Cefpotec 200.

Cefpotec 200 is a β-lactam antibiotic (3rd generation) that is used for oral administration (tablets).

The bactericidal activity of the drug is developed by suppressing the processes of binding of bacterial cell walls that cause the development of the disease. In addition, the drug has a significant effect on various pathogenic microorganisms - aerobes together with anaerobes, and also gram-negative and -positive bacteria.

Indications Cefpotheca 200.

It is used for certain infections that appear as a result of the influence of pathogenic microbes that are sensitive to cefpodoxime:

• lesions of the ENT organs (including tonsillitis with sinusitis and pharyngitis). In case of pharyngitis or tonsillitis, the drug is used only when the disease is recurrent or chronic, and in addition to this, in situations where resistance of the pathogen to popular antibiotics is suspected or has already been diagnosed;
• respiratory tract infections (including bacterial pneumonia and the active phase of bronchitis or its relapses, as well as exacerbations of its chronic form);
• lesions of the lower and upper regions of the urethra in the uncomplicated stage (this includes cystitis and pyelonephritis in the active phase);
• infections of subcutaneous tissues and epidermis (cellulitis, ulcers, abscesses, furuncles with carbuncles, as well as infected wounds, paronychia and folliculitis);
• gonococcal urethritis, occurring without complications.

Release form

The medicinal component is released in tablets - 5 pieces inside a cell plate; 2 or 4 plates in a box. It can also be released with 7 tablets inside a package; 2 packages inside a pack.

Pharmacodynamics

The range of therapeutic activity includes the following bacteria:

• Gram-positive: pneumococci, streptococci from subcategory A (pyogenic streptococci), B (agalactoid streptococci), as well as C and F with G. This list also includes diphtheria corynebacterium, streptococcus mitis, S. Sanguis and salivary streptococcus;
• Gram-negative: meningococci, influenza bacilli, Escherichia coli, Haemophilus parainfluenzae, gonococci, Moraxella catarrhalis (strains that produce or do not produce β-lactamase), as well as Proteus mirabilis and Klebsiella (Klebsiella oxytoca and Klebsiella pneumoniae);
• moderately sensitive microbes: strains that produce or do not produce penicillinase (epidermal staphylococci and Staphylococcus aureus), as well as methicillin-sensitive staphylococci.

Resistance to cefpodoxime (and other cephalosporins) is demonstrated by: Pseudomonas aeruginosa, Enterococci, Bacteroides fragilis, Pseudomonas, Clostridium difficile and Staphylococcus saprophyticus.

Pharmacokinetics

The active component of the drug is absorbed in the small intestine, hydrolyzing to the active metabolic element cefpodoxime. Plasma Cmax values are recorded after 2-4 hours from the moment of taking a single dose.

Cefpodoxime enters into synthesis with intraplasmic blood proteins (mainly with albumins) of unsaturated type. The MIC index of the element cefpodoxime relative to the majority of pathogenic microbes is noted in the bronchial mucosa, tonsils, pulmonary parenchyma, interstitial and pleural fluids, as well as prostate secretions.

It has a good rate of penetration into the renal tissue. After 12 hours from the moment of application of a single dose, the majority of bacteria causing infection of the urinary tract and kidneys have a MIC level of 90.

Excretion occurs primarily in urine; the half-life is approximately 2.4 hours.

Dosing and administration

It is recommended to take the tablets with food to enhance the absorption of the drug.

For adolescents aged 12 years and over and adults with healthy kidney function, the following portions are prescribed:

• lesions of the ENT organs (sinusitis and other infections, including pharyngitis with tonsillitis): the daily dose is 0.4 g - 0.2 g 2 times (for sinusitis) and 0.2 g - 0.1 g 2 times (for other diseases);
• respiratory tract infections: 0.2-0.4 g (taking into account the sensitivity of the causative bacteria), administered twice a day in portions of 0.1-0.2 g;
• uncomplicated urinary tract lesions: 0.4 mg - 0.2 g 2 times a day (in the active phase of pyelonephritis) or 0.2 g - 0.1 g 2 times a day (in cystitis);
• infections of the epidermis and subcutaneous layer: 0.4 g - 0.2 g of medicine 2 times a day;
• gonococcal urethritis developing without complications: 1-time dose of 0.2 g of the drug.

The duration of therapy is determined individually, taking into account the intensity of the disease.

For problems with kidney function.

If the CC values are >40 ml per minute, no change in the dose of the medicine is required.

If the patient's level is below the specified mark, it is necessary to adjust the dosage portion of Cefpotec 200:

• the level of CC is within 39-10 ml per minute – 1 serving* is consumed at 24-hour intervals (half of the standard adult);
• CC rate <10 ml per minute – 1-time dosage* is taken at 48-hour intervals (a quarter of the standard adult dosage);
• persons on hemodialysis – take a 1-fold dose* after each procedure.

*1-time portion – 0.1 or 0.2 g, taking into account the type of lesion.

Use Cefpotheca 200. during pregnancy

There is no information regarding the use of Cefpotec 200 during pregnancy. For this reason, during this period it is prescribed only in situations where the probable benefit to the woman is more expected than the risk of consequences for the fetus (especially in the early stages of pregnancy).

The drug is excreted in breast milk, so if it is used during lactation, breastfeeding should be discontinued.

Contraindications

Contraindicated for use in case of intolerance associated with penicillins, cephalosporins or other components of the drug.

Side effects Cefpotheca 200.

Main side effects:

• systemic disorders: malaise, fever, fungal infections, chills, increased fatigue, as well as back pain, asthenia, abscess, chest pain (which may radiate to the lumbar region), facial or local swelling, generalized or local pain, signs of allergy, an increase in the number of resistant microbes and bacterial infections;
• cardiovascular damage: vasodilation, migraine, CHF, palpitations, decreased or increased blood pressure and hematomas;
• digestive disorders: abdominal pain, flatulence, diarrhea, nausea, dyspepsia, feeling of fullness in the stomach, vomiting and tenesmus. In addition, anorexia, toothache, loss of appetite, dry mouth, constipation, belching, thirst, candidal stomatitis, ulcers inside the mouth, gastritis and pseudomembranous colitis. Enterocolitis may manifest itself in bloody diarrhea. If diarrhea is persistent or severe, appearing during or after therapy, one may suspect the development of pseudomembranous colitis;
• blood disorders: decreased hematocrit or hemoglobin levels, leukocytosis, hemolytic anemia, thrombocytosis and eosinophilia, as well as lymphocytosis, neutro-, leukopenia, thrombocyto- and lymphopenia. Agranulocytosis, increased TT and PT values, and positive Coombs test results are also noted;
• problems with metabolic processes: gout, weight gain, dehydration and peripheral edema;
• disorders associated with the musculoskeletal structure: myalgia;
• disorders of the nervous system function: hemorrhages, insomnia, dizziness, feeling of nervousness or anxiety, cephalgia, sleep disorders, vertigo and headaches, as well as gait instability, neurosis, paresthesia, changes in dreams (strange dreams or nightmares) and confusion;
• Respiratory system disorders: cough, pneumonia, sneezing, asthma, runny nose and suffocation, as well as nosebleeds, wheezing, pleural effusion and bronchial spasm;
• epidermal disorders: skin hyperemia, hyperhidrosis, rash, fungal dermatitis, urticaria, vesicular-bullous or maculopapular rash, as well as itching, epithelial desquamation, alopecia, dry epidermis, TEN, sunburn, erythema multiforme and SJS;
• problems with the functioning of the senses: eye irritation, loss of taste or change in taste, and ringing or noise in the ears;
• immune disorders: symptoms of intolerance of all degrees of severity, Quincke's edema, arthralgia, anaphylactic signs, fever, serum sickness or purpura;
• urogenital tract lesions: metrorrhagia, proteinuria or hematuria, thrush, urinary tract infections, dysuria, increased urinary creatinine and urea levels, and increased urination frequency. Problems with kidney function may occasionally occur (especially when the drug is combined with powerful diuretics or aminoglycosides);
• changes in test results: increased values of bilirubin, alkaline phosphatase, creatinine and urea, as well as an increase in the level of functional studies of the liver ALT and AST or false positive results of the Coombs test;
• biochemical tests: hyponatremia, -proteinemia or -albuminemia, and in addition hypo- or hyperglycemia and hyperkalemia.

Overdose

Signs of poisoning include diarrhea, vomiting, abdominal pain, and nausea. In people with renal insufficiency, encephalopathy may develop during intoxication (this disorder is often treatable if plasma cefpodoxime levels are low).

Peritoneal dialysis and hemodialysis sessions are carried out, as well as symptomatic measures.

Interactions with other drugs

Combining large doses of antacids (aluminum hydroxide and sodium bicarbonate) or substances that block the action of H2 endings with Cefpotec 200 reduces the intensity of absorption by 24-42%.

Orally administered anticholinesterase drugs increase the Tmax of the drug by 47% without changing the degree of its absorption.

Cephalosporins may potentially enhance the anticoagulant effect of coumarins and weaken the contraceptive properties of estrogens.

Administration with cephalosporins may sometimes result in positive Coombs test results.

The level of bioavailability of the drug decreases by approximately 30% if it is combined with drugs that neutralize gastric pH or inhibit gastric secretion.

Cefpotec 200 should be taken 2-3 hours after the administration of ranitidine.

The bioavailability of the drug increases when it is taken with food.

If glucosuria is detected using copper reduction methods (Fehling and Benedict tests), a false positive effect may develop, but cefpodoxime does not change the results of urine sugar tests using enzymatic methods.

Combination with loop diuretics may increase nephrotoxic effects. It is necessary to closely monitor kidney function when using the drug together with substances that have nephrotoxic activity.

Plasma values of the drug increase when combined with probenecid.

Storage conditions

Cefpotec 200 should be stored in a place closed to small children. Temperature marks - not higher than 25°C.

Shelf life

Cefpotec 200 can be used within a 2-year period from the date of sale of the medicine.

Application for children

The medication is not used in children under 12 years of age.

Analogues

The drug's analogues are Doccef, Cefodox, Auropodox with Cepodem, Foxero and Cefma with Cedoxime and Cefpodoxime Proxetil.