Orzol

Orzol is an antibacterial drug, an imidazole derivative. Contains the active ingredient ornidazole.

The principle of ornidazole's action is based on the destruction of the DNA structure of bacteria sensitive to the drug. Activity develops in relation to vaginal trichomonads, dysenteric amoebae, intestinal lamblia, and in addition to this, individual anaerobes (including fusobacteria, bacteroids, clostridia and sensitive strains of eubacteria) and anaerobic cocci (peptostreptococci and peptococci).

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Indications Orzola

It is used parenterally in severe and acute infections or when it is impossible to take the medicine orally – in the case of the following conditions and pathologies:

• general anaerobic infections associated with microflora sensitive to drugs: peritonitis and septicemia with meningitis, as well as endometritis, septic abortion, infections of postoperative wounds and sepsis occurring after childbirth;
• prevention of infections associated with anaerobes: in case of gynecological procedures or other operations (especially in the rectum and colon area);
• dysentery of amoebic genesis, occurring in a severe form, as well as any extraintestinal types of amebiasis;
• liver abscess and giardiasis.

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Release form

The medicinal substance is released in the form of an infusion liquid, inside 0.1 l vials.

Pharmacodynamics

Medicinal effect of ornidazole - DNA-tropic agent, which has selective effect on bacteria, whose enzyme systems can restore nitro category and stimulate interaction of proteins (from category of ferridoxins) and nitro compounds. The drug, having got inside bacterial cell, begins to restore activity of nitro group under influence of microbial nitroreductases and previously restored nitroimidazole.

The components of the restoration form bonds with DNA, leading to its degradation, and at the same time destroy the transcription and replication of DNA. In addition, the metabolic elements of the drug have a cytotoxic effect and destroy the processes of cellular respiration.

The drug penetrates into bacterial cells without complications, is synthesized with their DNA and destroys replication.

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Pharmacokinetics

The drug crosses the placenta and the BBB, penetrating into the cerebrospinal fluid, peritoneal and pleural fluid, saliva, bone tissue, bile with vaginal discharge and the liver, and is also excreted with breast milk. Protein synthesis of the substance inside the plasma is less than 20%.

After intravenous administration of a 15 mg/kg dose and subsequent use of a 7.5 mg/kg dose at 6-hour intervals, the equilibrium drug level is 18-26 mcg/ml. About 30-60% of the drug is subject to metabolic processes within the body (glucuronidation, hydroxylation, and oxidation processes).

Excretion of the drug is mainly realized through the kidneys (60-80%), with about 20% in an unchanged state. 6-15% is excreted through the intestines.

Dosing and administration

The medicine must be administered over 15-30 minutes.

In case of anaerobic infection for a teenager over 12 years of age and an adult, it is necessary to first prescribe the administration of 0.5 g of the drug with 12-hour breaks or 1 g with 24-hour intervals, for 5-10 days (stepped portion). After stabilization of the patient's condition, it is necessary to transfer him to taking ornidazole orally (for example, 1 tablet of 0.5 g with a 12-hour interval).

For persons under 12 years of age weighing over 6 kg, the daily dosage is selected based on 20 mg/kg and divided into 2 injections. The drug should be administered over 5-10 days.

To prevent the development of anaerobic infection (teenagers from 12 years of age and adults), use a dose of 0.5-1 g 60 minutes before the start of the operation.

To prevent the development of mixed infections, the drug is used in combination with penicillins, aminoglycosides or cephalosporins. In this case, the drugs are administered separately.

In case of dysentery of amoebic origin with a severe form of progression, as well as in case of any extraintestinal type of amoebiasis, persons over 12 years of age are given 1 injection equal to 0.5-1 g, and later 0.5 g with 12-hour breaks, for 3-6 days.

For persons under 12 years of age, the dose is selected from a ratio of 20-30 mg/kg; the dosage must be divided into 2 injections.

In people with renal dysfunction, it is necessary to prolong the interval between drug administrations or reduce its 1-time and daily dose.

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Use Orzola during pregnancy

Orzol should not be prescribed in the 1st trimester. In the 2nd and 3rd trimesters, it is used only if there are strict indications. Animal testing has not shown any toxic or teratogenic effects on the fetus.

If there is a need to use the drug during lactation, breastfeeding is stopped.

Contraindications

Main contraindications:

• severe intolerance to the components of the drug or other nitroimidazole derivatives;
• epilepsy or CNS dysfunction;
• multiple sclerosis;
• alcoholism of a chronic nature;
• circulatory disorders, blood diseases or other hematological abnormalities.

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Side effects Orzola

The intensity of ornidazole side effects depends on the dose size. Among the manifestations:

• blood and lymphatic lesions: symptoms of effects on bone marrow or neutropenia;
• immune disorders: signs of intolerance;
• lesions of the epidermis and subcutaneous layer: urticaria, epidermal rashes and itching;
• dysfunction of the nervous system: tremor, dizziness, convulsions, muscle rigidity, drowsiness, coordination disorder, headaches, symptoms of mixed or sensory polyneuropathy and transient loss of consciousness;
• problems with the gastrointestinal tract: vomiting, taste disturbances, metallic taste and nausea;
• liver and biliary tract damage: changes in liver function tests;
• Systemic disorders and changes at the injection site: fatigue, fever, dyspnea and changes at the injection site, including redness, burning, pain and thrombosis.

Overdose

Poisoning with Orzol can cause dizziness, loss of consciousness, convulsions, headaches, tremors, dyspeptic disorders or potentiation of symptoms of other side effects.

There is no antidote. Symptomatic procedures are performed. In case of seizures, diazepam is administered.

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Interactions with other drugs

Ornidazole differs from other nitroimidazole derivatives in that it does not slow down the action of aldehyde dehydrogenase, which allows it to be combined with alcoholic beverages.

The drug can potentiate the effect of coumarin anticoagulants taken orally (warfarin), which is why their dosage needs to be adjusted.

Orzol prolongs the muscle relaxant effect of vecuronium bromide.

Combination with phenobarbital and other enzyme inducers reduces the period of intraserum circulation of ornidazole, while combination with substances that slow down the action of enzymes (for example, with cimetidine), on the contrary, increases it.

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Storage conditions

Orzol must be stored in a place closed to small children. Temperature indicators - no more than 25 ° C.

Shelf life

Orzol can be used within 24 months from the date of sale of the medicinal substance.

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Application for children

The medication should not be used in infants weighing less than 6 kg.

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Analogues

Analogues of the drug are Dazolik, Ornigil, Ornisol with Intezol, Metronidazole and Meradazole with Ornigil, and in addition to Metrogil, Fazizhin with Meratin and Ornidazole. In addition, the list includes Metressa, Tinidazole, Efloran with Metridom, Tagera, Trichopol with Protozal and Trikaside.

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