Bi-sept

Bi-sept is a complex drug with antimicrobial activity.

Indications Bi-sept

It is used for various infections, against the background of which there are inflammations provoked by the action of bacteria that are sensitive to the therapeutic agent:

• infections affecting the urogenital system;
• diseases affecting the lungs with bronchi and ENT organs;
• preventing the occurrence of inflammation due to Pneumocystis carinii in people in the risk category;
• infections in the digestive system (paratyphoid with typhoid fever, cholecystitis with cholera, and at the same time colitis, dysentery and OKA);
• soft tissue and epidermis disorders;
• combined treatment for scarlet fever, meningitis with sepsis, and in addition, for toxoplasmosis, osteomyelitis, cladotrichosis and Maltese fever.

[1], [2]

Release form

The release of the substance is produced in tablets with a volume of 480 mg, inside blister packs, in an amount of 20 pieces. The box contains 1 blister pack.

Pharmacodynamics

The antimicrobial effect exerted by sulfamethoxazole is based on antagonism processes against PABA synthesized by bacteria. The drug selectively slows down its entry into DHPA and inhibits the binding of dihydropteroate synthetase, which interferes with the formation of microbial nucleic acids, which causes the death of the bacterium.

Trimethoprim leads to a violation of the activity of the enzyme dihydrofolate reductase - blocks the alignment of amino acids. Sulfamethoxazole with trimethoprim has a bacteriostatic effect and increases its antimicrobial effect, due to which antibacterial activity is potentiated.

Bi-septum exhibits activity in relation to Escherichia coli, brucella with streptococci, as well as indole-positive strains of Proteus (common and Mirabilis), Shigella with Klebsiella, bacteria that trigger the development of malaria, enterobacteria and bacilli Influenza. In addition, the list of moraccella cataris, Listeria monocytogenes, causative agents of pneumocytosis, as well as the bacteria Morgan and Nocardia asteroides.

The drug does not affect the fungi with viruses.

[3], [4]

Pharmacokinetics

The drug is absorbed at high speed from the gastrointestinal tract, its Cmax values are recorded after 2 hours. The therapeutic effect lasts for a maximum of 12 hours, as long as the necessary level of medication inside the blood is maintained.

Synthesis of trimethoprim with albumin reaches 70%, and sulfamethoxazole - up to 44-62%. Peak values of the drug are noted inside the bronchial secretions, bile, kidneys and prostate.

The half-life of Bi-septa is 10 hours. The drug undergoes metabolic processes inside the liver. Elimination occurs with urine.

[5], [6], [7]

Dosing and administration

The drug is taken orally, with a 12-hour interval after taking food. It is necessary to wash down the medicine with at least 0.3 l of liquid.

The average size of the dosage of the drug in adults: 2 tablets 2 times a day (with prolonged maintenance treatment, take 1 tablet 2 times a day). Children of the age group of 6-12 years are required to use 1-well pill 2-fold per day. Children aged 3-6 years - 0.5 tablets 2 times a day.

As a prophylactic substance, Bi-septa can be used within 3-12 months.

In the acute stages of infections, an average 7–14-day cycle of therapy is required. In the case of typhoid fever –28-90 days. During the Maltese fever - up to 28 days.

For a child with inflammation in the area of the urinary ducts or otitis media, you need to use portions calculated according to the 48 mg / kg scheme per day (divide the dosage into 2 uses).

During therapy for gonorrhea, 4-6 tablets of drugs are used 3 times a day. For pharyngitis of gonorrheal nature - 9 tablets 1 time for 5 days.

In case of inflammation within the respiratory system, triggered by the activity of Рneumosuist_sіrіnіі, take 90-120 mg / kg of the substance per day, with a 6-hour interval, for 2-3 weeks. Children need to take 0.5 tablets 2 times a day; The treatment cycle lasts from 5 to 14 days.

People with chronic renal failure reduce the portion by half, and when the GFR is below 15 ml / minute, no medicine is prescribed.

[17], [18]

Use Bi-sept during pregnancy

The drug should not be prescribed to pregnant or lactating women, because it passes through the placenta, and besides it is excreted in breast milk.

Contraindications

Main contraindications:

• use in people with severe intolerance in relation to the constituent components of the drug;
• megaloblastic form of anemia, accompanied by a lack of vitamin B9, against the background of which the values of GFR below 15 ml / minute are also noted.

[8], [9], [10], [11], [12], [13]

Side effects Bi-sept

Bi-septa is usually tolerated without complications. Among the most frequently occurring negative symptoms are signs of dyspepsia. If a patient has an individual hypersensitivity, then allergic manifestations may occur in the form of erythema, itching, and urticaria. Cases with the development of colitis of pseudomembranous nature, inflammation in the region of the liver and pancreas, as well as inflammations such as myalgia or arthralgia and symptoms of thrombophlebitis were also recorded.

TEN, acute hepatic necrosis, hemolytic or aplastic forms of anemia, purpura of allergic genesis, agranulocytosis, and bone marrow inhibition appear singly.

The drug can cause symptoms of impaired renal function, hypoglycemia or neuritis, and in addition, the appearance of tremor, tubulo-interstitial nephritis, or headaches.

There are only signs of photosensitivity.

[14], [15], [16]

Overdose

With the introduction of too large dosages of drugs can appear headaches, dyspeptic symptoms, drowsiness and a tendency to loss of consciousness due to dizziness. To assist in such cases, conduct gastric lavage and symptomatic procedures.

If large portions of the drug are administered for a long time, the process of the formation of red blood cells is suppressed, which may reach the platelet and leukopenia.

[19], [20]

Interactions with other drugs

The combination of medication and thiazide diuretic drugs in the elderly causes potentiation of the suppression of the processes of bone marrow activity.

The drug enhances the properties of indirect anticoagulants and hypoglycemic agents from the category of sulfanylureas.

Bi-septa can suppress the metabolic processes of phenytoin, because of which the duration of its medicinal effect increases.

The drug increases the blood levels of cyclosporine, resulting in an increased likelihood of the negative symptoms of the latter, along with potentiation of signs of nephrotoxicity.

The combination of methotrexate with trimethoprim can potentiate the symptoms of pancytopenia.

The drug increases the free fraction of methotrexate in the case of their simultaneous use - due to a violation of the synthesis of the latter with blood protein.

Drug and dofetilide can not be combined, because it can lead to ventricular arrhythmias.

[21], [22], [23], [24]

Storage conditions

Bi-septa must be kept in a place closed from the penetration of moisture and small children. Temperature marks - in the range of 15-25 ° C.

[25], [26],

Shelf life

Bi-sept is allowed to apply within 36 months from the date of manufacture of a therapeutic drug.

[27], [28], [29]

Application for children

You can not prescribe medication for children under the age of 3 years.

Analogs

Analogues of drugs are Co-trimoxazole and Biseptol with Bactrim suspension.

[30], [31], [32]

Reviews

Bi-sept receives good reviews from the patients who used it - many point out its rather high drug efficacy, which is especially valuable because the drug has a low cost. Of the negative aspects of the individual reported on the development of side signs.