bronchial mucosa, bone, pleural fluid, joint fluid, congestion, interstitial fluid, bile, phlegm and aquatic fluid. Cefuroxim passes through the bloody barrier when the meninges are inflamed.
Metabolism
Cefuroxim is not metabolized.
Elimination
Serum duration of the serum is from 1 to 1.5 hours. Cefuroxim is eliminated through glomerular filtration and excreted through the renal tubules. Kidney clearance ranges from 125 - 148 ml/minute/1.73m2.
Before taking Xorimax 500mg Sandoz treats acute sinusitis, acute otitis media (1 blister x 10 tablets)
How to use
oral medication.
Should use Xorimax tablets after meals to maximize the drug.
Do not crush Xorimax tablets, so it is not suitable for patients to not swallow the tablet. Children can use Xorimax orally.
Dosage
conventional treatment time is 7 days (can range from 5 to 10 days).
Table 1. Adults and children (weight ≥ 40 kg).
indicated
dose
250 mg x 2 times/day.
500 mg x 2 times/day. 500 mg x 2 times/day. 250 mg x 2 times/day. 250 mg x 2 times/day.
Skin and soft tissue infections 250 mg x 2 times/day.
Lyme disease
500 mg x 2 times/day for 14 days (ranging from 10 - 21 days).
indicated
Dosage
10 mg/kg x 2 times/day to a maximum dose of 125 mg x 2 times/day.
15 mg/kg x 2 times/day to a maximum dose of 250 mg x 2 times/day. 15 mg/kg x 2 times/day to a maximum dose of 250 mg x 2 times/day. 15 mg/kg x 2 times/day to a maximum dose of 250 mg 2 times/day from 10 - 14 days.
Skin and soft tissue infections 15 mg/kg x 2 times/day to a maximum dose of 250 mg x 2 times/day.
Lyme disease
15 mg/kg x 2 times/day to a maximum dose of 250 mg 2 times/day for 14 days (10 - 21 days).
Cefuroxim acetyl and cefuroxim acetyl acetyl in the form of micro -granular form to mix the oral mixture without the equivalent of bioavailability and cannot be replaced by milligrams to milligrams.
kidney failure
The safety and effectiveness of Cefuroxim acetyl in patients have not been set. Cefuroxim is excreted mainly through the kidneys. On patients with a significant impaired renal function, it is recommended to reduce the dose of Cefiroxim to compensate for more slowly. Cefuroxim is effectively removed by dialysis.
Table 3. Xorimax dose recommends for patients with renal failure
Creatinine clearance
t1/2 (now)
recommended dose
≥ 30 ml/min/1.73m2 1,4 - 2.4 Unsurprisingly dose adjustment (normal dose levels from 125 - 500 mg x 2 times/day).
10 - 29 ml/min/1.73m2
4.6
Standard doses every 24 hours.
16,8
Standard doses every 48 hours.
2 - 4
Continue to take a single dose at the end of each hemolysis.
There is no data available in patients with liver failure. Because Cefuroxim is excreted mainly through the kidneys, liver dysfunction is considered as no effect on the pharmacokinetics of Cefuroxim's pharmacokinetics.
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 symptoms may appear if there is no appropriate decrease in the patient's impaired renal function.
Cefuroxim concentration in serum may decrease due to blood and peritoneal competence.
In an emergency, call the 115 emergency center immediately or go to the nearest local health station.
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 Xorimax 500 mg , you may experience unwanted effects (ADR).
Common, ADR> 1/100
Uncommon, 1/1000 Unknown frequency Liver: jaundice (mainly cholestasis), hepatitis Skin and subcutaneous tissue: urticaria, itching, diverse erythema, Stevens-Johnson syndrome, poisoned epidermal necrosis, nerve angioedema. 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
Xorimax 500 mg contraindicated in the following cases:
History of severe sensitivity (for example, anaphylactic reaction) with any other antibiotic belonging to the beta-lactam group (penicillin, monobactam and carbapenem).
Be cautious when using
Hypersensitivity reactions
Patients with a history of allergic reactions to penicillin or other beta lactam antibiotics need to be monitored by the kidneys due to the risk of cross -sensitivity. Like all other beta-lactam antibiotics, serious hypersensitivity reactions and sometimes hypersensitivity reactions have been reported. In case of severe hypersensitivity reactions, Cefuroxim should be stopped immediately and started appropriate emergency measures.
Before starting treatment, the patient should have a history of hypersensitivity to cefuroxim or other cephalosporins or any other antibiotics belonging to the beta-lactam group. Be cautious when using Cefuroxim for patients with a history of hypersensitivity is not serious with other beta-lactam drugs.
Jarisch-HERXHEIMER reaction
Jarisch-HERXHEIMER reaction has been observed after using Cefuroxim acetyl to treat Lyme disease. It is the direct result from the bactericidal effect of Cefuroxim acetyl in Lyme pathogenic bacteria is Borrelia Burgdorferi. Patients should be advised that this reaction is common and limited to antibiotics to treat Lyme.
Excessive growth of non -sensitive microorganisms
Similar to other antibiotics, using cefuroxim acetyl can lead to over -growth of candidiasis. The use of prolonged drugs can also lead to excessive growth of non -sensitive microorganisms (such as intestinal bacteria and Clostridium difficile), requiring stopping the medication. Antibiotic colitis related to antibiotics has been reported to most antibiotics including Cefuroxim and severe severity can vary from mild to life -threatening. This diagnosis should be considered in patients with diarrhea during and after the process of using Cefuroxim. Cefuroxim should be considered for stop treatment and use other specialized clostridium difficile medications. Do not use intestinal peristalsis inhibitors.
Interaction with other diagnostic tests
Positive Cooom reaction related to the use of Cefuroxim may affect blood type diagonal test results.
Recommendations to determine blood glucose concentration or plasma patients using cefuroxim acetyl by glucose oxidase or hexokinase method due to false negative results that can appear with cyanid tips test.
Should be particularly cautious in patients with urinary phenylceton due to drug containing aspartame.
The ability to drive and operate machinery
There are no studies on the effects of the drug on the ability to drive and operate machinery. However, because the drug can cause dizziness, patients need to be cautious when driving and operating machinery.
Pregnancy
data on the use of cefuroxim for pregnant women is limited. Animal studies do not show the harmful effects of drugs on pregnancy, fetus and fetal development, labor or development after birth. Cefuroxim acetyl should only be prescribed in case of superior benefits.
The period of breastfeeding
Small amount of Cefuroxim is excreted into breast milk. The adverse effects at the level of treatment are not thought, but it is not possible to rule out the risk of diarrhea and fungal infections in the mucosa. Breastfeeding women may have to stop taking the drug due to these side effects. It is advisable to consider the ability to be sensitive. Cefuroxim should only be used during breastfeeding after the treatment doctor assessed the benefits/risk of drug use.
Medicinal interaction
Medications that reduce gastric acid can reduce the bioavailability of cefuroxim acetyl when compared to the bioavailability of the drug in a state of hunger and tend to eliminate the effects of increased drug absorption after eating.
Cefuroxim acetyl can affect the intestinal bacteria, leading to reducing the reabsorption of the estrogen and reducing the effectiveness of combined oral contraceptives.
Cefuroxim is eliminated through glomerular filtration and excreted through the renal tubules. Simultaneous use with Probenecid is not recommended. Timultant use with probenecid increases the meaning of the peak concentration, the area under the serum concentration curve and the semi -waste time of Cefuroxim.
Concentrated with oral anticoagulants can increase Inr.
Storage
Do not store over 30 ° C, hold in the original packaging.
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