Antibacterial agents. The drug "Levomycetin": what helps, instructions for use, composition and reviews Levomycetin spray instructions for use

Instructions for use:

Levomycetin is an antibacterial drug used to treat infectious diseases. Widely used in ophthalmology and pediatrics.

pharmachologic effect

Levomycetin is a broad-spectrum antibiotic.

The active substance of Levomycetin effectively affects many gram-positive and gram-negative bacteria, as well as pathogens of meningococcal infection, purulent infections, dysentery, typhoid fever.

Levomycetin is indicated in the treatment of diseases caused by hemophilic bacteria, chlamydia, rickettsia, brucella, spirochetes. At therapeutic concentrations, Levomycetin has a bacteriostatic effect.

According to the instructions, Levomycetin is weakly active against Pseudomonas aeruginosa, acid-fast bacteria, clostridia and protozoa. Drug resistance to Levomycetin develops relatively slowly, but usually there is no cross-resistance to other chemotherapy drugs.

With topical application of Levomycetin, a therapeutic concentration is created in the iris, cornea, vitreous body, aqueous humor, while Levomycetin does not penetrate into the lens.

Levomycetin according to the instructions is quickly and well absorbed both after oral administration and with rectal administration, reaching a maximum concentration in the blood after a few hours.

Penetrating into the organs, fluids and tissues of the body, Levomycetin penetrates well into the cerebrospinal fluid, as well as into mother's milk.

Release form

Levomycetin is produced in the form of:

• Yellowish round tablets Levomycetin containing 0.5 g and 0.25 g of the active ingredient Levomycetin. Auxiliary substances - stearic acid or calcium stearate, potato starch;
• Powder for solution for injection. Each vial contains 500 or 1000 mg of active ingredient;
• Eye drops (0.25% solution). 1 ml of the drug contains 2.5 mg of active ingredient. In dropper bottles of 5 and 10 ml.

Indications for the use of Levomycetin

Levomycetin is used for:

• persiniosis;
• Generalized forms of salmonellosis;
• Paratyphoid;
• Tularemia;
• Rickettsiosis;
• brucellosis;
• Typhoid fever;
• meningitis;
• Chlamydia.

In infectious diseases of another etiology, which are caused by pathogens sensitive to the drug, Levomycetin is indicated for the ineffectiveness of other chemotherapeutic agents or in cases where their use is not possible due to individual intolerance.

In ophthalmology, Levomycetin is indicated for the prevention and treatment of infectious eye diseases:

• Blepharitis;
• conjunctivitis;
• Keratitis.

Contraindications

According to the instructions, the use of Levomycetin is contraindicated in:

• Individual intolerance to the active substance;
• Various skin diseases, including psoriasis, fungal infections, eczema;
• Inhibition of hematopoiesis.

According to the instructions, Levomycetin is not used during pregnancy, in newborns, and also during lactation.

Levomycetin for children and adults should not be prescribed for angina, acute respiratory diseases, as well as for prophylactic purposes and for mild forms of infectious processes.

Levomycetin can not be administered simultaneously with:

• Sulfonamides;
• Difenin;
• Butamid;
• Cytostatics;
• Pyrazolone derivatives;
• Neodicoumarin;
• barbiturates.

Instructions for use Levomycetin

In tablets, Levomycetin is taken orally half an hour before meals.

Usually, adults take 1-2 tablets of Levomycetin (0.25 g each) 3-4 times a day, but not more than 2 g of the drug per day. In especially severe cases, the maximum dose may be 4 g, divided into 3-4 doses, under strict control of liver and kidney function and blood status.

A single dose of Levomycetin for children under 3 years old is calculated based on weight - 10-15 mg per 1 kg, children 3-8 years old - 0.15-2 g, older children - 0.2-0.3 mg per 1 kg masses.

A single dose of Levomycetin is taken by children from 3 to 4 times a day, depending on the course of the disease.

The duration of the course of treatment with Levomycetin according to the instructions is 7-10 days, and in some cases, with good tolerance of the drug and the absence of side effects, up to two weeks.

A solution prepared from a powder is used for intravenous and intramuscular administration. For children, Levomycetin is prescribed only intramuscularly, for which the contents of the vial are dissolved in 2-3 ml of water for injection. In case of diabetes mellitus for intravenous injection, the contents of the vial are dissolved in 10 ml of water for injection. Injections are carried out at regular intervals. The duration of the course of treatment with Levomycetin and doses are determined individually.

Adults are usually prescribed 2-3 times a day for 500-1000 mg of Levomycetin, and in severe infections the dose can be doubled, but not more than 4000 mg per day.

In ophthalmology, the prepared solution is used for instillations or parabulbar injections, instilling a few drops of a 5% solution of Levomycetin into the conjunctival sac from 3 to 5 times a day. The duration of the course is usually from 5 to 15 days.

Description of side effects of Levomycetin and reviews

According to the description and reviews, when using Levomycetin, various side effects may occur:

• Thrombocytopenia;
• Leukopenia;
• reticulocytopenia;
• Allergic reactions manifested as skin rashes;
• Cytoplasmic vacuolization of early erythrocyte forms;
• Decrease in the level of hemoglobin in the blood.

Usually these side effects are reversible and disappear on their own after the abolition of Levomycetin.

Also, according to the instructions and reviews Levomycetin can cause:

• confusion;
• Decreased visual acuity and hearing;
• psychomotor disorders;
• Visual and auditory hallucinations;
• Dyspeptic symptoms - vomiting, nausea or loose stools.

When Levomycetin is used in infants, in rare cases, cardiovascular collapse may develop.

Storage conditions

The shelf life of tablets is 3 years, the powder for solution for injection is 4 years, eye drops are 2 years, while the opened vial can be stored for no more than a month.

Modern pharmacology knows many different antibacterial drugs. There are many nuances in the use of such funds. Therefore, the intake of each antibiotic should be discussed with the doctor. In accordance with your complaints and indications, the doctor will prescribe the most appropriate medicine, which will quickly put you on your feet. One of the well-known and long-studied antimicrobial agents is the drug "Levomitsetin". From what it helps, you will learn from today's article. Remember that the information studied is not a reason for self-treatment. Misuse of antibiotics leads to the development of adverse reactions.

Forms of release of the drug and its preliminary characteristics

Before you find out for what purpose Levomycetin is prescribed to patients, what it helps with and in what doses it is used, you need to find out something important about the medication. The active ingredient of the antibiotic is chloramphenicol. It is produced in several forms. Depending on the type of drug, it contains additional components. Let's see which ones.

• Eye drops: boric acid and water for injection.
• Capsules: gelatin shell.
• Ointment: methyluracil and polyethylene oxide.
• External solution: alcohol base.
• Tablets: do not have auxiliary components.
• Powder for internal use: no additional substances until it is diluted.

The drug "Levomitsetin" from what helps? Instructions for use says that this tool refers to broad-spectrum antibiotics. The drug effectively copes with pathogenic microorganisms: gram-positive and gram-negative bacteria. It is effective against purulent and meningococcal infections, is able to eliminate intestinal diseases (typhoid fever, dysentery). The drug helps against Pseudomonas aeruginosa and bacteria resistant to other antibiotics, but rather weakly. After application, it is distributed over the tissues, effectively acting in them after a few hours.

Indications for the use of the drug "Levomycetin"

Do not recommend using "Levomitsetin" on its own instructions for use. Tablets, drops, products for internal and external use should be prescribed to you by a specialist. Indications for this may be as follows: purulent otitis media, meningitis, brain abscess, ENT infections, diseases of the lower respiratory tract, digestive tract, urogenital area. A medication is used in ophthalmology for bacterial eye lesions. It is used in dermatology for infected wounds, burns, cracks in the skin. Depending on the type of pathology, a certain type of drug is prescribed. The medicine effectively copes with its task only with the right dosage and form of application.

Contraindications that every consumer should be aware of

"Levomitsetin" from what helps, you already know. But this is not enough. If you have indications for use, then you should not immediately grab an antibiotic. It is important to take into account the limitations. They are always prescribed in the instructions - read. If you have contraindications, then treatment with Levomycetin is unacceptable. See your doctor for a replacement. It is forbidden to use the medication in the following cases:

• with high sensitivity, an allergic reaction to the active substance or additional components (the composition of a particular agent is always prescribed at the beginning of the attached insert);
• with certain diseases of the skin and mucous membranes caused by sensitive microbes (eczema, psoriasis);
• with blood diseases and oppression of hematopoiesis;
• with acute respiratory infection caused by viruses, tonsillitis;
• if you have serious liver disease;
• with renal failure;
• during pregnancy and breastfeeding.

"Levomitsetin" should not be given to newborn children. Also, do not use the medication for the purpose of prevention or for uncomplicated bacterial infections, when you can replace the medicine with a less strong one.

Eye drops

If you have been prescribed Levomycetin (drops), the application should be carried out strictly according to the instructions. The medication is applied to the conjunctival sac one drop two to four times a day. The frequency of use is set by the doctor, and depends on the severity of the disease. Independent use of the medication obliges you to limit therapy to three days. During this time, find an opportunity to see a doctor and get individual recommendations.

After applying the drug, the concentration of the active substance is created in the cornea, as well as in the aqueous humor and vitreous body. The main component does not penetrate the lens. "Levomitsetin" (drops) for children should not be used in the first months of life, especially in premature babies. The liver in newborns is still insufficiently functioning, which can lead to the accumulation of a toxic volume of the active substance.

"Levomitsetin" (tablets): what helps?

The instruction says that this medicine is used for various infections provoked by susceptible microorganisms. It is this form that is prescribed by doctors more often than others. About Levomycetin tablets, consumer reviews said that it is possible to purchase the drug at a dose of 500 and 250 mg. Indeed, the manufacturer produces an antibiotic in two forms. Tablets are often used for intestinal diseases. They also help with chlamydia, trachoma, pneumonia, bacterial diseases of the biliary tract, sepsis. Instructions for use recommends taking an antibiotic in the form of tablets and capsules half an hour before a meal. If the patient has vomiting, then the medication should be taken 1-2 hours after eating. Multiplicity of application - from three to four times a day. The dosage for adults is 1 tablet per dose. The daily portion should not exceed 2 grams, and in severe infections - 4 grams. Both forms of medication are contraindicated for children.

outdoor use

Levomycetin is produced in the form of a gel (it is also sometimes called an ointment) and an alcohol solution. These preparations are intended for external use. The gel is applied to the skin, damaged by a bacterial infection, as well as purulent wounds and burns. The medicine effectively copes with such pathologies, contributing to the speedy healing of the skin. Ointment is sometimes used in ophthalmic practice. Do not use this type of medication in children under the age of one month.

"Levomitsetin" - reviews report - can be used in liquid form. An alcohol solution is applied to the skin for the treatment of trophic ulcers, boils. This remedy is also prescribed in order to get rid of cracks in the nipples in nursing mothers. The affected area is treated with a solution, after which it is covered with a gauze bandage. If necessary, sterile swabs are moistened and applied as a compress. Some sources say that the alcohol solution is taken orally for certain indications. The drug in the form of an alcohol solution treats otitis media.

Solution for internal administration

In the pharmacy, you can also buy medicine for internal administration. It is in the form of a powder. Previously, the agent is diluted with a solvent prescribed by a doctor. The dosage depends on the nature of the pathology and the age of the patient. Adults are prescribed 500 or 1000 mg of the active substance 2-3 times a day. The daily rate of the drug should not exceed four grams. Children are injected with 12.5 to 25 milligrams for every kilogram of weight. The medicine is applied with a break of 6-12 hours. The duration of therapy is 8-10 days. It is permissible to administer the drug in several ways: intravenously, drip or intramuscularly. Be sure to follow the rules of asepsis.

Side effects that the medicine provokes

You already know the purpose for which "Levomitsetin" tablets are used (from which they help). The instruction warns that the medication can provoke unpleasant consequences. Among the adverse reactions, digestive disorders are most often noted. The antibiotic disrupts the intestinal microflora, which provokes diarrhea, bloating, pain, and vomiting.

The drug is able to change blood counts. It provokes leukopenia, thrombocytopenia, anemia and some other diseases. Also, the drug can affect the nervous system, which is manifested by headache, depression, hallucinations and agitation. An antibiotic sometimes causes an allergic reaction. If you notice any side effects, you should stop treatment and immediately consult a doctor.

additional information

Since the drug affects the process of hematopoiesis, it should not be used simultaneously with drugs of this kind. Simultaneous use with other antibiotics can inhibit the action of each other, in addition, the toxic effect on the liver will be stronger. The use of large doses of the drug is manifested by signs of intoxication: pale skin, vomiting, headache, lethargy. The use of the declared antibiotic in pediatrics is not welcome, as there is a risk of serious consequences. The medicine is given to children only according to indications. It is necessary to store the medicine in accordance with the rules prescribed in the instructions. Pay attention to the ophthalmic "Levomycetin". Eye drops do not allow long-term use. 15 days after opening, the vial must be disposed of.

Summarize

The medicine "Levomitsetin" is a highly effective and affordable drug. This medicine is non-prescription. But this does not mean that you can use it thoughtlessly. Check with your doctor before starting therapy. Strictly follow the recommendations and appointments received. Good luck!

Levomycetin is a drug (tablets) that corresponds to the group of antimicrobials for systemic use. Important features of the drug from the instructions for use:

• Sold by prescription only
• During pregnancy: contraindicated
• When breastfeeding: contraindicated
• In childhood: contraindicated
• For violations of liver function: contraindicated

Package

Compound

The active substance of Levomycetin in all its forms is chloramphenicol, a substance that belongs to the amphenicol group of antibiotics.

Drops in the eyes contain chloramphenicol at a concentration of 2.5 mg / ml.

Possible dosages of the active substance for capsules and tablets are 250 and 500 mg, for prolonged-release tablets - 650 mg (the tablets have 2 layers - the outer contains 250, the inner contains 400 mg of chloramphenicol).

Alcoholic solution of Levomycetin is available in a concentration of 0.25; 1, 3 and 5%. Ointment Levomycetin can have a concentration of 1 or 5%.

Preparations from different manufacturers have a different composition of auxiliary components.

All variants of the same drug produced by pharmaceutical companies in the post-Soviet countries differ slightly, since they use the same technology for producing chloramphenicol. Thus, Levomycetin DIA eye drops do not differ from drops produced, for example, by Belmedpreparaty.

Release form

• eye drops 0.25% (ATX code S01AA01);
• liniment 1%, 5%;
• alcohol solution 1%, 3%, 5% and 0.25% (ATC code D06AX02);
• tablets and capsules 250 and 500 mg, prolonged-release tablets 650 mg (ATX code J01BA01).

pharmachologic effect

Antibacterial. The drug stops inflammation and cures infections of any tissues and organs, provided that they are caused by microflora sensitive to chloramphenicol.

Pharmacodynamics and pharmacokinetics

Levomycetin is an antibiotic or not? An antibiotic of synthetic origin, which is identical to the product produced by the microorganisms Streptomyces venezuelae in the course of their vital activity.

Chloramphenicol is detrimental to most gram (+) and gram (-) bacteria (including strains that are resistant to the action of sulfonamides, streptomycin and penicillin), spirochetes, rickettsia, and certain large viruses.

Shows low activity against Clostridium, Pseudomonas aeruginosa, acid-fast bacteria and protozoa.

The mechanism of action of the drug is associated with the ability of chloramphenicol to disrupt the synthesis of proteins of microorganisms. The substance blocks the polymerization of activated amino acid residues that are associated with mRNA.

Microbial resistance to chloramphenicol develops relatively slowly; cross-resistance to other chemotherapy drugs, as a rule, does not occur.

When applied topically, the required concentration is created in aqueous humor, vitreous body fibers, cornea and iris. The drug does not penetrate the lens.

Pharmacokinetic parameters when taking chloramphenicol orally:

• absorption - 90%;
• bioavailability - 80%;
• the degree of binding to plasma proteins - 50-60% (in those born before the expected
• term of babies - 32%);
• Tmax - from 1 to 3 hours.

Therapeutic concentration in the bloodstream is maintained for 4-5 hours after oral administration. About a third of the dose taken is found in bile, the highest concentration of Levomycetin is created in the kidneys and liver.

The drug is able to pass the placental barrier, its serum concentration in the fetus can reach 30-80% of the serum concentration in the mother. Penetrates into milk.

Biotransformirovatsya mainly in the liver (90%). Under the influence of the normoflora of the intestine, it undergoes hydrolysis with the formation of inactive metabolites.

The elimination time is 24 hours. It is excreted mainly by the kidneys (90%). With the contents of the intestine, from 1 to 3% is excreted. T1 / 2 for an adult - from 1.5 to 3.5 hours, in children 1-16 years old - from 3 to 6.5 hours, in children 1-2 days after birth - 24 hours or more (with low weight body is longer), on the 10th-16th day of life - 10 hours.

Hemodialysis undergoes little.

Indications for use: what are tablets, eye solution and external therapy used for (liniment and alcohol solution)

What does the medicine help? Levomycetin is prescribed for diseases that provoke antibiotic-sensitive microbes: shigella, salmonella, streptococci, staphylococci, strains of Proteus, Neisseria, rickettsia, chlamydia, leptospira, Klebsiella and a number of other microorganisms.

The drug is available in several dosage forms. This allows you to deliver chloramphenicol directly to the lesion and in the concentration necessary for cure.

Indications for the use of Levomycetin in the form of liniment and solution:

• bacterial infections of the skin, provided that they are caused by microflora sensitive to chloramphenicol;
• trophic ulcers;
• bedsores;
• boils;
• wounds;
• infected burns;
• nipple cracks that occur during breastfeeding.

An alcohol solution in the ears is prescribed to be administered with purulent otitis media.

Why Levomycetin tablets?

Tableted forms should be used for infections of the biliary and urinary tract caused by microflora sensitive to the drug, generalized forms of salmonellosis, paratyphoid, typhoid fever, yersiniosis, rickettsiosis, brucellosis, dysentery, tularemia, meningococcal infection, brain abscess, chlamydia, trachoma, purulent wound infection, inguinal lymphogranuloma, purulent peritonitis, ehrlichiosis.

What are Levomycetin drops from?

Levomycetin (eye drops) is prescribed to treat the following types of bacterial eye infections:

• scleritis and episcleritis;
• conjunctivitis and keratoconjunctivitis;
• blepharitis;
• keratitis.

The use of the drug is ineffective if these diseases are caused by fungi, viruses and microbes that are resistant to the action of chloramphenicol.

Contraindications

The annotation states that contraindications to the use of Levomycetin are:

• hypersensitivity;
• depression of bone marrow hematopoiesis;
• acute intermittent (intermittent) porphyria;
• G6PD enzyme deficiency;
• renal/liver failure.

External therapy agents are not applied to extensive granulating wound surfaces, as well as to skin that is affected by a fungal infection, eczema, or psoriasis.

For patients who have previously received cytostatic drugs or undergone radiation therapy, pregnant women, young children (especially the first 4 weeks of life), the drug is prescribed for health reasons.

Side effects

Side effects of Levomycetin systemic nature:

• disorders of the digestive system - nausea, diarrhea, dyspepsia, vomiting, irritation of the mucous membrane of the pharynx and oral cavity, dysbacteriosis;
• violations of hemostasis and hematopoiesis - reticulocyto-, leuko- and thrombocytopenia, agranulocytosis, hypohemoglobinemia, aplastic anemia;
• sensory and nervous system disorders - depression, optic neuritis, mental and motor disorders, headache, impaired consciousness and / or taste, hallucinations (auditory or visual), delirium, decreased visual acuity / hearing;
• hypersensitivity reactions;
• attachment of a fungal infection;
• dermatitis;
• cardiovascular collapse (usually in children of the first year of life).

When using eye drops, liniment and alcohol solution, local allergic reactions are possible.

Instructions for use Levomycetin

Eye drops Levomycetin: instructions for use

Eye drops Levomycetin (DIA, Akri, AKOS, Ferein) are introduced into the conjunctival sac of each eye, one 3-4 rubles / day. The course of treatment usually lasts from 5 to 15 days.

When using the drug, you should tilt your head back, gently pull the lower eyelid towards the cheek so that a cavity forms between the skin and the surface of the eye, and, without touching the eyelid and the surface of the eye with the tip of the dropper bottle, add 1 drop of medicine into it.

After instillation, the outer corner of the eye is pressed with a finger and does not blink for 30 seconds. If you can’t blink, do it as carefully as possible so that the solution does not spill out of the eye.

For children in the neonatal period (the first 28 days after birth), the drug is used for health reasons.

With purulent otitis media, the drug is injected into the ear 1-2 rubles / day. 2-3 drops. With significant discharge from the ear canal, which wash off the applied solution, Levomycetin can be used up to 4 rubles / day.

Eye drops for barley

The use of chloramphenicol in barley in combination with boric acid, which is part of the solution as an auxiliary component, helps prevent infection of the conjunctiva and the development of complications after opening the abscess, accelerates the ripening of barley, partially relieves redness and reduces the intensity of pain, reduces the time by 2-3 days convalescence.

Treatment is carried out simultaneously for both the patient and the healthy eye. The agent should be instilled 1-2 drops 2-6 rubles / day. With severe pain, Levomycetin can be instilled every hour.

Levomycetin tablets: instructions for use

Tablets and capsules are taken, depending on the indications, 3-4 rubles / day. A single dose of Levomycetin in tablets / capsules for an adult is 1-2 tab. 250 mg. The highest dose - 4 tab. 500 mg per day.

In especially severe cases (for example, with peritonitis or typhoid fever), the dose may be increased to 3 or 4 g / day.

Duration of application - no more than 10 days.

Levomycetin is often used for diarrhea that occurs when food is poisoned, as well as in cases where intestinal upset is the result of a bacterial infection.

Levomycetin tablets for diarrhea are taken before meals, one every 4-6 hours. The highest dose is 4 g / day. If after taking the first 500 mg tablet the disorder has stopped, the second one should no longer be taken.

How to take Levomycetin for cystitis

With cystitis, as a rule, tablets are used. In especially severe cases, the doctor may recommend injections of chloramphenicol (to prepare a solution, the powder is dissolved in water for injection or novocaine) or a jet infusion of chloramphenicol on glucose into a vein.

Unless otherwise indicated, cystitis tablets should be taken at the standard dosage every 3-4 hours.

Instructions for alcohol solution

The solution is intended for lubrication of the affected skin surface or for use under an occlusive dressing.

The duration of treatment depends on the course of the pathological process, its severity and the effectiveness of therapeutic measures.

Cracked nipples should be treated with a 0.25% solution after each feeding. Treatment continues no more than 5 days.

Instructions for liniment

Liniment is applied to the burned skin or wound surface after purulent exudate and dead tissue are removed from it. Before treatment, the wound should also be washed with an antiseptic: 0.01% miramistin solution, 0.05% chlorhexidine bigluconate solution, 3% hydrogen peroxide solution or 0.02% furatsilina aqueous solution.

The ointment is applied to the affected area with a thin layer and then covered with a sterile bandage. You can also soak a sterile gauze cut with the drug and fill the wound with it or cover the burn surface.

In the treatment of wounds, liniment is used 1 rub/day, in the treatment of burns - 1 rub/day. or 2-3 rubles / week, depending on how abundantly purulent exudate is released.

In the treatment of bacterial infections of the skin, Levomycetin is applied to the lesions (after they have been pre-treated) 1 or 2 rubles / day, in a thin layer and without a bandage, if possible, rubbing the medicine until completely absorbed into the affected skin and capturing small areas of healthy skin around the pathological focus.

Wet areas before using the product are dried with a gauze napkin.

In cases where Levomycetin is used under a bandage, it is applied 1 p. / Day.

Single dose - 250-750 mg, daily - 1-2 g of chloramphenicol. For a course of treatment of a patient weighing 70 kg, up to 3 kg of the drug should be consumed.

On the cracks of the nipples, the ointment is applied in a thick layer on a sterile napkin.

Levomycetin for acne

What is Levomycetin? Antibacterial drug. The ability to quickly suppress infectious and inflammatory processes allows the use of a remedy (tablets and alcohol solution) for acne.

For skin problems, a 1% solution is usually recommended. The medicine is applied pointwise so as not to dry out the skin and not provoke the appearance of microbes resistant to chloramphenicol, which in the future can cause the appearance of purulent acne that is difficult to treat.

The solution is used from the moment the pimple appears until it disappears. It is important to remember that the remedy is not intended for prophylactic use.

Chloramphenicol is often used in combination with other treatments to treat acne and red, inflamed pimples.

The most popular are the following acne talkers with Levomycetin:

• Aspirin, Levomycetin and calendula tincture. Acetylsalicylic acid (aspirin) and chloramphenicol are taken 4 tablets each and, after grinding them into powder, pour 40 ml of calendula tincture.
• Boric acid, Levomycetin, salicylic acid and ethyl alcohol. To prepare the medicine, the ingredients are mixed in the following proportion: 5 ml of a two percent solution of salicylic acid, boric acid and alcohol - 50 ml each, Levomycetin - 5 g.
• Salicylic acid, streptocide, camphor alcohol, Levomycetin in the following proportion: 30 ml (2% solution) / 10 tablets / 80 ml / 4 tablets.

Reviews allow us to conclude that these remedies are very effective if acne is single, but if the problem is more extensive, it is necessary first of all to eliminate its cause from the inside.

Overdose

Severe complications from hematopoiesis are usually associated with the use for a long time of doses exceeding 3 g / day. Symptoms of chronic intoxication: pale skin, hyperthermia, sore throat, hemorrhage and bleeding, fatigue or weakness.

Treatment with high doses of newborns can provoke the development of a cardiovascular (“gray”) syndrome, the main features of which are:

• change in skin color to bluish-gray;
• hypothermia;
• bloating;
• vomit;
• lack of nervous reactions;
• violation of the rhythm of breathing;
• acidosis;
• circulatory collapse;
• cardiovascular insufficiency;
• coma.

In 2 out of 5 cases, the patient dies. The cause of death is the accumulation of the drug in the body due to the immaturity of liver enzymes and the direct toxic effect of floramphenicol on the myocardium.

Cardiovascular syndrome manifests itself when the plasma concentration of chloramphenicol exceeds 50 mcg / ml.

Treatment involves gastric lavage, the use of saline laxatives, enterosorbents, cleansing enema. In severe cases, hemosorption and symptomatic therapy are indicated.

High doses of eye drops may cause temporary visual impairment. If the dose is exceeded, rinse the eyes with running water.

An overdose of external therapy agents may be accompanied by irritation of the skin and mucous membranes, as well as local hypersensitivity reactions.

Interaction

Interaction with topical application is not described.

Chloramphenicol enhances the effect of hypoglycemic drugs (by increasing their plasma concentration and suppressing their metabolism in the liver), as well as the effect of drugs that inhibit bone marrow hematopoiesis.

The drug prevents the manifestation of the bactericidal effect of penicillin. It weakens the metabolism of warfarin, phenobarbital and phenytoin, increasing their concentration in the blood plasma and slowing down their excretion.

In combination with clindamycin, erythromycin and lincomycin, the drugs mutually weaken each other's action.

To prevent an increase in the inhibitory effect on hematopoiesis, chloramphenicol should not be used in conjunction with sulfanilamide drugs.

Terms of sale

Liniment and alcohol solution belong to the group of over-the-counter products. To purchase tablets and eye drops, you need a prescription from a doctor.

Storage conditions

Eye drops, alcohol solution, tablet forms should be stored at temperatures up to 25 ° C, liniment - at a temperature of 15-25 ° C.

Shelf life

For tablet forms - 5 years, for liniment - 2 years, for an alcohol solution - 1 year, for eye drops - 2 years (within 15 days after opening the original package).

special instructions

The State Pharmacopoeia states that chloramphenicol is white/white with a greenish-yellow tinge, bitter in taste and odorless crystalline powder. The substance is poorly soluble in water and readily soluble in 95% alcohol. Almost insoluble in chloroform.

The gross formula of the substance is C₁₁H₁₂N₂O₅Cl₂.

Is it possible to use drops in the nose and in the ear?

In practice, eye drops are used in practice for bacterial rhinitis, in the ear - for purulent otitis media.

Despite the fact that the use of the drug for other purposes cannot be considered correct, such treatment does help in some cases.

Most often, eye forms with a runny nose are prescribed to babies who still do not know how to blow their nose on their own: a large amount of mucus with bacteria, if it enters various sinuses, can provoke complications such as sinusitis or sinusitis.

Despite the fact that the use of Levomycetin drops in infants can dry the mucosa and reduce the flow of snot, it has been proven that topical antibiotics often do not effectively fight a bacterial infection.

If we talk about the treatment regimen according to the “off-label prescription” principle (not for the intended purpose), then Levomycetin is instilled into the ear 3-4 drops, into the nose - 1-2 drops. Treatment lasts from 5 to 10 days. Multiplicity of procedures - 1-2 per day.

Before you make the drug in the nose, you must first drip a vasoconstrictor. Before applying to the ear, the external auditory canal should be cleaned of pus.

Application in veterinary medicine

In veterinary practice, Levomycetin is used for colibacillosis, salmonellosis, leptospirosis, dyspepsia, colienteritis, coccidosis and pullorosis of chickens, infectious laryngotracheitis and mycoplasmosis of birds, urinary tract infections and bronchopneumonia.

The dose for farm animals, as well as for cats and dogs, is selected depending on the weight and severity of the disease.

How to give chickens the drug? To avoid the mass death of chickens from an intestinal infection, they are given 1 tablet of Levomycetin 2 times a day with food for 3-5 days. This dosage is calculated for 15-20 chicks.

Analogues

Preparations with the same active ingredient: Levomycetin Aktitab, Levomycetin sodium succinate.

Analogues according to the mechanism of action:

• for Levomycetin tablets - Fluimucil;
• for solution and ointment Levomycetin - aerosol Levovinizol (generic), Bactroban, Baneocin, Gentamicin, Lincomycin, Synthomycin, Fucidin, Fusiderm, Neomycin.

Levomycetin eye drops can be replaced with drugs: Levomycetin-DIA, Levomycetin-AKOS, Levomycetin-Akri.

Which is better - Levomycetin or Albucid?

Wikipedia states that Albucid (sulfacetamide) is an antimicrobial bacteriostatic agent from the group of sulfonamides.

The drug is used in ophthalmology for the treatment of bacterial keratitis, purulent ulcers of the cornea, blepharitis, conjunctivitis, chlamydial and gonorrheal diseases in adults, as well as blenorrhea in newborn babies.

Albucid, unlike Levomycetin, causes severe eye irritation.

The use of Levomycetin for children

The use of Levomycetin tablets in pediatrics

Tableted forms of the drug in pediatrics are used under constant monitoring of the serum concentration of chloramphenicol. Depending on age, the dose of Levomycetin tablets for children ranges from 25 to 100 mg / kg / day.

For newborn infants under the age of 2 weeks (including premature infants), the formula for calculating the daily dose is as follows: 6.25 mg / kg for each dose with a frequency of applications up to 4 rubles / day.

For infants older than 14 days, 12.5 mg / kg is prescribed for 1 dose every 6 hours or 25 mg / kg every 12 hours.

In severe infections (for example, meningitis), the dose is increased to 75-100 mg / kg / day.

How to take Levomycetin for diarrhea?

The drug is a fairly serious remedy and therefore should be prescribed by a doctor. However, it is often given to children when needed to relieve an intestinal disorder.

As a rule, the dose for children 3-8 years old is from 375 to 500 mg / day. (125 mg per 1 dose), for children 8-16 years old - 750-1000 mg (250 mg per 1 dose).

With diarrhea, a single use of the drug is allowed. If the child's condition does not improve, and the symptoms persist even 4-5 hours after taking the pill, you should consult a therapist.

Eye drops Levomycetin for children

Eye drops for newborns (in the first 4 weeks after birth) are used only for health reasons.

Levomycetin eye drops for infants are also used with caution. As a rule, an antibiotic is instilled 1 drop into the conjunctival sac of each eye every 6-8 hours.

The use of external therapy in children

The solution is not intended for the treatment of children under 1 year old, liniment is not used to treat premature and newborn babies.

Levomycetin and alcohol

Alcohol and chloramphenicol are incompatible. With simultaneous use with ethanol, there is a high risk of developing a disulfiram-like effect, which is manifested by tachycardia, flushing of the skin, nausea and vomiting, reflex cough, convulsions.

Levomycetin during pregnancy

Levomycetin for external and systemic use is contraindicated in pregnancy. If the drug is prescribed to a nursing woman, the child must be transferred to artificial feeding for the duration of treatment.

If indicated, eye drops can be used in pregnant women and during lactation, however, provided that the dosages recommended by the instructions are not exceeded.

Description

Tablets are white or white with a yellowish tint, scored* and chamfered.

*The notch is designed to divide the tablet to make it easier to swallow.

Compound

Each tablet contains:

active substance: chloramphenicol - 500 mg;

Excipients: povidone K-25, calcium stearate, potato starch.

Pharmacotherapeutic group

Antibacterial agents for systemic use. Amphenicols.

ATS code: J01BA01.

pharmachologic effect

A broad-spectrum bacteriostatic antibiotic that disrupts the process of protein synthesis in a microbial cell at the stage of transferring t-RNA amino acids to ribosomes. Effective against strains of bacteria resistant to penicillin, tetracyclines, sulfonamides. Active against many gram-positive and gram-negative bacteria, pathogens of purulent, intestinal infections, meningococcal infections: Escherichia coli, Shigella dysenteria, Shigella flexneri spp., Shigella boydii spp., Shigella sonnei, Salmonella spp.(incl. Salmonella typhi, Salmonella paratyphi), Staphylococcus spp., Streptococcus spp.(incl. Streptococcus pneumoniae), Neisseria meningitidis, Neisseria gonorrhoeae, a number of strains Proteus spp., Burkholderia pseudomallei, Rickettsia spp., Treponema spp., Leptospira spp., Chlamydia spp.(incl. Chlamydia trachomatis), Coxiella burnetii, Ehrlichia canis, Bacteroides fragilis, Klebsiella pneumoniae, Haemophilus influenzae. It does not affect acid-resistant bacteria (incl. Mycobacterium tuberculosis), anaerobes, methicillin-resistant strains of staphylococci, Acinetobacter, Enterobacter, Serratia marcescens,indole positive strains Proteus spp., Pseudomonas aeruginosa spp., protozoa and fungi. Microbial resistance develops slowly. Refers to reserve antibiotics and is used when other antibiotics are ineffective.

Indications for use

Severe, life-threatening infections caused by horamphenicol-susceptible organisms, especially haemophilus influenzae, and typhoid fever.

It is used as a reserve antibiotic in case of ineffectiveness or impossibility of using other antibacterial agents.

- Typhoid fever ( Salmonella Typhi);

– Paratyphoid A and B;

– Sepsis caused by salmonella;

- Meningitis caused by salmonella;

- Meningitis caused by Haemophilus influenzae;

– Purulent bacterial meningitis;

- Rickettsioses.

Dosage and administration

Doses:

adults (inclasstreating elderly patients): the generally recommended dose is 500 mg every 6 hours (50 mg/kg body weight per day in 4 divided doses). Treatment should be continued for another 2 or 3 days after normalization of body temperature. In severe infections (meningitis, sepsis), this dose may be doubled initially, but it should be reduced as soon as clinical improvement occurs.

Children over 6 years old: 50.0–100.0 mg/kg/day in 4 divided doses.

In children and elderly patients, it is necessary to control the concentration of chloramphenicol in the blood plasma. Recommended peak plasma concentration of chloramphenicol (approximately 2 hours after ingestion): 10–25 mg/l; . The "residual" concentration in the blood plasma before the next dose should not exceed 15 mg / l.

Mode of application: inside, 30 minutes before meals.

If you missland taking the drug, you must take the missed dose as soon as this omission has become noticed. However, ifdThis time of taking coincides with the next dose, do not take the missed dose againdwow. Take the drug in accordance with the recommended regimendozing without doubling the dose to make up for the missed dose.

Levomycetin tablet is notdis divided into parts, therefore, when neobthe use of chloramphenicol at a dose of less than 500 mg, it is recommended to use a medicinal mediumdstvodother productdtelator, providing the possibility of suchaboutPS

Side effect

Like all medicines, chloramphenicol can cause unwanted side effects.breactions, aboutdbut they don't happen to everyone.

The incidence of side effectsdena next yeardtions:

Rarely - may affect up to 1 in 1,000 people: reversible dose-dependent inhibition of bone marrow function and irreversible aplastic anemia, hypoplastic anemia, agranulocytosis.

Frequency unknown – ishodI'm fromthemeatingddata, the frequency of occurrence ofdit is impossible to eat: secondary fungal infection, reticulocytopenia, leukopenia, granulocytopenia, thrombocytopenia, erythrocytopenia, pancytopenia, increased bleeding time, hypersensitivity reactions (including allergic skin reactions), angioedema, in the treatment of patients with typhoid fever, the Jarisch-Herxheimer reaction may occur, psychomotor disorders, depression, confusion, peripheral neuritis, headache, optic neuritis, visual and auditory hallucinations, decreased visual acuity and hearing, acidosis cardiovascular collapse, dyspepsia, nausea, vomiting (the likelihood of development decreases when taken 1 hour after eating), diarrhea, irritation of the oral mucosa and pharynx, glossitis, stomatitis, enterocolitis, dysbacteriosis (suppression of normal microflora), paroxysmal nocturnal hemoglobinuria, fever, collapse (in children under 1 year old), "gray syndrome" of newborns *.

* "Gray syndrome" of newborns is accompanied by vomiting, bloating, respiratory disorders, cyanosis. In the future, vasomotor collapse, hypothermia, and acidosis join. The reason for the development of the "gray syndrome" of chloramphenicol, due to the immaturity of liver enzymes, the toxic effect on the myocardium. Lethality reaches 40%.

If you experience any adverse reactions, please consult your physician. Thisrecommendationcovers any possible adverse reactions, including those not listed in the leaflet.treasureabove. You can also reporteadverse reactions to the Adverse Reactions Database (Daystwiyam) to medicines, including reports of drug failurenny drugs. By reporting adverse reactions, you help to get more information about the safety of the drug.

Contraindications

Hypersensitivity to the active and auxiliary components of the drug, a history of toxic reactions to chloramphenicol, active immunization, oppression of bone marrow hematopoiesis, acute intermittent porphyria, glucose-6-phosphate dehydrogenase deficiency, liver and / or kidney failure, psoriasis, eczema, fungal skin diseases, prevention and treatment of mild infections, children under 6 years of age, pregnancy, lactation.

Chloramphenicol is contraindicated in patients taking drugs that can suppress bone marrow function.

Overdose

Levels of chloramphenicol above 25 µg/mL are considered toxic.

If more than 6 tablets are taken, gastric lavage should be performed and symptomatic treatment should be carried out. In case of severe overdose, such as "gray syndrome" in children, it is necessary to quickly reduce the concentration of chloramphenicol in blood plasma using hemoperfusion through ion exchange resins, which will significantly increase the clearance of chloramphenicol.

The most severe consequences of chloramphenicol poisoning can be in young children. With prolonged (exceeding the recommended time) intake in high doses - bleeding (due to depression of hematopoiesis or impaired synthesis of vitamin K by the intestinal microflora).

Treatment: there is no specific antidote. In case of a serious overdose of the drug, symptomatic therapy is recommended - the use of activated charcoal, hemoperfusion. In case of massive overdose, consider exchange transfusion.

Precautionary measures

During the period of treatment with chloramphenicol, alcohol is unacceptable: while taking alcohol, a disulfiram reaction may develop (skin hyperemia, tachycardia, nausea, vomiting, reflex cough, convulsions).

Severe complications from the hematopoietic system are associated with the use of large doses of chloramphenicol (more than 4000 mg / day) for a long time.

The use of the drug during active immunization is contraindicated.

Clostridiumdifficile-associated diarrhea (CDAD) has been reported to occur with the use of virtually all antibacterial agents, including chloramphenicol, and can range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal microflora of the colon, leading to overgrowth WITH. difficile.

WITH. difficile produces toxins A and B, which contribute to the development of diarrhea. Hypertoxin-producing strains WITH. difficile Because these infections may be refractory to antibiotic therapy and may require colectomy, CDAD should be suspected in all patients with antibiotic-induced diarrhea.

A careful history is necessary, as diarrhea may occur up to 2 months after the use of antibacterial drugs.

If CDAD is suspected or confirmed, continued use of non-targeted antibiotics WITH. difficile, must be terminated. Use appropriate fluids and electrolytes, protein supplements, antibiotics against WITH. difficile, surgical evaluation should be performed. Repeated courses of chloramphenicol treatment should be avoided. Treatment should not be carried out before the start of treatment and more than is really necessary.

An excessively high level of the drug in the blood can be observed in patients with impaired liver or kidney function. In such patients, the use of the drug is contraindicated.

The use of chloramphenicol, as with other antibiotics, may lead to overgrowth of non-susceptible organisms, including fungi. If infections caused by non-susceptible microorganisms occur during drug therapy, appropriate measures should be taken.

The use of chloramphenicol can cause severe blood disorders (aplastic anemia, bone marrow hypoplasia, thrombocytopenia, granulocytopenia). There are two types of bone marrow depression associated with the use of chloramphenicol. Mild bone marrow depression is usually observed, dose-dependent and reversible, which can be detected by early changes in blood tests. Very rarely there is a sudden fatal lesion of the bone marrow hypoplasia without previous symptoms. Baseline blood tests should be performed before starting treatment and approximately every two days during drug therapy. Chloramphenicol should be discontinued if reticulocytopenia, leukopenia, thrombocytopenia, anemia, or any other laboratory blood changes occur. However, it should be noted that such studies do not exclude the possible subsequent occurrence of irreversible bone marrow suppression. Concurrent use with chloramphenicol of other drugs that inhibit the function of the red bone marrow is contraindicated.

When using the drug in diabetic patients in tests for the presence of glucose in the urine, false positive results are possible.

Dentistry. The use of the drug leads to an increase in the frequency of microbial infections of the oral cavity, a slowdown in the healing process and bleeding of the gums, which may be a manifestation of myelotoxicity. Dental interventions should, if possible, be completed prior to initiation of therapy.

Previous treatment with cytostatics or radiation therapy. Possible accumulation of chloramphenicol and toxic reactions in the form of bone marrow suppression, impaired liver function.

Geriatric use. Features of use in the elderly have not been sufficiently studied due to the small number of people aged 65 years and older who participated in clinical trials. There are clinical studies showing no difference in therapeutic response to drug treatment between elderly and young patients. However, dose selection for elderly patients should be cautious, usually starting at the lower end of the dosing range. The drug is substantially excreted through the kidneys and the risk of developing toxic reactions may be higher in patients with impaired renal function. Since elderly patients are more likely to have decreased renal function, caution should be exercised in dose selection and renal function should be monitored.

Use during pregnancy and periodlactation

Adequate, well-controlled studies on the use of the drug during pregnancy have not been conducted. Chloramphenicol crosses the placental barrier, but it is not known whether it has a toxic effect on the fetus. The use of the drug during pregnancy is contraindicated.

The drug is excreted in the mother's breast milk. Due to the possibility of developing severe adverse reactions in a child, breastfeeding should be discontinued during treatment with the drug. The development of "gray syndrome" is possible: toxic reactions, including fatal cases, are described in newborns; the signs and symptoms associated with these reactions have been termed "grey syndrome". Cases of "gray syndrome" have been described in newborns born to a mother who received chloramphenicol during pregnancy. Cases up to 3 months of life have been described. In most cases, chlorifenicol therapy was initiated within the first 48 hours of life. Symptoms appeared 3 to 4 days after continuous treatment with high doses of chloramphenicol. The symptoms appeared in the following order:

– bloating with or without vomiting;

- progressive pale cyanosis;

- vasomotor collapse, often accompanied by irregular breathing;

death within a few hours of the onset of these symptoms.

The progression of symptoms is associated with high doses. Preliminary serum studies have shown unusually high concentrations of chloramphenicol (greater than 90 µg/mL on repeated doses). Assistance measures: exchange transfusion or hemosorption. Termination of therapy in the early stages often led to reversal of symptoms until complete recovery.

Influence on the ability to drive transport environmentsdand potentially dangerouswithmechanisms

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Interaction with other drugs

Chloramphenicol inhibits the cytochrome P450 enzyme system, therefore, when used simultaneously with phenobarbital, phenytoin, indirect anticoagulants, tolbutamide, there is a weakening of the metabolism of these drugs, a slowdown in excretion and an increase in their plasma concentration. Dose adjustment of anticonvulsants and anticoagulants may be required if they are used concomitantly with chloramphenicol.

With simultaneous use with phenobarbital, a decrease in the concentration of chloramphenicol is possible (it is necessary to control the concentration of chloramphenicol in the blood). Reduces the antibacterial effect of penicillins and cephalosporins.

When combined with penicillins and rifampicin, complex effects (including a decrease / increase in plasma concentration) have been registered, requiring monitoring of plasma concentrations of chloramphenicol.

When used with rifampicin, a decrease in the concentration of chloramphenicol is possible.

Simultaneous administration with drugs that inhibit hematopoiesis (sulfonamides, cytostatics), affecting the metabolism in the liver, with radiation therapy increases the risk of side effects.

When administered with oral hypoglycemic drugs, there is an increase in their action (due to the suppression of metabolism in the liver and an increase in their concentration in plasma).

Calcineurin inhibitors (cyclosporine and tacrolimus): Chloramphenicol therapy may increase plasma concentrations of calcineurin inhibitors (cyclosporine and tacrolimus).

Barbiturates: The metabolism of chloramphenicol is accelerated by barbiturates such as phenobarbital, resulting in a decrease in its plasma concentration.

Estrogens: There is a small risk that chloramphenicol may reduce the contraceptive effect of estrogens.

Paracetamol: The simultaneous use of chloramphenicol in patients receiving paracetamol should be avoided, as the half-life of chloramphenicol is significantly prolonged.

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug. Chloramphenicol is contraindicated in patients receiving drugs that cause agranulocytosis. These include: carbamazepine, sulfonamides, phenylbutazone, penicillamine, cytotoxic agents, some antipsychotics, including clozapine and especially depot antipsychotics, procainamide, nucleoside reverse transcriptase inhibitors, propylthiouracil.

Shelf life

3 years. Do not use after the expiry date stated on the packaging.

Holiday conditions

On prescription.

Manufacturer:

RUE “Belmedpreparaty”,

Republic of Belarus, 220007, Minsk,

st. Fabriciusa, 30, t./fa.: (+375 17) 220 37 16,

e-mail: [email protected]

LP-004849

Trade name:

Levomycetin

International non-proprietary or grouping name:

chloramphenicol

Dosage form:

film-coated tablets

Compound

Composition per tablet:

Description:

Dosage 250 mg: round biconvex film-coated tablets, white or almost white. On a cross section, the tablet core is white, grayish-white or yellowish-white in color.

Dosage 500 mg: oblong biconvex film-coated tablets, white or almost white with a score. On a cross section, the tablet core is white, grayish-white or yellowish-white in color.

Pharmacotherapeutic group:

antibiotic

ATC Code:

Pharmacological properties

Pharmacodynamics
A bacteriostatic broad-spectrum antibiotic that disrupts the process of protein synthesis in a microbial cell.

Effective against strains of bacteria resistant to penicillins, tetracyclines, sulfonamides.

Active against many gram-positive and gram-negative bacteria, pathogens of purulent infections, typhoid fever, dysentery, meningococcal infections, hemophilic bacteria, Escherichia coli, Shigella dysenteria spp., Shigella flexneri spp., Shigella boydii spp., Shigella sonnei spp., Salmonella spp. (including Salmonella typhi, Salmonella paratyphi), Staphylococcus spp., Streptococcus spp. (including Streptococcus pneumoniae), Neisseria meningitidis, a number of strains of Proteus spp., Pseudomonas pseudomallei, Rickettsia spp., Treponema spp., Leptospira spp., Chlamydia spp. (including Chlamydia trachomatis), Coxiella burnetii, Ehrlichia canis, Bacteroides fragilis, Klebsiella pneumoniae, Haemophilus influenzae.

He acts on acid-resistant bacteria (including Mycobacterium tuberculosis), Pseudomonas aeruginosa, clostridia, methicillin-resistant strains of staphylococci, Acinetobacter, Enterobacter, Serratia marcescens, indole-positive strains of Proteus spp., Pseudomonas aeruginosa spp., protozoa and fungi.

Resistance of microorganisms to chloramphenicol develops slowly.

Pharmacokinetics
Absorption - 90% (fast and almost complete). Bioavailability - 80% after oral administration and 70% - after i / m administration. Communication with plasma proteins - 50-60%, in premature newborns - 32%. The time to reach the maximum concentration (TC max) after oral administration is 1-3 hours, after intravenous administration - 1-1.5 hours. The volume of distribution is 0.6-1 l / kg. Therapeutic concentration in the blood is maintained for 4-5 hours after administration. It penetrates well into body fluids and tissues. Its highest concentrations are in the liver and kidneys. Up to 30% of the administered dose is found in bile. The maximum concentration (C max) in the cerebrospinal fluid (CSF) is determined 4-5 hours after a single oral administration and can reach, in the absence of inflammation of the meninges, 21-50% of the maximum concentration (C max) in plasma and 45-89% - with the presence of inflammation of the meninges. Passes through the placental barrier, the concentration in the serum of the fetus can be 30-80% of that in the mother's blood. Penetrates into breast milk.

The main amount (90%) is metabolized in the liver. In the intestine, under the influence of intestinal bacteria, it is hydrolyzed to form inactive metabolites.

Excreted within 24 hours by the kidneys - 90% (by glomerular filtration - 5-10% unchanged, by tubular secretion in the form of inactive metabolites - 80%), through the intestines - 1-3%. The half-life in adults is 1.5-3.5 hours, in case of impaired renal function - 3-11 hours. The half-life in children from 3 to 16 years is 3-6.5 hours. Poorly excreted during hemodialysis.

Indications for use

Urinary and biliary tract infections caused by susceptible microorganisms.

Contraindications

Hypersensitivity to chloramphenicol or other components of the drug, inhibition of bone marrow hematopoiesis, acute intermittent porphyria, glucose-6-phosphate dehydrogenase deficiency, liver and / or kidney failure, pregnancy, lactation, children under 3 years old and weighing less than 20 kg.

Carefully

Patients who have previously received cytotoxic drugs or radiation therapy.

Use during pregnancy and during breastfeeding

The drug is contraindicated during pregnancy and during breastfeeding.

Dosage and administration

Inside (30 minutes before meals, and with the development of nausea and vomiting - 1 hour after eating) 3-4 times a day.

A single dose for adults is 250-500 mg, daily - 2000 mg.

Children over 3 years of age and weighing more than 20 kg are used at 12.5 mg / kg every 6 hours or 25 mg / kg every 12 hours (under the control of the concentration of the drug in the blood serum).

The average duration of treatment is 8-10 days.

Side effect

From the digestive system: dyspepsia, nausea, vomiting (the likelihood of development decreases when taken 1 hour after eating), diarrhea, irritation of the oral mucosa and throat, dysbacteriosis (suppression of normal microflora).

On the part of the hematopoietic organs: reticulocytopenia, leukopenia, granulocytopenia, thrombocytopenia, erythrocytopenia; aplastic anemia, agranulocytosis.

From the nervous system: psychomotor disorders, depression, confusion, peripheral neuritis, optic neuritis, visual and auditory hallucinations, decreased visual acuity and hearing, headache.

Allergic reactions: skin rash, angioedema.

Other: secondary fungal infection.

Overdose

Symptoms: oppression of bone marrow hematopoiesis, gastrointestinal disorders, liver and kidney damage, neuropathy (including the optic nerve) and retinopathy.
Treatment: hemosorption, symptomatic therapy.

Interaction with other drugs

Suppresses the enzyme system of cytochrome P450, therefore, with simultaneous use with phenobarbital, phenytoin, indirect anticoagulants, there is a weakening of the metabolism of these drugs, a slowdown in excretion and an increase in their plasma concentration.

Reduces the antibacterial effect of penicillins and cephalosporins.

When used simultaneously with erythromycin, clindamycin, lincomycin, there is a mutual weakening of the action due to the fact that chloramphenicol can displace these drugs from the bound state or prevent them from binding to the 50S subunit of bacterial ribosomes.

Simultaneous administration with drugs that inhibit hematopoiesis (sulfonamides, cytostatics), affecting the metabolism in the liver, with radiation therapy increases the risk of side effects.

When administered with oral hypoglycemic drugs, there is an increase in their action (due to the suppression of metabolism in the liver and an increase in their concentration in plasma).

Myelotoxic drugs increase the manifestations of hematotoxicity of the drug.

special instructions

With the simultaneous administration of ethanol, a disulfiram-like reaction may develop (hyperemia of the skin, tachycardia, nausea, vomiting, reflex cough, convulsions).

In the process of treatment, systematic monitoring of the picture of peripheral blood is necessary.

Influence on the ability to drive vehicles, mechanisms

During the period of treatment with the drug, special care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Release form

Film-coated tablets, 250 mg, 500 mg.
10 or 15 tablets in a blister pack made of polyvinyl chloride film and printed lacquered aluminum foil.
1, 2, 3, 4, 5, 6 or 10 blisters with instructions for use in a carton pack.

Storage conditions

In original packaging, at a temperature not exceeding 30 °C.
Keep out of the reach of children.

Shelf life

3 years.
Do not use after the expiration date indicated on the package.

Holiday conditions

Released by prescription.

Legal entity in whose name the registration certificate is issued / Organization accepting consumer claims

BRIGHTPHARM LLC, Russia
249033, Kaluga region, Obninsk, st. Gorky, 4

Manufacturer

CJSC Obninsk Chemical-Pharmaceutical Company (CJSC OKHPC), Russia
Legal address: 249036, Kaluga region, Obninsk, st. Koroleva, 4
Place of production address: Kaluga region, Obninsk, Kievskoe shosse, bld. 103, bld. 107