Levobaks

Levobaks is an antimicrobial agent with pronounced bactericidal properties.

Indications of the levobaksa

It is used to treat people with chronic prostatitis, pulmonary inflammation, and in addition to diseases affecting the skin and soft tissues that develop under the influence of flora, sensitive to levofloxacin.

In addition, tablets can be used to eliminate sinusitis in the acute stage and exacerbated bronchitis, which has a chronic form.

In the treatment of pulmonary inflammation in severe degree, and besides the diseases provoked by the activity of Pseudomonas aeruginosa, it is necessary to use a medication in combination with other antimicrobial drugs.

Release form

The release takes place in the form of an infusion fluid, in flacons with a volume of 100 ml. Inside the box there is one such bottle.

Also, the drug is produced in tablets, 7 in each of the blister packs. In a pack - 1 such a plate.

Pharmacodynamics

The active element of Levobax is levofloxacin, an artificial component from the category of fluoroquinolones. Its effect is developed by influencing bacterial topoisomerase 4, as well as DNA-gyrase.

The drug has activity against the action of a large range of Gram-positive, as well as-negative microbes. For example, such strains are susceptible to the action of levofloxacin:

• pneumococcus, streptococcus agalactia, streptococcus pyogenic;
• Staphylococcus aureus and epidermal staphylococcus, as well as fecal enterococcus;
• Enterobacter aerogenes, Enterobacter agglomerans, Enterobacter sakazakii, Enterobacter cloaca;
• E. Coli;
• Pfeiffer's wand, Haemophilus parainfluenzae;
• category of Viridans streptococci;
• proteus mirabilis, vulgar proteus;
• Klebsiella Oxytoca and Friedlander's wand;
• fluorescent pseudomonas, Pseudomonas aeruginosa;
• moraxella cataralis;
• Acinetobacter anitratus, akinetobaktery Bauman and Acinetobacter calcoaceticus;
• Legionella pneumophile, chlamydophile pneumonia, pertussis;
• Citrobacter frowni and Citrobacter koseri;
• clostridia perfringence, mycoplasma pneumonia, Morgan's bacterium, Providence of Rettger and Stewart, as well as serration of the marcesess.

Resistance to levofloxacin is possessed by spirochetes. Crossover resistance to the drug and other fluoroquinolones may also develop. But cross-resistance is usually not developed for antimicrobial drugs from other groups and for Levobax.

Pharmacokinetics

After ingestion, the level of absolute bioavailability of the drug reaches 100%. Peak values of the substance inside the plasma are recorded after the lapse of the first hour after admission. The use of food does not affect the level of bioavailability and the rate of absorption of drugs.

About 40% of the drug is synthesized with plasma protein. Its active element almost does not pass inside the liquor. Levofloxacin forms high medicinal concentrations inside the bronchi, lung tissue, organs of the urination system, the prostate, and at the same time inside the secretion secreted by the bronchial tubes.

Metabolism of the drug occurs inside the liver, and its excretion is carried out mainly with the help of the kidneys - as an unchanged element (in the form of metabolic products, about 5% of the drug is excreted). The half-life of the component is about 6-8 hours for people with healthy kidney work.

In people with kidney failure, the half-life can be prolonged (at CC values below 20 ml / minute this time can be extended to 35 hours).

Dosing and administration

Use of tablets.

The drug is consumed inside without crushing the tablet before use. The medication is taken without reference to eating. The daily portion of Levobaks can be consumed in 1 reception or divided into 2 parts (a single portion in this case should not be more than 0.5 g).

The duration of the course, as well as the dosage size of the drug, are selected by the doctor for each patient separately.

Persons with community-acquired pneumonia, acute stage of sinusitis, chronic type of bacterial origin of prostatitis, and also with infections affecting the skin and subcutaneous layers, often prescribed the use of 0.5 g of the drug per day. In the treatment of community-acquired pneumonia, the portion of the drug may be increased to 1 g per day.

People with chronic bronchitis at the stage of exacerbation and with infections affecting the urinary system are usually prescribed 0.25 g of drugs per day. People with exacerbated bronchitis, if necessary, can increase the dosage to 0.5 g per day. The duration of such treatment is usually within 7-10 / 14 days. With infections in the area of the urinary system of an uncomplicated nature, therapy lasts 3 days, and with a chronic prostatitis, 28 days.

Treatment with Levobaks should be continued until the moment of receiving negative indications of microbiological studies, or for another 2 days after the clinical manifestations of the disease disappear.

Use of an infusion fluid.

The medicine is injected through the intravenous drip. The speed of the performed infusion can not be higher than 0.25 g / half an hour. If during the procedure the decrease in blood pressure values began, it is required to immediately stop the infusion. Taking into account the patient's condition, it is necessary to switch to oral medicine as soon as possible (tablets). The length of such treatment and the size of the dosage of the drug is selected by the doctor.

In the treatment of community-acquired pneumonia, infections in the skin surface and subcutaneous layers, and with this chronic bacterial prostatitis, usually inject 0.5 g of drugs per day. With the elimination of skin infections and community-acquired pneumonia, the daily dose of the drug can be increased to 1 g (the portion is divided into 2 infusions).

During the treatment of infections in the area of the urethra, a daily dose of 0.25 g of drugs is usually administered.

The total duration of treatment (and parenteral use, and ingestion) can not exceed 2 weeks (except therapy with prostatitis, when the course can be extended to 28 days).

For people with problems in the work of the kidneys, correct the size of the portion of Levobax (both forms of release).

At QC values in the range of 20-50 ml / minute 0.25 g of medicines are usually applied on the first day, and then 125 mg are taken for a day. If a severe degree of the disease is observed, the dose on the first day can be increased to 0.5 g, and then the drug is administered in a dose of 125 mg at intervals of 12 hours.

At a QC level below 20 ml / minute on the first day, 0.25 g of medicament is usually applied, and then it is taken in portions of 125 mg with intervals lasting 48 hours. In pathologies with severe severity, the dose can be increased to 0.5 g for the first day, and later the patient should take 125 mg LS at intervals of 12-24 hours.

[1]

Use of the levobaksa during pregnancy

It is forbidden to prescribe Levobax to pregnant women - because of the risk of lesions in the fetus in the articular cartilage region.

Women who are in reproductive age should be excluded from pregnancy before starting treatment. During the use of drugs it is recommended to use reliable contraceptives. If the pregnancy has occurred during the period of therapy, you need to notify your doctor about it.

When lactating the drug can be used only in the case of refusal to breastfeed during therapy.

Contraindications

The main contraindications:

• the presence of hypersensitivity to levofloxacin or other antimicrobial drugs from the category of fluoroquinolones;
• tablets are forbidden to people with a lack of lactase, galactosemia, and in addition glucose-galactose malabsorption;
• appointment to persons with epilepsy (also if there is an indication of epilepsy in an anamnesis);
• The patient has a history of tendonitis, which developed due to the use of fluoroquinolones.

With care, the medication is prescribed in such cases:

• people who use corticosteroids, and in addition to elderly patients (because of the high probability of a rupture in the Achilles tendon in this group of patients);
• appointment to persons with a tendency to develop seizures;
• people with a deficiency in the body element G6FD, and in addition with functional disorders of the liver or kidney;
• patients with diabetes, and in addition with psychotic disorders and photophobia (also in the presence of indications of photosensitivity in history);
• use in people with the prolongation syndrome of QT-interval, having an inborn character;
• in disorders of electrolyte balance and pathologies in the CCC region.

Side effects of the levobaksa

The use of a medication can lead to the appearance of such side effects:

• violations in the work of the National Assembly: the emergence of causeless anxiety, hallucinations, thoughts of suicide, seizures, headaches and paresthesias. Development of depressive state, tremor in the limbs, agitation, polyneuropathy, as well as disorders of wakefulness and sleep. In addition, there may be disorders of taste, smell, and, at the same time, hearing, and there is also an ear noise. There are data on the occurrence of motor coordination disorders and extrapyramidal symptoms;
• problems with the function of hematopoiesis and CCC: lowering the level of blood pressure, the development of thrombocyto-, leuko-, pancito- or neutropenia, and in addition agranulocytosis, eosinophilia and hemolytic form of anemia. Also, prolongation of the QT-interval occurs;
• disorders of digestive activity and the work of the hepatobiliary system: decrease in glucose values within the plasma, weakening of appetite, swelling, stool disorders, nausea, symptoms of dyspepsia, hepatitis, vomiting, hyperbilirubinemia, and increased activity of liver enzymes. Along with this, the use of drugs can cause the appearance of a pseudomembranous form of colitis, liver failure in the acute stage and hepatic pathologies in severe form;
• disorders in the work of the OAA: pain in the muscles or joints, rhabdomyolysis, myasthenia gravis, as well as tendonitis and ruptures in the tendon area;
• signs of allergy: urticaria, Quincke edema, bronchial spasms, allergic pneumonitis, vasculitis, TEN, hyperhidrosis, photosensitivity, Stevens-Johnson syndrome and anaphylaxis;
• Other: the emergence of candidiasis, superinfection, acute renal failure, hypercreatininemia, pain in the sternum, limbs and back, and in addition, exacerbation of the porphyria. Also, the use of the drug may lead to false positive indications of research on opiates.

Overdose

The use of very large portions of medication can cause the appearance of seizures, dizziness, and a confusion. In addition, intoxication Levobaksom leads to the prolongation of the QT-interval. At the same time, when poisoning with tablets, disorders of the digestive function are noted (erosion in the area of gastric mucosa and vomiting).

The medicine does not have an antidote. If signs of poisoning appear, stop the infusion or perform a gastric lavage and take antacids with enterosorbents (oral form of the drug). If necessary, symptomatic measures are taken. Persons with an overdose of levofloxacin should be supervised by medical personnel (ECG monitoring is required and the victim's condition is monitored until signs of poisoning completely disappear).

The implementation of procedures for peritoneal dialysis, as well as hemodialysis, will not lead to a decrease in the rates of levofloxacin.

Interactions with other drugs

When ingested together with iron, sucralfate, and in addition to aluminum and magnesium-containing antacids, the level of bioavailability of the drug decreases.

You can not combine Levobax with ethanol.

Infusion fluid can not be mixed with heparin, alkaline solutions, and in addition with other parenteral agents (this includes 5% glucose solution, saline solution and 2.5% dextrose solution inside Ringer's solution).

It is forbidden to combine levofloxacin with medications, which lower the convulsive threshold.

Combination of the drug with cimetidine, fenbufen and probenecid leads to an increase in its values within the plasma.

The lengthening of the half-life of cyclosporine is observed in case of its combined use with medication.

It is required to monitor the level of coagulation in the case of combined use of the drug along with vitamin A antagonists from category K.

With caution use in people taking medications prolonging the QT-interval values.

[2], [3]

Storage conditions

Levobaks in any form of production should be kept at temperature values not exceeding 25 ° C.

Infusion fluid should be kept in a dark place, closed from penetration of light (this solution can stay stable for 3 days under the light of a room lamp).

[4]

Shelf life

Levobaks tablets can be used for 3 years from the date of release of the therapeutic agent.

Infusion of the drug has a shelf life of 2 years. The opened vial or bottle with a medicine should be applied for introduction at once. Remains of the drug after the infusion of the required therapeutic dose should be disposed of.

Application for children

Children should not prescribe medicine.

Analogues

The analogues of the drug are Oftacwix, Levofloxacin, Loxof with Leflocin and Tigeron, and also Glevo, Abiflox, L-Flox, Levoximed with Levoflox and Tavanik with Levomak, Eleflox, Flexide and Floracid.