Lomefloxacin (Atc Code J01MA07)
When ATH:
J01MA07
Characteristic.
Fluoroquinolone antibacterial agent II generation. Lomefloksacina hydrochloride is a white to pale yellow powder. Slightly soluble in water and practically insoluble in alcohol, resistant to heat and moisture, sensitive to light in aqueous solution. Molecular weight 387,8.
Pharmacological action.
Broad-spectrum antibacterial, bactericide.
Application.
Pills: urinary tract infection (incl. prevention of infection before and after transurethral surgery): cystitis, pyelonephritis, uretrit; GI (dysentery, typhoid fever, salmonellosis, cholera) and biliary tract, Respiratory infections (incl. exacerbation of chronic bronchitis), purulent infections of the skin and soft tissues, infected wounds, burns, gonorrhea, Chlamydia (incl. chlamydial conjunctivitis and Blepharoconjunctivitis), prostatitis, osteomyelitis. Pulmonary tuberculosis (in the complex therapy) -osteoprogressirujushhie form, multidrug resistance of mycobacteria, poor tolerance of rifampicin.
Eye drops: bacterial infections of the anterior eye: conjunctivitis, .Aloe, blefarokonъyunktyvyt, incl. chlamydial infection.
Contraindications.
Hypersensitivity (incl. to other fluoroquinolones), childhood and adolescence (in the period of formation and skeletal growth is a till 18 years).
Restrictions apply.
Cerebral atherosclerosis, epilepsy and other conditions with a predisposition to seizures.
Pregnancy and breast-feeding.
Contraindicated in pregnancy (adequate and well-controlled studies in humans have not held). Displaying, lomefloksatsin that cause arthropathy in young animals.
In monkeys, an increase rate of fetal loss at doses, about 6-12 times higher than the dose, recommended for a person (in mg / kg). At doses, in 16 times the recommended human, teratogenic in rats and monkeys revealed no. In rabbits at doses, twice the recommended human (in mg / m2), It revealed a toxic effect on the mother, accompanied by toxic effects on the fetus, changes coccygeal vertebrae and weight of the placenta.
Should not be used during breastfeeding (unknown, Do lomefloksatsin penetrates into breast milk).
Side effects.
Pills:
From the digestive tract: nausea, vomiting, dry mouth, epigastric pain, flatulence, constipation / diarrhea, dysbiosis, psevdomembranoznыy colitis, dysphagia, bleeding in the gastrointestinal tract, color change language, decrease / increase in appetite, dysgeusia, increase in liver transaminases.
From the nervous system and sensory organs: headache, dizziness, fatiguability, malaise, asthenia, insomnia, nervousness, hallucinations, depression, excitation, convulsions, hyperkinesia, tremor, paraesthesia, pain and tinnitus, blurred vision, sore eyes.
Cardio-vascular system and blood (hematopoiesis, hemostasis): gipotenziya, tachycardia, bradycardia, arrythmia, cyanosis, progression of heart failure and angina, myocardial infarction, pulmonary embolism, cerebrovascular disorders, miokardiopatija, phlebitis, thrombocytopenia, purpura, increased fibrinolysis, nose bleed, lymphadenopathy.
From the respiratory system: dyspnoea, respiratory infections, bronchospasm, cough, increased secretion of mucus, flu-like symptoms.
On the part of the musculoskeletal system: leg cramps, arthralgia, myalgia, vasculitis, pain in the back and chest.
With the genitourinary system: glomerulonephritis, dizurija, polyuria, anurija, albuminuria, kristallurija, hematuria, strangury, tenesmus, swelling, women have vaginitis, leykoreya, intermenstrual bleeding, pain in the perineum, vaginal candidiasis, men-Orchitis, epididymitis.
Allergic reactions: itching, hives, photosensitivity, malignant exudative erythema.
Other: flushing, increased sweating, chills, thirst, gipoglikemiâ, gout, candidiasis, superimposed infection.
Eye drops: burning sensation in the eyes after instillation; with long-term use is the development of a secondary fungal infection.
Cooperation.
It increases the activity of oral anticoagulants and increases the toxicity of NSAIDs. Antacids and sucralfate slow down absorption and reduce bioavailability (chelate compounds) — should not take antatsida and sukralfat during 4 hour before and 2 hours after administration of lomefloxacin. Vitamins with mineral supplements should be used for 2 hours before or after 2 hours after administration of lomefloxacin. Probenecid reduces renal excretion. In the treatment of tuberculosis patients lomefloksatsin used in conjunction with isoniazid, pirazinamidom, streptomycin and ethambutol (not recommended combination with rifampicin-antagonism). PM, block tubular secretion, slows down. No cross-resistance with penicillins, cephalosporins, aminoglikozidami, co-trimoxazole, metronidazolom. Do not have a material effect on the clearance of theophylline and caffeine.
Overdose.
Treatment: simptomaticheskaya therapy. Hemodialysis and peritoneal dialysis are ineffective.
Dosing and Administration.
Inside, the dosage regimen and duration of treatment are determined individually depending on indications, disease severity and susceptibility. Adults 400 mg (to 600-800 mg), 1 once a day. In normal infections urinary tract- 400 mg / day for 3-5 days, complications infections urinary tract- 400 mg / day for 10-14 days; for prevention of infectious and inflammatory diseases of the urinary tract with transuretralnah transactions — once for 2-6 hours before the operation. In purulent infections of soft tissue and infected wounds — 400 mg / day days 5-14; If chlamydial infection in patients of rheumatism — 400 mg / day 20 days; in acute gonoree- 600 mg dose, in chronic gonoree- 600 mg for 5 days (against the background of specific immunotherapy); urogenital chlamydiosis 400-600 mg / day, duration of the course is to 28 days. After chronic osteomielite-400-800 mg/day 3-8 weeks. When TB is on 200 mg 2 twice a day for 14-28 days, and more; Ostrom at neoslozhnennom bronchi, bronchopneumonia- 400 mg / day for 10 days, When complicated by pneumonia and acute chronic bronchitis-400-800 mg/day to 14 days. With mycoplasmal infection- 600 mg / day to 10 days.
If the kidney function dose is determined depending on Cl creatinine: if Cl creatinine <30 ml / min and patients, hemodialysis, the initial dose - 400 mg/day, followed by a decline to 200 mg / day.
Locally, adult, instilled into the conjunctival sac 1 drop 2-3 times per day for 7-9 days; at the beginning of treatment requires more frequent instillation — 5 drops during 20 m (by 1 drop at intervals of 5 m) or 1 drop per hour for 6-10 h.
Precautions.
During treatment should avoid sunlight and UV radiation (evening reception reduces the risk of reaction to UV radiation). At the first sign of photosensitivity (increased sensitivity of the skin, burn, redness, edema, blisters, rash, itching, dermatitis) or hypersensitivity, neurotoxicity (excitation, convulsions, tremor, photophobia, confusion, toxic psychosis, hallucinations) therapy should be discontinued. May cause drowsiness and dizziness, that should be considered when handling potentially dangerous machinery and operating a vehicle. For the prevention of candidiasis simultaneously with lomefloxacin prescribe Nystatin or levorin.
In the treatment of eye drops should avoid wearing contact lenses.
