Benemycin

Benemycin is an antibiotic with a wide range of medicinal effects. It is used as anti-tuberculosis, antibacterial, and anti-leprosy drug.

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Indications Benemycin

The medicine is indicated for the elimination of the following pathologies:

• tuberculosis of any form;
• lepra (together with dapsone);
• infectious processes provoked by the action of bacteria sensitive to drugs;
• Brucellosis (in combination with tetracyclines).

It is also used to prevent the development of meningococcal meningitis in the carriers themselves, as well as people who come into contact with them.

Release form

Available in the form of capsules. In one pencil case contains 100 capsules, in one box - 1 such a pencil case.

Pharmacodynamics

The active ingredient of the drug is rifampicin. Benemycin is used to eliminate diseases caused by the following bacteria: Koch's stick, pneumonophil legionella, Chlamydia trachomatis, Hansen's stick, Brucella spp., And in addition Rickettsia typhi. High concentrations of drugs can act on individual gram-negative microorganisms. The medication is particularly active against the bacillus of anthrax, streptococci and staphylococci, as well as clostridia. Benemycin is also active against gram-negative cocci (such as gonococci and meningococci).

The active component slows down bacterial RNA polyester, which depends on DNA.

Rifampicin is not allowed for use in monotherapy, since in this case bacteria that are resistant to this component are rapidly formed.

Pharmacokinetics

After ingestion, rifampicin is rapidly absorbed from the digestive tract (almost 100%). It should be borne in mind that if there is food in the stomach of the stomach, the absorption of LS is significantly slowed down.

Peak concentrations within the blood serum (after oral administration of the average daily dosage dosage (600 mg)) the substance reaches 1.5-2 hours and equals 6-7 μg / ml. Suppression of growth, as well as reproduction of the majority of strains of the Koch sticks, begins already when the concentration reaches 0.5 μg / ml. Drug concentration in the blood lasts about 8-12 hours.

With the protein inside the plasma is synthesized by about 75%, and the half-life is 2-5 hours. The active substance passes well into the bone tissue, lymph nodes, caverns, foci of tuberculosis, and also biological fluids. It is also able to penetrate the placenta and into breast milk. Drug concentration inside the cerebrospinal fluid occurs in the case of inflammation of the membranes of the brain.

After the absorption of rifampicin into the blood, the substance penetrates through the portal vein into the liver, and then, together with the bile, is again introduced into the digestive tract, and then reabsorbed into the blood.

Part of the active substance undergoes a metabolism in the liver, in the course of which disacetyltrifampicin is formed, which retains antituberculous properties, but it is worse absorbed in the intestine. Excretion is carried out through the digestive canal, with bile, in unchanged form. That is why during the first 3 weeks of therapy (as long as the body adapts to such an exchange cycle), a rise in transaminases is detected in the blood plasma, eventually disappearing.

About 60% of the ingested substance is excreted along with the feces, and another 30% - along with the urine (unchanged, as well as in the form of decay products). A small amount of drugs is excreted with tears, and then with other biological fluids, while giving them an orange color.

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Dosing and administration

The medicine should be consumed inside half an hour before eating.

In the treatment of tuberculosis, the drug is used in combination with other anti-tuberculosis drugs (eg, pyrazinamil, ethambutol, streptomycin, and isoniazid). Adults with a weight within 50 kg - daily dose equals 450 mg. If the patient weighs more than 50 kg, it is prescribed to 600 mg per day. Infants and children are allowed to give 10 mg / kg per day. Within a day, you can take no more than 600 mg of the drug.

The treatment course for a tubercular form of meningitis, disseminated form of tuberculosis, tuberculosis against HIV, as well as for neurological damage to the spine, lasts a minimum of 9 months with daily drug use. In this case, at the initial stage (during the first 2 months) the drug should be taken in combination with drugs isoniazid and pyrazinamide, and together with them etabutol or streptomycin, and the remaining 7 months - combined with isoniazid.

The treatment course for pulmonary tuberculosis lasts six months, and is carried out according to one of the schemes described below:

• During the first 2 months, standard treatment is performed - a combination of Benemycin with the above four anti-tuberculosis drugs. The next 4 months the drug is taken with isoniazid;
• according to the above scheme, taking during the first 2 months, and then 2-3 times per week in combination with isoniazid;
• taking drugs 3 times a week for 6 months (along with pyrazinamide, as well as isoniazid and streptomycin (or instead of etabutol)).

When taking anti-tuberculosis drugs 2-3 times a week, the treatment process should be carefully monitored by a doctor.

When multibacillary type leprosy is eliminated, the size of the adult dosage is 600 mg once a month (combined dose with clofazimine (daily 50 mg + monthly for 300 mg), and also dapsone (100 mg per day)). The size of the child's dosage is 10 mg per month in combination with clofazimine (in a day at a rate of 50 mg + 200 mg once a month), and besides it with dapsone (1-2 mg / kg per day). The duration of the course is 2 years. 

In the treatment of lepra pausibacillary type, the adult dosage is 600 mg once a month (in combination with dapsone 1-2 mg / kg (100 mg dose) once per day). For children, the medication is given at a dosage of 10 mg / kg once a month (in combination with dapsone, 1-2 mg / kg per day). The treatment course lasts six months.

To eliminate infectious pathologies provoked by microbes that are sensitive to the drug, other antibacterial agents are also used. The adult dosage for the day is 0.6-1.2 g, and for infants and children - 10-20 mg / kg per day. The medicine should be taken twice a day.

In the treatment of brucellosis, the drug is taken once a day (in the morning), at a rate of 900 mg. In addition, it is also required to drink doxycycline. The duration of the course is selected individually, on average - at least 45 days.

In the prevention of meningococcal meningitis, it is necessary to take a medicine in the amount of 600 mg twice a day with an interval of 12 hours. The course lasts 2 days.

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Use Benemycin during pregnancy

During pregnancy, the medicine should not be taken.

Contraindications

Among the contraindications of the medicine:

• diagnosed disorder of renal function;
• jaundice;
• infectious form of hepatitis, transferred less than 1 year ago;
• increased sensitivity to rifampicin and other elements of drugs;
• lactation period. 

It is also necessary to carefully prescribe the medicine to children.

Side effects Benemycin

The taking of a medicinal product is capable of provoking such side effects:

• Gastrointestinal organs: nausea along with vomiting, diarrhea, loss of appetite, development of hepatitis, pseudomembranous colitis, erosive form of gastritis, and hyperbilirubinemia. In addition, the level of liver transaminases may increase;
• CNS organs: the appearance of headaches, a sense of disorientation, a drop in vision, and the development of ataxia;
• organs of the urinary system: nephronecrosis or tubulointerstitial nephritis;
• allergies: fever, bronchial spasms, urticaria, Quincke edema or eosinophilia, as well as arthralgia;
• Other: muscle weakness, development of leukopenia or dysmenorrhea, also induction of porphyria, and in addition hyperuricemia and gout at the stage of exacerbation.

Due to irregular intake of medicines or at an early stage of a re-treatment course, skin allergy may develop, and in addition flu-like syndrome (febrile condition, severe dizziness along with headaches, muscle pains and chills), hemolytic anemia, Verlhof disease and acute insufficiency kidney.

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Overdose

When poisoning with a drug due to an overdose, such manifestations may occur:

• the appearance of seizures;
• falling into lethargy;
• a sense of confusion.

To eliminate these disorders, therapy is needed to combat symptoms, as well as gastric lavage and intake of activated charcoal. An intensive diuresis procedure may also be performed.

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Interactions with other drugs

Benemycin is able to weaken the effects of sex hormones, hormonal contraception, oral anticoagulants, antiarrhythmic drugs (such as mexiletine, disopyramide, as well as tokaineid, quinidine and pirmenon), antidiabetic drugs, and besides dapsone, ketoconazole, phenytoin, hexobarbital and nortriptyline. Together with this also theophylline, benzodiazepines, GCS, cyclosporine type A, traconazole and β-adrenoblockers, and besides chloramphenicol enalapril, cimetidine (acceleration of the metabolic process) and BCCC.

As a result of a combination with ketoconazole, antacid and cholinolytic drugs, as well as opiates, the bioavailability of the drug decreases.

In people who have problems with hepatic function, the combination with pyrazinamide and isonazide can provoke the progression of the disease.

PASC medicines containing bentonite substance are allowed to be taken with an interval of 4 hours after the use of Benemycin, since there is a possibility of disturbance of the absorption processes of the active ingredients.

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Storage conditions

Beneamycin should be kept out of the reach of moisture and sunlight, a place inaccessible to young children. Temperature - not more than 25 ^o C.

Shelf life

Benemycin is allowed to be consumed for 3 years after the release of the medicine.

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