Norbactin for cystitis in women and men: how to take?

The active substance of the drug norfloxacin belongs to the group of fluorinated quinolones, which have a wide spectrum of antibacterial activity. Its bactericidal activity is manifested to Escherichia coli, which is responsible for the vast majority of inflammation of the bladder, as well as staphylococci, gonococci, enterobacteria, proteins, individual strains of ureaplasma. Norbactin for cystitis is one of the preferred drugs that can cope with both acute and chronic infections.

Indications Norbactin for cystitis

This drug is prescribed as part of the complex therapy of inflammation of the upper and lower urinary tract. It is active in almost all pathogens of nonspecific cystitis, which, due to the characteristics of the anatomy, is the prerogative of the fairer sex. Therefore, doctors often prescribe norbactin for cystitis in women.

The spectrum of its activity extends to gonococcal strains, with gonorrhea cystitis, the drug is prescribed to patients of both sexes.

Norbactin is effective in chronic cystitis caused by microorganisms sensitive to it.

The purpose of the drug for prophylactic purposes may be associated with urological operations, manipulations and invasive diagnostics.

Release form

The drug is intended for oral administration and is an elongated tablet, each of which is engraved with the NBT 400 marking, which includes the letters of the name and dosage - each tablet contains 400 mg of norfloxacin.

In addition, tablets contain auxiliary ingredients that provide them with the necessary physical and chemical properties:

• strength and uniformity - microcrystalline cellulose;
• increasing the bioavailability of the active component of sodium crossscarmellose;
• emulsifier - sodium lauryl sulfate;
• fillers - corn starch, talc;
• sorbent - silicon dioxide colloidal anhydrous;
• consistency stabilizer - magnesium stearate;
• film former - hydroxypropyl methylcellulose, macrogol, titanium dioxide.

Pharmacodynamics

The bactericidal action of the active ingredient norfloxacin, like all drugs of this class, is realized by suppressing the enzymatic activity of DNA gyrase and topoisomerase of bacteria, without which the process of DNA replication is impossible, which leads to the death of pathogenic microorganisms sensitive to this action.

Pharmacokinetics

After oral administration, the active ingredient is well and quickly absorbed from the digestive canal into the systemic circulation. The maximum serum concentration is determined in the first two hours from the time of administration. Food in the gastrointestinal tract slows down the absorption of norfloxacin.

About 14% of the accepted dose of the drug binds to plasma proteins, high concentrations of the active substance are determined in the tissues of the genitourinary organs, urine and bile. Eliminated from the body in approximately equal proportions through the urinary organs and intestines, with about 30% leaving the body unchanged in the urine, sanitizing the urinary tract along the way.

Dosing and administration

For adult patients with uncomplicated acute nonspecific cystitis, norbactin is prescribed a three-day dose of one tablet (400 mg) every 12 hours. It is better to take the medicine in the morning and in the evening before eating, drinking plenty of water. Treatment with norfloxacin at a dose of 400 mg twice a day for 3 days and fosfomycin in a single dose of 3.0 g has high clinical and microbiological efficacy in uncomplicated cystitis.[2]

In cases of chronic cystitis, the drug is prescribed in the same daily dose, but the duration of treatment can be extended to 12 weeks. In each case, the dose, frequency of administration, duration of treatment is assigned individually, depending on the severity of the patient's condition, the pathogen identified and the response to treatment. If during the first month of treatment a satisfactory therapeutic effect is achieved, the daily dose of the drug can be reduced to a maintenance dose of one tablet. Patients with impaired renal function are prescribed no more than 400 mg per day.

200 mg daily dose of norfloxacin at bedtime is an effective way to prevent recurrent cystitis. Colonization was rare during 1 year of norfloxacin therapy, and superinfection with norfloxacin-resistant organisms was not observed.[3]

In pediatric practice, norbactin is not used.

Use Norbactin for cystitis during pregnancy

Norfloxacin belong to the category of drugs that are not recommended for use during pregnancy, since there is a certain risk of undesirable effects on the fetus. However, in cases where the clinical benefit outweighs the risk, it can be prescribed to a pregnant woman. During lactation, it is recommended to refrain from taking the drug.

Studies have proven the embryotoxic and teratogenic effects of norfloxacin. It significantly reduced the number of viable fruits, caused a delay in the growth of viable fruits; some visceral and skeletal defects were seen, and these effects were dose dependent. [1]

Contraindications

Children's age, pregnancy and lactation, known hypersensitivity to quinolone class drugs and any of the auxiliary ingredients, including manifested as inflammation and subsequent tendon degeneration up to rupture.

Side effects Norbactin for cystitis

The immune system can respond to norbactin in a variety of ways, from banal urticaria to the development of Quincke edema, Lyell and Steven-Johnson syndromes, etc. The drug causes a hypersensitivity reaction to insolation. This should be taken into account by all patients undergoing treatment and avoid sunlight whenever possible.

From the musculoskeletal system - inflammatory processes in tendons and joints, muscle and joint pain up to the destruction of myocytes and rupture of tendons.

From the side of the cardiovascular system, hypotension can be observed up to loss of consciousness, increased heart rate and heart rhythm disturbance until, in rare cases, flutter and fibrillation of the ventricles of the heart or spindle-shaped ventricular tachycardia (QT interval elongation syndrome on the cardiogram) develop, vasculitis.

On the part of the hematopoietic system - a decrease in the level of leukocytes, neutrophils, platelets, hemoglobin, the volume of red blood cells, an increase in the level of eosinophils.

On the part of the central and peripheral nervous system, dizziness, migraines, fainting, drowsiness, mood disorders, confusion, up to psychosis, convulsions, hallucinations, are more common; in addition - trembling in the limbs, muscle twitching and tics, polyneuropathy, myasthenia gravis, upset taste sensations.

The digestive organs can have abdominal pains of various localization, including moderate gastralgia, dyspeptic symptoms and loss of appetite, a feeling of bitterness in the mouth, inflammation of the small intestine and pancreas (usually with prolonged use).

The urinary organs can respond to the intake of norbactin by the formation of crystalline compounds, inflammation of the kidneys, delayed or excessive excretion of urine, hematuria, an increase in creatinine levels, and in rare cases, acute renal failure develops.

Skin manifestations can be limited to swelling, itching and rash, in rare cases, stronger and more severe reactions are possible - intra- and subcutaneous hematomas, exanthema, multiple, papules and boules merging into the cortex with vascular involvement and hemorrhagic manifestations.

On the part of the liver, the development of its inflammation, jaundice, changes in the activity of transaminases is possible.

From the side of the organs of vision: increased lacrimation, blurred vision and other disorders.

Hearing organs - noise and ringing in the ears, deafness.

Genitals - candidiasis colpitis.

Shortness of breath and respiratory dysfunction may develop.

Given the side effects of the cardiovascular and central nervous system during treatment with norbactin, you should refrain from work associated with the risk of a decrease in concentration.

Overdose

An acute reaction to an overdose of the drug may look like hyperthermia, fever, shortness of breath, QT interval lengthening syndrome, dyspepsia, affective disorders, psychosis, acute renal failure and other manifestations of adverse reactions, in particular, hematopoiesis.

Calcium is the antidote, therefore, the patient needs to quickly drink a calcium-containing solution, milk or kefir (yogurt), induce vomiting and rinse the stomach.

Then he will turn to a medical institution to examine the preservation of vital functions.

Interactions with other drugs

The active ingredient of norbactin blocks the enzymatic activity of CYP1A2, therefore, it can affect the effectiveness of drugs that are cleaved with the help of this enzyme.

It is not prescribed simultaneously with nitrofurantoin, since under laboratory conditions these drugs reveal incompatibility.

If you need a combined dose with probenecid, it should be noted that the elimination of norfloxacin in the urine will decrease, but the serum concentration will remain at the proper level.

Simultaneous administration with theophylline increases the toxicity of norfloxacin (increases serum concentration), therefore, if necessary, their combined use should monitor the level of drugs in the blood plasma, so as not to miss the opportunity to adjust the dose.

Norbactin helps to delay caffeine in the body, which should be taken into account during treatment and refrain from drinking coffee while taking caffeinated analgesics.

If necessary, simultaneous administration with cyclosporine, its serum level must be controlled in order to adjust the dosage in time.

With the simultaneous administration of norbactin with anticoagulants - warfarin derivatives, it is necessary to control the blood coagulation parameters in order to avoid bleeding resulting from the synergistic effect of the drugs.

Oral contraception can be ineffective when combined with the use of antibacterial drugs, so you should be safe with other methods.

Fenbufen in combination with norbactin increases the risk of developing epileptiform seizures.

If the patient is already taking clozapine or ropinirole, and he needs to treat cystitis with norbactin, then the dose of psychotropic drugs is adjusted.

Not compatible with centrally acting muscle relaxant tizanidine.

If it is impossible to avoid the combination with glibenclamide, it is necessary to strictly control the blood sugar level of the patient.

Combination with didanosine should be avoided or a break between doses of at least two hours, since the drugs mutually interfere with absorption from the digestive canal.

The combination with non-steroidal analgesics increases the risk of convulsive seizures and affective disorders. This should be considered when it is impossible to avoid this combination.

Calcium is an antagonist of norfloxacin, therefore, preparations with calcium, milk, cottage cheese, and other calcium-containing products are consumed with an interval of two hours after taking norbactin. If the drug has already been taken, then the time interval before consuming calcium is four hours.

As with calcium, quinolones form insoluble compounds in the gastrointestinal tract with iron, aluminum, bismuth, magnesium, and zinc. Therefore, preparations containing these substances are taken in compliance with the above conditions.

If necessary, combine norbactin with antiarrhythmic drugs, macrolide class antibiotics, antipsychotics, and tricyclic antidepressants, the high risk of synergy with respect to lengthening the QT interval should be considered.

Storage conditions

Store purchased tablets at room temperature, which should not exceed 25 ℃. Regarding the light mode, the instructions do not say anything, but keeping the packaging in the sun is not recommended. The place must not be accessible to children and animals.

If you do not violate the original packaging, the maximum shelf life of the tablets is three years from the date of manufacture, which is indicated on the box.

Analogs

Cystitis of bacterial origin is treated with antibacterial therapy. Broad-spectrum drugs are usually used. They are prescribed even before the sensitivity test is ready, since the patient's condition is quite painful.

In urology, quinolones, nitrofurans, the new antibiotic fosfomycin, better known under the trade name monural, are most often used. They are increasingly active to the most common causative agents of cystitis. However, furadonin or furazolidone helps some patients, while monural or norbactin helps others.

What's the matter? What is better with cystitis? Here a lot depends on the pathogen and on whether the disease was first detected or is it an exacerbation of long-cured cystitis.

If you have diagnosed acute cystitis for the first time, then the doctor often prescribes the drug with the widest spectrum of action, and it, in the vast majority of cases, helps to remove acute symptoms. And then a lot depends on the patient. Those who, having got rid of discomfort, decided to stop treatment, have every chance to replenish the ranks of chronic urological patients.

With recurrent chronic cystitis, the tactics of treatment are different, a bacteriological examination of urine is necessarily done, the pathogen is detected, its sensitivity to antibacterial drugs is determined. And only then treatment is prescribed.

Therefore, the best medicine should be selected for you by your doctor after laboratory tests.

Fluoroquinolones, moreover, belonging to earlier generations, are most often the drugs of choice for the treatment of cystitis. They are recommended by the Association of Urology, as they are active in non-specific and some specific causative agents of cystitis. In addition, they are not as toxic as newer drugs from this group.

Which is better: norbactin or nolicin? These are synonymous drugs with the same active substance - norfloxacin. Even its dosage is exactly the same. Different manufacturers: norbactin - India, nolicin - Slovenia. There are slight differences in excipients, which can play a role in the selection if the patient has an established allergy. The therapeutic effect of taking these two drugs should be the same.

A single dose of rufloxacin is as effective as the standard 3-day treatment with norfloxacin for uncomplicated cystitis. [4]

The 3-day regimen with lomefloxacin is more effective than the 10-day regimen with norfloxacin for the treatment of recurring uncomplicated lower urinary tract infection in women. [5]

Reviews about the drug are excellent. Women share their impressions, and their cystitis is clearly chronic recurrent. They note, first of all, performance. Most symptoms disappear after taking the first pill. All, basically, drank five days, although with the first diagnosed acute cystitis, three days are enough, according to the instructions. Of the side effects, complaints of drowsiness were most often found, they recommended taking a sick leave, because they slept almost all day and night. In addition, women taking norbactin caused candidiasis (a common complication after taking antibiotics) and insomnia. Before the rupture of the tendons, no one got it.

Many people write that it is norbactin that relieves the symptoms of pain; other drugs simply do not help them. Ladies with recurrent cystitis share that the next exacerbation after norbactin visits them five years later. Compared to the more expensive monural, norbactin wins in price, but loses in side effects.

In general, there was no response that norbactin did not help. The most common undesirable effects accompanying the pill were related to sleep disturbances.