L-Phlox

L-Phlox is an antimicrobial drug that has a wide spectrum of action. The action of the drug is aimed at destroying the cellular structure of bacteria, on enzymes - isomerases (affecting the structure of DNA) and DNA gyrase.

Use L-Phlox is prohibited in childhood and adolescence, because the drug can damage the cartilage joints. For the treatment of elderly people, it is necessary to take into account that there may be a violation of kidney function. When treatment with this drug, after the body temperature becomes normal, taking the drug continue for 2 - 3 days. During treatment with L-Phlox, sunlight should be avoided (skin damage due to photosensitivity may be involved). Also, it is worth paying attention to the patient's anamnesis, since brain trauma (stroke, neurotrauma) can lead to convulsive syndrome.

When taking the drug is prohibited the use of alcohol in any form, in addition, the drug has a strong effect on the reaction rate, so it is prohibited when driving L-Phlox to drive vehicles and other mechanisms that require increased attention and speed.

L-Phlox should be taken only according to the doctor's prescription and under his strict control.

[1],

Indications L-Phlox

L-Phlox is prescribed when the organism is affected by microorganisms that are sensitive to the active ingredient that is part of the preparation. Such diseases include acute sinusitis, otitis, sinusitis (all diseases of the ENT organs), pneumonia, bronchitis (upper and lower respiratory tract disease), prostatitis, pyelonephritis in the stage of exacerbation (diseases of the genitourinary system), soft tissue and skin lesions. The active substance of the drug is levoflaxocin, an antibiotic that adversely affects bacteria and stops their further development. It must be remembered that excessive or prolonged use of L-Phlox may lead to a decrease in effectiveness.

Release form

L-Phlox for intravenous administration is released in special ampoules of 100 ml, in one ampoule contains 500 mg of the main active substance.

The oral form is available in the form of tablets covered with a yellowish sheath. One tablet contains a standard dose of 250 or 500 mg of active ingredient.

Pharmacodynamics

The main active ingredient of L-Phlox is levofloxacin an antimicrobial synthetic drug belonging to the group of fluoroquinolones. The main action of the antimicrobial agent is directed to a complex of DNA-gyrase and enzymes-isomerase. As a rule, there is no cross-resistance between the active substance of L-Phlox and other groups of antimicrobial agents.

[2], [3]

Pharmacokinetics

L-Phlox has a good ability to penetrate into the intercellular and intracellular fluids, due to which a high concentration of the drug after administration is observed. The drug is well absorbed from the gastrointestinal tract, the maximum content of active substance in the blood is observed after 2 - 3 hours after administration.

It is excreted mainly with the help of kidneys, 87% of the drug is excreted in the urine, due to which a large amount of the drug accumulates in the urogenital system. Partially the drug is excreted by the gallbladder. Feces are excreted from 3 to 15% of the drug.

Violation of the functions of the liver does not require additional adjustment of the doses of the drug, and this also applies to reduced creatinine clearance.

There is no significant difference between intravenous administration of the drug and oral administration. Intravenous administration leads to accumulation of the drug in the bronchial mucosa, bronchial secretion of the lung tissue, urine. In the cerebrospinal fluid, the active substance falls in very small doses.

In patients with renal insufficiency, withdrawal of the drug decreases, the half-life increases.

The use of L-Phlox in young and old age has no special differences, except for cases associated with the withdrawal of creatinine.

[4]

Dosing and administration

L-Phlox is usually prescribed at 500 mg per day. You should take the drug before eating, the course of treatment, as a rule, is two weeks (without breaks).

Intravenous injection of the drug is carried out no later than 3 hours after opening the bottle, to prevent bacterial contamination). The dose of the drug is administered individually, depending on the patient's condition, the severity of the disease, and the type of microorganisms. The solution is drip-wise, very slowly. It is necessary to enter a bottle with a capacity of 100 ml (with an active substance content of 500 mg) for at least an hour. With intravenous injection, it is extremely important to monitor the patient's response to the drug, after a few days, you can go to oral intake of the drug in the same dosage.

In case of severe infection, the dosage of the drug may be increased (only for intravenous administration). Patients with a dysfunction of the kidney dose of the drug should be reduced. In the elderly (if there are no violations in the work of the kidneys), with liver failure, adjustment of doses of the drug L-Phlox is not required.

[11], [12]

Use L-Phlox during pregnancy

L-Phlox is strictly prohibited during pregnancy, as well as for women who are breastfeeding. In this area, little research has been done, it is likely that the drug can damage the cartilage joint in a new growing body.

If a woman finds out that she is pregnant during treatment with L-Phlox, she should immediately inform her doctor about it.

Contraindications

L-Phlox is contraindicated in case of individual intolerance to levofloxacin or other drugs of the quinolone group. Also, the drug is not prescribed if epileptic seizures have previously occurred. L-Phlox is not prescribed for patients who have previously experienced side effects after taking quinolones.

L-Phlox is not prescribed in childhood and adolescence.

[5], [6], [7], [8]

Side effects L-Phlox

Taking L-Phlox can cause nausea, burning in the upper abdomen, rashes on the skin, headache, decreased vision, tremors, convulsions, candidiasis. The drug has an effect on the nervous system, which can lead to impaired coordination of movements.

In very rare cases, the drug provokes anorexia, hypoglycemia (especially in patients who suffer from diabetes mellitus).

From the side of the immune system, anaphylactic shock can occur, the frequency of such reactions is not known.

Possible mental disorders - insomnia, nervousness. In very rare cases, there is depression, confusion, anxiety, hallucinations, self-destructive behavior (suicidal tendencies).

L-Phlox can act on the nervous system, as a result of which a person feels dizzy, headache, drowsiness. In very rare cases, a disorder or loss of taste develops, a violation of the scent (also a complete lack of a scent), a hearing disorder (ringing in the ears).

Possible heart disorders: tachycardia. Also, the drug can provoke bronchospasm, in very rare cases, allergic pneumonitis develops.

Possible disorders of the digestive system: nausea, diarrhea, abdominal pain, swelling, constipation.

After the first dose or with time, the skin-mucosal reaction to the drug may develop. Possible violation of the musculoskeletal system (defeat of tendons, myalgia, etc.). In rare cases, the drug provokes a rupture of the tendon, this reaction develops within 48 hours of the first dose. Muscle weakness is possible.

L-Phlox can increase the level of serum creatinine, in very rare cases, kidney failure develops.

Among other unwanted reactions to the drug, L-Phlox can be hypersensitive vasculitis, various coordination disorders, porphyria attacks in patients who have this disease (one of the genetic pathologies of the liver).

[9], [10]

Overdose

The most significant symptoms of an overdose of L-Flox are loss of consciousness, convulsions, dizziness. Clinical studies show that an overdose of the drug leads to an increase in the QT interval on the ECG (cardiac rhythm disturbance, gastric tachycardia). In case of an overdose, it is necessary to closely monitor the patient's condition, in particular, to monitor cardiac activity. In case of overdoses, symptomatic treatment is performed. At present, there are no special antidotes for the withdrawal of levofloxacin from the body, peritoneal dialysis or detoxification will not have a sufficiently effective result.

[13]

Interactions with other drugs

When the drug L-Phlox interacts with non-steroidal anti-inflammatory drugs (theophylline, fenbufen), convulsions decrease, the concentration of levofloxacin increases by 13%.

Cimetidine and probenecid affect the excretion of the active substance of L-Phlox. Excretory function of kidneys with cimetidine is reduced by 24%, with probenecid by 34%. This is due to the fact that these two drugs block the tubular secretion of levofloxacin. It is necessary to use levofloxacin and medicines at the same time, which influence the transportation of substances from the blood to the urine (the lumen of the tubules), such as probenecid or cimetidine, especially in patients with renal insufficiency.

Clinically significant results for simultaneous administration with levofloxacin do not have calcium carbonate, digoxin, glibenclamide, ranitidine.

L-Phlox affects the excretion of cyclosporine from the body, the half-life is 33% higher.

Taking the drug concomitantly with vitamin K antagonists (warfarin, etc.) can provoke bleeding or increase coagulation tests. Therefore, patients who take in parallel with L-Phlox antagonists of vitamin K, you need to monitor the coagulation indicators.

With caution use L-Phlox in patients who take drugs that increase the interval of QT (class IA, III, macrolides, tricyclic antidepressants).

[14]

Storage conditions

L-Phlox should be stored in a place well protected from sunlight and moisture, at room temperature (up to 250C). Keep the drug in a place inaccessible to small children. Do not expose the product to freezing.

[15]

Shelf life

L-Phlox is stored for two years provided all storage conditions are met.