Oriprim

Oriprim is an effective drug that combines in its composition two different drug components - trimethoprim along with sulfamethoxazole.

The drug has a pronounced bactericidal effect against a large number of gram-negative and positive bacteria. The principle of the influence of drugs is based on the antimicrobial effect of the complex of active elements, which is developed by therapeutic effects in 2 phases of binding 4-folic acid.

[1], [2]

Indications Oriprima

It is used in the case of inflammatory infections, developing under the influence of drug-sensitive bacteria:

• lesions of the urinary system: active and chronic phases of infection of the urinary ducts - the chronic stage of bacteriuria, cystitis in the active or chronic stage, prostatitis, pyelonephritis, and urethritis;
• respiratory tract infections: pharyngitis, bronchitis of active or chronic nature, otitis, pneumonia or sinusitis;
• infections affecting the gastrointestinal tract;
• inflammations and infections associated with the epidermis and soft tissues: furunculosis, pyoderma, infected wounds and abscesses;
• active phase of urethritis gonococcal nature (in women and men);
• non-smokers;
• active phase of brucellosis;
• mycetoma (excluding provoked by the action of true fungi).

Release form

The release of drugs is sold in tablets - 10 pieces inside the cell packaging. Inside a pack of 2 or 10 such packages.

Pharmacodynamics

Sulfamethoxazole slows down the penetration of PABA into dihydrofolic acid, while trimethoprim prevents the return of dihydrofolic acid to the state of 4-folic acid. As a result, the complex of active elements blocks 2 consecutive stages of protein biosynthesis with nucleic acids, which are extremely important for a variety of microbes.

The drug actively influences a wide range of bacteria, including gram-negative and positive aerobes, nocardias (actinomycetes), chlamydia, many anaerobes and some protozoa with mycobacteria.

Among drug-resistant microbes are pale treponema, Koch wand, Mycoplasma species, and Pseudomonas aeruginosa.

The range of activity with respect to Gram-negative microorganisms is Ducrey’s sticks, Klebsiella oxytococa, Haemophilus parainfluenzae, cloaca enterobacteria, freundi citrobacter, marcescense serration and so on.

Pharmacokinetics

The drug is absorbed at high speed after oral use. A high indicator of drugs is formed inside the prostate, bile, lung tissue, cerebrospinal fluid, bones and kidneys. The introduction of trimethoprim with sulfomethoxazole in the proportion of 5k1 leads to the development of a ratio within 20k1-30k1; at the same time, Cmax level is noted after 2 hours. It is in these proportions that the most pronounced synergism of influence is observed with respect to most of the bacteria.

A significant part of taken inside trimethoprim is excreted unchanged along with the urine and only 10% - in the form of metabolic elements that have weak activity (or do not possess at all).

The level inside the urine when taking a standard portion exceeds plasma values approximately 100 times, remaining within these limits for 24 hours.

Sulfamethoxazole is almost completely excreted with urine. Its performance inside the urine is significantly higher than plasma.

Trimethoprim is rapidly distributed within the tissues.

Dosing and administration

It is necessary to select a portion of Oryprim personally. The therapeutic cycle lasts at least 5 days or until the disappearance of signs of the disease.

With the active phase of brucellosis and prostatitis, therapy lasts at least 1 month, while actinomycetoma and nocardiosis are treated with long courses.

Take the medication orally after consuming food.

For adolescents over the age of 12 and adults, the dosage is 0.8 sulfamethoxazole / 0.16 g trimethoprim, 2 times a day. The supporting portion is similar, but you need to take it once a day.

For the age group of 5-12 years old, the dose is 0.4 g of sulfamethoxazole / 0.08 g of trimethoprim, 2 times a day.

The age category 2-5 years - 0.2 g sulfamethoxazole / 0.04 g trimethoprim, 2 times a day.

Use Oriprima during pregnancy

It is forbidden to appoint Oriprim during pregnancy.

Contraindications

The main contraindications:

• strong sensitivity to drug elements (sulfamethoxazole with trimethoprim);
• severe pathologies affecting the hepatic parenchyma;
• intense renal impairment;
• blood diseases;
• breast-feeding;
• lack of G6FD component.

Side effects Oriprima

When using standard doses of drugs complications are not observed. Most often develop side signs affecting the work of the gastrointestinal tract, as well as epidermal lesions of allergic origin.

Gastrointestinal disorders include vomiting, diarrhea, glossitis, nausea, stomatitis, and pancreatitis, and (occasionally) colitis of a pseudomembranous variety.

Allergic disorders - allergic forms of myocarditis, anaphylactoid symptoms, photosensitivity and hemorrhagic vasculitis.

Common manifestations are lupus erythematosus or nodose panarteritis. Sometimes marked TEN or erythema.

Due to the presence of sulfamethoxazole in the composition of the drug, there is a risk of the appearance of pathological changes in blood tests. Among these are purpura, eosinophilia, anemia of a hemolytic nature, leuco-, thrombocyto- or neutropenia. Sometimes pernicious anemia, pancytopenia or agranulocytosis occurs. At the same time, it is believed that in older people blood disorders are more likely.

Disorders of a neurological nature - ear noise, ataxia, headaches, convulsions, hallucinations, aseptic meningitis, and dizziness.

Lesions of the musculoskeletal structure - myalgia or arthralgia.

Disorders of urogenital function - toxic nephrosis, tubulo-interstitial nephritis and an increase in plasma creatinine level.

Overdose

In acute intoxication with sulfonamides, symptoms such as vomiting, headaches, colic, dizziness, nausea, anorexia, loss of consciousness and drowsiness may develop. There is information about the appearance of crystalluria, hyperthermia or hematuria. 

In the case of chronic poisoning, hematopoietic processes are suppressed (leuco- or thrombocytopenia), and in addition, other pathological changes in the blood structure associated with B9-vitamin deficiency.

Among the standard procedures used in overdose is induction of vomiting or gastric lavage, and in addition, potentiation of renal excretion through forced diuresis (due to alkalinization of urine, excretion of sulfamethoxazole is enhanced). To remove the symptoms of trimethoprim in relation to hematopoietic function, Ca folinate is used: i / m injections of 3-6 mg for 5-7 days. In case of poisoning, you need to monitor blood processes and the biochemical structure of the blood (also for salt indicators).

With the development of jaundice or significant pathological changes in the blood, special therapeutic measures are carried out. Peritoneal dialysis procedures will be ineffective, while hemodialysis demonstrates a moderate effect on the elimination of sulfamethoxazole with trimethoprim.

Interactions with other drugs

It is forbidden to combine the drug with ingested antidiabetic drugs, salicylates, thiazide-type diuretic, phenylbutazone, and in addition with indirect coagulants, phenytoin and naproxen.

Older people who use diuretics (especially thiazides) along with Oriprim sometimes develop purpura with thrombocytopenia.

There is information about the continuation of PV in individuals who combined the drug with warfarin.

Trimethoprim with sulfamethoxazole can inhibit intrahepatic metabolic processes of phenytoin. Clinical portions of the drug by 39% prolong the term half-life of phenytoin and reduce the rate of metabolic purification by 27%.

Sulfonamides violate intraplasma protein synthesis of methotrexate, due to which the indicator of this free component increases.

[3], [4], [5]

Storage conditions

Oriprim is required to keep in a closed from the children, a dark place. Temperature indicators - not higher than 30 ° C.

[6],

Shelf life

Oriprim can be used within a 4-year term from the time the therapeutic substance is produced.

[7], [8]

Application for children

The drug is not used in premature babies, children younger than 3 months of age (there is a likelihood of developing jaundice of the nuclear type). In general, children under 5 years old are recommended to use a suspension of the drug.

[9], [10]

Analogs

Analogs of the drug are the substances Bakteisepol, Groseptol, Bikotrim with Bactrim, Bryfeseptol and Bel-septol with Biseptol, and in addition to this Solyuceptole and Bi-septa. Also on the list are Sumetrolim, Bi-Tol, Raseptol with Biseptrim, Triseptol and Co-Trimoxazole.