Universal reference book for medicines
Name of the drug: CEPROVA

Active substance: ciprofloxacin

Type: Antibacterial drug of the group of fluoroquinolones

Manufacturer: LUPIN (India)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
Antimicrobial agent of a broad spectrum of action of a group of fluoroquinolones.
Has a bactericidal effect. Suppresses DNA-gyrase and inhibits the synthesis of bacterial DNA.
Highly active against most Gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.

It is active against Staphylococcus spp.
(including strains producing and not producing penicillinase, methicillin-resistant strains), some strains of Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp.
Ciprofloxacin is active against bacteria that produce β-lactamase.

Ciprofloxacin is resistant to Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides.
The action against Treponema pallidum has not been adequately studied.
PHARMACOKINETICS
Quickly absorbed from the digestive tract.
Bioavailability after oral administration is 70%. Food intake has little effect on the absorption of ciprofloxacin. The binding with plasma proteins is 20-40%. It is distributed in tissues and body fluids. Penetrates into the cerebrospinal fluid: the concentration of ciprofloxacin in non-inflamed meninges reaches 10%, with inflamed - up to 37%. High concentrations are achieved in bile. Excreted in urine and bile.
INDICATIONS
Infectious and inflammatory diseases caused by microorganisms sensitive to ciprofloxacin, incl.
diseases of the respiratory tract, abdominal cavity and pelvic organs, bones, joints, skin; septicemia; severe infections of the ENT organs. Treatment of postoperative infections. Prevention and treatment of infections in patients with reduced immunity.
For topical application: acute and subacute conjunctivitis, blepharoconjunctivitis, blepharitis, bacterial ulcers of the cornea, keratitis, keratoconjunctivitis, chronic dacryocystitis, meibomites.
Infectious lesions of the eyes after injuries or foreign bodies. Preoperative prophylaxis in ophthalmic surgery.
DOSING MODE
Individual.
Inside - 250-750 mg 2 times / day. The duration of treatment is from 7-10 days to 4 weeks.
For iv introduction single dose - 200-400 mg, multiplicity of administration - 2 times / day;
duration of treatment - 1-2 weeks, if necessary and more. It can be injected intravenously, but more preferably a drip for 30 minutes.
When topical application is instilled in 1-2 drops in the lower conjunctival sac of the affected eye every 1-4 hours. After improvement, the intervals between instillations can be increased.

The maximum daily intake for adults when ingested is 1.5 g.

SIDE EFFECT
On the part of the digestive system: nausea, vomiting, diarrhea, abdominal pain, increased activity of hepatic transaminases, alkaline phosphatase, LDH, bilirubin, pseudomembranous colitis.

From the side of the central nervous system: headache, dizziness, a sense of fatigue, sleep disorders, nightmares, hallucinations, fainting, vision disorders.

On the part of the urinary system: crystalluria, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, transient increase in serum creatinine.

On the part of the hematopoiesis system: eosinophilia, leukopenia, neutropenia, change in the number of thrombocytes.

From the side of the cardiovascular system: tachycardia, cardiac arrhythmias, arterial hypotension.

Allergic reactions: itching, hives, Quincke's edema, Stevens-Johnson syndrome, arthralgia.

Adverse reactions associated with the chemotherapeutic effect: Candidiasis.

Local reactions: soreness, phlebitis (with iv introduction).
When using eye drops in some cases, slight soreness and congestion hyperemia are possible.
Other: vasculitis.

CONTRAINDICATIONS
Pregnancy, lactation (breastfeeding), children and adolescents under 18, hypersensitivity to ciprofloxacin and other preparations of the quinolone series.

PREGNANCY AND LACTATION
Contraindicated in pregnancy, during lactation.

Ciprofloxacin penetrates the placental barrier, excreted in breast milk.

In experimental studies it is established that it causes arthropathy.

APPLICATION FOR FUNCTIONS OF THE LIVER
Patients with impaired renal function require a correction of the dosing regimen.

APPLICATION FOR CHILDREN
Contraindicated in children and adolescents under 15 years.

APPLICATION IN ELDERLY PATIENTS
Use with caution in elderly patients.

SPECIAL INSTRUCTIONS
Patients with impaired renal function require a correction of the dosing regimen.
They are used with caution in elderly patients, with atherosclerosis of cerebral vessels, cerebral circulation disorders, epilepsy, convulsive syndrome of unclear etiology.
During treatment, patients should receive a sufficient amount of fluid.

In case of persistent diarrhea, ciprofloxacin should be discontinued.

With simultaneous intravenous administration of ciprofloxacin and barbiturates, it is necessary to monitor heart rate, blood pressure, and ECG.
During the treatment, it is necessary to control the concentration in the blood of urea, creatinine, hepatic transaminases.
During the treatment period, a decrease in the reactivity is possible (especially when used simultaneously with alcohol).

Do not administer ciprofloxacin subconjunctivalally or directly into the anterior chamber of the eye.

DRUG INTERACTION
With the simultaneous use of ciprofloxacin with didanosine, ciprofloxacin absorption decreases due to the formation of ciprofloxacin complexones with aluminum and magnesium buffers in didanosine.

With simultaneous use with warfarin, the risk of bleeding increases.

With the simultaneous use of ciprofloxacin and theophylline, an increase in the concentration of theophylline in the blood plasma, an increase in T 1/2 theophylline, which leads to an increased risk of toxic action associated with theophylline.

Simultaneous reception of antacids, as well as preparations containing ions of aluminum, zinc, iron or magnesium, can cause a decrease in absorption of ciprofloxacin, so the interval between the appointment of these drugs should be at least 4 hours.

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