Biseptol

Biseptol contains the active component co-trimoxazole, which includes a combination of 2 antimicrobial substances in a 5:1 ratio (sulfamethoxazole with trimethoprim). The principle of the therapeutic effect of co-trimoxazole is associated with double blocking of metabolic processes inside bacterial cells. Trimethoprim with sulfamethoxazole affect the processes of folate biosynthesis inside pathogenic microbial cells. [ 1 ]

The antibacterial effect of the drug covers a wide range of gram-negative and -positive pathogenic bacteria. [ 2 ]

Indications Biseptol

It is used for the following disorders:

• lesions of the ENT organs and respiratory tract: otitis media, tonsillitis, active and chronic bronchitis, pneumonia (also caused by Pneumocystis carinii) and pharyngitis;
• infections in the urogenital system: urethritis, active and chronic forms of cystitis, pyelonephritis, chancroid and prostatitis;
• infections affecting the digestive system: paratyphoid fever, cholera, typhoid fever, shigellosis (caused by sensitive strains of Shigella flexneri and Shigella sonnei when antibacterial treatment is carried out) and traveler's diarrhea caused by enterotoxigenic strains of E. coli;
• other bacterial infections: brucellosis, toxoplasmosis, active and chronic osteomyelitis and nocardiosis. [ 3 ]

Release form

The therapeutic agent is produced in tablets of 0.1 g/20 mg (20 pieces per package) and 0.4 g/80 mg (14 or 20 pieces per pack).

It is also available as a suspension (in 80 ml vials) and as a concentrate for making infusion fluid (inside 5 ml ampoules – 10 pieces inside a box).

Dosing and administration

For adolescents over 12 years of age and adults, tablets (0.4 g/80 mg) are prescribed in a portion of 2 pieces 2 times a day. In case of severe violations, maximum daily dosages are used - up to 3 tablets per use.

Children aged 6-12 years can take 30 mg/kg of sulfamethoxazole and 6 mg/kg of trimethoprim per day. The dosage is divided into 2 doses - in the morning and in the evening.

Biseptol should be taken after meals, with plain water.

The suspension is administered to children aged 2-5 months in a 2.5 ml portion, to persons aged 0.5-5 years – 5 ml, and to children aged 5 years and over – 10 ml 2 times per day.

The infusion concentrate is administered exclusively intravenously. The drug should be diluted immediately before use. Adolescents over 12 years of age and adults are administered 10 ml of the drug (2 ampoules) 2 times a day. For a child under 12 years of age, the dosage is calculated based on weight; the drug should be administered 2 times a day.

• Application for children

In the form of an infusion concentrate, the drug can be used from 1.5 months of age, and in the form of a suspension - from 2 months of age.

Use Biseptol during pregnancy

It is prohibited to prescribe Biseptol during pregnancy and breastfeeding.

Contraindications

Main contraindications:

• severe intolerance to medicinal elements (including sulfanilamide derivatives, hypoglycemic sulfonylurea agents and thiazide-type diuretics);
• liver failure, active hepatitis, liver dysfunction;
• blood disorders, megaloblastic anemia, hematopoietic disorders, G6PD deficiency and severe hematological disorders;
• severe renal failure;
• use of drugs during chemotherapy.

Side effects Biseptol

When using the recommended dosages, the drug is usually tolerated without complications. Often, side effects associated with the gastrointestinal tract (nausea, loss of appetite, vomiting) and the epidermis (urticaria, rashes) develop. Candidiasis may develop.

Occasionally, dangerous health manifestations may occur: TEN, active hepatonecrosis and SSc.

Overdose

Signs of acute poisoning include vomiting, headache, hepatitis, nausea, confusion and mental disturbances. Signs of chronic intoxication include nausea, drowsiness, loss of appetite, diarrhea, fever, loss of consciousness and colicky pain.

If symptoms of intoxication occur, it is necessary to induce vomiting and drink large amounts of liquid.

In case of chronic overdose, leukopenia or megaloblastic anemia develops, as well as suppression of spinal cord function. In this case, leucovorin must be used.

Interactions with other drugs

The introduction of Biseptol together with NSAIDs, diphentin, barbiturates, hypoglycemic sulfonylurea derivatives, anticoagulants increases the likelihood of developing side effects.

The use of vitamin C increases blood levels of salicylates, which can lead to the development of crystalluria.

Trimethoprim should not be combined with dofetilide.

The medication weakens the effectiveness of oral contraceptives.

Co-trimoxazole increases serum digoxin levels.

Biseptol slows down the metabolic processes of phenytoin.

When tricyclics are used together with the drug, their therapeutic effect is weakened.

In elderly people, when combining drugs with individual diuretics, the likelihood of thrombocytopenia increases.

Administration of the drug together with pyrimethamine (used as a malaria prophylaxis in doses greater than 25 mg per week) may result in the development of megaloblastic anemia.

Storage conditions

Biseptol should be stored in a place closed to small children. Temperature level – no more than 25°С.

Shelf life

Biseptol can be used for a period of 5 years from the date of sale of the medicinal product.

Analogues

The analogs of the drug are the substances Sumetrolim, Bactrim with Bi-sept, Baktiseptol and Bi-Tol.